Sample records for anti-tuberculosis medications rifampin

  1. Rifampin (United States)

    ... your medications or monitor you carefully for side effects.if you are taking antacids, take them at least 1 hour after you take rifampin.tell your doctor if you are taking or using hormonal contraceptives (birth control pills, patches, rings, implants, and injections). Rifampin can decrease ...

  2. Pediatric tuberculous meningitis: Model-based approach to determining optimal doses of the anti-tuberculosis drugs rifampin and levofloxacin for children. (United States)

    Savic, R M; Ruslami, R; Hibma, J E; Hesseling, A; Ramachandran, G; Ganiem, A R; Swaminathan, S; McIlleron, H; Gupta, A; Thakur, K; van Crevel, R; Aarnoutse, R; Dooley, K E


    Pediatric tuberculous meningitis (TBM) is a highly morbid, often fatal disease. Standard treatment includes isoniazid, rifampin, pyrazinamide, and ethambutol. Current rifampin dosing achieves low cerebrospinal fluid (CSF) concentrations, and CSF penetration of ethambutol is poor. In adult trials, higher-dose rifampin and/or a fluoroquinolone reduced mortality and disability. To estimate optimal dosing of rifampin and levofloxacin for children, we compiled plasma and CSF pharmacokinetic (PK) and outcomes data from adult TBM trials plus plasma PK data from children. A population PK/pharmacodynamic (PD) model using adult data defined rifampin target exposures (plasma area under the curve (AUC)0-24 = 92 mg*h/L). Levofloxacin targets and rifampin pediatric drug disposition information were literature-derived. To attain target rifampin exposures, children require daily doses of at least 30 mg/kg orally or 15 mg/kg intravenously (i.v.). From our pediatric population PK model, oral levofloxacin doses needed to attain exposure targets were 19-33 mg/kg. Our results provide data-driven guidance to maximize pediatric TBM treatment while we await definitive trial results.

  3. Factors associated with anti-tuberculosis medication adverse effects: a case-control study in Lima, Peru.

    Directory of Open Access Journals (Sweden)

    Kocfa Chung-Delgado

    Full Text Available BACKGROUND: Long-term exposure to anti-tuberculosis medication increases risk of adverse drug reactions and toxicity. The objective of this investigation was to determine factors associated with anti-tuberculosis adverse drug reactions in Lima, Peru, with special emphasis on MDR-TB medication, HIV infection, diabetes, age and tobacco use. METHODOLOGY AND RESULTS: A case-control study was performed using information from Peruvian TB Programme. A case was defined as having reported an anti-TB adverse drug reaction during 2005-2010 with appropriate notification on clinical records. Controls were defined as not having reported a side effect, receiving anti-TB therapy during the same time that the case had appeared. Crude, and age- and sex-adjusted models were calculated using odds ratios (OR and 95% confidence intervals (95%CI. A multivariable model was created to look for independent factors associated with side effect from anti-TB therapy. A total of 720 patients (144 cases and 576 controls were analyzed. In our multivariable model, age, especially those over 40 years (OR = 3.93; 95%CI: 1.65-9.35, overweight/obesity (OR = 2.13; 95%CI: 1.17-3.89, anemia (OR = 2.10; IC95%: 1.13-3.92, MDR-TB medication (OR = 11.1; 95%CI: 6.29-19.6, and smoking (OR = 2.00; 95%CI: 1.03-3.87 were independently associated with adverse drug reactions. CONCLUSIONS: Old age, anemia, MDR-TB medication, overweight/obesity status, and smoking history are independent risk factors associated with anti-tuberculosis adverse drug reactions. Patients with these risk factors should be monitored during the anti-TB therapy. A comprehensive clinical history and additional medical exams, including hematocrit and HIV-ELISA, might be useful to identify these patients.

  4. Effect of Rifampin on Thyroid Function Test in Patients on Levothyroxine Medication (United States)

    Kim, Hye In; Kim, Tae Hyuk; Kim, Hosu; Kim, Young Nam; Jang, Hye Won; Chung, Jae Hoon; Moon, Seong Mi; Jhun, Byung Woo; Lee, Hyun; Koh, Won-Jung; Kim, Sun Wook


    Background Levothyroxine (LT4) and rifampin (RIF) are sometimes used together; however, no clinical studies have assessed the effects of these drugs on thyroid function or the need to adjust LT4 dose. Methods We retrospectively reviewed the records of 71 Korean patients who started RIF during LT4 treatment. Clinically relevant cases that required dose adjustment according to the American Thyroid Association (ATA)/American Association of Clinical Endocrinologists (AACE) guidelines were identified, and risk factors of increased LT4 dose were analyzed. Results After administering RIF, median serum thyroid-stimulating hormone (TSH) level (2.58 mIU/L, interquartile range [IQR] 0.21–7.44) was significantly higher than that before RIF (0.25 mIU/L, IQR, 0.03–2.62; P hypothyroidism. Risk factor analysis showed that remaining thyroid gland (odds ratio [OR] 9.207, P = 0.002), the time interval between starting RIF and TSH measurement (OR 1.043, P = 0.019), and baseline LT4 dose per kg body weight (OR 0.364, P = 0.011) were clinically relevant variables. Conclusions In patients receiving LT4, serum thyroid function test should be performed after starting RIF treatment. For patients with no remnant thyroid gland and those receiving a lower LT4 dose, close observation is needed when starting RIF and TB medication. PMID:28081173

  5. A population-based case-control study of the safety of oral anti-tuberculosis drug treatment during pregnancy

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Olsen, J.


    OBJECTIVE: To study the human teratogenic potential of isoniazid and other anti-tuberculosis drug treatment during pregnancy. DESIGN AND SETTING: Cases from a large population-based dataset at the Hungarian Case-Control Surveillance of Congenital Abnormalities, and controls from the National Birth...... Registry, between 1980 and 1996. Information on all oral anti-tuberculosis drug treatments during pregnancy was medically recorded. STUDY PARTICIPANTS: Women who had newborns or fetuses with congenital abnormalities (case group), and women who had babies with no congenital abnormality (control group). MAIN...

  6. Fresh Air and Good Food: Children and the Anti-Tuberculosis Campaign in the Netherlands c.1900-1940 (United States)

    Bakker, Nelleke


    As elsewhere in the Western world, between 1900 and 1940 the anti-tuberculosis campaign in the Netherlands produced a wide range of initiatives to promote child health. In each of these the social and the medical were linked, as the hygienic "mood" was encouraged by a child-saving ethos that focused upon the poor. In this article the…

  7. Fresh air and good food : Children and the anti-tuberculosis campaign in the Netherlands c.1900-1940

    NARCIS (Netherlands)

    Bakker, Nelleke


    As elsewhere in the Western world, between 1900 and 1940 the anti-tuberculosis campaign in the Netherlands produced a wide range of initiatives to promote child health. In each of these the social and the medical were linked, as the hygienic 'mood' was encouraged by a child-saving ethos that focused

  8. Silymarin protects liver against toxic effects of anti-tuberculosis drugs in experimental animals

    Directory of Open Access Journals (Sweden)

    Izzettin Fikret V


    protective effects against hepatotoxic actions of drugs used in the chemotherapy of tuberculosis in animal models. Since no significant toxicity of silymarin is reported in human studies, this plant extract can be used as a dietary supplement by patients taking anti-tuberculosis medications.

  9. Hematological and liver toxicity of anti-tuberculosis drugs (United States)

    Mirlohi, Maryam-Sadat; Ekrami, Alireza; Shirali, Saeed; Ghobeishavi, Mehdi; Pourmotahari, Fatemeh


    Introduction Tuberculosis (TB) is a major global health problem, and anti-tuberculosis drugs can cause severe adverse reactions. The aim of this study was to determine hematological and biochemical changes and associated risk factors in smear positive pulmonary tuberculosis patients undergoing treatment with standard protocols. Methods In a descriptive study, a total of 40 tuberculosis patients aged between 15–60 years were collected from hospitals in Khuzestan Province (Iran) from March 2013 to March 2014. The patients were treated with drugs (isoniazid, rifampicin, ethambutol, and pyrazinamide) during the initial two months, followed by isoniazid and rifampicin for the next four to six months. Activities of liver enzymes (ALT, AST, and ALP) and hematological parameters were recorded before and after treatment. Data were analyzed using paired samples t-test and Wilcoxon test by SPSS 16. Results After using drug treatments, hematological parameters (RBC, Hb, HCT, MCV, MCH, and MCHC), except platelet count, were changed significantly (p ≤ 0.001). Liver enzyme activities (ALT, AST, and ALP) were decreased significantly (p ≤ 0.001) after treatment. Conclusion In this study, changes of hematological and biochemical parameters have been observed in patients with pulmonary tuberculosis. It can be concluded that the anti-tuberculosis treatment is associated with changes of hematological parameters and liver enzymes.

  10. Adequacy of anti-tuberculosis drug prescriptions in Viet Nam

    DEFF Research Database (Denmark)

    Hoa, N B; Lauritsen, J M; Rieder, H L


    SETTING: National Tuberculosis Program, Viet Nam, 2008. OBJECTIVES: To determine drug prescription adherence to national guidelines, to examine factors associated with an erroneous dosage of rifampin (RMP) and to evaluate the impact of an insufficient RMP dosage on treatment outcome. METHODS: A r...

  11. Incidence, clinical features and impact on anti-tuberculosis treatment of anti-tuberculosis drug induced liver injury (ATLI in China.

    Directory of Open Access Journals (Sweden)

    Penghui Shang

    Full Text Available BACKGROUND: Anti-tuberculosis drug induced liver injury (ATLI is emerging as a significant threat to tuberculosis control in China, though limited data is available about the burden of ATLI at population level. This study aimed to estimate the incidence of ATLI, to better understand its clinical features, and to evaluate its impact on anti-tuberculosis (TB treatment in China. METHODOLOGY/PRINCIPAL FINDINGS: In a population-based prospective study, we monitored 4,304 TB patients receiving directly observed treatment strategy (DOTS treatment, and found that 106 patients developed ATLI with a cumulative incidence of 2.55% (95% Confidence Interval [CI], 2.04%-3.06%. Nausea, vomiting and anorexia were the top three most frequently observed symptoms. There were 35 (33.02% ATLI patients with no symptoms, including 8 with severe hepatotoxicity. Regarding the prognosis of ATLI, 84 cases (79.25% recovered, 18 (16.98% improved, 2 (1.89% failed to respond to the treatment with continued elevation of serum alanine aminotransferase, and 2 (1.89% died as result of ATLI. Of all the ATLI cases, 74 (69.81% cases changed their anti-TB treatment, including 4 (3.77% cases with medication administration change, 21 (19.81% cases with drugs replacement, 54 (50.94% cases with therapy interruption, and 12 (11.32% cases who discontinued therapy. In terms of treatment outcomes, 53 (51.46% cases had TB cured in time, 48 (46.60% cases had therapy prolonged, and 2 (1.94% cases died. Compared with non-ATLI patients, ATLI patients had a 9.25-fold (95%CI, 5.69-15.05 risk of unsuccessful anti-TB treatment outcomes and a 2.11-fold (95%CI, 1.23-3.60 risk of prolonged intensive treatment phase. CONCLUSIONS/SIGNIFICANCE: ATLI could considerably impact the outcomes of anti-TB treatment. Given the incidence of ATLI and the size of TB population in China, the negative impact is substantial. Therefore, more research and efforts are warranted in order to enhance the diagnosis and the

  12. Rifampin-associated pseudomembranous colitis. (United States)

    Chen, Tun-Chieh; Lu, Po-Liang; Lin, Wei-Ru; Lin, Chun-Yu; Wu, Jeng-Yih; Chen, Yen-Hsu


    Pseudomembranous colitis (PMC) is known to develop after antibiotic treatment, but is rarely associated with antituberculosis (anti-TB) agents. We report a 28-year-old woman without underlying diseases developing PMC after 126 days of anti-TB treatment. Severe diarrhea and abdominal cramping pain were experienced. Colonoscopic biopsy proved the diagnosis of PMC. Her symptoms improved after discontinuing the anti-TB agents but recurred shortly after challenging with rifampin and isoniazid. Metronidazole administration and replacement of rifampin with levofloxacin successfully cured the PMC. Our report supports the notion that rifampin can induce PMC.

  13. The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India

    Directory of Open Access Journals (Sweden)

    Jonnalagada Subbanna


    Full Text Available Abstract Background India has 2.0 million estimated tuberculosis (TB cases per annum with an estimated 280,000 TB-related deaths per year. Understanding when in the course of TB treatment patients die is important for determining the type of intervention to be offered and crucially when this intervention should be given. The objectives of the current study were to determine in a large cohort of TB patients in India:- i treatment outcomes including the number who died while on treatment, ii the month of death and iii characteristics associated with "early" death, occurring in the initial 8 weeks of treatment. Methods This was a retrospective study in 16 selected Designated Microscopy Centres (DMCs in Hyderabad, Krishna and Adilabad districts of Andhra Pradesh, South India. A review was performed of treatment cards and medical records of all TB patients (adults and children registered and placed on standardized anti-tuberculosis treatment from January 2005 to September 2009. Results There were 8,240 TB patients (5183 males of whom 492 (6% were known to have died during treatment. Case-fatality was higher in those previously treated (12% and lower in those with extra-pulmonary TB (2%. There was an even distribution of deaths during anti-tuberculosis treatment, with 28% of all patients dying in the first 8 weeks of treatment. Increasing age and new as compared to recurrent TB disease were significantly associated with "early death". Conclusion In this large cohort of TB patients, deaths occurred with an even frequency throughout anti-TB treatment. Reasons may relate to i the treatment of the disease itself, raising concerns about drug adherence, quality of anti-tuberculosis drugs or the presence of undetected drug resistance and ii co-morbidities, such as HIV/AIDS and diabetes mellitus, which are known to influence mortality. More research in this area from prospective and retrospective studies is needed.

  14. Rifampin-induced Pseudomembranous Colitis with Rectosigmoid Sparing. (United States)

    Yim, Sun Young; Koo, Ja Seol; Kim, Ye Ji; Park, Sang Jung; Kim, Jin Nam; Jung, Sung Woo; Yim, Hyung Joon; Lee, Sang Woo; Choi, Jai Hyun; Kim, Chang Duck


    Pseudomembranous colitis (PMC) is known to be associated with antibiotic treatment, but is not commonly related to antitubercular (anti-TB) agent, rifampin. PMC is frequently localized to rectum and sigmoid colon, which can be diagnosed with sigmoidoscopy. We report a case of rifampin-induced PMC with rectosigmoid sparing in a pulmonary tuberculosis patient. An 81-year-old man using anti-TB agents was admitted with a 30-day history of severe diarrhea and general weakness. On colonoscopy, nonspecific findings such as mucosal edema and erosion were found in sigmoid colon, whereas multiple yellowish plaques were confined to cecal mucosa only. Biopsy specimen of the cecum was compatible with PMC. Metronidazole was started orally, and the anti-TB medications excluding rifampin were readministerred. His symptoms remarkably improved within a few days without recurrence. Awareness of rectosigmoid sparing PMC in patients who develop diarrhea during anti-TB treatment should encourage early total colonoscopy.

  15. A Study of the Timing of Death in Patients with Tuberculosis Who Die During Anti-Tuberculosis Treatment

    Directory of Open Access Journals (Sweden)

    Bhavik Patel


    Full Text Available Introduction: India has 2.0 million estimated tuberculosis (TB cases per annum with an estimated 280,000 TB related deaths per year. Understanding when in the course of TB treatment patients die is important for determining the type of intervention to be offered and crucially when this intervention should be given. The objectives of the current study were to determine in a large cohort of TB patients in India: - i treatment outcomes including the number who died while on treatment, ii the month of death and iii characteristics associated with and ldquo;early and rdquo; death, occurring in the initial 8 weeks of treatment. Methodology: This was a retrospective study in C.U.Shah Medical College and Hospital in Surendranagar, Gujarat India. A review was performed of treatment cards and medical records of all TB patients (adults and children registered and placed on standardized anti-tuberculosis treatment from January 2007 to April 2012. Results: There were 376 TB patients of whom 41 (11% were known to have died during treatment. Case-fatality was higher in those previously treated (24% and lower in those with extra-pulmonary TB (1%.Most of deaths during anti-tuberculosis treatment were early, with 66% of all patients dying in the first 8 weeks of treatment. Increasing age and new as compared to recurrent TB disease were significantly associated with and ldquo;early death and rdquo;. In this large cohort of TB patients, Most of deaths occurred early after starting anti-TB treatment. Reasons may relate to i the treatment of the disease itself, raising concerns about drug adherence, quality of anti-tuberculosis drugs or the presence of undetected drug resistance and ii co-morbidities, such as HIV/ AIDS and diabetes mellitus, which are known to influence mortality. iii Late stage presentation by patients themselves. More research in this area from prospective and retrospective studies is needed. [Natl J Med Res 2016; 6(2.000: 186-190

  16. Duration of anti-tuberculosis therapy and timing of antiretroviral therapy initiation: association with mortality in HIV-related tuberculosis.

    Directory of Open Access Journals (Sweden)

    Claudia P Cortes

    Full Text Available BACKGROUND: Antiretroviral therapy (ART decreases mortality risk in HIV-infected tuberculosis patients, but the effect of the duration of anti-tuberculosis therapy and timing of anti-tuberculosis therapy initiation in relation to ART initiation on mortality, is unclear. METHODS: We conducted a retrospective observational multi-center cohort study among HIV-infected persons concomitantly treated with Rifamycin-based anti-tuberculosis therapy and ART in Latin America. The study population included persons for whom 6 months of anti-tuberculosis therapy is recommended. RESULTS: Of 253 patients who met inclusion criteria, median CD4+ lymphocyte count at ART initiation was 64 cells/mm(3, 171 (68% received >180 days of anti-tuberculosis therapy, 168 (66% initiated anti-tuberculosis therapy before ART, and 43 (17% died. In a multivariate Cox proportional hazards model that adjusted for CD4+ lymphocytes and HIV-1 RNA, tuberculosis diagnosed after ART initiation was associated with an increased risk of death compared to tuberculosis diagnosis before ART initiation (HR 2.40; 95% CI 1.15, 5.02; P = 0.02. In a separate model among patients surviving >6 months after tuberculosis diagnosis, after adjusting for CD4+ lymphocytes, HIV-1 RNA, and timing of ART initiation relative to tuberculosis diagnosis, receipt of >6 months of anti-tuberculosis therapy was associated with a decreased risk of death (HR 0.23; 95% CI 0.08, 0.66; P=0.007. CONCLUSIONS: The increased risk of death among persons diagnosed with tuberculosis after ART initiation highlights the importance of screening for tuberculosis before ART initiation. The decreased risk of death among persons receiving > 6 months of anti-tuberculosis therapy suggests that current anti-tuberculosis treatment duration guidelines should be re-evaluated.

  17. Trends of Mycobacterium bovis Isolation and First-Line Anti-tuberculosis Drug Susceptibility Profile: A Fifteen-Year Laboratory-Based Surveillance.

    Directory of Open Access Journals (Sweden)

    Miriam Bobadilla-del Valle


    Full Text Available Mycobacterium tuberculosis causes the majority of tuberculosis (TB cases in humans; however, in developing countries, human TB caused by M. bovis may be frequent but undetected. Human TB caused by M. bovis is considered a zoonosis; transmission is mainly through consumption of unpasteurized dairy products, and it is less frequently attributed to animal-to-human or human-to-human contact. We describe the trends of M. bovis isolation from human samples and first-line drug susceptibility during a 15-year period in a referral laboratory located in a tertiary care hospital in Mexico City.Data on mycobacterial isolates from human clinical samples were retrieved from the laboratory's database for the 2000-2014 period. Susceptibility to first-line drugs: rifampin, isoniazid, streptomycin (STR and ethambutol was determined. We identified 1,165 isolates, 73.7% were M. tuberculosis and 26.2%, M. bovis. Among pulmonary samples, 16.6% were M. bovis. The proportion of M. bovis isolates significantly increased from 7.8% in 2000 to 28.4% in 2014 (X(2trend, p<0.001. Primary STR resistance was higher among M. bovis compared with M. tuberculosis isolates (10.9% vs.3.4%, p<0.001. Secondary multidrug resistance (MDR rates were 38.5% and 34.4% for M. bovis and M. tuberculosis, respectively (p = 0.637. A rising trend of primary STR monoresistance was observed for both species (3.4% in 2000-2004 vs. 7.6% in 2010-2014; p = 0.02.There is a high prevalence and a rising trend of M. bovis isolates in our region. The proportion of pulmonary M. bovis isolates is higher than in previous reports. Additionally, we report high rates of primary anti-tuberculosis resistance and secondary MDR in both M. tuberculosis and M. bovis. This is one of the largest reports on drug susceptibility of M. bovis from human samples and shows a significant proportion of first-line anti-tuberculosis drug resistance.

  18. Chemical constituents and anti-tuberculosis activity of ink extracts of cuttlefish, Sepiella inermis

    Directory of Open Access Journals (Sweden)

    Muthusamy Ravichandiran


    Full Text Available Objective: To study the chemical constituents and the anti-tuberculosis activity of methanol and chloroform ink extracts of Sepiella inermis. Methods: Pulverized ink powder was extracted separately with chloroform and methanol. Chemical analysis was carried out by UV-VIS spectrophotometer, FT-IR and GC-MS. Crude extracts were tested in vitro for their activity against Mycobacterium tuberculosis using Lowenstein Jensen (L-J medium. Activity in L-J medium was assessed by mean reduction in number of colonies on extract containing bottles as compared to extract free controls. Results: GC-MS of methanol extract revealed four compounds viz. hexadecanoic acid, 9, 12- octadecadienoic acid, 9-octadecenoic acid and octadecanoic acid. The chloroform extract containing fourteen compounds. The methanol extract exhibited anti-tuberculosis activity in L-J medium at 64 µg/mL with the observed inhibition of 14 CFU. Chloroform extract displayed a weak activity against Mycobacterium tuberculosis. Conclusions: This investigation showed the methanol extract exhibited significant activity against Mycobacterium tuberculosis than chloroform extract. Since ink of sepia is available abundantly as a waste material, further studies aimed at isolation and efficacy of active substances pave the way for new anti-tuberculosis drugs.

  19. Chemical constituents and anti-tuberculosis activity of ink extracts of cuttlefish, Sepiella inermis

    Institute of Scientific and Technical Information of China (English)

    Muthusamy Ravichandiran; Selvam Thiripurasalini; Vaithilingam Ravitchandirane; Srinivasa Gopalane; Chelladurai Stella


    Objective: To study the chemical constituents and the anti-tuberculosis activity of methanol and chloroform ink extracts of Sepiella inermis.Methods:Chemical analysis was carried out by UV-VIS spectrophotometer, FT-IR and GC-MS. Crude extracts Pulverized ink powder was extracted separately with chloroform and methanol. were tested in vitro for their activity against Mycobacterium tuberculosis using Lowenstein Jensen (L-J) medium. Activity in L-J medium was assessed by mean reduction in number of colonies on extract containing bottles as compared to extract free controls.Results:octadecadienoic acid, 9-octadecenoic acid and octadecanoic acid. The chloroform extract GC-MS of methanol extract revealed four compounds viz. hexadecanoic acid, 9, 12-containing fourteen compounds. The methanol extract exhibited anti-tuberculosis activity in L-J medium at 64 µg/mL with the observed inhibition of 14 CFU. Chloroform extract displayed a weak activity against Mycobacterium tuberculosis.Conclusions:Mycobacterium tuberculosis than chloroform extract. Since ink of sepia is available abundantly as This investigation showed the methanol extract exhibited significant activity against a waste material, further studies aimed at isolation and efficacy of active substances pave the way for new anti-tuberculosis drugs.

  20. New Non-Toxic Semi-Synthetic Derivatives from Natural Diterpenes Displaying Anti-Tuberculosis Activity. (United States)

    Matos, Priscilla M; Mahoney, Brian; Chan, Yohan; Day, David P; Cabral, Mirela M W; Martins, Carlos H G; Santos, Raquel A; Bastos, Jairo K; Page, Philip C Bulman; Heleno, Vladimir C G


    We report herein the synthesis of six diterpene derivatives, three of which are new, generated through known organic chemistry reactions that allowed structural modification of the existing natural products kaurenoic acid (1) and copalic acid (2). The new compounds were fully characterized using high resolution mass spectrometry, infrared spectroscopy, ¹H- and (13)C-NMR experiments. We also report the evaluation of the anti-tuberculosis potential for all compounds, which showed some promising results for Micobacterium tuberculosis inhibition. Moreover, the toxicity for each of the most active compounds was also assessed.

  1. Synergism between ethanolic extract of propolis (EEP) and anti-tuberculosis drugs on growth of mycobacteria. (United States)

    Scheller, S; Dworniczak, S; Waldemar-Klimmek, K; Rajca, M; Tomczyk, A; Shani, J


    Ethanolic extract of propolis exerts a strong anti-bacterial activity, in addition to antifungal, antiviral and antiprotozoal properties. In previous studies from these laboratories we have demonstrated that the intensity of the bactericidal activity of EEP is correlated with the virulence of the mycobacteria tested, and that EEP has a synergistic effect with antibiotics on growth of staphylococcus aureus. In the present study we investigated whether the same synergism and correlation exists between EEP and some anti-tuberculosis drugs on tuberculosis mycobacteria with different degrees of virulence. Six standard strains and 11 wild strains of mycobacteria were exposed for 30 days to EEP, with or without streptomycin, rifamycin, isoniazid or ethambutol. Out of the 17 strains, 8 were resistant to at least two standard antibiotics, and were considered "multi-resistant strains". The rest were either susceptible or resistant to only one of the antimycobacterial drugs. Antagonism was recorded only in one case, when Staphylococcus aureus were treated with a mixture of EEP and ethambutol, suggesting that a chemical bond could have been formed between this anti-tuberculosis antibiotic and one of the active components of the ethanol extract of propolis.

  2. Research Progress of the Anti-Tuberculosis Drugs%抗结核药物的研究进展

    Institute of Scientific and Technical Information of China (English)

    耿叶慧; 李子强


    目的:为进一步研发新型抗结核药物提供参考。方法通过Science Direct,Wiley,Springer Link等数据库进行文献检索,将近几年文献报道抗结核候选药物进行归纳和总结。结果最低抑菌浓度小于7μmol/L,低毒和高选择性的最有潜力的抗结核候选药物已大量出现。结论抗结核候选药物的开发思路为研发更多新型抗结核药物提供了参考。%Objective To provide a reference for further researching and developping new anti-tuberculosis drugs. Methods Through document retrieval in the databases of Science Direct, Wiley and Springer Link, etc., the literatures about new antitubercular drugs were summarized. Results The most potent anti-tuberculosis drugs with low toxicity, a high selective index and MIC values ﹤ 7 μmol/L were appeared in large numbers. Conclusion The thoughts on the development of anti-tuberculosis drugs provide perspectives on the development of new anti-tuberculosis drugs.

  3. Early stationary phase culture supernatant accelerates growth of sputum cultures collected after initiation of anti-tuberculosis treatment. (United States)

    Kolwijck, E; Friedrich, S O; Karinja, M N; van Ingen, J; Warren, R M; Diacon, A H


    We investigated the effect of Mycobacterium tuberculosis culture supernatant added to sputum cultures collected during the first 8 weeks of anti-tuberculosis treatment. With ongoing treatment duration, time to culture positivity decreased significantly in supernatant-enriched cultures, possibly due to stimulation of dormant or slowly metabolizing M. tuberculosis cells.

  4. Drug-induced complications of anti-tuberculosis drugs in HIV patients

    Directory of Open Access Journals (Sweden)

    Rasoulinejad M


    Full Text Available "n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: Tuberculosis with high prevalence in HIV/AIDS patients is the main reason for morbidity and mortality in these patients. About one-third of patients with HIV infection have concomitant tuberculosis. Lack of appropriate infection control on many social and economic communities will impose. Comprehensive study on the effects of anti-tuberculosis drugs in patients with HIV infecting less done, also due to the importance of reducing morbidity and mortality, reduce the cost of disease, identifying drug pharmacokinetics, the importance of completing treatment tuberculosis, this study was performed to evaluate the effects of anti- tuberculosis drugs on HIV infection and to identify the drug pharmacokinetics and so more complete tuberculosis treatment."n"nMethods: A historical cohort study was performed on patients referring to the research center for HIV/AIDS, consultation center, department of infection diseases of Imam Khomeini Hospital in Tehran, Iran. A total number of 75 cases with HIV negative versus HIV positive patients with pulmonary tuberculosis and positive sputum smear in accordance with inclusion and exclusion criteria were selected."n"nResults: In this study, the frequency of peripheral neuropathy 27(73%, arthralgia 31(83.8%, vomiting 18(48.6%, headache 26(70.3%, dizziness 20(54.1%, renal toxicity 4(10.8% and of skin rash 10(27% in patients with HIV virus infection were significantly more than HIV- negative patients. Hepatotoxicity, fever and

  5. Rapid determination of anti-tuberculosis drug resistance from whole-genome sequences

    KAUST Repository

    Coll, Francesc


    Mycobacterium tuberculosis drug resistance (DR) challenges effective tuberculosis disease control. Current molecular tests examine limited numbers of mutations, and although whole genome sequencing approaches could fully characterise DR, data complexity has restricted their clinical application. A library (1,325 mutations) predictive of DR for 15 anti-tuberculosis drugs was compiled and validated for 11 of them using genomic-phenotypic data from 792 strains. A rapid online ‘TB-Profiler’ tool was developed to report DR and strain-type profiles directly from raw sequences. Using our DR mutation library, in silico diagnostic accuracy was superior to some commercial diagnostics and alternative databases. The library will facilitate sequence-based drug-susceptibility testing.

  6. Sale of anti-tuberculosis drugs through private pharmacies: a cross sectional study in Kerala, India.

    Directory of Open Access Journals (Sweden)

    Binoo Divakaran


    Full Text Available

    Background: Private health care providers are largely the first point of contact for Tuberculosis (TB patients, who either undergo treatment from private practitioners or buy medicines on their own from private pharmacies. Aims: This study assessed the availability, sale and magnitude of anti-tuberculosis drugs dispensing through private pharmacies.

    Methodology: The present cross sectional study was conducted among private pharmacies located along the national highway from Thalassery to Payyannur in the Kannur district of Kerala, India. A total of 38 private pharmacies located along the national highway were included.

    Results: The duration that anti–TB drugs had been on sale showed that 74.3% of pharmacies had started to sell these drugs only less than ten years ago. The majority (82.9% of the private pharmacies received up to 5 prescriptions for anti-TB drugs weekly. Out of the total of 35 pharmacies selling these drugs, 22 (62.9% reported an increase in their sales. Nearly 82% of those pharmacies that reported an increase in the sale of anti-TB drugs were selling these drugs for less than the past ten years.

    Conclusions: The current study shows that a large number of tuberculosis patients are still approaching private pharmacies for anti-tuberculosis drugs. This tendency has to be completely stopped and needs properly planned strategies to encourage private pharmacies to participate actively in the DOTS (Direct Observation Treatment Short course program of the Government, by providing them attractive alternative incentives

  7. Efficacy and safety of anti-tuberculosis drugs in HIV-positive patients: A prospective study

    Directory of Open Access Journals (Sweden)

    Jigar D Kapadia


    Full Text Available Objectives: To assess the efficacy and safety of anti-tuberculosis drugs in HIV-positive patients at a tertiary care teaching hospital. Materials and Methods: As a part of an ongoing study of opportunistic infections (OIs in HIV-positive patients, drug treatment in patients suffering from tuberculosis was assessed to determine its efficacy and safety. Based on prevalence data for last three years, a purposive sampling of study population was carried out in this observational, prospective, single centre study. Tuberculosis (TB was the most common OI observed. The selected patients were followed up for a period of one year to evaluate the clinical course and outcome of OIs, and the efficacy and safety of drugs used was checked. Results: Tuberculosis was observed in 89 out of 134 enrolled patients. These included 79 adults and 10 children. Males (66.2% were commonly affected. Extra pulmonary TB (73% was the most common manifestation with abdominal TB observed in 55 (61.7% patients. All patients were treated in accordance with the Revised National Tuberculosis Control Programme (RNTCP guidelines as recommended by National AIDS Control Organization (NACO, India. Outcome of TB was assessable in 70 patients. Majority (82.8% of the patients were cured, while 12 patients (17.1% died during the course of treatment. A total of 149 ADRs were observed in 67 (75.2% patients. Majority of ADRs (n = 147 were non-serious and did not warrant a change in therapy. Discoloration of urine was the most common ADR observed. Conclusion: TB is the most common opportunistic infection in HIV-positive patients with abdominal TB being the most common manifestation. RNTCP and NACO guidelines are adhered to in these patients. Anti-tuberculosis drugs are well tolerated and effective in majority of the patients.

  8. Transdermal delivery of isoniazid and rifampin in guinea pigs by electro-phonophoresis. (United States)

    Chen, Suting; Han, Yi; Yu, Daping; Huo, Fengmin; Wang, Fen; Li, Yunxu; Dong, Lingling; Liu, Zhidong; Huang, Hairong


    Electro-phonophoresis (EP) has been used as a drug delivery approach in clinical fields. The objective of the present study is to evaluate the skin permeability of isoniazid and rifampin in guinea pigs by EP to provide reference basis for clinical applications of such transdermal delivery system in the treatment of patients with superficial tuberculosis. Isoniazid and rifampin solutions were delivered transdermally with or without EP in health guinea pigs for 0.5 h. Local skin and blood samples were collected serially at 0, 1/2, 1, 2, 4, 6 and 24 h after dosing. Drug concentrations in local skin and blood were evaluated by high-performance liquid chromatography. Isoniazid concentrations in local skin of guinea pigs receiving isoniazid through EP transdermal delivery were significantly higher than in animals receiving only isoniazid with transdermal patch. However, for rifampin, patches alone group presented almost uniform concentration versus time curve with that of EP group, and both groups had concentrations much higher than the therapeutic concentration of the drug over sustainable time. After EP transdermal delivery, the mean peak concentrations of isoniazid and rifampin in skin were 771.0 ± 163.4 μg/mL and 81.2 ± 17.3 μg/mL respectively. Neither isoniazid nor rifampin concentration in blood could be detected (below the lower detection limit of 1 μg/mL) at any time point. The present study showed that application of EP significantly enhanced INH penetration through skin in guinea pigs, while RIF patch alone obtained therapeutic concentration in local skin. Our work suggests several possible medication approaches for efficient treatment of superficial tuberculosis.

  9. 14C-urea breath test in patients undergoing anti-tuberculosis therapy

    Institute of Scientific and Technical Information of China (English)

    Sayed Amir Mirbagheri; Amir Ali Sohrabpour; Mehrdad Hasibi; Babak Moghimi; Mehdi Mohamadnejad


    AIM: Urea breath test (UBT) is a non-invasive diagnostic test for detecting the presence of Helicobacter pylori(H pylori).In this study we evaluated the effect of anti-tuberculosis therapy on the results of 14C-UBT.METHODS: Patients, with the diagnosis of tuberculosis (TB) who had a positive UBT at the point of starting antiTB therapy, were included. None had a history of peptic ulcer disease or had taken antibiotics, bismuth compounds and/or PPI in the previous month, 14C-UBT was repeated at the end of the second month and the end of treatment period and one month after completion of treatment course.RESULTS: Thirty-five patients (23 males) were enrolled.14C-UBT was negative in all 35 patients (100%) at the end of the second month and remained negative in 30cases (85.7%) at the end of the treatment course. One month after completion of treatment course, UBT remained negative in 13 patients (37.1%).CONCLUSION: Our report underscores the need for caution while interpreting urea breath test results in patients undergoing anti-TB therapy. Furthermore, the combination of drugs used in this study resulted in H pylori eradication in a minority of patients.

  10. Preparation, characterization, and in vitro cytotoxicity evaluation of a novel anti-tuberculosis reconstruction implant.

    Directory of Open Access Journals (Sweden)

    JunFeng Dong

    Full Text Available BACKGROUND: Reconstruction materials currently used in clinical for osteoarticular tuberculosis (TB are unsatisfactory due to a variety of reasons. Rifampicin (RFP is a well-known and highly effective first-line anti-tuberculosis (anti-TB drug. Poly-DL-lactide (PDLLA and nano-hydroxyapatite (nHA are two promising materials that have been used both for orthopedic reconstruction and as carriers for drug release. In this study we report the development of a novel anti-TB implant for osteoarticular TB reconstruction using a combination of RFP, PDLLA and nHA. METHODS: RFP, PDLLA and nHA were used as starting materials to produce a novel anti-TB activity implant by the solvent evaporation method. After manufacture, the implant was characterized and its biodegradation and drug release profile were tested. The in vitro cytotoxicity of the implant was also evaluated in pre-osteoblast MC3T3-E1 cells using multiple methodologies. RESULTS: A RFP/PDLLA/nHA composite was successfully synthesized using the solvent evaporation method. The composite has a loose and porous structure with evenly distributed pores. The production process was steady and no chemical reaction occurred as proved by Fourier Transform Infrared Spectroscopy (FTIR and X-Ray Diffraction (XRD. Meanwhile, the composite blocks degraded and released drug for at least 12 weeks. Evaluation of in vitro cytotoxicity in MC3T3-E1 cells verified that the synthesized composite blocks did not affect cell growth and proliferation. CONCLUSION: It is feasible to manufacture a novel bioactive anti-TB RFP/PDLLA/nHA composite by the solvent evaporation method. The composite blocks showed appropriate properties such as degradation, drug release and biosafety to MC3T3-E1 cells. In conclusion, the novel composite blocks may have great potential for clinical applications in repairing bone defects caused by osteoarticular TB.

  11. Prevention of hepatotoxicity due to anti tuberculosis treatment: A novel integrative approach

    Institute of Scientific and Technical Information of China (English)

    Meghna R Adhvaryu; Narsimha M Reddy; Bhasker C Vakharia


    AIM: To evaluate the ability of Curcuma longa (CL) and Tinospora cordifolia (TC) formulation to prevent anti-tuberculosis (TB) treatment (ATT) induced hepatotoxicity.METHODS: Patients with active TB diagnosis were randomized to a drug control group and a trial group on drugs plus an herbal formulation.Isoniazid,rifampicin,pyrazinamide and ethambutol for first 2 mo followed by continuation phase therapy excluding Pyrazinamide for 4 mo comprised the anti-tuberculous treatment.Curcumin enriched (25%) CL and a hydro-ethanolic extract enriched (50%) TC 1 g each divided in two doses comprised the herbal adjuvant.Hemogram,bilirubin and liver enzymes were tested initially and monthly till the end of study to evaluate the result.RESULTS: Incidence and severity of hepatotoxicity was significantly lower in trial group (incidence: 27/192 vs 2/316,P < 0.0001).Mean aspartate transaminase (AST) (195.93 ± 108.74 vs 85 ± 4.24,P < 0.0001),alanine transaminase (ALT) (75.74 ± 26.54 vs 41 ±1.41,P < 0.0001) and serum bilirubin (5.4 ± 3.38 vs 1.5± 0.42,P < 0.0001).A lesser sputum positivity ratio at the end of 4 wk (10/67 vs 4/137,P = 0.0068) and decreased incidence of poorly resolved parenchymal lesion at the end of the treatment (9/152 vs 2/278,P = 0.0037) was observed.Improved patient compliance was indicated by nil drop-out in trial vs 10/192 in control group (P < 0.0001).CONCLUSION: The herbal formulation prevented hepatotoxicity significantly and improved the disease outcome as well as patient compliance without any toxicity or side effects.

  12. The pharmacokinetics of a single oral or rectal dose of concurrently administered isoniazid, rifampin, pyrazinamide, and ethambutol in Asian elephants (Elephas maximus). (United States)

    P Brock, A; Isaza, R; Egelund, E F; Hunter, R P; Peloquin, C A


    Tuberculosis, caused by Mycobacterium tuberculosis, is a disease of concern in captive Asian elephants (Elephas maximus). Treatment for tuberculosis in elephants utilizes multidrug protocols combining isoniazid, rifampin, pyrazinamide, and/or ethambutol. In this study, a single, coformulated dose of isoniazid 5 mg/kg, rifampin 10 mg/kg, pyrazinamide 30 mg/kg, and ethambutol 30 mg/kg was administered orally to six Asian elephants, and rectally to five elephants using a cross-over design. Blood samples were collected serially over 24 h. Pyrazinamide and ethambutol concentrations were determined using validated gas chromatography assays. Isoniazid and rifampin concentrations were determined using validated high-performance liquid chromatography assays. Rectal isoniazid produced an earlier Tmax compared with oral administration. Oral isoniazid resulted in a comparatively lower Cmax , but higher AUC values compared with rectal isoniazid. Oral rifampin and oral ethambutol were well absorbed while rectal rifampin was not. Oral pyrazinamide produced comparatively higher Cmax and AUC values compared with rectal pyrazinamide. Results of this study indicate that currently recommended therapeutic monitoring sample collection times for rectal isoniazid and oral rifampin do not provide an accurate assessment of exposure for these drugs. This study demonstrates notable individual variability, indicating that dosing of these medications requires individual monitoring and provides additional information to guide the clinician when treating elephants.

  13. The protective effect of diammonium glycyrrhizinate and polyene phosphatidyl choline on livery damage caused by anti-tuberculosis drugs

    Institute of Scientific and Technical Information of China (English)

    Li Wang


    Objective:To study the protective effect of diammonium glycyrrhizinate and polyene phosphatidyl choline on livery damage caused by anti-tuberculosis drugs.Methods:Patients who received initial 2HRS(E)Z/4HR short-range anti-tuberculosis treatment in our hospital from October 2013 to October 2015 were selected and randomly divided into diammonium glycyrrhizinate group (group A) and polyene phosphatidyl choline group (group B), and after 4 weeks of liver protection treatment, serum levels of liver damage marker molecules, stress marker molecules and NF-κB-mediated inflammatory molecules as well as protein expression levels of bile acid metabolism genes were determined.Results: Serum ALT, AST, GGT, ALP, GDH, TBIL, NF-κB, IL-1β, TNF-α and MCP-1 levels of group B were significantly lower than those of group A while HO-1, GSH-Px, SOD, ERK, MEK and SIRT1 levels were significantly higher than those of group A; serum CYP7A1, FXR and SHP protein expression levels of group B were significantly lower than those of group A while BESP protein expression level was significantly higher than that of group A.Conclusion:Polyene phosphatidyl choline has better protective effect on liver damage caused by anti-tuberculosis drugs than diammonium glycyrrhizinate, and the molecular mechanisms of polyene phosphatidyl choline to protect the liver are enhancing the antioxidant effect mediated by HO-1 and SIRT1, inhibiting the inflammatory response mediated by NF-κB and regulating the expression of bile acid metabolism genes.

  14. Synthesis, characterization and pharmacological studies of copper complexes of flavone derivatives as potential anti-tuberculosis agents. (United States)

    Joseph, J; Nagashri, K; Suman, A


    Novel series of different hydroxyflavone derivatives and their copper complexes were synthesized. They were characterized using analytical and spectral techniques. The superoxide dismutase (SOD) mimetic activity of the synthesized complexes demonstrated that copper complex of L(10) has promising SOD-mimetic activity than other ligands & complexes. The in vitro antimicrobial activities of the synthesized compounds were tested against the bacterial species and fungal species. The DNA binding properties of copper complexes were studied using cyclic voltametry and electronic absorption techniques. Anti-tuberculosis activity was also performed. The effective complexes was subjected to antimycobacterial activity using MABA method and summarized. The antimycobacterial activity of copper complexes have been evaluated and discussed.

  15. Comparison between Efficacy of Ciprofioxacin -Doxycycline with Rifampin – Doxycycline Regimens inrelapse of Brucellosis

    Directory of Open Access Journals (Sweden)

    Hossein Sarmadian


    Full Text Available Background: Brucellosis is one of the endemic diseases in Iran that has a worldwide spread and is associated with chronic disabilities in humans. Combination therapy of Brucellosis leads to recovery of symptoms, shortening of the symptomatic intervals, and decrease in the rate of relapse and drug resistance. Considering the use of rifampin in the treatment of tuberculosis, and the necessity for an alternative treatment in regions endemic for both tuberculosis and brucellosis, the aim ofthis study was to compare the efficiency of the regimen of rifampin-Doxycycline with ciprofloxacin-Doxycycline in relapse of brucellosis. Materials and methods: This randomized controlled trial was performed on 90 patients, older than 17 years old, affected with brucellosis, which were referred to the Infectious Disease Clinics at ArakUniversity of medical sciences between the years 1384-1387. The patients were randomly divided into two groups: the DR groups, receiving 100 mg of Doxycycline twice a day and 300 mg of rifampin Bid daily for eight weeks and the CD group, receiving 100 mg of Doxycycline plus 500 mg of ciprofloxacin twice a day for eight weeks. The patients were analyzed for the relief of symptoms, drug side effects, and laboratory findings during the treatment. Results:In this study, the rate of relapse in both groups were similar. The relapse was seen in 4.5% and 3.2% of the patients for the DR and CD groups, respectively (P=0.168. The drug side effects were slight in both of groups, with no significant difference, and did not lead to discontinuation of the therapy. Conclusion: According to the same rate of relapse in both CD and DR regimens in the treatment of brucellosis and considering the usage of rifampin in regions with high prevalence of tuberclusis, the CD regimen is recommended as an appropriate one.

  16. Design, synthesis and study of quinoxaline-2- carboxamide 1,4-DI-N-Oxide derivatives as anti-tuberculosis agents


    Moreno-Viguri, E. (Elsa); Monge, A; Perez-Silanes, S. (Silvia)


    The experimental work presented in this memory is based on the hypothesis that quinoxalines di-N-oxide, considered to be the core of the structure, which present a carboxamide moiety on position two and aliphatic linker between this group and an aromatic system, can be proposed as potent anti-tuberculosis agents. The main purpose of this project is the synthesis of new quinoxaline di-N-oxide derivatives as anti-tuberculosis agents. The strategy consists of the design and synthesis of several ...

  17. Polyneuropathy, anti-tuberculosis treatment and the role of pyridoxine in the HIV/AIDS era: a systematic review. (United States)

    van der Watt, J J; Harrison, T B; Benatar, M; Heckmann, J M


    Tuberculosis (TB) is increasing in incidence in certain parts of the world, particularly where there is a co-epidemic of human immunodeficiency virus/acquired immune-deficiency syndrome (HIV/AIDS), and it is associated with a significant degree of morbidity and mortality. One of the most common complications of anti-tuberculosis treatment is the development of a painful isoniazid (INH) associated polyneuropathy (PN), which is preventable with adequate pyridoxine supplementation. As PN is also the most frequent neurological complication associated with HIV infection, subjects who are HIV and TB co-infected may be at increased risk of developing PN. In this review, we explore current knowledge of anti-tuberculosis drug associated PN focusing on INH and its relationship to pyridoxine, as well as the additional impact of antiretroviral treatment and TB-HIV co-infection. It is evident that guidelines established for the prevention and treatment of this problem differ between industrialised and developing countries, and that further research is needed to define the optimum dosing of pyridoxine supplementation in populations where there is a significant burden of TB and HIV.

  18. Bioautography with TLC-MS/NMR for Rapid Discovery of Anti-tuberculosis Lead Compounds from Natural Sources. (United States)

    Grzelak, Edyta M; Hwang, Changhwa; Cai, Geping; Nam, Joo-Won; Choules, Mary P; Gao, Wei; Lankin, David C; McAlpine, James B; Mulugeta, Surafel G; Napolitano, José G; Suh, Joo-Won; Yang, Seung Hwan; Cheng, Jinhua; Lee, Hanki; Kim, Jin-Yong; Cho, Sang-Hyun; Pauli, Guido F; Franzblau, Scott G; Jaki, Birgit U


    While natural products constitute an established source of lead compounds, the classical iterative bioassay-guided isolation process is both time- and labor-intensive and prone to failing to identify active minor constituents. (HP)TLC-bioautography-MS/NMR, which combines cutting-edge microbiological, chromatographic, and spectrometric technologies, was developed to accelerate anti-tuberculosis (TB) drug discovery from natural sources by acquiring structural information at a very early stage of the isolation process. Using the avirulent, bioluminescent Mtb strain mc(2)7000 luxABCDE, three variations of bioautography were evaluated and optimized for sensitivity in detecting anti-TB agents, including established clinical agents and new leads with novel mechanisms of action. Several exemplary applications of this approach to microbial extracts demonstrate its potential as a routine method in anti-TB drug discovery from natural sources.

  19. Detection and confirmation of alkaloids in leaves of Justicia adhatoda and bioinformatics approach to elicit its anti-tuberculosis activity. (United States)

    Jha, Deepak Kumar; Panda, Likun; Lavanya, P; Ramaiah, Sudha; Anbarasu, Anand


    The extraction and determination of alkaloids was performed and confirmed by phytochemical analysis. Six different quinazoline alkaloids (vasicoline, vasicolinone, vasicinone, vasicine, adhatodine and anisotine) were found in the leaf of Justicia adhatoda (J. adhatoda). The presence of the peaks obtained through HPLC indicated the diverse nature of alkaloid present in the leaf. The enzyme β-ketoacyl-acyl-carrier protein synthase III that catalyses the initial step of fatty acid biosynthesis (FabH) via a type II fatty acid synthase has unique structural features and universal occurrence in Mycobacterium tuberculosis (M. tuberculosis). Thus, it was considered as a target for designing of anti-tuberculosis compounds. Docking simulations were conducted on the above alkaloids derived from J. adhatoda. The combination of docking/scoring provided interesting insights into the binding of different inhibitors and their activity. These results will be useful for designing inhibitors for M. tuberculosis and also will be a good starting point for natural plant-based pharmaceutical chemistry.

  20. Amelioration of anti-tuberculosis drug induced oxidative stress in kidneys by Spirulina fusiformis in a rat model. (United States)

    Martin, Sherry Joseph; Sabina, Evan Prince


    Nephrotoxicity is a rare complication caused by anti-tuberculosis therapy-induced oxidative stress. The Cyanobacterium Spirulina fusiformis Voronikhin belonging to Oscillatoriaceae family is used traditionally as a source of antioxidants against oxidative stress. We aimed to investigate the efficacy of S. fusiformis in modifying isoniazid (INH) and rifampicin (RIF)-induced changes in Wistar rat kidneys. Animals were divided into six groups: normal control rats; toxic control (INH & RIF-50 mg/kg b.w./d each; p.o.); INH & RIF + S. fusiformis (400 mg/kg b.w./d); INH & RIF + S. fusiformis (800 mg/kg b.w./d); S. fusiformis (800 mg/kg b.w./d) alone-treated rats; INH & RIF + silymarin (25 mg/kg b.w./d). Study duration was 28 d after which blood and kidneys were analyzed. We also studied the binding and interactions of the transcription factors Liver X Receptor (LXR) and Farnesoid X Receptor (FXR) with INH, RIF, and representative active compounds of S. fusiformis by in silico methods. INH & RIF treatment caused significant (p< 0.05) decrease in antioxidant levels and significant (p< 0.05) increase in the levels of creatinine, urea, and uric acid showing impaired kidney function. Spirulina fusiformis ameliorated these effects in a dose dependent manner. Histological examination of kidneys supported these findings. Results of the in silico analyses showed that selected active components of S. fusiformis interact with LXR and FXR and could be a possible mechanism of action. S. fusiformis rendered protection against anti-tuberculosis drugs-induced oxidative stress in kidney tissues of rats.

  1. Mycobacterium tuberculosis whole genome sequencing and protein structure modelling provides insights into anti-tuberculosis drug resistance

    KAUST Repository

    Phelan, Jody


    Background Combating the spread of drug resistant tuberculosis is a global health priority. Whole genome association studies are being applied to identify genetic determinants of resistance to anti-tuberculosis drugs. Protein structure and interaction modelling are used to understand the functional effects of putative mutations and provide insight into the molecular mechanisms leading to resistance. Methods To investigate the potential utility of these approaches, we analysed the genomes of 144 Mycobacterium tuberculosis clinical isolates from The Special Programme for Research and Training in Tropical Diseases (TDR) collection sourced from 20 countries in four continents. A genome-wide approach was applied to 127 isolates to identify polymorphisms associated with minimum inhibitory concentrations for first-line anti-tuberculosis drugs. In addition, the effect of identified candidate mutations on protein stability and interactions was assessed quantitatively with well-established computational methods. Results The analysis revealed that mutations in the genes rpoB (rifampicin), katG (isoniazid), inhA-promoter (isoniazid), rpsL (streptomycin) and embB (ethambutol) were responsible for the majority of resistance observed. A subset of the mutations identified in rpoB and katG were predicted to affect protein stability. Further, a strong direct correlation was observed between the minimum inhibitory concentration values and the distance of the mutated residues in the three-dimensional structures of rpoB and katG to their respective drugs binding sites. Conclusions Using the TDR resource, we demonstrate the usefulness of whole genome association and convergent evolution approaches to detect known and potentially novel mutations associated with drug resistance. Further, protein structural modelling could provide a means of predicting the impact of polymorphisms on drug efficacy in the absence of phenotypic data. These approaches could ultimately lead to novel resistance

  2. A case of pseudomembranous colitis associated with rifampin. (United States)

    Park, Ji Young; Kim, Joon Seok; Jeung, Sun Jong; Kim, Myung Sook; Kim, Seok Chan


    Pseudomembranous colitis is known to develop with long-term antibiotic administration, but antitubercular agents are rarely reported as a cause of this disease. We experienced a case of pseudomembranous colitis associated with rifampin. The patient was twice admitted to our hospital for the management of frequent bloody, mucoid, jelly-like diarrhea and lower abdominal pain that developed after antituberculosis therapy that included rifampin. Sigmoidoscopic appearance of the rectum and sigmoid colon and mucosal biopsy were compatible with pseudomembranous colitis. The antitubercular agents were discontinued and metronidazole was administered orally. The patient's symptoms were resolved within several days. The antituberculosis therapy was changed to isoniazid, ethambutol and pyrazinamide after a second bout of colitis. The patient had no further recurrence of diarrhea and abdominal pain. We report here on a case of pseudomembranous colitis associated with rifampin.

  3. Rifampin therapy of Staphylococcus epidermidis. Use in infections from indwelling artificial devices. (United States)

    Archer, G L; Tenenbaum, M J; Haywood, H B


    Rifampin was added to existing antibiotic regimens in two patients with Staphylococcus epidermidis infections; one patient had prosthetic valve endocarditis and the other had an infection of a CSF shunt. The addition of rifampin increased serum or CSF bactericidal titers 16-fold or greater and was correlated with a favorable clinical response. The results of tests for tube-dilution antibiotic susceptibility showed rifampin to be the most active of all antibiotics tested against the patients' organisms. The combinations of gentamicin sulfate, nafcillin sodium, or vancomycin hydrochloride with rifampin prevented the emergence of rifampin resistance in vitro and promoted enhanced killing when compared with either antibiotic alone.

  4. A comparison between doxycycline-rifampin and ciprofloxacin-rifampin regimens in the treatment of acute Brucellosis

    Directory of Open Access Journals (Sweden)

    Majid Reza Erfanian Taghvaee


    Full Text Available Introduction: Brucellosis, a serious zoonosis, is a widespread disease in many countries, especially the developing ones, with an annual report of 500,000 new cases to the World Health Organization (WHO. Although successful results have been achieved by the combination therapies recommended by the WHO, their relapse rates have been high, and therefore, the most effective agents with least side-effects are still undetermined. Materials and Methods: An observational study has been prospectively carried out from 2007 to 2010 in the Infectious Clinics of Hashemi-nejad and Imam Reza Hospitals, Mashhad, Iran. In this study, among the patients of brucellosis, whose diseases were recently diagnosed, 50 patients, receiving one of the two common authentic regimens of doxycycline plus rifampin for eight weeks or ciprofloxacin plus rifampin for six weeks, were selected. The diagnosis was based on the presence of signs and symptoms compatible with brucellosis, including a positive Wright and 2ME tests, with titers equal to or more than 1/160 and 1/40 respectively. Results: The cure rate was the same for the groups (P=0.55. However, the relapse rate was much more for the latter (P= 0.02. Conclusion: Doxycycline plus rifampin was considered better than ciprofloxacin plus rifampin for the treatment of acute brucellosis.

  5. Structure-based design,synthesis of novel inhibitors of Mycobacterium tuberculosis FabH as potential anti-tuberculosis agents

    Institute of Scientific and Technical Information of China (English)

    Xue Hui Zhang; Hong Yu; Wu Zhong; Li Li Wang; Song Li


    Mycobacterium tuberculosis FabH,an essential enzyme in mycolic acids biosynthetic pathway,is an attractive target for novel anti-tuberculosis agents.Structure-based design,synthesis of novel inhibitors of mrFabH was reported in this paper.A novel scaffold structure was designed,and 12 candidate compounds that displayed favorable binding with the active site were identified and synthesized.

  6. 1,4-Di-N-oxide quinoxaline-2-carboxamide: Cyclic voltammetry and relationship between electrochemical behavior, structure and anti-tuberculosis activity


    Moreno-Viguri, E. (Elsa); Perez-Silanes, S. (Silvia); Gouravaram, S. (S.); Macharam, A. (Abinav); Ancizu, S. (Saioa); Torres, E; Aldana, I.; Monge, A; Crawford, P.W. (Philip W.)


    To gain insight into the mechanism of action, the redox properties of 37 quinoxaline-2-carboxamide 1,4-di-N-oxides with varying degrees of anti-tuberculosis activity were studied in dimethylformamide (DMF) using cyclic voltammetry and first derivative cyclic voltammetry. For all compounds studied, electrochemical reduction in DMF is consistent with the reduction of the N-oxide functionality to form a radical anion. The influence of molecular structure on reduction potential is addressed and i...


    Directory of Open Access Journals (Sweden)

    Kuchma Y.U


    Full Text Available The mechanism of anti-tuberculosis immunity drew the attention of scientists since the established of the infectious nature of tuberculosis. The famous ukrainian microbiologist and immunologist M.M. Tsehnovitser in period from 1921 to 1940 years spent a lot of original experiments for elucidation of the role of allergy in the anti-tuberculosis immunity. M.M. Tsehnovitser believed that a common cause of infectious allergy is tuberculosis granuloma, which even at rest eliminated weakened microbes and their products in general lymphatic and blood stream of the body. In his experiments M.M. Tsehnovitser discovered: 1 When the body comes in contact with M.tuberculosisi formed tuberculosis centre. Infection meets local tissue reaction and in incubation period formed sensitization. In this state the body manifested as a natural susceptibility and resistance to infection. During this period organism going through the initial stage of allergy. 2. Meanwhile, the infectious process goes on and the M.tuberculosisi giving rise. The body reacts to this change in the formula blood - leukocytosis, monocytosis, eosinophilia. Tuberculosis focus represents a formed granuloma. This phase of tuberculosis infection accompanied by severe allergy. 3. Then there are two versions of the process. In the first case happened the generalization of tuberculosis infection. The blood reacts are leukopenia, monocytosis, eosinophilia and lymphocytosis due to toxic processes. In the second case M.tuberculosi multiplied only local in the granuloma and is not generalization of tuberculosis process. In this case, natural immunity is raised. There are allergy and positive anergy in later. 4. It is exclusively unique phenomenon for tuberculous process is the regression of the fire with his sterilization. This type of tuberculous process is in BCG-infection. In the source of infection observed complete resolution of pathological tissue, blood initially reacts slightly, but quickly comes

  8. Effect of anti-tuberculosis therapy on liver function of pulmonary tuberculosis patients infected with hepatitis B virus

    Institute of Scientific and Technical Information of China (English)

    Lei Pan; Zhan-Sheng Jia; Lin Chen; En-Qing Fu; Guang-Yu Li


    AIM: To observe the effect of anti-tuberculosis therapy on liver function of pulmonary tuberculosis patients with hepatitis B virus (HBV) infection, and to compare the differences of liver function by two treatments of antituberculosis.METHODS: Forty-seven TB patients with HBV infection and 170 TB patients without HBV infection were divided into HPBE(S) and HLAMKO treatment groups. Liver function tests before and after the treatments were performed once in 2 wk or monthly, and their clinical manifestations were recorded.RESULTS: The rate of hepatotoxicity occurred in 26 (59%)TB patients with HBV during anti-TB treatment, higher than that in 40 (24%) TB patients without HBV. Hepatotoxicity occurred in 66 out of 217 patients, and the incidence of liver dysfunction was 46.1% in HPBE(S) group, significantly higher than that in HLAMKO group (12.7%) (P<0.01).CONCLUSION: TB patients with HBV should choose HLAMKO treatment because of fewer hepatotoxicity.

  9. Hepatitis B or hepatitis C co-infection in individuals infected with human immunodeficiency virus and effect of anti-tuberculosis drugs on liver function

    Directory of Open Access Journals (Sweden)

    Padmapriyadarsini C


    Full Text Available Background: Tuberculosis (TB and hepatitis are the two common co-infections in patients infected with human immunodeficiency virus (HIV. Anti-tuberculosis treatment (ATT may have an effect on the liver enzymes in these co-infected HIV patients. Aims: To determine the prevalence of Hepatitis B and C virus coinfection in HIV infected patients in Tamilnadu and assess effects of anti-tuberculosis drugs on their liver function. Settings: HIV positive subjects referred to the Tuberculosis Research Centre, Chennai Materials and Methods: All HIV infected patients referred to the Tuberculosis Research centre, from March 2000 to May 2004, were screened for Hepatitis B surface antigen (HBsAg & Hepatitis C virus (HCV antibodies by enzyme linked immunoabsorbent assay (ELISA. HIV infection was confirmed using two rapid tests and one ELISA. Patients were given either short- course anti-tuberculosis treatment or preventive therapy for tuberculosis, depending on the presence or absence of active TB, if their baseline liver functions were within normal limits. None of these patients were on antiretroviral therapy during the study period. Statistical Analysis: Paired t-test was used to find the significance between baseline and end of treatment liver enzymes levels, while logistic regression was done for assessing various associations. Results: Of the 951 HIV-infected patients, 61 patients (6.4% were HBsAg positive, 20 (2.1% had demonstrable anti HCV antibodies in their blood. Serial estimation of liver enzymes in 140 HIV patients (81 being co-infected with either HBV or HCV showed that 95% did not develop any liver toxicity while they were on anti-tuberculosis treatment or prophylaxis. Conclusions: The prevalence of hepatitis B and C coinfection was fairly high in this largely heterosexually infected population supporting the use of more careful screening for these viruses in HIV positive persons in this region. Anti-tuberculosis therapy as well as TB preventive

  10. In vitro evaluation of clindamycin in combination with oxacillin, rifampin, or vancomycin against Staphylococcus aureus. (United States)

    Ho, J L; Klempner, M S


    In a study of antibiotic combinations of clindamycin with rifampin, oxacillin, or vancomycin using the time kill-curve method, the combination of clindamycin and rifampin were sometimes synergistic (5 of 15 times), otherwise indifferent and always enhanced killing of fifteen tested Staphylococcus aureus isolates. In contrast, vancomycin and clindamycin or oxacillin and clindamycin were either indifferent or antagonistic (approximately 50%). Vancomycin alone, however, was generally as effective as the combinations of clindamycin and rifampin.

  11. Discovery of potent anti-tuberculosis agents targeting leucyl-tRNA synthetase. (United States)

    Gudzera, Olga I; Golub, Andriy G; Bdzhola, Volodymyr G; Volynets, Galyna P; Lukashov, Sergiy S; Kovalenko, Oksana P; Kriklivyi, Ivan A; Yaremchuk, Anna D; Starosyla, Sergiy A; Yarmoluk, Sergiy M; Tukalo, Michail A


    Tuberculosis is a serious infectious disease caused by human pathogen bacteria Mycobacterium tuberculosis. Bacterial drug resistance is a very significant medical problem nowadays and development of novel antibiotics with different mechanisms of action is an important goal of modern medical science. Leucyl-tRNA synthetase (LeuRS) has been recently clinically validated as antimicrobial target. Here we report the discovery of small-molecule inhibitors of M. tuberculosis LeuRS. Using receptor-based virtual screening we have identified six inhibitors of M. tuberculosis LeuRS from two different chemical classes. The most active compound 4-{[4-(4-Bromo-phenyl)-thiazol-2-yl]hydrazonomethyl}-2-methoxy-6-nitro-phenol (1) inhibits LeuRS with IC50 of 6μM. A series of derivatives has been synthesized and evaluated in vitro toward M. tuberculosis LeuRS. It was revealed that the most active compound 2,6-Dibromo-4-{[4-(4-nitro-phenyl)-thiazol-2-yl]-hydrazonomethyl}-phenol inhibits LeuRS with IC50 of 2.27μM. All active compounds were tested for antimicrobial effect against M. tuberculosis H37Rv. The compound 1 seems to have the best cell permeability and inhibits growth of pathogenic bacteria with IC50=10.01μM and IC90=13.53μM.

  12. Frequency of Mycobacterium tuberculosis-specific CD8+ T-cells in the course of anti-tuberculosis treatment

    Directory of Open Access Journals (Sweden)

    Rebecca Axelsson-Robertson


    Full Text Available Anti-tuberculosis drug treatment is known to affect the number, phenotype, and effector functionality of antigen-specific T-cells. In order to objectively gauge Mycobacterium tuberculosis (MTB-specific CD8+ T-cells at the single-cell level, we developed soluble major histocompatibility complex (MHC class I multimers/peptide multimers, which allow analysis of antigen-specific T-cells without ex vivo manipulation or functional tests. We constructed 38 MHC class I multimers covering some of the most frequent MHC class I alleles (HLA-A*02:01, A*24:02, A*30:01, A*30:02, A*68:01, B*58:01, and C*07:01 pertinent to a South African or Zambian population, and presenting the following MTB-derived peptides: the early expressed secreted antigens TB10.4 (Rv0288, Ag85B (Rv1886c, and ESAT-6 (Rv3875, as well as intracellular enzymes, i.e., glycosyltransferase 1 (Rv2957, glycosyltransferase 2 (Rv2958c, and cyclopropane fatty acid synthase (Rv0447c. Anti-TB treatment appeared to impact on the frequency of multimer-positive CD8+ T-cells, with a general decrease after 6 months of therapy. Also, a reduction in the total central memory CD8+ T-cell frequencies, as well as the antigen-specific compartment in CD45RA−CCR7+ T-cells was observed. We discuss our findings on the basis of differential dynamics of MTB-specific T-cell frequencies, impact of MTB antigen load on T-cell phenotype, and antigen-specific T-cell responses in tuberculosis.

  13. Qualitative and quantitative results of interferon-γ release assays for monitoring the response to anti-tuberculosis treatment (United States)

    Park, I-Nae; Shim, Tae Sun


    Background/Aims The usefulness of interferon-γ release assays (IGRAs) in monitoring to responses to anti-tuberculosis (TB) treatment is controversial. We compared the results of two IGRAs before and after anti-TB treatment in same patients with active TB. Methods From a retrospective review, we selected patients with active TB who underwent repeated QuantiFERON-TB Gold (QFN-Gold, Cellestis Limited) and T-SPOT.TB (Oxford Immunotec) assays before and after anti-TB treatment with first-line drugs. Both tests were performed prior to the start of anti-TB treatment or within 1 week after the start of anti-TB treatment and after completion of treatment. Results A total of 33 active TB patients were included in the study. On the QFN-Gold test, at baseline, 23 cases (70%) were early secreted antigenic target 6-kDa protein 6 (ESAT-6) or culture filtrate protein 10 (CFP-10) positive. On the T-SPOT. TB test, at baseline, 31 cases (94%) were ESAT-6 or CFP-10 positive. Most of patients remained both test-positive after anti-TB treatment. Although changes in interferon-γ release responses over time were highly variable in both tests, there was a mean decline of 27 and 24 spot-forming counts for ESAT-6 and CFP-10, respectively on the T-SPOT.TB test (p < 0.05 for all). Conclusions Although limited by the small number of patients and a short-term follow-up, there was significant decline in the quantitative result of the T-SPOT. TB test with treatment. However, both commercial IGRAs may not provide evidence regarding the cure of disease in Korea, a country where the prevalence of TB is within the intermediate range. PMID:27951621

  14. Exposure to total and protein-unbound rifampin is not affected by malnutrition in Indonesian tuberculosis patients. (United States)

    te Brake, L H M; Ruslami, R; Later-Nijland, H; Mooren, F; Teulen, M; Apriani, L; Koenderink, J B; Russel, F G; Burger, D M; Alisjahbana, B; Wieringa, F; van Crevel, R; Aarnoutse, R E


    Nutritional status may have a profound impact on the pharmacokinetics of drugs, yet only few data are available for tuberculosis (TB) drugs. As malnutrition occurs frequently among TB patients, we assessed the effect of malnutrition on the steady-state pharmacokinetics of total and protein-unbound rifampin during the intensive phase of TB treatment. In a descriptive pharmacokinetic study in Bandung, Indonesia, patients received a fixed standard rifampin dose of 450 mg once daily during the intensive phase of TB treatment. A full pharmacokinetic curve for rifampin was recorded, and total and unbound concentrations of rifampin were analyzed in all samples. Rifampin pharmacokinetic parameters were compared between severely malnourished (BMI of effect on total and protein-unbound pharmacokinetic parameters of rifampin in Indonesian subjects. The large interindividual variability in the free fraction of rifampin suggests that protein-unbound rather than total rifampin concentrations should preferably be used to study exposure-response relationships.

  15. Mobile phone text messaging for promoting adherence to anti-tuberculosis treatment: a systematic review protocol

    Directory of Open Access Journals (Sweden)

    Nglazi Mweete D


    Full Text Available Abstract Background In 2010, there were approximately 8.8 million incident cases of tuberculosis (TB worldwide. The treatment of TB is at least six months long and may be complicated by a high pill burden. In addition, TB patients often do not take their medication on schedule simply because they forget. Mobile phone text messaging has the potential to help promote TB treatment adherence. We, therefore, propose to conduct a review of current best evidence for the use of mobile phone text messaging to promote patient adherence to TB treatment. Methods This is a systematic review of the literature. We will preferably include randomized controlled trials (RCTs. However, non-randomized studies (NRS will be considered if there is an inadequate number of RCTs. We will search PubMed, EMBASE, CINAHL, CENTRAL, Science Citation Index, Africa-Wide Information, and WHOLIS electronic databases for eligible studies available by 30 November 2012 regardless of language or publication status. We will also check reference lists for additional studies, identify abstracts from conference proceedings and communicate with authors for any relevant material. At least two authors will independently screen search outputs, select studies, extract data and assess the risk of bias (using separate criteria for RCTs and NRS; resolving discrepancies by discussion and consensus. We will assess clinical heterogeneity by examining the types of participants, interventions and outcomes in each study and pool studies judged to be clinically homogenous. We will also assess statistical heterogeneity using the chi-square test of homogeneity and quantify it using the I-square statistic. If study results are found to be statistically homogeneous (that is heterogeneity P > 0.1, we will pool them using the fixed-effect meta-analysis. Otherwise, we will use random-effects meta-analysis. We will calculate risk ratios and their corresponding 95% confidence intervals for dichotomous outcomes

  16. Influence of Rifampin Therapy on Serum Bactericidal Activity in the Presence of Cloxacillin and Vancomycin

    Directory of Open Access Journals (Sweden)

    Andrew MR Mackenzie


    Full Text Available In this study the effect of rifampin on serum inhibitory and serum bactericidal titres was examined. Sera were prepared from pooled human serum to contain vancomycin (10 mg/L, cloxacillin (5 mg/L or rifampin (1 mg/L, and the combinations cloxacillin/rifampin and vancomycin/rifampin. These five sera were tested by a microtitre method for serum inhibitory power and serum bactericidal titre against 11 strains of Staphylococcus aureus. A 48 h incubation period was required to detect full colony growth for subculture plates. It was found with all strains that the effect of the addition of rifampin to the other two antibiotics was to increase the serum inhibitory power, lower the serum bactericidal titre, increase the inhibitory/cidal ratio, and slow colony growth on subculture. In the clinical part of the study it was shown that only three of 38 sera (8% from patients receiving betalactam or vanomycin but not rifampin gave an inhibitory/cidal ratio greater than 8, but that nine of 10 sera (90% from patients receiving rifampin in addition to betalactam or vancomycin gave a ratio greater than 8 (P<0.001. The study verified that the effect of rifampin in serum was to increase inhibitory power and decrease bactericidal titre. The clinical significance of these results is not known and it is suggested that a high ratio of inhibitory to bactericidal titre in the presence of rifampin is to be expected, and that a low bactericidal titre under these circumstances is not necessarily an indication to modify therapy.

  17. Mycobacterium tuberculosis Is Selectively Killed by Rifampin and Rifapentine in Hypoxia at Neutral pH. (United States)

    Iacobino, Angelo; Piccaro, Giovanni; Giannoni, Federico; Mustazzolu, Alessandro; Fattorini, Lanfranco


    The activities of rifampin, rifapentine, bedaquiline, PA-824, clofazimine, nitazoxanide, isoniazid, amikacin, moxifloxacin, niclosamide, thioridazine, and pyrazinamide were tested against nonreplicating (dormant) Mycobacterium tuberculosis H37Rv under conditions of hypoxia at pHs 5.8 and 7.3, mimicking environments of cellular granulomas and caseous granulomas, respectively. At pH 5.8, several drugs killed dormant bacilli, with the best being rifampin and rifapentine. At pH 7.3, only rifampin and rifapentine efficiently killed dormant bacilli, while all other drugs showed little activity.

  18. Reagent Precoated Targets for Rapid In-Tissue Derivatization of the Anti-Tuberculosis Drug Isoniazid Followed by MALDI Imaging Mass Spectrometry (United States)

    Manier, M. Lisa; Reyzer, Michelle L.; Goh, Anne; Dartois, Veronique; Via, Laura E.; Barry, Clifton E.; Caprioli, Richard M.


    Isoniazid (INH) is an important component of front-line anti-tuberculosis therapy with good serum pharmacokinetics but unknown ability to penetrate tuberculous lesions. However, endogenous background interferences hinder our ability to directly analyze INH in tissues. Chemical derivatization has been successfully used to measure isoniazid directly from tissue samples using matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS). MALDI targets were pretreated with trans-cinnamaldehyde (CA) prior to mounting tissue slices. Isoniazid present in the tissues was efficiently derivatized and the INH-CA product measured by MS/MS. Precoating of MALDI targets allows the tissues to be directly thaw-mounted and derivatized, thus simplifying the preparation. A time-course series of tissues from tuberculosis infected/INH dosed animals were assayed and the MALDI MS/MS response correlates well with the amount of INH determined to be in the tissues by high-performance liquid chromatography (HPLC)-MS/MS.

  19. Evaluation of DNA microarray for detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis isolates

    Institute of Scientific and Technical Information of China (English)



    Objective To evaluate the performance of DNA microarray for rapid detection resistance to rifampin and isoniazid in Mycobacterium tuberculosis clinical isolates and identify suitable target sites for molecular genetic test. Methods Twenty-four clinical Mycobacterium

  20. Use of rifampin in persistent coagulase negative staphylococcal bacteremia in neonates

    Directory of Open Access Journals (Sweden)

    Walther Frans J


    Full Text Available Abstract Background Coagulase negative staphylococci (CoNS are the most common cause of neonatal sepsis in the Neonatal Intensive Care Unit (NICU. A minority of neonates does not respond to vancomycin therapy and develops persistent bacteremia, which may be treated with rifampin. We evaluated the use of rifampin in persistent CoNS bacteremia. Methods Retrospective study of 137 neonates with CoNS bacteremia during admission to a tertiary NICU between July 2006 and July 2009. Main outcome measures were total duration of bacteremia and the adequacy of vancomycin and rifampin therapy. Results 137/1696 (8.0% neonates developed a CoNS bacteremia. Eighteen were treated with rifampin because of persistent bacteremia (3 positive blood cultures at least 48 hours apart with clinical symptoms or (a serious suspicion of an intravascular thrombus. Duration of bacteremia prior to rifampin therapy (8.0 ± 3.6 days was positively correlated (p Conclusion Rifampin may be effective in the treatment of persistent CoNS infections in neonates. Outcome may be improved by adequate monitoring of vancomycin trough levels.

  1. Carbapenems and Rifampin Exhibit Synergy against Mycobacterium tuberculosis and Mycobacterium abscessus. (United States)

    Kaushik, Amit; Makkar, Nayani; Pandey, Pooja; Parrish, Nicole; Singh, Urvashi; Lamichhane, Gyanu


    An effective regimen for treatment of tuberculosis (TB) is comprised of multiple drugs that inhibit a range of essential cellular activities in Mycobacterium tuberculosis. The effectiveness of a regimen is further enhanced if constituent drugs act with synergy. Here, we report that faropenem (a penem) or biapenem, doripenem, or meropenem (carbapenems), which belong to the β-lactam class of antibiotics, and rifampin, one of the drugs that forms the backbone of TB treatment, act with synergy when combined. One of the reasons (carba)penems are seldom used for treatment of TB is the high dosage levels required, often at the therapeutic limits. The synergistic combination of rifampin and these (carba)penems indicates that (carba)penems can be administered at dosages that are therapeutically relevant. The combination of faropenem and rifampin also limits the frequency of resistant mutants, as we were unable to obtain spontaneous mutants in the presence of these two drugs. The combinations of rifampin and (carba)penems were effective not only against drug-sensitive Mycobacterium tuberculosis but also against drug-resistant clinical isolates that are otherwise resistant to rifampin. A combination of doripenem or biapenem and rifampin also exhibited synergistic activity against Mycobacterium abscessus. Although the MICs of these three drugs alone against M. abscessus are too high to be of clinical relevance, their concentrations in combinations are therapeutically relevant; therefore, they warrant further evaluation for clinical utility to treat Mycobacterium abscessus infection, especially in cystic fibrosis patients.

  2. Mixed Infections and Rifampin Heteroresistance among Mycobacterium tuberculosis Clinical Isolates. (United States)

    Zheng, Chao; Li, Song; Luo, Zhongyue; Pi, Rui; Sun, Honghu; He, Qingxia; Tang, Ke; Luo, Mei; Li, Yuqing; Couvin, David; Rastogi, Nalin; Sun, Qun


    Mixed infections and heteroresistance of Mycobacterium tuberculosis contribute to the difficulty of diagnosis, treatment, and control of tuberculosis. However, there is still no proper solution for these issues. This study aimed to investigate the potential relationship between mixed infections and heteroresistance and to determine the high-risk groups related to these factors. A total of 499 resistant and susceptible isolates were subjected to spoligotyping and 24-locus variable-number tandem repeat methods to analyze their genotypic lineages and the occurrence of mixed infections. Two hundred ninety-two randomly selected isolates were sequenced on their rpoB gene to examine mutations and heteroresistance. The results showed that 12 patients had mixed infections, and the corresponding isolates belonged to Manu2 (n = 8), Beijing (n = 2), T (n = 1), and unknown (n = 1) lineages. Manu2 was found to be significantly associated with mixed infections (odds ratio, 47.72; confidence interval, 9.68 to 235.23; P mutation in the rpoB gene were significantly associated with mixed infections (χ(2), 56.78; P mutation in the rpoB gene to become rifampin resistant. Further studies should focus on this lineage to clarify its relevance to mixed infections.

  3. Characterization of rifampin-resistant isolates of Mycobacterium tuberculosis from Sichuan in China. (United States)

    Tang, Ke; Sun, Honghu; Zhao, Yuding; Guo, Jianhua; Zhang, Congcong; Feng, Qin; He, Yongquan; Luo, Mei; Li, Yuqing; Sun, Qun


    Rifampin is a key component of standard short-course first-line therapy against Mycobacterium tuberculosis, and rifampin resistance of this pathogen has been reported to be related to rpoB gene mutations. The objective of this study was to characterize the rpoB gene mutations in rifampin-resistant M. tuberculosis isolates circulated in Sichuan. Sequencing of rpoB gene and spoligotyping were performed on 268 randomly selected isolates from January 2008 to May 2010. The results indicated that 207 (97.2%) rifampin-resistant isolates had mutations at 26 codons in the amplified region with 50 different genotypes, while 1 (1.8%) of 55 susceptible isolates had a nonsense mutation. The most common mutations were in codon 531 (55.9%), 526 (16.4%), 516 (10.3%) and 511 (8.9%). Among the 213 resistant isolates, 150 (70.4%) belonged to the Beijing family and mutation at codon 531 (TCG→TTG) was associated with Beijing genotype (χ(2), 9.8305; p, 0.0017). It is demonstrated that the frequency of 511 (CTG→CCG) mutations in Sichuan was higher than in other provinces of China, as well as other geographic regions worldwide. It is suggested that only a small portion (2.7%) of rifampin-resistant Beijing genotype isolates in Sichuan be spread by clonal expansion during the study period.

  4. Effect of coadministration of moxifloxacin and rifampin on Mycobacterium tuberculosis in a murine aerosol infection model. (United States)

    Balasubramanian, V; Solapure, S; Gaonkar, S; Mahesh Kumar, K N; Shandil, R K; Deshpande, Abhijeet; Kumar, Naveen; Vishwas, K G; Panduga, Vijender; Reddy, Jitendar; Ganguly, Samit; Louie, A; Drusano, G L


    Coadministration of moxifloxacin and rifampin was evaluated in a murine model of Mycobacterium tuberculosis pulmonary infection to determine whether the finding of antagonism documented in a hollow-fiber infection model could be recapitulated in vivo. Colony counts were followed in a no-treatment control group, groups administered moxifloxacin or rifampin monotherapy, and a group administered a combination of the two agents. Following 18 days of once-daily oral administration to mice infected with M. tuberculosis, there was a reduction in the plasma exposure to rifampin that decreased further when rifampin was coadministered with moxifloxacin. Pharmacodynamic analysis demonstrated a mild antagonistic interaction between moxifloxacin and rifampin with respect to cell kill in the mouse model for tuberculosis (TB). No emergence of resistance was noted over 28 days of therapy, even with monotherapy. This was true even though one of the agents in the combination (moxifloxacin) induces error-prone replication. The previously noted antagonism with respect to cell kill shown in the hollow-fiber infection model was recapitulated in the murine TB lung model, although to a lesser extent.

  5. First findings on the seroepidemiology of human paragonimosis at the anti-tuberculosis centre of Divo, Republic of Ivory Coast (West Africa

    Directory of Open Access Journals (Sweden)

    Aka N.A.


    Full Text Available An epidemiological study was carried out in 2004-2005 at the anti-tuberculosis centre of Divo (Ivory Coast to collect sera from patients who consulted for tuberculosis suspicion and to estimate the seroprevalence of human paragonimosis in the context of a systematic screening. No Paragonimus egg was found in the stools and/or sputa of the 167 persons investigated. In contrast, 41 sera were ascertained with antibodies against Paragonimus africanus using ELISA testing. As the optical density (OD values related to seropositive findings were found under 0.6 (the minimal OD to detect an active paragonimosis, the above antibody titres might originate from patients in chronic or in convalescent stages, or might result of cross reactions with trematodes. Concomitantly, dissection of local crabs (Callinectes marginatus demonstrated the presence of Paragonimus metacercariae in six out of 34 examined. The parasite burdens in crabs ranged from two to 35 cysts with a mean diameter of 302 μm. In Ivory Coast, the locality of Divo must be considered an at-risk zone in reason of the presence of anti-Paragonimus antibodies in several human sera and the presence of infected crabs at the local market.

  6. Adverse events in healthy individuals and MDR-TB contacts treated with anti-tuberculosis drugs potentially effective for preventing development of MDR-TB: a systematic review. (United States)

    Langendam, Miranda W; Tiemersma, Edine W; van der Werf, Marieke J; Sandgren, Andreas


    A recent systematic review concluded that there is insufficient evidence on the effectiveness to support or reject preventive therapy for treatment of contacts of patients with multidrug resistant tuberculosis (MDR-TB). Whether preventive therapy is favorable depends both on the effectiveness and the adverse events of the drugs used. We performed a systematic review to assess adverse events in healthy individuals and MDR-TB contacts treated with anti-tuberculosis drugs potentially effective for preventing development of MDR-TB. We searched MEDLINE, EMBASE, and other databases (August 2011). Record selection, data extraction, and study quality assessment were done in duplicate. The quality of evidence was assessed using the GRADE approach. Of 6,901 identified references, 20 studies were eligible. Among the 16 studies in healthy volunteers (a total of 87 persons on either levofloxacin, moxifloxacin, ofloxacin, or rifabutin, mostly for 1 week), serious adverse events and treatment discontinuation due to adverse events were rare (MDR-TB contacts, therapy was stopped for 58-100% of the included persons because of the occurrence of adverse events ranging from mild adverse events such as nausea and dizziness to serious events requiring treatment. The quality of the evidence was very low. Although the number of publications and quality of evidence are low, the available evidence suggests that shortly after starting treatment the occurrence of serious adverse events is rare. Mild adverse events occur more frequently and may be of importance because these may provoke treatment interruption.

  7. Development of a Nafion/MWCNT-SPCE-Based Portable Sensor for the Voltammetric Analysis of the Anti-Tuberculosis Drug Ethambutol

    Directory of Open Access Journals (Sweden)

    Rosa A. S. Couto


    Full Text Available Herein we describe the development, characterization and application of an electrochemical sensor based on the use of Nafion/MWCNT-modified screen-printed carbon electrodes (SPCEs for the voltammetric detection of the anti-tuberculosis (anti-TB drug ethambutol (ETB. The electrochemical behaviour of the drug at the surface of the developed Nafion/MWCNT-SPCEs was studied through cyclic voltammetry (CV and square wave voltammetry (SWV techniques. Electrochemical impedance spectroscopy (EIS and scanning electron microscopy (SEM were employed to characterize the modified surface of the electrodes. Results showed that, compared to both unmodified and MWCNTs-modified SPCEs, negatively charged Nafion/MWCNT-SPCEs remarkably enhanced the electrochemical sensitivity and selectivity for ETB due to the synergistic effect of the electrostatic interaction between cationic ETB molecules and negatively charged Nafion polymer and the inherent electrocatalytic properties of both MWCNTs and Nafion. Nafion/MWCNT-SPCEs provided excellent biocompatibility, good electrical conductivity, low electrochemical interferences and a high signal-to-noise ratio, providing excellent performance towards ETB quantification in microvolumes of human urine and human blood serum samples. The outcomes of this paper confirm that the Nafion/MWCNT-SPCE-based device could be a potential candidate for the development of a low-cost, yet reliable and efficient electrochemical portable sensor for the low-level detection of this antimycobacterial drug in biological samples.

  8. The comparison of the efficacy of different anti -tuberculosis schemes in the treatment of tuberculous meningitis%不同抗结核方案治疗结核性脑膜炎的疗效比较

    Institute of Scientific and Technical Information of China (English)

    王敬; 周杰


    目的:探讨改良抗结核方案治疗结核性脑膜炎的疗效与安全性。方法对60例结核性脑膜炎患者采用随机数字表法分为两组,每组30例,传统抗结核组采用异烟肼、利福平、吡嗪酰胺、链霉素等传统抗结核方案治疗,改良抗结核组采用含异烟肼、利福平、吡嗪酰胺、左氧氟沙星的抗结核方案进行12个月的治疗,通过临床表现和辅助检查、脑脊液动态变化、统计学方法等手段评价其疗效与安全性。结果改良抗结核组总有效率明显高于传统抗结核组(86.6%比63.3%,χ2=4.36,P <0.05);改良抗结核组治疗后脑脊液常规及生化指标明显优于传统抗结核组(均 P <0.05);两组不良反应发生率差异无统计学意义(26.6%比16.7%,χ2=0.88,P >0.05)。结论左氧氟沙星联合其他一线抗结核药,并结合激素、脱水、改善脑功能等综合措施治疗结核性脑膜炎是值得推荐的抗结核方案。%Objective To evaluate the clinical efficacy and safety of modified anti -tuberculosis scheme in the treatment of tuberculous meningitis.Methods 60 cases with tuberculous meningitis were randomly divided into two groups.We enrolled 30 patients in each group.The traditional anti -tuberculosis group used traditional anti -tuberculosis scheme with isoniazid,rifampicin,pyrazinamide,streptomycin,and the modified anti -tuberculosis group was given isoniazid,rifampicin,pyrazinamide,levofloxacin,the treatment course of tuberculous meningitis was 12 months.The efficacy and safety through clinical manifestations and laboratory examinations,the dynamic changes of cerebrospinal fluid were evaluated by statistical methods.Results The total effective rate of the modified anti -tuberculosis group was significantly higher than the traditional anti -tuberculosis group(86.6% vs.63.3%,χ2 =4.36,P 0.05).Conclusion Levofloxacin combined with other first -line anti

  9. In vitro activity of fosfomycin combined with rifampin, pefloxacin and imipenem against staphylococci: a study by the time-kill curve method. (United States)

    Quentin, C; Saivin, S; Lafferriere, C; Noury, P; Bebear, C


    The in vitro activity of fosfomycin alone and in combination with rifampin, pefloxacin and imipenem was studied by the time-kill method against staphylococci. Fosfomycin, pefloxacin and imipenem used at concentrations within the therapeutic range, exerted a bactericidal effect, whereas rifampin acted as a bacteriostatic drug. The combination of fosfomycin and rifampin was found to be antagonistic against rifampin-susceptible strains and indifferent for rifampin-resistant isolates. Fosfomycin combined with pefloxacin usually produced an indifferent effect. The interaction between fosfomycin and imipenem was mainly indifferent but synergism occurred with methicillin-resistant strains and antagonism was observed for one methicillin-susceptible isolate of Staphylococcus aureus.

  10. Effect of Itraconazole and Rifampin on the Pharmacokinetics of Olaparib in Patients With Advanced Solid Tumors

    DEFF Research Database (Denmark)

    Dirix, Luc; Swaisland, Helen; Verheul, Henk M W;


    ; in Study 8, a separate group of patients received olaparib alone and co-administered with rifampin. No interaction between itraconazole and olaparib was concluded if two-sided 90% CIs for the treatment ratios of AUC and/or AUC0-t and Cmax fell within the bioequivalence range of 0.80-1.25. An interaction...

  11. Population pharmacokinetics of rifampin in the treatment of Mycobacterium tuberculosis in Asian elephants. (United States)

    Egelund, E F; Isaza, R; Brock, A P; Alsultan, A; An, G; Peloquin, C A


    The objective of this study was to develop a population pharmacokinetic model for rifampin in elephants. Rifampin concentration data from three sources were pooled to provide a total of 233 oral concentrations from 37 Asian elephants. The population pharmacokinetic models were created using Monolix (version 4.2). Simulations were conducted using ModelRisk. We examined the influence of age, food, sex, and weight as model covariates. We further optimized the dosing of rifampin based upon simulations using the population pharmacokinetic model. Rifampin pharmacokinetics were best described by a one-compartment open model including first-order absorption with a lag time and first-order elimination. Body weight was a significant covariate for volume of distribution, and food intake was a significant covariate for lag time. The median Cmax of 6.07 μg/mL was below the target range of 8-24 μg/mL. Monte Carlo simulations predicted the highest treatable MIC of 0.25 μg/mL with the current initial dosing recommendation of 10 mg/kg, based upon a previously published target AUC0-24/MIC > 271 (fAUC > 41). Simulations from the population model indicate that the current dose of 10 mg/kg may be adequate for MICs up to 0.25 μg/mL. While the targeted AUC/MIC may be adequate for most MICs, the median Cmax for all elephants is below the human and elephant targeted ranges.

  12. Clinical Study of Drug-resistant Pulmonary Tuberculosis Treated by Combination of Anti-Tuberculosis Chemicals and Compound Astragalus Capsule(复方黄芪胶囊)

    Institute of Scientific and Technical Information of China (English)

    姜艳; 李新; 于志勇; 尹红义; 韩玉庆


    Objective: To observe and evaluate the therapeutic effect of anti-tuberculosis (anti-TB) chemicals and Compound Astragalus Capsule (CAC) in combinedly treating drug resistant pulmonary tuberculosis (DR-TB). Methods: Ninety-two patients with DR-TB were equally randomized into the treated group (treated with combination therapy) and the control group (treated with anti-TB chemicals alone). The therapeutic course for both groups was 18 months. Therapeutic effects between the two groups were compared at the end of the therapeutic course. Sputum bacterial negative rate, focal absorption effective rate, cavity closing rate, 10-day symptom improving rate, the incidence of adverse reaction and 2-year bacteriological recurrence rate between the two groups were compared. Results: In the treated group, the sputum bacterial negative conversion rate was 84. 8%, focal absorption effective rate 91.3 %, cavity closing rate 58. 7 % and 10-day symptom improving rate 54.4%, while in the control group, the corresponding rates were 65.2%,73.9 %, 37. 0% and 26.1%, respectively. Comparison between the groups showed significant difference in all the parameters ( P<0.05, P<0.05, P<0.05 and P<0.01 ). The incidence of adverse reaction and 2year bacteriological recurrence rate in the treated group were 23.9 % and 2.6 % respectively, while those in the control group 50.0% and 16.7%, which were higher than the former group with significant difference ( P<0.01 and P<0.05, respectively). Conclusion: The therapeutic effect of combined treatment with antiTB and CAC is superior to that of treatment with anti-TB chemicals alone, and the Chinese herbal medicine showed an adverse reaction alleviating effect, which provides a new therapy for DR-TB, and therefore, it is worth spreading in clinical practice.

  13. Polymeric emulsion and crosslink-mediated synthesis of super-stable nanoparticles as sustained-release anti-tuberculosis drug carriers. (United States)

    Choonara, Yahya E; Pillay, Viness; Ndesendo, Valence M K; du Toit, Lisa C; Kumar, Pradeep; Khan, Riaz A; Murphy, Caragh S; Jarvis, Debbie-Leigh


    This study focused on evaluating four emulsion-based processing strategies for polymeric nanoparticle synthesis to explicate the mechanisms of nanoparticle formation and the influence on achieving sustained-release of two anti-tuberculosis drugs, isoniazid and rifampicin. Poly(lactic-co-glycolic acid) (PLGA) nanoparticles were formulated with and without sorbitan mono-oleate as a stabilizer using emulsion-solvent-surfactant-evaporation (ESSE) and emulsion-solvent-evaporation (ESE) approaches. An alginate solution gelled by ionic crosslinking with calcium chloride was employed to prepare alginate hydrogel nanoparticles via reverse-emulsion-cationic-gelification (RECG) and reverse-emulsion-surfactant-cationic-gelification (RESCG) approaches. In vitro drug release analysis was performed. The size, zeta potential and morphology of the nanoparticles were analyzed. Molecular mechanics energy relationships (MMER) were employed to explore the spatial disposition of alginate and PLGA with respect to the emulsifying profile of sorbitan monooleate and to corroborate the experimental findings. Results revealed that particle size of the PLGA nanoparticles was influenced by the stabilizer concentration. Nanoparticles synthesized by the ESSE approach had smaller sizes of 240±8.7 nm and 195.5±5.4 nm for rifampicin- and isoniazid-loaded nanoparticles, respectively. This was a substantial size reduction from nanoparticles generated by the ESE approach (>1000 nm). The RESCG approach produced stable and higher nanoparticle yields with desirable size (277±1.0 nm; 289±1.2 nm), a low polydispersity index (27.1±0.3 mV; 28.5±0.5 mV) and drug entrapment efficiency of 73% and 75% for isoniazid and rifampicin, respectively. Drug release from the ESSE and RESCG synthesized nanoparticles displayed desirable release of the two anti-TB drugs with sustained zero-order kinetics over a period of 8h. MMER supported the mechanisms of nanoparticle formation with a sphericalized interlaced network

  14. Pharmacokinetic interaction between rifampin and the combination of indinavir and low-dose ritonavir in HIV-infected patients

    DEFF Research Database (Denmark)

    Justesen, U S; Andersen, A B; Klitgaard, N A;


    of indinavir (800 mg) and ritonavir (100 mg) twice a day was performed to evaluate whether the inducing effect of rifampin on the drug-metabolizing enzyme cytochrome P450 (CYP) 3A4 could be overcome by the inhibitory effect of ritonavir. Pharmacokinetic evaluations of steady-state concentrations of indinavir......Rifampin is an important drug in the treatment of tuberculosis, but administration of rifampin in combination with protease inhibitors is complicated because of drug-drug interactions. A prospective, controlled, multiple-dose study involving 6 HIV-infected patients receiving a combination...

  15. Successful treatment with rifampin for fulminant antibiotics-associated colitis in a patient with non-Hodgkin's lymphoma

    Institute of Scientific and Technical Information of China (English)

    Kenichi Nomura; Masafumi Taniwaki; Yosuke Matsumoto; Naohisa Yoshida; Sawako Taji; Naoki Wakabayashi; Shoji Mitsufuji; Shigeo Horiike; Masuji Morita; Takeshi Okanoue


    A 74-year-old man was admitted to the hospital because of chemotherapy for relapsed non-Hodgkin's lymphoma (NHL).The patient became febrile and experienced diarrhea after chemotherapy. Although ceftazidime and amikacin sulfate were administered as empiric therapy, diarrhea was continued.After several days, stool cytotoxin assay for clostridium difficile (C. difficile) was positive and he was diagnosed as having antibiotics-associated colitis (AAC). Although antibiotics were discontinued and both oral vancomycin and metronidazole were administrated, disease was not improved. To rule out the presence of an additional cause of diarrhea, colon fiberoscopic examination was performed. It revealed multiple deep ulcerative lesions at right side colon, surface erosive and minute erosive lesions in all continuous colon.Pseudomembranes were not seen. These findings are compatible with AAC without pseudomembranes. There are no reports that the rifampin is effective on refractory AAC.However, we administered oral rifampin for the current patient.The reasons are 1) conventional antibiotics were not effective,2) rifampin has excellent in vitro activity against C difficile,and 3) the efficacy of rifampin on relapsing colitis due to C.difficile is established. After administration of rifampin, fever alleviated and diarrhea was improved. Because AAC may result in significant mortality, patients with refractory or fulminant AAC should be treated with oral rifampin from outset.

  16. Radiometric macrophage culture assay for rapid evaluation of antileprosy activity of rifampin

    Energy Technology Data Exchange (ETDEWEB)

    Mittal, A.; Seshadri, P.S.; Prasad, H.K.; Sathish, M.; Nath, I.


    The antileprosy effect of rifampin was evaluated by a newly developed rapid in vitro assay wherein 31 human-derived strains and 1 armadillo-derived strain of Mycobacterium leprae were maintained for 2 and 3 weeks, respectively, in murine and human macrophages in the presence of (3H)thymidine. Of these strains, 27 showed significant incorporation of the radiolabel in cultures of live bacilli as compared with control cultures of heat-killed bacilli of the same strain. Consistent and significant inhibition of (3H)thymidine uptake was observed in M. leprae resident cultures with 3 to 200 ng of rifampin per ml as compared with similar cultures without the drug. In general, an increase in percent inhibition was seen from 3 to 20 ng/ml, with marginal increases at 40, 50, and 100 ng/ml. M. leprae strains appear to be remarkably susceptible to this drug in the in vitro assay.

  17. Clinical Impact on Tuberculosis Treatment Outcomes of Discordance Between Molecular and Growth-Based Assays for Rifampin Resistance, California 2003-2013. (United States)

    Shah, Neha S; Grace Lin, S Y; Barry, Pennan M; Cheng, Yi-Ning; Schecter, Gisela; Desmond, Ed


    Background.  Data from international settings suggest that isolates of Mycobacterium tuberculosis with rpoB mutations testing phenotypically susceptible to rifampin (RIF) may have clinical significance. We analyzed treatment outcomes of California patients with discordant molecular-phenotypic RIF results. Methods.  We included tuberculosis (TB) patients, during 2003-2013, whose specimens tested RIF susceptible phenotypically but had a rpoB mutation determined by pyrosequencing. Demographic data were abstracted from the California TB registry. Phenotypic drug-susceptibility testing, medical history, treatment, and outcomes were abstracted from medical records. Results.  Of 3330 isolates tested, 413 specimens had a rpoB mutation (12.4%). Of these, 16 (3.9%) had molecular-phenotypic discordant RIF results. Seven mutations were identified: 511Pro, 516Phe, 526Asn, 526Ser (AGC and TCC), 526Cys, and 533Pro. Fourteen (88%) had isoniazid (INH) resistance, 6 of whom were also phenotypically resistant to ethambutol (EMB) and/or pyrazinamide (PZA). Five patients (25%), 1 with 511Pro and 4 with 526Asn, relapsed or failed treatment. The initial regimen for 3 patients was RIF, PZA, and EMB; 1 patient received RIF, PZA, EMB, and a fluoroquinolone (FQN); and 1 patient received RIF, EMB, FQN, and some second-line medications. Upon retreatment with an expanded regimen, 3 (75%) patients completed treatment, 1 patient moved before treatment completion, and 1 patient continues on treatment. The remaining 11 patients had a successful outcome with 9 having received a FQN and/or a rifamycin. Conclusions.  Rifampin molecular-phenotypic discordance was rare, and most isolates had INH resistance. Patients who did not receive an expanded regimen had poor outcomes. These mutations may have clinical importance, and expanded treatment regimens should be considered.

  18. Detection of Rifampin Resistance in Mycobacterium tuberculosis by Double Gradient-Denaturing Gradient Gel Electrophoresis (United States)

    Scarpellini, Paolo; Braglia, Sergio; Carrera, Paola; Cedri, Maura; Cichero, Paola; Colombo, Alessia; Crucianelli, Rosella; Gori, Andrea; Ferrari, Maurizio; Lazzarin, Adriano


    We applied double gradient-denaturing gradient gel electrophoresis (DG-DGGE) for the rapid detection of rifampin (RMP) resistance from rpoB PCR products of Mycobacterium tuberculosis isolates and clinical samples. The results of this method were fully concordant with those of DNA sequencing and susceptibility testing analyses. DG-DGGE is a valid alternative to the other methods of detecting mutations for predicting RMP resistance. PMID:10508043

  19. Interaction of CarD with RNA polymerase mediates Mycobacterium tuberculosis viability, rifampin resistance, and pathogenesis. (United States)

    Weiss, Leslie A; Harrison, Phillip G; Nickels, Bryce E; Glickman, Michael S; Campbell, Elizabeth A; Darst, Seth A; Stallings, Christina L


    Mycobacterium tuberculosis infection continues to cause substantial human suffering. New chemotherapeutic strategies, which require insight into the pathways essential for M. tuberculosis pathogenesis, are imperative. We previously reported that depletion of the CarD protein in mycobacteria compromises viability, resistance to oxidative stress and fluoroquinolones, and pathogenesis. CarD associates with the RNA polymerase (RNAP), but it has been unknown which of the diverse functions of CarD are mediated through the RNAP; this question must be answered to understand the CarD mechanism of action. Herein, we describe the interaction between the M. tuberculosis CarD and the RNAP β subunit and identify point mutations that weaken this interaction. The characterization of mycobacterial strains with attenuated CarD/RNAP β interactions demonstrates that the CarD/RNAP β association is required for viability and resistance to oxidative stress but not for fluoroquinolone resistance. Weakening the CarD/RNAP β interaction also increases the sensitivity of mycobacteria to rifampin and streptomycin. Surprisingly, depletion of the CarD protein did not affect sensitivity to rifampin. These findings define the CarD/RNAP interaction as a new target for chemotherapeutic intervention that could also improve the efficacy of rifampin treatment of tuberculosis. In addition, our data demonstrate that weakening the CarD/RNAP β interaction does not completely phenocopy the depletion of CarD and support the existence of functions for CarD independent of direct RNAP binding.

  20. Pharmacokinetics-pharmacodynamics of rifampin in an aerosol infection model of tuberculosis. (United States)

    Jayaram, Ramesh; Gaonkar, Sheshagiri; Kaur, Parvinder; Suresh, B L; Mahesh, B N; Jayashree, R; Nandi, Vrinda; Bharat, Sowmya; Shandil, R K; Kantharaj, E; Balasubramanian, V


    Limited information exists on the pharmacokinetic (PK)-pharmacodynamic (PD) relationships of drugs against Mycobacterium tuberculosis. Our aim was to identify the PK-PD parameter that best describes the efficacy of rifampin on the basis of in vitro and PK properties. Consistent with 83.8% protein binding by equilibrium dialysis, the rifampin MIC for M. tuberculosis strain H37Rv rose from 0.1 in a serum-free system to 1.0 mg/ml when it was tested in the presence of 50% serum. In time-kill studies, rifampin exhibited area under the concentration-time curve (AUC)-dependent killing in vitro, with maximal killing seen on all days and with the potency increasing steadily over a 9-day exposure period. MIC and time-kill studies performed with intracellular organisms in a macrophage monolayer model yielded similar results. By use of a murine aerosol infection model with dose ranging and dose fractionation over 6 days, the PD parameter that best correlated with a reduction in bacterial counts was found to be AUC/MIC (r(2) = 0.95), whereas the maximum concentration in serum/MIC (r(2) = 0.86) and the time that the concentration remained above the MIC (r(2) = 0.44) showed lesser degrees of correlation.

  1. Detection of Mycobacterium tuberculosis resistance mutations to rifampin and isoniazid by real-time PCR

    Directory of Open Access Journals (Sweden)

    Hristea A


    Full Text Available Objective: The objective of our study was to evaluate the use of a real-time polymerase chain reaction (PCR-based technique for the prediction of phenotypic resistance of Mycobacterium tuberculosis. Materials and Methods: We tested 67 M tuberculosis strains (26 drug resistant and 41 drug susceptible using a method recommended for the LightCycler platform. The susceptibility testing was performed by the absolute concentration method. For rifampin resistance, two regions of the rpoB gene were targeted, while for identification of isoniazid resistance, we searched for mutations in katG and inhA genes. Results: The sensitivity and specificity of this method for rapid detection of mutations for isoniazid resistance were 96% (95% CI: 88% to 100% and 95% (95% CI: 89% to 100%, respectively. For detection of rifampin resistance, the sensitivity and specificity were 92% (95% CI: 81% to 100% and 74% (95% CI: 61% to 87%, respectively. The main isoniazid resistance mechanism identified in our isolates is related to changes in the katG gene that encodes catalase. We found that for rifampin resistance the concordance between the predicted and observed phenotype was less than satisfactory. Conclusions: Using this method, the best accuracy for genotyping compared with phenotypic resistance testing was obtained for detecting isoniazid resistance mutations. Although real-time PCR assay may be a valuable diagnostic tool, it is not yet completely satisfactory for detection of drug resistance mutations in M tuberculosis.

  2. Putative compensatory mutations in the rpoC gene of rifampin-resistant Mycobacterium tuberculosis are associated with ongoing transmission. (United States)

    de Vos, M; Müller, B; Borrell, S; Black, P A; van Helden, P D; Warren, R M; Gagneux, S; Victor, T C


    Rifampin resistance in clinical isolates of Mycobacterium tuberculosis arises primarily through the selection of bacterial variants harboring mutations in the 81-bp rifampin resistance-determining region of the rpoB gene. While these mutations were shown to infer a fitness cost in the absence of antibiotic pressure, compensatory mutations in rpoA and rpoC were identified which restore the fitness of rifampin-resistant bacteria carrying mutations in rpoB. To investigate the epidemiological relevance of these compensatory mutations, we analyzed 286 drug-resistant and 54 drug-susceptible clinical M. tuberculosis isolates from the Western Cape, South Africa, a high-incidence setting of multidrug-resistant tuberculosis. Sequencing of a portion of the RpoA-RpoC interaction region of the rpoC gene revealed that 23.5% of all rifampin-resistant isolates tested carried a nonsynonymous mutation in this region. These putative compensatory mutations in rpoC were associated with transmission, as 30.8% of all rifampin-resistant isolates with an IS6110 restriction fragment length polymorphism (RFLP) pattern belonging to a recognized RFLP cluster harbored putative rpoC mutations. Such mutations were present in only 9.4% of rifampin-resistant isolates with unique RFLP patterns (P mutations were associated with specific strain genotypes and the rpoB S531L rifampin resistance mutation. Among isolates harboring this rpoB mutation, 44.1% also harbored rpoC mutations, while only 4.1% of the isolates with other rpoB mutations exhibited mutations in rpoC (P mutations in the transmission of multidrug-resistant tuberculosis and illustrates how epistatic interactions between drug resistance-conferring mutations, compensatory mutations, and different strain genetic backgrounds might influence compensatory evolution in drug-resistant M. tuberculosis.

  3. [In vitro activity of linezolid, moxifloxacin, levofloxacin, clindamycin and rifampin, alone and in combination, against Staphylococcus aureus and Staphylococcus epidermidis]. (United States)

    Soriano, A; Jurado, A; Marco, F; Almela, M; Ortega, M; Mensa, J


    Information about the in vitro effect of combinations of anti-staphylococcal agents on staphylococci is scarce. The aim of the study was to evaluate the in vitro activity of linezolid, moxifloxacin, levofloxacin, clindamycin and rifampin, alone or in combination, against Staphylococcus spp. Two Staphylococcus aureus and two Staphylococcus epidermidis strains isolated from blood cultures were studied using the killing curve method. The combinations analyzed were linezolid+moxifloxacin, linezolid+levofloxacin, linezolid+clindamycin, linezolid+rifampin, moxifloxacin+rifampin, moxifloxacin+clindamycin, levofloxacin+rifampin and levofloxacin+clindamycin. The following concentrations (mg/l) were used: 8 and 16 for linezolid, 2 for moxifloxacin, 3 for levofloxacin, 2 for clindamycin and 2 and 5 for rifampin. The activity was considered synergistic when a reduction in growth of at least 2 log(10) was produced with the combination in comparison to the most active antibiotic alone; antagonistic when a growth of at least 2 log(10) was produced with the combination in comparison to the most active antibiotic alone; and indifferent if the variation was less than 1 log(10). Linezolid and clindamycin were bacteriostatic, while moxifloxacin and levofloxacin were bactericidal. Rifampin was bacteriostatic against S. aureus and bactericidal against S. epidermidis. Linezolid and clindamycin reduced the bactericidal activity of levofloxacin and moxifloxacin, however an antagonistic effect was only observed against S. aureus. Other combinations of linezolid, rifampin, clindamycin, levofloxacin or moxifloxacin were indifferent. Linezolid and clindamycin antagonize the bactericidal activity of fluorquinolones against staphylococci. There was no difference between any other combinations against either S. aureus or S. epidermidis.

  4. 抗痨颗粒对耐多药结核分枝杆菌蛋白质组学的影响%Effect of Anti-tuberculosis Particles on Proteomics of Drug-resistant Mycobacterium Tuberculosis

    Institute of Scientific and Technical Information of China (English)

    李建国; 刘湘花; 汤红琴; 董修兵; 李宁宁


    目的:应用蛋白质组学的双向电泳技术,比较分析抗痨颗粒提取物作用前后耐多药结核分枝杆菌的全菌蛋白表达差异,揭示药物作用机制.方法:临床耐多药结核分枝杆菌接种在7H9添加OADC液体培养基中37℃培养6~8d,细菌密度为1×108/mL~2 × 108/mL.抗痨颗粒浸提物的最低抑菌浓度(MIC)为0.638 8 g·L-1.加到液体培养基中,作用20 h,终浓度为相当于生药0.255 6 g·mL-1.局部内环境与外部环境完全隔离下,采用双向凝胶电泳分离全菌总蛋白,得到差异表达的蛋白质点进行分析比对.结果:耐多药结核分枝杆菌用药前后,发现了8个差异斑点,确定其中2个蛋白质为:硫代硫酸硫转移酶( thiosulfate sulfurtransferase)和假定蛋白Rv0634A.结论:揭示了抗痨颗粒对耐多药结核分枝杆菌的翻译,结构组成,氨基酸代谢,氰化物和H2S的解毒以及硫和铁转移等各方面均有一定影响,从而破坏结核分枝杆菌的生活能力,从而达到抑制结核分枝杆菌的目的.%Objective; To reveal the mechanism of drug action to compare and analyze of the effect of anti-tuberculosis particles extract on multi-drug resistant-mycobacterium tuberculosis proteomics to reveal the mechanism of drug action. Method; The clinical mycobacterium tuberculosis with multidrug resistance was added in Middlebrook 7H9 OADC liquid medium at 37 ℃ for 6-8 d, when the bacterial density researched 1 × l08/mL-2 × l08/mL, the minimum inhibitory concentration ( MIC) of anti-tuberculosis particulate extracts was 0. 638 8 g · L-1 , the final concentration was equivalent to 0. 255 6 g · mL . Local environment and external environment was completely isolated, two-dimensional gel electrophoresis separation of whole cell total protein was used to analyze differentially expressed protein spots. Result; Before and after treatment by anti-tuberculosis particles extract, multidrug-resistant mycobacterium tuberculosis showed eight

  5. Disparity between timed-kill and checkerboard methods for determination of in vitro bactericidal interactions of vancomycin plus rifampin versus methicillin-susceptible and -resistant Staphylococcus aureus. (United States)

    Bayer, A S; Morrison, J O


    The role of rifampin as an adjunctive agent to vancomycin in the therapy of serious systemic staphylococcal infections remains controversial. Several in vitro studies utilizing differing methodologies to define the bactericidal interactions of vancomycin plus rifampin versus Staphylococcus aureus have yielded markedly disparate results. The in vitro bactericidal synergistic activities of vancomycin plus rifampin were examined versus 48 clinical isolates of S. aureus, both methicillin susceptible and resistant. Each strain was tested simultaneously in timed-kill curve and checkerboard systems. By timed-kill curve, vancomycin plus rifampin usually had either an indifferent (67%) or synergistic (19 to 29%) effect, with a frequency dependent on sampling times; bactericidal antagonism was infrequently noted after 48 h of incubation (4%). Indifference was seen as a prevention of rifampin resistance by vancomycin. Synergy was more commonly noted at 48 than at 24 h of incubation. The bactericidal interaction results were similar for both methicillin-susceptible and -resistant strains. In contrast to the killing curve data, the checkerboard technique uniformly demonstrated bactericidal antagonism of vancomycin plus rifampin against all 48 staphylococci. We conclude that the nature of the in vitro bactericidal interactions of vancomycin plus rifampin against S. aureus is difficult to establish in vitro. This fact relates to the markedly disparate findings, which depended on both the synergy technique utilized and the test system conditions employed. In vivo studies are required to delineate the bactericidal interaction potentials of vancomycin plus rifampin versus S. aureus.

  6. Molecular Identification of Mycobacterium tuberculosis and Analysis of Its Resistance to Rifampin in Sputa From Tuberculosis Suspected Patients

    Directory of Open Access Journals (Sweden)

    M. Syaifudin


    Full Text Available An accurate identification of different species of Mycobacterium provides to allow appropriate treatment for Mycobacterium tuberculosis infection. Beside that, drug resistance of M. tuberculosis strains to rifampin is not clearly understood in contributing to the spread of tuberculosis in Indonesia. To assess the molecular mechanism of rifampin resistance, a number of clinical specimens of M. tuberculosis were analyzed their molecular nature of a part of the rpoB gene using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP methods. DNA’s extracted from sputum samples were amplified and 32P-labeled by PCR with the specific primers and the product was analyzed their mutation conferring resistance by MDE gel electrophoresis. Of the 70 specimens tested, 57 specimens were positive for M. tuberculosis organism only, three specimens contained a mixture of M. tuberculosis and non tuberculosis mycobacteria (NTM, and 10 specimens were negative approved by Duplex PCR. Of these sixty DNA positive samples (thus the sensitivity of PCR was 85.71%, 5 (8.3% of them suspected to contain mutations in rpoB which were associated with rifampin resistance. Even though the frequency of mutation was low, the results from our study clearly indicate that the molecular mechanism of rifampin resistance in M. tuberculosis isolates from Indonesia involves alterations in the rpoB gene. Molecular diagnosis by PCR which is fast and easy to perform is useful for early and rapid detection of TB in sputum specimen.

  7. Comparative study of the effects of pyridoxine, rifampin, and renal function on hematological adverse events induced by linezolid. (United States)

    Soriano, Alex; Ortega, Mar; García, Sebastián; Peñarroja, Georgina; Bové, Albert; Marcos, Miguel; Martínez, Juan C; Martínez, José A; Mensa, Josep


    Hematological disturbances that develop during linezolid treatment are a major concern when linezolid is administered for prolonged periods of time. The aim of this study was to evaluate the influences of pyridoxine, rifampin, and renal function on hematological adverse events. From January 2002 to April 2006, 52 patients received a long-term course of linezolid. Blood cell counts were monitored weekly. Thrombocytopenia was defined as a decrease to or =2 g/liter from the baseline value. Twenty-four patients received linezolid alone, and 28 patients received linezolid plus 200 mg of pyridoxine. The Kaplan-Meier survival method, followed by the log-rank test, was used to estimate the cumulative probability of adverse events, and Cox regression analysis was performed to evaluate the independent predictors of toxicity. The baseline characteristics of the patients in both groups were similar. The cumulative probability of thrombocytopenia and anemia in patients who received pyridoxine was not different from that in patients who did not receive it. Hematological adverse events were less frequent in patients taking rifampin and were more frequent in patients with renal failure. However; the Cox regression analysis showed that rifampin was the only independent predictor associated with a lower risk of thrombocytopenia (hazard ratio, 0.37; 95% confidence interval, 0.14 to 0.98; P = 0.045). In conclusion, pyridoxine did not prevent linezolid-related hematological adverse events, and the coadministration of rifampin was associated with a lower risk of thrombocytopenia.

  8. Crystallization of toxic glycol solvates of rifampin from glycerin and propylene glycol contaminated with ethylene glycol or diethylene glycol. (United States)

    de Villiers, Melgardt M; Caira, Mino R; Li, Jinjing; Strydom, Schalk J; Bourne, Susan A; Liebenberg, Wilna


    This study was initiated when it was suspected that syringe blockage experienced upon administration of a compounded rifampin suspension was caused by the recrystallization of toxic glycol solvates of the drug. Single crystal X-ray structure analysis, powder X-ray diffraction, thermal analysis and gas chromatography were used to identify the ethylene glycol in the solvate crystals recovered from the suspension. Controlled crystallization and solubility studies were used to determine the ease with which toxic glycol solvates crystallized from glycerin and propylene glycol contaminated with either ethylene or diethylene glycol. The single crystal structures of two distinct ethylene glycol solvates of rifampin were solved while thermal analysis, GC analysis and solubility studies confirmed that diethylene glycol solvates of the drug also crystallized. Controlled crystallization studies showed that crystallization of the rifampin solvates from glycerin and propylene glycol depended on the level of contamination and changes in the solubility of the drug in the contaminated solvents. Although the exact source of the ethylene glycol found in the compounded rifampin suspension is not known, the results of this study show how important it is to ensure that the drug and excipients comply with pharmacopeial or FDA standards.

  9. Molecular detection of rifampin and isoniazid resistance to guide chronic TB patient management in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Pinsi Gabriele


    Full Text Available Abstract Background Drug-resistant tuberculosis (DR-TB is considered a real threat to the achievement of TB control. Testing of mycobacterial culture and testing of drug susceptibility (DST capacity are limited in resource-poor countries, therefore inadequate treatment may occur, favouring resistance development. We evaluated the molecular assay GenoType® MTBDRplus (Hain Lifescience, Germany in order to detect DR-TB directly in clinical specimens as a means of providing a more accurate management of chronic TB patients in Burkina Faso, a country with a high TB-HIV co-infection prevalence. Methods Samples were collected in Burkina Faso where culture and DST are not currently available, and where chronic cases are therefore classified and treated based on clinical evaluation and sputum-smear microscopy results. One hundred and eight chronic TB patients (sputum smear-positive, after completing a re-treatment regimen for pulmonary TB under directly observed therapy were enrolled in the study from December 2006 to October 2008. Two early morning sputum samples were collected from each patient, immediately frozen, and shipped to Italy in dry ice. Samples were decontaminated, processed for smear microscopy and DNA extraction. Culture was attempted on MGIT960 (Becton Dickinson, Cockeysville, USA and decontaminated specimens were analyzed for the presence of mutations conferring resistance to rifampin and isoniazid by the molecular assay GenoType® MTBDRplus. Results We obtained a valid molecular test result in 60/61 smear-positive and 47/47 smear-negative patients. Among 108 chronic TB cases we identified patients who (i harboured rifampin- and isoniazid-susceptible strains (n 24, (ii were negative for MTB complex DNA (n 24, and (iii had non-tuberculous mycobacteria infections (n 13. The most represented mutation conferring rifampin-resistance was the D516V substitution in the hotspot region of the rpoB gene (43.8% of cases. Other mutations recognized

  10. Polymyxin B in Combination with Rifampin and Meropenem against Polymyxin B-Resistant KPC-Producing Klebsiella pneumoniae. (United States)

    Diep, John K; Jacobs, David M; Sharma, Rajnikant; Covelli, Jenna; Bowers, Dana R; Russo, Thomas A; Rao, Gauri G


    Safe and effective therapies are urgently needed to treat polymyxin-resistant KPC-producing Klebsiella pneumoniae infections and suppress the emergence of resistance. We investigated the pharmacodynamics of polymyxin B, rifampin, and meropenem alone and as polymyxin B-based double and triple combinations against KPC-producing K. pneumoniae isolates. The rates and extents of killing with polymyxin B (1 to 128 mg/liter), rifampin (2 to 16 mg/liter), and meropenem (10 to 120 mg/liter) were evaluated against polymyxin B-susceptible (PB(s)) and polymyxin B-resistant (PB(r)) clinical isolates using 48-h static time-kill studies. Additionally, humanized triple-drug regimens of polymyxin B (concentration at steady state [Css] values of 0.5, 1, and 2 mg/liter), 600 mg rifampin every 12 or 8 h, and 1 or 2 g meropenem every 8 h dosed as an extended 3-h infusion were simulated over 48 h by using a one-compartment in vitro dynamic infection model. Serial bacterial counts were performed to quantify the pharmacodynamic effect. Population analysis profiles (PAPs) were used to assess the emergence of polymyxin B resistance. Monotherapy was ineffective against both isolates. Polymyxin B with rifampin demonstrated early bactericidal activity against the PB(s) isolate, followed by regrowth by 48 h. Bactericidal activity was sustained at all polymyxin B concentrations of ≥2 mg/liter in combination with meropenem. No two-drug combinations were effective against the PB(r) isolate, but all simulated triple-drug regimens showed early bactericidal activity against both strains by 8 h that was sustained over 48 h. PAPs did not reveal the emergence of resistant subpopulations. The triple-drug combination of polymyxin B, rifampin, and meropenem may be a viable consideration for the treatment of PB(r) KPC-producing K. pneumoniae infections. Further investigation is warranted to optimize triple-combination therapy.

  11. Thymopentin Combined with Anti -tuberculosis Drugs Therapy and Different Risk Factors for Recur-rence of Pulmonary Tuberculosis Parient%胸腺五肽联合化疗与肺结核复发的危险因素

    Institute of Scientific and Technical Information of China (English)

    李奎; 江自成; 杨才勇; 刘胜昔; 方坚


    Objective To investigate thymopentin combined with anti -tuberculosis drugs therapy and the risk factors for recurrence of pulmo-nary tuberculosis parient.Methods A total of 428 patients receiving anti -tuberculosis therapy in our hospital from January 2004 to December 2011 were enrol ed in this study to review the clinical characteristics,radiology features and treatment,ten parameters contributing to the recurrence were ana-lyzed.Results Nineteen patients (4.43%)had recurrence.Of the 19 patients,12 patients had early recurrence and 7 patients had the late one.High bacterial loads and cavitations disease were risk factors for early recurrence while higher age and diabetes mel itus were risk factor for the late recur-rence.Conclusions The identification of significant risk factors for recurrence may enable bet er selection of treatment options.%目的:探讨胸腺五肽联合抗结核治疗与肺结核复发的相关性及危险因素。方法分析2004年1月至2011年12月收治的428例经细菌学证实为肺结核的病例,经随访2年以上,选择10项临床、放射及治疗等指标分析对早/晚复发的影响。结果全组有19例复发,复发率为4.43%,早期复发(小于等于1年)12例,晚期复发(大于1年)7例。胸肽腺联合标准一线抗结核药物的早期复发率为1.77%,晚期复发率为1.18%。高细菌学含量和空洞是早期复发的危险因素,而年龄和糖尿病则是晚期复发的危险因素。结论辨别肺结核复发的危险因素对于选择治疗方案有积极的意义。

  12. Treatments and Effects of Congenital Tuberculosis by Early Venous Anti-tuberculosis%早期静脉抗结核治疗先天性结核病的方法与效果

    Institute of Scientific and Technical Information of China (English)

    庄晓玲; 杨尧


    Objective To explore the clinical characteristics of congenital tuberculosis and the value of early venous an-ti-tuberculosis treatment,as well as to deepen the understanding of the disease and improve the treatment efficiency. Methods By giving the 9 patients in our hospital,who were suffering from congenital tuberculosis early venous anti-tuberculosis treatment. Re-sults In these 9 cases,5 were cured,and the follow-up survey suggested that they were of good growth and development. Unfortu-nately,there were 3 patients who gave up treatment and died not long. Another 1 patient did not receive regular treatment and died 20 days later because of tuberculosis meningitis. Conclusion Congenital tuberculosis lacks of specific clinical manifestations,it should be combined with the chest imaging and the etiology examination results of various kinds of body fluids to reach a clear diag-nosis. Early venous anti-tuberculosis treatment can effectively treat this disease,as well as reducing the side effects of taking an-ti-tuberculosis drugs.%目的 探讨先天性结核的临床特点及早期静脉抗结核治疗的价值,加深对本病的认识. 方法 对我院收治的9例先天性结核的患儿给予早期静脉抗结核治疗. 结果 9例患儿中治愈5例,随访生长发育良好. 3例未坚持治疗,不久死亡.1例未正规治疗,20d合并结核性脑膜炎死亡. 结论 先天性结核缺乏特异性临床表现,需结合胸部影像学,各种体液的病原学检查明确诊断. 早期静脉抗结核治疗可有效治疗该病,同时减少口服抗结核药的副反应.

  13. Protective properties of rifampin-resistant rough mutants of Brucella melitensis. (United States)

    Adone, R; Ciuchini, F; Marianelli, C; Tarantino, M; Pistoia, C; Marcon, G; Petrucci, P; Francia, M; Riccardi, G; Pasquali, P


    Vaccination against Brucella infections in animals is usually performed by administration of live attenuated smooth B. abortus strain S19 and B. melitensis strain Rev1. They are proven effective vaccines against B. abortus in cattle and against B. melitensis and B. ovis in sheep and goats, respectively. However, both vaccines have the main drawback of inducing O-polysaccharide-specific antibodies that interfere with serologic diagnosis of disease. In addition, they retain residual virulence, being a cause of abortion in pregnant animals and infection in humans. To overcome these problems, one approach is to develop defined rough mutant Brucella strains lacking O antigen of lipopolysaccharide. B. abortus rough strain RB51, a rifampin-resistant mutant of virulent strain B. abortus 2308, is used as a vaccine against B. abortus infection in cattle in some countries. However, RB51 is not effective in sheep, and there is only preliminary evidence that it is effective in goats. In this study, we tested the efficacies of six rifampin-resistant rough strains of B. melitensis in protecting BALB/c mice exposed to B. melitensis infection. The protective properties, as well as both humoral and cellular immune responses, were assessed in comparison with those provided by B. melitensis Rev1 and B. abortus RB51 vaccines. The results indicated that these rough mutants were able to induce a very good level of protection against B. melitensis infection, similar to that provided by Rev1 and superior to that of RB51, without inducing antibodies to O antigen. In addition, all B. melitensis mutants were able to stimulate good production of gamma interferon. The characteristics of these strains encourage further evaluation of them as alternative vaccines to Rev1 in primary host species.

  14. Hepatoprotective effect of ethanolic extract of Crocus sativus L. (Saffron stigma in comparison with silymarin against rifampin induced hepatotoxicity in rats

    Directory of Open Access Journals (Sweden)

    Daryoush Mohajeri


    Full Text Available Background: Anti-tuberculous drug Rifampin is a potent hepatotoxicant. The aim of the present study was to evaluate the protective effect of ethanolic extract of Crocus sativus L. stigma (EECSL.S in comparison with standard drug silimarin against rifampin-induced hepatotoxicity in the rats. Materials and Method: 40 male Wistar rats with the mean body weight of 200±20 gr and age of 10 weeks were randomly assigned into 5 groups of 8 animals and kept in specific cages with 12/12 h light/dark cycle at 21±2οC. Group I as normal control received normal saline (10 ml/kg and group II as toxicant control received rifampin (500 mg/kg. Group Ш as positive control received silymarin plus rifampin (500 mg/kg and groups IV and V (50 mg/kg received EECSL.S at 40 mg/kg and 80 mg/kg plus rifampin, respectively. All the treatments were carried out through the gavage dissolving in 10 ml/kg normal saline daily for 1 month. At the end of experiment, levels of liver function marker enzymes (Aspartate aminotransferase, Alanine aminotransferase and Alkaline Phosphatase, total bilirubin, albumin and total proteins were assessed in serum of the rats. Moreover, histopathological observation was assayed at the degree of hepatic injury. Results: In rifampin-treated rats, silymarin and EECSL.S (40 and 80 mg/kg significantly decreased the levels of serum biomarker of hepathic injury and total bilirubin and elevated the levels of albumin and total proteins. Histopathologically, silymarin and EECSL.S ameliorated rifampin induced hepatic injury. Histopathological changes were in agreement with biochemical findings.Conclusion: Results indicated that EECSL.S (80 mg/kg equals with silymarin as standard drug, point of view hepatoprotective effects against rifampin-induced hepatotoxicity

  15. Comparative Study of the Effects of Pyridoxine, Rifampin, and Renal Function on Hematological Adverse Events Induced by Linezolid▿



    Hematological disturbances that develop during linezolid treatment are a major concern when linezolid is administered for prolonged periods of time. The aim of this study was to evaluate the influences of pyridoxine, rifampin, and renal function on hematological adverse events. From January 2002 to April 2006, 52 patients received a long-term course of linezolid. Blood cell counts were monitored weekly. Thrombocytopenia was defined as a decrease to

  16. HIV-1 Coinfection Does Not Reduce Exposure to Rifampin, Isoniazid, and Pyrazinamide in South African Tuberculosis Outpatients (United States)

    Meintjes, Graeme; Chirehwa, Maxwell; Wiesner, Lubbe; McIlleron, Helen; Wilkinson, Robert J.


    There are contrasting data in the literature about antituberculosis plasma drug concentrations in HIV-1-coinfected patients. We report the pharmacokinetics of rifampin, isoniazid, and pyrazinamide in a cohort of patients being treated for active tuberculosis, the majority of whom were coinfected with HIV-1 and had commenced antiretroviral therapy within 2 months of starting antituberculosis treatment. We also examined the association between antituberculosis drug concentrations and reported drug side effects at the 2-month clinical review. One hundred patients with pulmonary tuberculosis (65% coinfected with HIV-1) were intensively sampled to determine rifampin, isoniazid, and pyrazinamide plasma concentrations after 7 to 8 weeks of a daily quadruple-therapy regimen dosed according to World Health Organization (WHO) weight bands. Pharmacokinetic parameters were determined for each patient by using nonlinear mixed-effects models. HIV-1-coinfected patients had lower clearance rates for rifampin (21% decrease) and isoniazid (23% decrease) than HIV-1-uninfected patients, with resulting higher areas under the concentration-time curve from 0 to 24 h (AUC0–24) and maximum concentrations of drug in serum (Cmax). Antiretroviral therapy (ART) that included double-standard-dose lopinavir/ritonavir further lowered rifampin clearance, by 46%, and increased the AUC0–24. The current uniform dosing (per kilogram of body weight) across WHO weight bands was associated with a trend of decreased pharmacokinetic exposures for the lowest weight band. Use of fat-free mass as opposed to total body weight for allometric scaling of clearance significantly improved the model. Ambulant HIV-1-coinfected patients, the majority of whom were coprescribed ART, did not have reduced antituberculosis drug concentrations compared to HIV-1-uninfected patients. PMID:27480859

  17. Evaluation of GenoFlow DR-MTB Array Test for Detection of Rifampin and Isoniazid Resistance in Mycobacterium tuberculosis (United States)

    Molina-Moya, B.; Kazdaglis, G.; Lacoma, A.; Prat, C.; Gómez, A.; Villar-Hernández, R.; García-García, E.; Haba, L.; Maldonado, J.; Samper, S.; Ruiz-Manzano, J.; Ausina, V.


    The aim of this study was to evaluate the GenoFlow DR-MTB array test (DiagCor Bioscience, Hong Kong) on 70 cultured isolates and 50 sputum specimens. The GenoFlow array test showed good sensitivity and specificity compared to the phenotypic Bactec 460TB. This array accurately detected mutations in rpoB, katG, and inhA associated with resistance to rifampin and isoniazid. PMID:26865688

  18. Effects of ketoconazole or rifampin on the pharmacokinetics of tivozanib hydrochloride, a vascular endothelial growth factor receptor tyrosine kinase inhibitor. (United States)

    Cotreau, Monette M; Siebers, Nicholas M; Miller, James; Strahs, Andrew L; Slichenmyer, William


    The vascular endothelial growth factor (VEGF) pathway is associated with the promotion of endothelial cell proliferation, migration, and survival necessary for angiogenesis. VEGF and its three receptor isoforms are often overexpressed in many human solid tumors. Tivozanib is a potent, selective inhibitor of VEGF receptors 1, 2, and 3, with a long half-life. The purpose of these studies was to evaluate the effect of ketoconazole, a potent inhibitor of CYP3A4, and rifampin, a potent inducer of CYP3A4, on the pharmacokinetics of tivozanib. Two phase I, open-label, 2-period, single-sequence studies evaluated the effect of steady-state ketoconazole (NCT01363778) or rifampin (NCT01363804) on the pharmacokinetic profile, safety, and tolerability of a single oral 1.5-mg dose of tivozanib. Tivozanib was well tolerated in both studies. Steady-state ketoconazole did not cause a clinically significant change in the pharmacokinetics of a single dose of tivozanib; therefore, dosing of tivozanib with a CYP3A4 pathway inhibitor should not cause a clinically significant change in serum tivozanib levels. However, coadministration of tivozanib with rifampin caused a significant decrease in the area under the curve from 0 to infinity and half-life and an increase in clearance of tivozanib, which suggest increased clearance via the enhanced CYP3A4-mediated metabolism of tivozanib.

  19. Bacteriological conversion in twenty urinary tuberculosis patients treated with ofloxacin, rifampin and isoniazid: a 10-year follow-up study. (United States)

    Castiñeiras, A Alberte; Pérez-Pascual, P; Zarranz, J Estébanez; Della-Latta, P; Herreras, A


    Twenty patients with urinary tuberculosis were treated with ofloxacin (200 mg/day, 6 months), rifampin (600 mg/day, 3 months) and isoniazid (300 mg/day, 3 months) between 1989 and 1990. All patients were new cases, diagnosed by observation and/or isolation of Mycobacterium tuberculosis in one of the three morning urine samples. Bacteriological culture conversion (negativization) was assessed as a clinical guide of efficacy, comparing it, as the only parameter, against a control group (150 patients) with urinary tuberculosis who received conventional therapy. Bacteriological follow-up studies were performed in both groups monthly for 6 months, then again 6 months later and then every year for 10 years after completion of treatment. In the 20 patients, the initial culture was positive with over 100 colonies per culture (>50%); the smear was positive in 45% of the patients (most were 2+). All strains were susceptible to rifampin, isoniazid and ofloxacin. Two patients discontinued treatment. Beginning with the first month of treatment, the bacteriological conversion was 100%, 89.5% and 100% in the remaining controls. In the control group, which received conventional treatment, the conversion was: 90%, 87%, 93% and 100% in the remaining controls. Treatment with ofloxacin resulted in a bacteriological conversion similar to that following conventional treatment ( p>0.05, Fisher's exact test). After 10 years of patient follow-up, we conclude that ofloxacin, in combination with rifampin and isoniazid (both for 3 months only is effective against M. tuberculosis, providing satisfactory bacteriological and clinical efficacy.

  20. Molecular characteristics of rifampin and isoniazid resistant Mycobacterium tuberculosis strains from Beijing, China

    Institute of Scientific and Technical Information of China (English)

    JIAO Wei-wei; Mokrousov Igor; SUN Gui-zhi; LI Mo; LIU Jia-wen; Narvskaya Olga; SHEN A-dong


    Background China is one of the high burden countries of Mycobacterium tuberculosis (TB) infection globally, with high incidence and mortality. We studied the molecular characteristics of rifampin (RIF) and isoniazid (INH) resistant Mycobacterium tuberculosis strains from Beijing, China, in order to find out the genetic marker for rapid detection of specific drug resistance.Methods Forty pansusceptible and 81 resistant strains of Mycobacterium tuberculosis isolated from Beijing, China during 2002-2005 were analyzed. The modified rifampin oligonucleotide (RIFO) assay based on reverse line blot hybridization was used to detect mutations in the 81 bp hot-spot region of rpoB gene, which is associated with RIF resistance. The INH resistance associated genes, regulatory region mab-inhA (-15C/T) and structural gene katG S315T were detected by reverse line blot hybridization and PCR-restriction fragment length polymorphism (RFLP) method respectively. All the strains were typed by spoligotying and the Beijing genotype was further subdivided by NTF locus analysis. The distribution of drug resistance associated mutations in the above genes was compared in these groups.Results Sixty-five (91.5%) of 71 RIF resistant and 52 (92.9%) of 56 multidrug-resistant (MDR, Ⅰ.e. Resistant to at least RIF and INH) strains were found to harbor mutations in the rpoB hot-spot region. No mutation was detected in RIF sensitive strains. The specificity and sensitivity of the modified RIFO assay were 100% and 91.5%, respectively. katG315 AGC>ACC and inhA-15C>T mutations were found in 40 (60.6%) and 10 (15.2%) of 66 Ⅰ NH resistant strains, respectively;7.6% of INH-resistant strains had mutations in both of these genes. Therefore, a combined use of both katG315 and inhA-15 identified 68.2% of INH-resistant strains. The Beijing genotype accounted for 91.7% of total strains and was further subdivided into "modern" (76.6%) and "ancestral" (23.4%) group. There is no significant difference between

  1. Activities of rifampin, Rifapentine and clarithromycin alone and in combination against mycobacterium ulcerans disease in mice.

    Directory of Open Access Journals (Sweden)

    Deepak Almeida

    Full Text Available BACKGROUND: treatment of Mycobacterium ulcerans disease, or Buruli ulcer (BU, has shifted from surgery to treatment with streptomycin(STR+rifampin(RIF since 2004 based on studies in a mouse model and clinical trials. We tested two entirely oral regimens for BU treatment, rifampin(RIF+clarithromycin(CLR and rifapentine(RPT+clarithromycin(CLR in the mouse model. METHODOLOGY/PRINCIPAL FINDINGS: BALB/c mice were infected in the right hind footpad with M. ulcerans strain 1059 and treated daily (5 days/week for 4 weeks, beginning 11 days after infection. Treatment groups included an untreated control, STR+RIF as a positive control, and test regimens of RIF, RPT, STR and CLR given alone and the RIF+CLR and RPT+CLR combinations. The relative efficacy of the drug treatments was compared on the basis of footpad CFU counts and median time to footpad swelling. Except for CLR, which was bacteriostatic, treatment with all other drugs reduced CFU counts by approximately 2 or 3 log(10. Median time to footpad swelling after infection was 5.5, 16, 17, 23.5 and 36.5 weeks in mice receiving no treatment, CLR alone, RIF+CLR, RIF alone, and STR alone, respectively. At the end of follow-up, 39 weeks after infection, only 48%, 26.4% and 16.3% of mice treated with RPT+CLR, RPT alone and STR+RIF had developed swollen footpads. An in vitro checkerboard assay showed the interaction of CLR and RIF to be indifferent. However, in mice, co-administration with CLR resulted in a roughly 25% decrease in the maximal serum concentration (Cmax and area under the serum concentration-time curve (AUC of each rifamycin. Delaying the administration of CLR by one hour restored Cmax and AUC values of RIF to levels obtained with RIF alone. CONCLUSIONS/SIGNIFICANCE: these results suggest that an entirely oral daily regimen of RPT+CLR may be at least as effective as the currently recommended combination of injected STR+oral RIF.

  2. Synthesis, characterization and drug-delivery activity of rifampin anchored poly(vinyl alcohol)

    Indian Academy of Sciences (India)

    Palanichamy Jeyaraman; Balakrishnan Meenarathi; Ramasamy Anbarasan


    Poly(vinyl alcohol) (PVA) has wide applications in film industries owing to the hydrophilicity and biocompatibility. In recent times the application of PVA is extended to drug-delivery field. Unfortunately, the thermal stability of PVA is very poor. In order to increase the thermal stability, the drugs were chemically conjugated with PVA. In the present investigation rifampin (Rif.) a bactericidal antibiotic drug was chemically conjugated with PVA backbone. The resultant Rif.-conjugated PVA was characterized by Fourier transform infrared spectroscopy, UV–visible spectroscopy, nuclear magnetic resonance (NMR) spectroscopy, differential scanning calorimetry, and thermogravimetric analysis (TGA). Finally, the Rif.-conjugated PVA was tested for the drug-release activity. The scanning electron microscope morphology declared the presence of microvoids on the surface of PVA and the same was effectively used for the drug-loading purpose. Mechanical properties of PVA before and after the structural modification process were also tested. The aromatic carbon signal around 120–150 ppm in the 13C NMR confirmed the chemical grafting of Rif. on to the PVA backbone. The TGA confirmed the four-step degradation process for the structurally modified PVA.

  3. Nutritional supplementation increases Rifampin exposure among tuberculosis patients coinfected with HIV

    DEFF Research Database (Denmark)

    Jeremiah, Kidola; Denti, Paolo; Chigutsa, Emmanuel


    Nutritional supplementation to tuberculosis (TB) patients has been associated with increased weight and reduced mortality, but its effect on the pharmacokinetics of first-line anti-TB drugs is unknown. A cohort of 100 TB patients (58 men; median age, 35 [interquartile range {IQR}, 29 to 40] years......, and median body mass index [BMI], 18.8 [17.3 to 19.9] kg/m(2)) were randomized to receive nutritional supplementation during the intensive phase of TB treatment. Rifampin plasma concentrations were determined after 1 week and 2 months of treatment. The effects of nutritional supplementation, HIV, time...... on nutritional supplementation achieved higher Cmax and AUC0-24 values of 6.4 μg/ml and 31.6 μg · h/ml, respectively, and only 13.3% bioavailability reduction. No effect of the SLCO1B1 rs4149032 genotype was observed. In conclusion, nutritional supplementation during the first 2 months of TB treatment reduces...

  4. Meta Analysis on Chinese Patent Medicine in Prevention and Cure of Hepatic Lesion Caused by Anti-tuberculosis Drugs%中医成方防治抗结核药物致肝损害的Meta分析

    Institute of Scientific and Technical Information of China (English)



    目的:系统评价中医成方防治抗结核药致肝损害的疗效和安全性.方法:电子检索2000年1月到2011年7月的Medline、Embase、Cochrane library、中国生物医学光盘数据库,万方、维普数据库,并手工检索相关文献,纳入治疗组为中医成方,对照组为常规保肝治疗,逐个对其进行质量评价和资料提取,用RevMan 4.2软件进行Meta分析.结果:最终纳入6个半随机对照试验,共372例患者,纳入研究质量均为C级.中医成方组肝功正常率优于常规l保肝治疗(P<0.01,OR-13.50,95%CI 6.89~26.46);未发现严重不良反应.结论:中医成方防治肝损害效果优于常规保肝治疗,且无明显不良反应.但由于纳入研究的方法学质量较低、观察时间较短,且存在中西医结合诊断不标准、中药使用不规范等问题,可能影响评价结果,尚需更多高质量、长周期、中西医结合规范化研究以系统评价其疗效.%Objective: To evaluate systemically the efficacy and safety of Chinese patent medicine in prevention and cure hepatic lesion caused by anti-tuberculosis drugs. Method :Medline, Embase, Cochrane Library, CBM, VIP and WanFang data from 2000 to May, 2011 were searched online and the literatures published or not were manually retrieved. The papers on Chinese patent medicine were divided into treatment group while routine treatment were in control group, all were undergoing the quality analysis and information extraction. RevMan 4.2 was used for data analysis. Finally six Quasi-randomized control trials involving 372 patients were recruited. Methodological qualities were all graded C. Result: After 1-6 months' treatment, normal rate of liver function in Chinese patent medicine group were higher than in routine treatment (P <0.01, OR=13.50, 95% CI 6.89-26.46) without serious side effects. Conclusion: Chinese patent medicine is better than routine treatment in prevention and cure hepatic lesion caused by anti-tuberculosis drugs

  5. Anti-tuberculosis treatment defaulting: an analysis of perceptions and interactions in Chiapas, Mexico Abandono del tratamiento antituberculosis: un análisis de percepciones e interacciones en Chiapas, México

    Directory of Open Access Journals (Sweden)

    Ivett Reyes-Guillén


    Full Text Available OBJECTIVE: To analyze the perceptions and interactions of the actors involved in anti-tuberculosis treatment, and to explore their influence in treatment defaulting in Los Altos region of Chiapas, Mexico. MATERIAL AND METHODS: From November 2002 to August 2003, in-depth interviews were administered to patients with PTB, patients' family members, institutional physicians, community health coordinators, and traditional medicine practitioners. RESULTS: We found different perceptions about PTB between patients and their families and among health personnel, as well as communication barriers between actors. Defaulting is considered to be mainly due to the treatment's adverse effects. CONCLUSIONS: It is necessary to conduct research and interventions in the studied area with the aim of changing perceptions, improving sensitization, quality and suitability of management of patients with PTB in a multicultural context, and promoting collaboration between institutional and traditional medicine.OBJETIVO: Analizar percepciones e interacciones entre actores involucrados en el tratamiento antituberculosis y su influencia en el abandono del tratamiento en los Altos de Chiapas, México. MATERIAL Y MÉTODOS: De noviembre 2002 a agosto 2003, se realizaron entrevistas a profundidad a pacientes con TBP, familiares, médicos institucionales, coordinadores comunitarios de salud y médicos tradicionales. RESULTADOS: Se encontraron diferentes percepciones entre los pacientes y sus familiares, respecto a las del personal de salud, así como barreras de comunicación entre los distintos actores. Los efectos adversos del tratamiento antituberculosis, son consideradas como una de las principales causas de su abandono. CONCLUSIONES: Es necesario que en la región estudiada se realicen investigaciones e intervenciones encaminadas a: cambiar percepciones y mejorar la sensibilidad, calidad y adecuación del manejo de pacientes con TBP en contextos multiculturales, así como

  6. 抗结核药物性肝损伤临床危险因素分析%Analysis of clinical risk factors associated with anti-tuberculosis drug-inducing liver injury

    Institute of Scientific and Technical Information of China (English)

    卫安娜; 方怡; 梁国添; 余燕华; 邝浩斌; 温文沛


    Objective To analyze the clinical risk factors associated with anti-tuberculosis drug-inducing liv-er injury (ATLI). Methods From 2013 January to 2014 July, a total of 100 pulmonary tuberculosis patients com-plicated with ATLI were enrolled as the case group, and 100 patients only with pulmonary tuberculosis were randomly selected as the control group. The retrospective case-control study and multivariate logistic regression were used to an-alyze the risk factor associated with liver injury caused by anti-tuberculosis therapy. The factors for analysis included initial/ retreated pulmonary tuberculosis cases, range, sputum smear positive, whether complicated with extra pulmo-nary tuberculosis lesions, hepatitis B surface antigen carriers, alcohol abuse, history of hepatitis diseases besides hepatitis B, diabetes, heart function incomplete, respiratory failure, hypoproteinemia, and anemia. Results The results of multivariate logistic regression analysis showed that the risk factors included hepatitis B surface antigen car-riers (OR = 3. 113, P = 0. 005), history of alcoholism (OR = 3. 427, P = 0. 008), history of the other hepatitis dis-eases besides hepatitis B (OR = 2. 359, P = 0. 032), respiratory failure (OR = 1. 622, P = 0. 045), cardiac func-tional insufficiency (OR = 1. 700, P = 0. 015), hypoproteinemia ( OR = 1. 860, P = 0. 012) and anemia ( OR =1. 718, P = 0. 014). Conclusion The risk factors for liver injury caused by anti tuberculosis drugs include hepatitis B surface antigen carriers, history of alcoholism, history of hepatitis diseases besides hepatitis B, respiratory failure, cardiac functional insufficiency, hypoproteinemia and anemia.%目的:分析肺结核化疗中发生抗结核药物性肝损伤(ATLI)的临床危险因素。方法收集2013年1月到2014年7月期间在我院住院治疗的肺结核合并抗结核药物性肝损伤病例100例为观察组,随机抽取同一时间段在我院住院治疗的肺结核无合并抗

  7. Analysis of Related Factors of Liver Damage Caused by Anti Tuberculosis Drugs%抗结核药物致肝损害的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    陈雨燕; 李丹; 林秀华; 陈晓红; 林剑东; 刘建清


    目的:探讨抗结核药物致肝损害的相关因素。方法:回顾性分析本院自2010年1月-2013年8月收治的1538例结核病患者的临床资料,分析抗结核药物致肝损害的因素,其中包括患者的性别、年龄、种族、糖尿病史、饮酒史、HBsAg、结核类型以及肝炎史等方面。结果:本组1538例患者中,发生轻度肝损伤154例(10.01%),中度肝损伤45例(2.93%),重度肝损伤25例(1.63%),总损伤224例(14.56%)。HBsAg呈现阳性的患者发生肝损伤的几率明显高于阴性者,有糖尿病史和肝炎史患者发生肝损伤几率明显高于无糖尿病史和肝炎史,有饮酒史的患者发生药物性肝损伤的几率要明显高于无饮酒史患者,进行过预防性保肝治疗的患者其患病率明显低于没有进行过治疗的患者,营养状况的好坏也与患者患病的几率有关,差异有统计学意义(P<0.05)。结论:在进行抗结核药物治疗时,应充分了解患者的病情、病史等,选择对患者危害性较小的抗结核药物,并采取适当的护肝措施,以尽可能减少药物性肝损害的发生,保证抗结核治疗的顺利进行。%Objective:To investigate the related factors liver damage caused by anti tuberculosis drugs. Method:The clinical data of 1538 tuberculosis patients in our hospital from January 2010 to August 2013 were retrospectively analyzed,the factors of liver damage caused by anti tuberculosis drugs were analyzed,including gender, age,race,diabetes history,drinking history,HbsAg,tuberculosis type and hepatitis history etc of patients. Result:In 1538 patients,the occurrence of mild liver injury in 154 cases(10.01%),45 cases of moderate liver injury (2.93%),severe liver injury in 25 cases(1.63%),the total injury in 224 cases(14.56%).The probability of occurrence of liver injury in HBsAg positive patients was significantly higher than that of negative,the probability of occurrence of

  8. Evaluation of the Genotype MTBDR Assay for Rapid Detection of Rifampin and Isoniazid Resistance in Mycobacterium tuberculosis Isolates



    A novel PCR-based reverse hybridization method Genotype MTBDR assay (Hain Lifescience GmbH, Nehren, Germany) was evaluated for rapid detection of rifampin (RIF) and isoniazid (INH) resistance in Turkish Mycobacterium tuberculosis isolates. The Genotype MTBDR assay is designed to detect mutations within the 81-bp hotspot region of rpoB and mutations at katG codon 315. A total of 41 RIF-resistant M. tuberculosis isolates with rpoB mutations that were previously tested by the INNO-LiPA Rif.TB ki...

  9. Evaluation of the pharmacokinetic interaction between repeated doses of rifapentine or rifampin and a single dose of bedaquiline in healthy adult subjects. (United States)

    Winter, Helen; Egizi, Erica; Murray, Stephen; Erondu, Ngozi; Ginsberg, Ann; Rouse, Doris J; Severynse-Stevens, Diana; Pauli, Elliott


    This study assessed the effects of rifapentine or rifampin on the pharmacokinetics of a single dose of bedaquiline and its M2 metabolite in healthy subjects using a two-period single-sequence design. In period 1, subjects received a single dose of bedaquiline (400 mg), followed by a 28-day washout. In period 2, subjects received either rifapentine (600 mg) or rifampin (600 mg) from day 20 to day 41, as well as a single bedaquiline dose (400 mg) on day 29. The pharmacokinetic profiles of bedaquiline and M2 were compared over 336 h after the administration of bedaquiline alone and in combination with steady-state rifapentine or rifampin. Coadministration of bedaquiline with rifapentine or rifampin resulted in lower bedaquiline exposures. The geometric mean ratios (GMRs) and 90% confidence intervals (CIs) for the maximum observed concentration (Cmax), area under the concentration-time curve to the last available concentration time point (AUC0-t), and AUC extrapolated to infinity (AUC0-inf) of bedaquiline were 62.19% (53.37 to 72.47), 42.79% (37.77 to 48.49), and 44.52% (40.12 to 49.39), respectively, when coadministered with rifapentine. Similarly, the GMRs and 90% CIs for the Cmax, AUC0-t, and AUC0-inf of bedaquiline were 60.24% (51.96 to 69.84), 41.36% (37.70 to 45.36), and 47.32% (41.49 to 53.97), respectively, when coadministered with rifampin. The Cmax, AUC0-t, and AUC0-inf of M2 were also altered when bedaquiline was coadministered with rifapentine or rifampin. Single doses of bedaquiline, administered alone or with multiple doses of rifapentine or rifampin, were well tolerated, with no safety concerns related to coadministration. Daily administration of rifapentine to patients with tuberculosis presents the same drug interaction challenges as rifampin and other rifamycins. Strong inducers of the cytochrome P450 isoenzyme CYP3A4 should be avoided when considering the use of bedaquiline. (This study is registered at under identifier NCT02216331.).

  10. Pharmacokinetic drug interactions of the selective androgen receptor modulator GTx-024(Enobosarm) with itraconazole, rifampin, probenecid, celecoxib and rosuvastatin. (United States)

    Coss, Christopher C; Jones, Amanda; Dalton, James T


    GTx-024 (also known as enobosarm) is a first in class selective androgen receptor modulator being developed for diverse indications in oncology. Preclinical studies of GTx-024 supported the evaluation of several potential drug-drug interactions in a clinical setting. A series of open-label Phase I GTx-024 drug-drug interaction studies were designed to interrogate potential interactions with CYP3A4 inhibitor (itraconazole), a CYP3A4 inducer (rifampin), a pan-UGT inhibitor (probenecid), a CYP2C9 substrate (celecoxib) and a BCRP substrate (rosuvastatin). The plasma pharmacokinetics of GTx-024, its major metabolite (GTx-024 glucuronide), and each substrate were characterized in detail. Itraconazole administration had no effect on GTx-024 pharmacokinetics. Likewise, GTx-024 administration did not significantly change the pharmacokinetics of celecoxib or rosuvastatin. Rifampin administration had the largest impact on GTx-024 pharmacokinetics of any co-administered agent and reduced the maximal plasma concentration (Cmax) by 23 % and the area under the curve (AUC∞) by 43 %. Probenecid had a complex interaction with GTx-024 whereby both GTx-024 plasma levels and GTx-024 glucuronide plasma levels (AUC∞) were increased by co-administration of the UGT inhibitor (50 and 112 %, respectively). Overall, GTx-024 was well tolerated and poses very little risk of generating clinically relevant drug-drug interactions.

  11. Effect of Diet Intervention on Hyperuricemia Induced by Anti-tuberculosis Drugs%饮食干预对抗结核药物性高尿酸血症的影响

    Institute of Scientific and Technical Information of China (English)



    [Objective] To analyze the effect of diet intervention on the increased uric acid level in serum leading to withdrawal caused by anti-tuberculosis drug pyrazinamide and its significance .[Methods]The control study was used .The tuberculosis patients with the increased uric acid level in serum caused by pyrazinamide were divided into two groups .To-tally 112 outpatients in the tuberculosis department of our hospital from 2007 to 2008 were taken as intervention group , while 110 patients treated in tuberculosis prevention and control department of the center for disease control in Changning district from 2006 to 2007 were taken as control group .The intervention group received anti-tuberculosis treatment and simple diet intervention without other medicines to control serum urinary acid .Family members sustained the work of diet intervention effectively .The main methods of diet intervention included drinking more water ,keeping warm and alkalizing urine ,etc .The control group needed no dietary requirements .The change of serum uric acid level and withdrawal rate in two groups were observed and compared .[Results] The withdrawal rate in intervention group during chemotherapy process was 6 .25% (7/112) which was obviously lower than that in control group (76 .36% ,84/110) ,and there was sig-nificant difference between two groups ( P<0 .05) .Compared with control groups ,the increased uric acid value in inter-vention group at the end of treatment after one month and two months deceased by 7% and above 10% ,respectively .[Conclusion]Diet intervention can effectively control the increased uric acid level in serum caused by pyrazinamide and largely reduce the withdrawal in chemotherapy process .Therefore ,it has good clinical significance .%[目的]分析饮食干预对抗结核药物吡嗪酰胺引起血尿酸水平升高而导致停药的影响及意义。[方法]采用对照研究,将服用吡嗪酰胺等引起血尿酸增高的结核患者分为两组,2007~2008

  12. Two-stage treatment of chronic staphylococcal orthopaedic implant-related infections using vancomycin impregnated PMMA spacer and rifampin containing antibiotic protocol. (United States)

    Isiklar, Z U; Demirörs, H; Akpinar, S; Tandogan, R N; Alparslan, M


    To determine the clinical role of rifampin containing antibiotic combination and modified two-stage exchange arthroplasty with a vancomycin loaded polymethylmethacrylate (PMMA) spacer for the treatment of orthopaedic implant related Staphylococcus epidermidis infections, a prospective study was initiated. A total of 10 patients, with a mean age of 59 years (range: 32 to 78 years) were included in the study. The mean follow up was 23.4 months (range: 16 to 36 months). Six patients had an infected hemiarthroplasty of the hip, three had infected total hip arthroplasty, and one had an infected femoral neck fracture with implant failure and pseudoarthrosis. All had culture-proven Staphylococcus epidermidis infections, six of the isolates were methicillin resistant. Following debridement and implantation of a PMMA spacer, a rifampin-vancomycin antibiotic protocol was initiated until the erythrocyte sedimentation rate and C-reactive protein levels were within normal limits. After reimplantation and discharge from the hospital, oral antibiotics with rifampin-ciprofloxacin were continued for three to six months. At the final follow-up none of the patients had any clinical or laboratory signs of infection. Although this study includes a limited number of patients and relatively short-term follow-up the results indicate that in the presence of orthopaedic implant infection with Staphylococcus epidermidis, modified two-stage exchange arthroplasty using a vancomycin-loaded PMMA spacer and a rifampin-containing antibiotic protocol may be beneficial.

  13. Draft Genome Sequence of Highly Rifampin-Resistant Propionibacterium namnetense NTS 31307302T Isolated from a Patient with a Bone Infection. (United States)

    Aubin, Guillaume Ghislain; Kambarev, Stanimir; Bémer, Pascale; Lawson, Paul A; Corvec, Stéphane


    Propionibacterium namnetense was recently described as a potential bone pathogen, which is closely related to Propionibacterium acnes, a skin commensal microorganism. Here, we report the draft genome sequence of the highly rifampin-resistant strain NTS 31307302(T) isolated from a patient with a tibia infection.

  14. Activity of Colistin in Combination with Meropenem, Tigecycline, Fosfomycin, Fusidic Acid, Rifampin or Sulbactam against Extensively Drug-Resistant Acinetobacter baumannii in a Murine Thigh-Infection Model.

    Directory of Open Access Journals (Sweden)

    Bing Fan

    Full Text Available Few effective therapeutic options are available for treating severe infections caused by extensively drug-resistant Acinetobacter baumannii (XDR-AB. Using a murine thigh-infection model, we examined the in vivo efficacy of colistin in combination with meropenem, tigecycline, fosfomycin, fusidic acid, rifampin, or sulbactam against 12 XDR-AB strains. Colistin, tigecycline, rifampin, and sulbactam monotherapy significantly decreased bacterial counts in murine thigh infections compared with those observed in control mice receiving no treatment. Colistin was the most effective agent tested, displaying bactericidal activity against 91.7% of strains at 48 h post-treatment. With strains showing a relatively low minimum inhibitory concentration (MIC for meropenem (MIC ≤ 32 mg/L, combination therapy with colistin plus meropenem caused synergistic inhibition at both 24 h and 48 h post-treatment. However, when the meropenem MIC was ≥64 mg/L, meropenem did not significantly alter the efficacy of colistin. The addition of rifampin and fusidic acid significantly improved the efficacy of colistin, showing a synergistic effect in 100% and 58.3% of strains after 24 h of treatment, respectively, while the addition of tigecycline, fosfomycin, or sulbactam did not show obvious synergistic activity. No clear differences in activities were observed between colistin-rifampin and colistin-fusidic acid combination therapy with most strains. Overall, our in vivo study showed that administering colistin in combination with rifampin or fusidic acid is more efficacious in treating XDR-AB infections than other combinations. The colistin-meropenem combination may be another appropriate option if the MIC is ≤32 mg/L. Further clinical studies are urgently needed to confirm the relevance of these findings.

  15. Intensified prophylaxis of febrile neutropenia with ofloxacin plus rifampin during severe short-duration neutropenia in patients with lymphoma. (United States)

    Muñoz, L; Martino, R; Subirà, M; Brunet, S; Sureda, A; Sierra, J


    To analyse the impact of intensified prophylaxis with ofloxacin plus rifampin (O+R) in neutropenic patients we used this combination in 40 consecutive cycles of ifosfamide, cytarabine, prednisolone and etoposide (IAPVP-16). This salvage chemotherapy regimen for lymphoma usually produces four to six days of severe neutropenia without significant extrahematologic toxicities. We compared the infectious morbidity during neutropenia under O+R with 58 consecutives cycles using either norfloxacin or no prophylaxis (control group). Fifty-three percent of control group patients and 20% of the O+R group developed febrile neutropenia that required hospital admission (pfebril neutropenia was 42 days and 158 days, respectively (pfebrile neutropenia and GPC bacteremia in patients with short and severe neutropenia, which translates into a reduction in the need for hospitalization.

  16. Rate of relapse in multibacillary patients after cessation of long-course dapsone monotherapy supplemented by a final supervised single dose of 1500 mg of rifampin. (United States)

    Cartel, J L; Naudin, J C


    When multidrug therapy was implemented in Senegal, 406 multibacillary (MB) patients who had been treated for more than 10 years by dapsone alone, and who had become clinically inactive and skin-smear negative, were released from treatment. Of these 406 patients, 298 were given a supervised single dose of 1500 mg of rifampin. Subsequently, 302 of them (229 who had been given rifampin and 73 who had not) were followed up by means of annual clinical and bacteriological examinations. Of the former 229 followed up for a mean period of 4.9 years, 34 patients relapsed (22 males and 12 females), giving a crude relapse rate of 15% and an overall risk of relapse of 3.1 per 100 patient-years. Of the latter 73 followed up for a mean period of 2.4 years, 5 relapsed (4 males and 1 female), giving a crude relapse rate of 6.8% and an overall risk of relapse of 2.9 per 100 patient-years. Such results, which are in agreement with those of a similar study conducted recently in Mali, indicate that the intake of a single dose of 1500 mg of rifampin by MB patients when they are released from long-course dapsone monotherapy does not result in a decrease of the relapse rate. Therefore, MB patients who have been treated with dapsone alone, even for long periods, should be put under multidrug therapy prior to their release from control.

  17. Chemoprophylaxis of leprosy with a single dose of 25 mg per kg rifampin in the southern Marquesas; results after four years. (United States)

    Cartel, J L; Chanteau, S; Moulia-Pelat, J P; Plichart, R; Glaziou, P; Boutin, J P; Roux, J F; Grosset, J H


    In January-February 1988, a program of chemoprophylaxis for leprosy, using a single 25 mg/kg dose of rifampin, was conducted among 2786 (98.7%) inhabitants of the Southern Marquesas and 3144 South Marquesan "emigrants" and their families. Among the treated population, during the 4 years which followed the implementation of the program, two leprosy patients were detected, one of whom can be considered as a failure of chemoprophylaxis because she was not known by the leprosy control unit. During the same period (1988-1991), a decrease in detection rates for leprosy in the entire French Polynesian population has been observed, an event which makes the interpretation of these findings very difficult. Nevertheless, according to presently available data, the effectiveness of chemoprophylaxis with a single dose of 25 mg/kg rifampin is estimated to be about 40% to 50%. When considering not only the results of the present study but also the financial and logistic constraints raised by such a program, one is led to the conclusion that chemoprophylaxis, even with a single dose of rifampin, is not likely to become an effective component of leprosy control programs.

  18. Gauging the clinical significance of P-glycoprotein-mediated herb-drug interactions: comparative effects of St. John's wort, Echinacea, clarithromycin, and rifampin on digoxin pharmacokinetics. (United States)

    Gurley, Bill J; Swain, Ashley; Williams, D Keith; Barone, Gary; Battu, Sunil K


    Concomitant administration of botanical supplements with drugs that are P-glycoprotein (P-gp) substrates may produce clinically significant herb-drug interactions. This study evaluated the effects of St. John's wort and Echinacea on the pharmacokinetics of digoxin, a recognized P-gp substrate. Eighteen healthy volunteers were randomly assigned to receive a standardized St. John's wort (300 mg three times daily) or Echinacea (267 mg three times daily) supplement for 14 days, followed by a 30-day washout period. Subjects were also randomized to receive rifampin (300 mg twice daily, 7 days) and clarithromycin (500 mg twice daily, 7 days) as positive controls for P-gp induction and inhibition, respectively. Digoxin (Lanoxin 0.25 mg) was administered orally before and after each supplementation and control period. Serial digoxin plasma concentrations were obtained over 24 h and analyzed by chemiluminescent immunoassay. Comparisons of area under the curve (AUC)((0-3)), AUC((0-24)), elimination half-life, and maximum serum concentration were used to assess the effects of St. John's wort, Echinacea, rifampin, and clarithromycin on digoxin disposition. St. John's wort and rifampin both produced significant reductions (p St. John's wort than with Echinacea.

  19. Investigation of the pharmacokinetic interactions of deferasirox, a once-daily oral iron chelator, with midazolam, rifampin, and repaglinide in healthy volunteers. (United States)

    Skerjanec, Andrej; Wang, Jixian; Maren, Kelly; Rojkjaer, Lisa


    Deferasirox, a newly developed iron chelator, was coadministered orally with either a known inducer of drug metabolism or with cosubstrates for cytochrome P450 (CYP) to characterize the potential for drug-drug interactions. In the induction assessment, single-dose deferasirox pharmacokinetics were obtained in the presence and absence of a repeated-dose regimen of rifampin. In the CYP3A interaction evaluation, midazolam and its active hydroxylated metabolite were assessed after single doses of midazolam in the presence and absence of steady-state concentrations of deferasirox. To test for interaction at the level of CPY2C8, single-dose repaglinide pharmacokinetics/pharmacodynamics were determined with and without repeated-dose administration of deferasirox. After rifampin, a significant reduction (44%) in plasma exposure (AUC) to deferasirox was observed. Upon coadministration of midazolam, there was a modest reduction of up to 22% in midazolam exposure (AUC, C(max)), suggesting a modest induction of CYP3A4/5 by deferasirox. Def erasirox caused increases in repaglinide plasma C(max) and AUC of 1.5-fold to over 2-fold, respectively, with little change in blood glucose measures. Specific patient prescribing recommendations were established when coadministering deferasirox with midazolam, repaglinide, and rifampin. These recommendations may also apply to other substrates of CYP3A4/5 and CYP2C8 or potent inducers of glucuronidation.

  20. Comparative efficacy of oral rifampin and topical chloramphenicol in eradicating conjunctival carriage of Haemophilus influenzae biogroup aegyptius. Brazilian Purpuric Fever Study Group. (United States)

    Perkins, B A; Tondella, M L; Bortolotto, I M; Takano, O A; da Silva, G A; Irino, K; Brandileone, M C; Harrison, L H; Wenger, J D; Broome, C V


    Persistent conjunctival carriage of the Haemophilus influenzae biogroup aegyptius (Hae) strain (BPF clone) responsible for Brazilian purpuric fever (BPF) has been documented. Topical chloramphenicol is routinely used to treat conjunctivitis in areas affected by BPF in Brazil. Although the BPF clone is susceptible to chloramphenicol, we observed a number of children treated with topical chloramphenicol for conjunctivitis who still developed BPF. During an investigation of an outbreak of BPF in Mato Grosso State, Brazil, we compared oral rifampin (20 mg/kg/day for 4 days) with topical chloramphenicol for eradication of conjunctival carriage of H. influenzae biogroup aegyptius among children with presumed BPF clone conjunctivitis. Conjunctival samples were taken for culture on the day treatment was initiated and a mean of 8 and 21 days later. At 8 days the eradication rates for oral rifampin and topical chloramphenicol were 100 and 44%, respectively (P = 0.003); at 21 days they were 100 and 50% (P = 0.01). Oral rifampin was more effective than topical chloramphenicol for eradication of the BPF clone and may be useful in prevention of BPF.

  1. Marked increase in biofilm-derived rough pneumococcal variants and rifampin-resistant strains not due to hex gene mutations. (United States)

    McEllistrem, M Catherine; Scott, Jennifer R; Zuniga-Castillo, Jacobo; Khan, Saleem A


    Otitis, pneumonia, and meningitis are tissue-based pneumococcal infections that can be associated with biofilms. The emergence of phenotypic rough variants, also known as acapsular small-colony variants, is essential for pneumococcal biofilm formation. These rough variants can increase nearly 100-fold in biofilms over time and can arise through single nucleotide polymorphisms (SNPs), deletions, or tandem duplications in the first gene of the capsular operon, cps3D. We detected a 100-fold increase in rifampin-resistant (Rif(r)) mutants in biofilms compared to planktonic cultures using a nonvaccine serotype 3 strain, which is causing an increasing number of cases of otitis in the 7-valent pneumococcal conjugate vaccine era. Since both rough variants and Rif(r) strains can arise through SNPs, they could emerge due to alteration of the mismatch repair (MMR) system. The Hex system, a pneumococcal MMR system, repairs mismatches during replication and transformation. In this study, no mutations were detected in the hexAB gene sequences among several rough variants with unique mutations in the cps3D gene. Within a hexA null mutant grown in broth, we detected only a 17.5-fold increase in rough variants compared to the wild-type parental strain. Taken together, these data suggest that mutations in the hex genes and modulation of hexA activity are unlikely to account for the generation of biofilm-derived rough variants.

  2. Rifabutin and rifampin resistance levels and associated rpoB mutations in clinical isolates of Mycobacterium tuberculosis complex. (United States)

    Berrada, Zenda L; Lin, Shou-Yean Grace; Rodwell, Timothy C; Nguyen, Duylinh; Schecter, Gisela F; Pham, Lucy; Janda, J Michael; Elmaraachli, Wael; Catanzaro, Antonino; Desmond, Edward


    Cross-resistance in rifamycins has been observed in rifampin (RIF)-resistant Mycobacterium tuberculosis complex isolates; some rpoB mutations do not confer broad in vitro rifamycin resistance. We examined 164 isolates, of which 102 were RIF-resistant, for differential resistance between RIF and rifabutin (RFB). A total of 42 unique single mutations or combinations of mutations were detected. The number of unique mutations identified exceeded that reported in any previous study. RFB and RIF MICs up to 8 μg/mL by MGIT 960 were studied; the cut-off values for susceptibility to RIF and RFB were 1 μg/mL and 0.5 μg/mL, respectively. We identified 31 isolates resistant to RIF but susceptible to RFB with the mutations D516V, D516F, 518 deletion, S522L, H526A, H526C, H526G, H526L, and two dual mutations (S522L + K527R and H526S + K527R). Clinical investigations using RFB to treat multidrug-resistant tuberculosis cases harboring those mutations are recommended.

  3. 3D-printed hierarchical scaffold for localized isoniazid/rifampin drug delivery and osteoarticular tuberculosis therapy. (United States)

    Zhu, Min; Li, Kun; Zhu, Yufang; Zhang, Jianhua; Ye, Xiaojian


    After surgical treatment of osteoarticular tuberculosis (TB), it is necessary to fill the surgical defect with an implant, which combines the merits of osseous regeneration and local multi-drug therapy so as to avoid drug resistance and side effects. In this study, a 3D-printed macro/meso-porous composite scaffold is fabricated. High dosages of isoniazid (INH)/rifampin (RFP) anti-TB drugs are loaded into chemically modified mesoporous bioactive ceramics in advance, which are then bound with poly (3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) through a 3D printing procedure. The composite scaffolds show greatly prolonged drug release time compared to commercial calcium phosphate scaffolds either in vitro or in vivo. In addition, the drug concentrations on the periphery tissues of defect are maintained above INH/RFP minimal inhibitory concentrations even up to 12 weeks post-surgery, while they are extremely low in blood. Examinations of certain serum enzymes suggest no harm to hepatic or renal functions. Micro-CT evaluations and histology results also indicate partly degradation of the composite scaffolds and new bone growth in the cavity. These results suggest promising applications of our hierarchical composite scaffold in bone regeneration and local anti-TB therapy after osteoarticular TB debridement surgery.

  4. Study on polymorphisms of genes with susceptibility to drug induced liver injury in a cohort receiving anti-tuberculosis treatment%抗结核治疗队列人群药物性肝损害的感基因多态性研究

    Institute of Scientific and Technical Information of China (English)

    陈茹; 王晶; 唐少文; 吕晓珍; 张渊; 武珊珊; 夏愔愔; 詹思延


    Objective To investigate the association between the polymorphisms of genes involving in drug metabolism and transport as well as immunological reaction and the risk of anti-tuberculosis drug-induced liver injury (ATLI) in Chinese.Methods This 1∶4 matched casecontrol study was conducted by using the data from a cohort study of Anti-tuberculosis Drugs Induced Adverse Reactions in National Tuberculosis Prevention and Control Progtam of China.Genes involving in three phase of drug metabolism and transport as well as related immunological reaction were chosen and single nucleotide polymorphisms (SNPs) were genotyped by TaqMan allele discrimination technology.Lasso regression and multivariate conditional logistic regression analysis were used to select susceptible genes.Results A total of 33 genes with 75 SNPs were tested.The combined results of Lasso and regression logistic regression analysis showed that genetic polymorphism of SLCO1BI rs4149014,HSPA1L rs2227956,STAT3 rs1053023 and IL-6 rs2066992 were significantly associated with the risk of ATLI (P<0.05).Conclusion SLCO1B1,HSPA1L,STAT3 and IL-6 might be the susceptibility genes of drug induced liver injury in patients receiving anti-tuberculosis treatment.%目的 探索药物代谢、转运和免疫反应基因多态性与中国人群抗结核药致肝损害的关联.方法 利用“中国结核病防治规划抗结核病药品不良反应研究”的人群资料和样本,构建1∶4巢式病例对照研究,选择与抗结核药物所致肝损害相关的三相代谢基因以及相关免疫基因,采用TaqMan分型技术检测基因单核苷酸多态性(SNP),结合Lasso回归和多因素条件logistic回归筛选易感基因.结果 共检测33个基因的75个SNP位点,Lasso回归和logistic回归的合并分析显示,SLCO1B1 rs4149014、HSPAIL rs2227956、STAT3 rs1053023和IL-6 rs2066992基因多态性与抗结核药致肝损害的关联有统计学意义(P<0.05).结论 SLCOIB1、HSPAlL、STAT3和IL-6基因

  5. 两性霉素B联合抗结核药物治疗结核性脑膜炎合并隐球菌性脑膜炎的疗效观察%Efficacy Observation of Amphoterincin B Combined with Anti-tuberculosis Agents for Tuberculous Meningifts Complicating with Cryptococcal Neoformans Meningitis

    Institute of Scientific and Technical Information of China (English)

    银春莲; 黄欣欣


    目的 观察两性霉素B联合抗结核药物治疗结核性脑膜炎合并隐球菌性脑膜是的临床疗效.方法 将52例结核性脑膜炎合并隐球菌性脑膜炎患者随机均分为治疗组和对照组.2组患者均采用抗结核、降颅内高压、应用激素、保肝等综合治疗.治疗组在综合治疗的基础上给予两性霉素B注射剂,以1 mg·kg-1·d-1为首次剂量逐渐递增治疗;对照组在综合治疗的基础上给予氟康唑注射剂200 mg·kg-1·d-1,首次剂量加倍.2组均治疗45d,均于治疗期间每周复查脑脊液蛋白量.结果 治疗后治疗组脑脊液蛋白量下降至正常率为84.6%,对照组为57.7%,2组比较差异有统计学意义(P<0.05).治疗组有5例(19.2%)、对照组有4例(15.4%)发生不良反应,2组比较差异无统计学意义(P>0.05).结论 两性霉素B联合抗结核药物治疗结核性脑膜炎合并隐球菌性脑膜炎可明显降低脑脊液蛋白量,且不良反应少.%OBJECTIVE: To observe the clinical efficacy of amphoterincin B combined with anti-tuberculosis agents for tuberculous meningitis complicating with cryptococcal neoformans meningitis. METHODS: 52 tuberculous meningitis patients with cryp-tococcal neoformans meningitis were randomly divided into treatment group and control group with each group of 26 cases. Both 2 groups were given therapy of anti-tuberculosis, lowering intracranial hypertension, glucorticoids, hepatoprotectives and heteropathy. Treatment group was additionally given Amphoterincin B injection 1 mg·kg-1·d-1 as initial dose and then escalated dose gradually; Control group was additionally given double initial dose of fluconazole injection 200 mg·kg-1·d-1. During the 45 days of treatment, protein of cerebrospinal fluid was reviewed every week. RESULTS: Protein of cerebrospinal fluid went down to normal in 84.6% patients of treatment group, while in 57.7% of control group. There was significant difference (P0.05). CONCLUSION: Amphoterincin B

  6. 抗病毒联合抗结核药物在艾滋病合并肺结核患者治疗中应用分析%Analysis of the application of anti-virus combined with anti-tuberculosis drugs in the treatment of acquired immune deficiency syndrome complicated with pulmonary tuberculosis

    Institute of Scientific and Technical Information of China (English)



    Objective:To explore the application effect of anti-virus combined with anti-tuberculosis drugs in the treatment of acquired immune deficiency syndrome complicated with pulmonary tuberculosis.Methods:32 patients with AIDS combined with tuberculosis were selected.They were given AZT+NVP+DDI antiviral regimen and 2H3R3Z3E3/7H3R3 regimen for tuberculosis treatment.We compared the treatment effect.Results:In 23 cases of HIV/AIDS/TB double infections,15 cases were clinically cured;5 cases completed one course;chest X-ray of 3 cases showed focus was absorbed and they continued to take medicine.Compared with before treatment,the CD4+T lymphocyte count at 6 months and 9 months after treatment was significantly improved(P<0.05). Conclusion:The dual anti infection treatment program of anti tuberculosis and anti-virus can effectively control tuberculosis and improve the immunity of HIV patients.%目的:探讨抗病毒联合抗结核药物在艾滋病合并肺结核患者治疗中应用效果。方法:收治艾滋病合并肺结核患者32例,采用AZT+NVP+DDI抗病毒方案治疗及2H3R3Z3E3/7H3R3抗结核方案治疗,比较治疗效果。结果:23例HIV/AIDS/TB双重感染患中,15例临床治愈,5例完成1个疗程,3例胸片提示病灶吸收好转继续服药。治疗6个月、9个月的CD4+T淋巴细胞计数较治疗前均有明显提高(P<0.05)。结论:该抗结核抗病毒双重抗感染治疗方案,可达到有效控制结核病,提高HIV患者免疫力。

  7. A randomized, comparative study of dual therapy (doxycycline–rifampin versus triple therapy (doxycycline–rifampin–levofloxacin for treating acute/subacute brucellosis

    Directory of Open Access Journals (Sweden)

    Ahmad Hasanain

    Full Text Available Abstract Aim The aim of this study was to compare both the efficacy and safety profile of the WHO-recommended, dual therapy (doxycycline–rifampin to a quinolone-based, triple therapy (doxycycline–rifampin–levofloxacin for treating acute/subacute brucellosis. Patients and methods We studied 107 consecutive, naïve patients with acute/subacute brucellosis admitted to Assiut University Hospital. Patients were randomly allocated to receive the dual therapy of doxycycline–rifampin (group-A or to receive the triple therapy of doxycycline–rifampin–levofloxacin (group-B. Acute/subacute brucellosis was diagnosed based on the presence of: (1 contact with animals or fresh animal products, (2 suggestive clinical manifestations of less than one-year duration, and (3 positive antibody titer (1:160 by standard tube agglutination test. Results There was no significant difference between the two groups regarding their demographic data. Fever was the most frequent manifestation (96.3%. Epigastric pain was the most frequent adverse effect of treatment (12.1%. Group-A patients had a significantly higher relapse rate compared to group-B patients (22.6% versus 9.3%, p-value = 0.01. The rate of treatment adverse effects was higher among group-B patients, although not reaching statistical significance (20.4% versus 11.3%, p-value = 0.059. Conclusions Adding levofloxacin to the dual therapy for acute/subacute brucellosis (doxycycline–rifampin may increase its efficacy in terms of lowering the relapse rate of the disease. Further, larger scale studies are needed before considering modifying the standard, dual therapy for brucellosis.

  8. Detection of rifampin resistance by single-strand conformation polymorphism analysis of cerebrospinal fluid of patients with tuberculosis of the central nervous system. (United States)

    Scarpellini, P; Braglia, S; Brambilla, A M; Dalessandro, M; Cichero, P; Gori, A; Lazzarin, A


    Mutations in a 69-bp region of the rpoB gene of Mycobacterium tuberculosis are associated with rifampin resistance (Rif[r]). These have been detected with mycobacterial DNA extracted from bacterial suspensions or respiratory specimens that were acid-fast smear positive. We experimented with a strategy for the rapid detection of Rif(r) in cerebrospinal fluid (CSF) samples. The strategy involves the amplification of the 69-bp region of rpoB by means of PCR and the identification of nucleotide mutations by single-strand conformation polymorphism (SSCP) analysis of the amplification products. Sixty-five CSF specimens collected from 29 patients (19 patients were coinfected with human immunodeficiency virus) with culture or autopsy-confirmed (22 patients) or highly probable (7 patients) tuberculosis of the central nervous system (CNS-TB) were processed. Amplified products suitable for evaluation by SSCP analysis were obtained from 37 CSF specimens from 25 subjects (86.2%). PCR-SSCP of CSF correctly identified the rifampin susceptibility phenotype of isolates from all 17 patients for whom the results of susceptibility tests carried out with strains cultured from CSF or respiratory samples were available. Moreover, this assay revealed the rifampin susceptibility genotype of isolates from the eight patients (three patients with culture-confirmed CNS-TB and five patients in whom CNS-TB was highly probable) for whom no susceptibility test results were available; the PCR-SSCP data obtained for these patients were concordant with the outcome after a standard antituberculosis treatment. The evolution of a mutation in the rpoB gene was documented in a patient during the course of treatment. PCR-SSCP analysis of CSF seems to be an efficacious method of predicting Rif(r) and would reduce the time required for susceptibility testing from approximately 4 to 8 weeks to a few days. PMID:9350737

  9. Frequency of Mutation to Rifampin Resistance in Streptococcus pneumoniae Clinical Strains: hexA and hexB Polymorphisms Do Not Account for Hypermutation


    Morosini, María-Isabel; Baquero, María-Rosario; Sánchez-Romero, J. M.; Negri, María-Cristina; Galán, Juan-Carlos; Campo, Rosa del; Pérez-Díaz, J C; Baquero, Fernando


    The frequency of mutation to rifampin resistance of 200 clinical Streptococcus pneumoniae isolates was examined. Two peaks were observed in the distribution, with mode frequencies of 2.5 × 10−7 (20% of isolates) and 2.5 × 10−8. The hexA and hexB gene entire sequences were analyzed in 13 isolates. Sequences from both hypermutable and “normomutable” strains were conserved relative to that of the R6 S. pneumoniae control strain. The phenotypic Hex system proficiency, in terms of transforming eff...

  10. Frequency of mutation to rifampin resistance in Streptococcus pneumoniae clinical strains: hexA and hexB polymorphisms do not account for hypermutation. (United States)

    Morosini, María-Isabel; Baquero, María-Rosario; Sánchez-Romero, J M; Negri, María-Cristina; Galán, Juan-Carlos; del Campo, Rosa; Pérez-Díaz, J C; Baquero, Fernando


    The frequency of mutation to rifampin resistance of 200 clinical Streptococcus pneumoniae isolates was examined. Two peaks were observed in the distribution, with mode frequencies of 2.5 x 10(-7) (20% of isolates) and 2.5 x 10(-8). The hexA and hexB gene entire sequences were analyzed in 13 isolates. Sequences from both hypermutable and "normomutable" strains were conserved relative to that of the R6 S. pneumoniae control strain. The phenotypic Hex system proficiency, in terms of transforming efficiency, was also maintained irrespective of the variations in mutation frequency values.

  11. Rapid detection of Mycobacterium tuberculosis complex and rifampin resistance in smear-negative clinical samples by use of an integrated real-time PCR method. (United States)

    Moure, Raquel; Muñoz, Laura; Torres, Miriam; Santin, Miguel; Martín, Rogelio; Alcaide, Fernando


    Sixty-four of 85 (75.3%) smear-negative respiratory (n = 78) and nonrespiratory (n = 7) samples with positive cultures of Mycobacterium tuberculosis complex (MTC) were detected by the GeneXpert system using the Xpert MTB/RIF assay (GX). In addition, GX found rpoB mutations in all six of the rifampin-resistant strains detected. The test was negative in 20 culture-negative and 20 nontuberculous culture-positive samples (100% specificity). GX offers high potential for the diagnosis of tuberculosis due to its capacity for direct detection of MTC, its rapidity, and its simplicity.

  12. Assessing the utility of three TaqMan probes for the diagnosis of tuberculosis and resistance to rifampin and isoniazid in Veracruz, México. (United States)

    Zenteno-Cuevas, Roberto; Cuevas-Cordoba, Betzaida; Enciso, Antonio; Enciso, Leonor; Cuellar, Aremy


    Mutations at codons 526 and 531 in the rpoB gene and at 315 in the katG gene are considered diagnostic markers for resistance to rifampin and isoniazid in tuberculosis. The aim of this study was to design and evaluate three TaqMan probes for the identification of these mutations in 138 respiratory samples positive for acid-fast bacilli, and 32 clinical isolates from a region with considerable levels of drug resistance. The specificities of the probes for the diagnosis of resistance to both drugs were 100%; however, the sensitivities were calculated to be 50% for isoniazid and 56% for rifampin. DNA sequencing of rpoB and katG; and the spoligotyping assay of the clinical isolates, confirmed the diversity of the mutations and the presence of 11 spoligotypes with a shared international type and eight unique spoligotypes. Analysis of the respiratory samples identified 22 (16%) as drug-resistant and 4 (3%) as multidrug-resistant tuberculosis. The diagnostic value of the TaqMan probes was compromised by the diversity of mutations found in the clinical isolates. This highlights the need for better understanding of the molecular mechanisms responsible for drug resistance prior to the use of molecular probes, especially in regions with significant levels of drug-resistant tuberculosis.

  13. Activity of daptomycin or linezolid in combination with rifampin or gentamicin against biofilm-forming Enterococcus faecalis or E. faecium in an in vitro pharmacodynamic model using simulated endocardial vegetations and an in vivo survival assay using Galleria mellonella larvae. (United States)

    Luther, Megan K; Arvanitis, Marios; Mylonakis, Eleftherios; LaPlante, Kerry L


    Enterococci are the third most frequent cause of infective endocarditis. A high-inoculum stationary-phase in vitro pharmacodynamic model with simulated endocardial vegetations was used to simulate the human pharmacokinetics of daptomycin at 6 or 10 mg/kg of body weight/day or linezolid at 600 mg every 12 h (q12h), alone or in combination with gentamicin at 1.3 mg/kg q12h or rifampin at 300 mg q8h or 900 mg q24h. Biofilm-forming, vancomycin-susceptible Enterococcus faecalis and vancomycin-resistant Enterococcus faecium (vancomycin-resistant enterococcus [VRE]) strains were tested. At 24, 48, and 72 h, all daptomycin-containing regimens demonstrated significantly more activity (decline in CFU/g) than any linezolid-containing regimen against biofilm-forming E. faecalis. The addition of gentamicin to daptomycin (at 6 or 10 mg/kg) in the first 24 h significantly improved bactericidal activity. In contrast, the addition of rifampin delayed the bactericidal activity of daptomycin against E. faecalis, and the addition of rifampin antagonized the activities of all regimens against VRE at 24 h. Also, against VRE, the addition of gentamicin to linezolid at 72 h improved activity and was bactericidal. Rifampin significantly antagonized the activity of linezolid against VRE at 72 h. In in vivo Galleria mellonella survival assays, linezolid and daptomycin improved survival. Daptomycin at 10 mg/kg improved survival significantly over that with linezolid against E. faecalis. The addition of gentamicin improved the efficacy of daptomycin against E. faecalis and those of linezolid and daptomycin against VRE. We conclude that in enterococcal infection models, daptomycin has more activity than linezolid alone. Against biofilm-forming E. faecalis, the addition of gentamicin in the first 24 h causes the most rapid decline in CFU/g. Of interest, the addition of rifampin decreased the activity of daptomycin against both E. faecalis and VRE.

  14. Detection of rifampin resistance patterns in Mycobacterium tuberculosis strains isolated in Iran by polymerase chain reaction-single-strand conformation polymorphism and direct sequencing methods

    Directory of Open Access Journals (Sweden)

    Bahram Nasr Isfahani


    Full Text Available Mutations in the rpoB locus confer conformational changes leading to defective binding of rifampin (RIF to rpoB and consequently resistance in Mycobacterium tuberculosis. Polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP was established as a rapid screening test for the detection of mutations in the rpoB gene, and direct sequencing has been unambiguously applied to characterize mutations. A total of 37 of Iranian isolates of M. tuberculosis, 16 sensitive and 21 resistant to RIF, were used in this study. A 193-bp region of the rpoB gene was amplified and PCR-SSCP patterns were determined by electrophoresis in 10% acrylamide gel and silver staining. Also, 21 samples of 193-bp rpoB amplicons with different PCR-SSCP patterns from RIFr and 10 from RIFs were sequenced. Seven distinguishable PCR-SSCP patterns were recognized in the 21 Iranian RIFr strains, while 15 out of 16 RIFs isolates demonstrated PCR-SSCP banding patterns similar to that of sensitive standard strain H37Rv. However one of the sensitive isolates demonstrated a different pattern. There were seen six different mutations in the amplified region of rpoB gene: codon 516(GAC/GTC, 523(GGG/GGT, 526(CAC/TAC, 531(TCG/TTG, 511(CTG/TTG, and 512(AGC/TCG. This study demonstrated the high specificity (93.8% and sensitivity (95.2% of PCR-SSCP method for detection of mutation in rpoB gene; 85.7% of RIFr strains showed a single mutation and 14.3% had no mutations. Three strains showed mutations caused polymorphism. Our data support the common notion that rifampin resistance genotypes are generally present mutations in codons 531 and 526, most frequently found in M. tuberculosis populations regardless of geographic origin.

  15. Detection of rifampin resistance patterns in Mycobacterium tuberculosis strains isolated in Iran by polymerase chain reaction-single-strand conformation polymorphism and direct sequencing methods. (United States)

    Isfahani, Bahram Nasr; Tavakoli, Akbar; Salehi, Mansoor; Tazhibi, Mehdi


    Mutations in the rpoB locus confer conformational changes leading to defective binding of rifampin (RIF) to rpoB and consequently resistance in Mycobacterium tuberculosis. Polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) was established as a rapid screening test for the detection of mutations in the rpoB gene, and direct sequencing has been unambiguously applied to characterize mutations. A total of 37 of Iranian isolates of M. tuberculosis, 16 sensitive and 21 resistant to RIF, were used in this study. A 193-bp region of the rpoB gene was amplified and PCR-SSCP patterns were determined by electrophoresis in 10% acrylamide gel and silver staining. Also, 21 samples of 193-bp rpoB amplicons with different PCR-SSCP patterns from RIFr and 10 from RIFs were sequenced. Seven distinguishable PCR-SSCP patterns were recognized in the 21 Iranian RIFr strains, while 15 out of 16 RIFs isolates demonstrated PCR-SSCP banding patterns similar to that of sensitive standard strain H37Rv. However one of the sensitive isolates demonstrated a different pattern. There were seen six different mutations in the amplified region of rpoB gene: codon 516(GAC/GTC), 523(GGG/GGT), 526(CAC/TAC), 531(TCG/TTG), 511(CTG/TTG), and 512(AGC/TCG). This study demonstrated the high specificity (93.8%) and sensitivity (95.2%) of PCR-SSCP method for detection of mutation in rpoB gene; 85.7% of RIFr strains showed a single mutation and 14.3% had no mutations. Three strains showed mutations caused polymorphism. Our data support the common notion that rifampin resistance genotypes are generally present mutations in codons 531 and 526, most frequently found in M. tuberculosis populations regardless of geographic origin.

  16. Ototoxic Medications (Medication Effects) (United States)

    ... Information for the Public / Hearing and Balance Ototoxic Medications (Medication Effects) By Barbara Cone, Patricia Dorn, Dawn Konrad- ... Audiology Information Series [PDF]. What Is Ototoxicity? Certain medications can damage the ear, resulting in hearing loss, ...

  17. Application of genotype MTBDRplus in rapid detection of the Mycobacterium tuberculosis complex as well as its resistance to isoniazid and rifampin in a high volume laboratory in Southern China. (United States)

    Zhang, Lei; Ye, Yuanxing; Duo, Lina; Wang, Tingting; Song, Xingbo; Lu, Xiaojun; Ying, Binwu; Wang, Lanlan


    The alarmingly worsening epidemics of drug-resistant tuberculosis (TB) call urgent need for a simple method for the rapid detection of drug-resistant TB in clinical settings. In an attempt to establish a rapid procedure for laboratory diagnosis of TB and investigate the local TB epidemiology, molecular line probe assay of the Genotype MTBDRplus was used to identify Mycobacterium tuberculosis complex (MTBC) and detect mutations conferring resistance to two most active first-line drugs against TB: Rifampin and Isoniazid. 96 acid-fast bacillus (AFB) smear- positive sputums and 18 PCR-positive non-sputum specimens have been determined for the MTBC and resistance to Rifampin and Isoniazid. The MTBC detection rates in two sources of specimens were 93.8% (90/96) and 77.8% (14/18) respectively. The overall drug resistance (Rifampin or Isoniazid) occurred in 34.6% (36/104). Resistance to rifampin (RMP) was 28.8% (30/104) and 25% (26/104) was to Isoniazid (INH), in which high level drug resistance accounted for 88.5% (23/26) and low level drug resistance accounted for 7.7% (2/26). Multidrug resistance (MDR), defined as resistant to both RMP and INH, was found in 19.2% (20/104) of clinical samples, which was double that of official statistics. In addition, 63.3% (19/30) RMP-resistant mutations were identified in the region of RopB 530-533 and 57.9% (11/19) were the S531L mutation. 84.6% (22/26) of resistance to INH was mediated by Kat S315T1 mutations which conferred the high-level resistance to INH. The Genotype MTBDRplus line probe assay is a suitable and applicable method for establishing the rapidness in detection of drug-resistant TB in clinical laboratory. It will be a valuable addition to the conventional TB diagnostic approaches.

  18. 治疗剂量下4种抗结核药物与Caco-2细胞上P-gp相互作用研究%Initial Study on Interaction between Therapeutic Doses of Four Anti-Tuberculosis Drugs and P-Glycoprotein in Caco-2 Cells

    Institute of Scientific and Technical Information of China (English)

    方平飞; 高维; 李焕德; 刘艺平


    目的 研究治疗剂量下4种抗结核药物(异烟肼、左氧氟沙星、乙胺丁醇、吡嗪酰胺)对Caco-2细胞上P-糖蛋白功能、表达及MDR1 mRNA表达的影响,从而解释联合抗痨治疗中不同组合的合理性.方法 采用流式细胞仪测定细胞内罗丹明-123的浓度,考察药物对P-糖蛋白功能的影响,流式细胞术分析药物对Caco-2细胞上P-糖蛋白表达的影响,实时荧光定量PCR技术分析药物对Caco-2细胞MDRI基因mRNA水平表达的影响.结果 含药培养20 d后,异烟肼和乙胺丁醇减少了罗丹明-123在Caco-2细胞内的蓄积(P<0.05),为诱导作用;异烟肼、乙胺丁醇均上调了Caco-2细胞上P-糖蛋白的表达(P<0.05),其P-糖蛋白表达量分别为阴性对照组的3.5和3.8倍;同时上调了Caco-2细胞上MDR1 mRNA的表达(P<0.05),其MDRImRNA的表达量分别为阴性对照组的11.5和11倍.左氧氟沙星增加了罗丹明-123在Caco-2细胞内的蓄积(P<0.05),为抑制作用;下调了Caco-2细胞上P-糖蛋白和MDR1 mRNA的表达(P<0.05),其P-糖蛋白和MDR1 mRNA表达量分别为阴性对照组的50%和32%.而吡嗪酰胺与P-糖蛋白无明显相互作用.结论 治疗剂量的异烟肼和乙胺丁醇为P-糖蛋白的诱导剂,左氧氟沙星为P-糖蛋白的抑制剂,而吡嗪酰胺对P-糖蛋白功能和表达无明显影响.%OBJECTIVE To study the effects of four anti-tuberculosis drugs on the function and expression of P-glycoprotein and the MDR1 mRNA expression, for explaining the rationality of different combination in anti-tuberculosis chemotherapy. METHODS The effect of the drugs on P-glycoprotein function was analyzed using Rh-123 assay. The flow cytometry was used to determine the intracellular Rh-123 concentration and the expression of P-glycoprotein in Caco-2 cells. Real-time fluorescent quantitative polymerase chain reaction was used to measure the expression of MDR1 gene mRNA in Caco-2 cells. RESULTS After the intervention for 20 d, the

  19. Some Nigerian Anti-Tuberculosis Ethnomedicines: A Preliminary Efficacy Assessment (United States)

    Ibekwe, Nneka N.; Nvau, John B.; Oladosu, Peters O.; Usman, Auwal M.; Ibrahim, Kolo; Boshoff, Helena I.; Dowd, Cynthia S.; Orisadipe, Abayomi T.; Aiyelaagbe, Olapeju; Adesomoju, Akinbo A.; Barry, Clifton E.; Okogun, Joseph I.


    Ethnopharmacological significance Nigerian herbalists possess indigenous ethnomedicinal recipes for the management of tuberculosis and related ailments. Aim of the study To carry out a collaborative preliminary modern scientific evaluation of the efficacy of some Nigerian ethnomedicines used by traditional medicine practitioners (TMPs) in the management of tuberculosis and related ailments Materials and methods Ethnomedicinal recipes (ETMs) were collected from TMPs from locations in various ecological zones of Nigeria under a collaborative understanding. The aqueous methanolic extracts of the ETMs were screened against Mycobacterium bovis, BCG and Mycobacterium tuberculosis (M. tb.) strain H37Rv using the broth microdilution method. Results Extracts of ETMs screened against BCG showed 69% activity against the organism. The activities varied from weak, ≤ 2500μg /mL to highly active, 33μg /mL 64% of the extracts were active against M. tb. The activities of the extracts against M.tb. varied from weak, ≤ 2500μg /mL to highly active, 128μg/mL. There was 77% agreement in results obtained using BCG or M. tb. as test organisms Conclusion The results show clear evidence for the efficacy of the majority of indigenous Nigerian herbal recipes in the ethnomedicinal management of tuberculosis and related ailments. BCG may be effectively used, to a great extent, as the organism for screening for potential anti-M. tb. agents. A set of prioritization criteria for the selection of plants for initial further studies for the purpose of antituberculsis drug discovery research is proposed. PMID:24911338

  20. Screening difficult-to-reach populations for tuberculosis using a mobile medical unit, Punjab India (United States)

    Binepal, G.; Agarwal, P.; Kaur, N.; Singh, B.; Bhagat, V.; Verma, R. P.; Satyanarayana, S.; Oeltmann, J. E.


    Background: In India, the National Health Mission has provided one mobile medical unit (MMU) per district in the state of Punjab to provide primary health care services for difficult-to-reach populations. Objectives: To determine the number of patients with presumptive tuberculosis (TB) and the number of TB cases detected and treated among patients who used the MMU services from May to December 2012 in Mohali district, Punjab, India. Methods: A cross-sectional study was conducted and registers of the out-patient, laboratory, radiology, and TB departments of the MMU were reviewed to determine the number of persons presumed to have TB and the number of persons diagnosed with TB. Results: Of 8346 patients who attended the MMUs, 663 (8%) had symptoms suggestive of TB. Among those with TB symptoms, 540 (81%) were evaluated for pulmonary TB using sputum examination or chest X-ray. In total, 58 (11%) patients had clinical or laboratory evidence of pulmonary TB, of whom 21 (36%) started anti-tuberculosis treatment. Conclusion: As MMUs are an integral part of the general public health system, these units have the potential to detect TB cases among difficult-to-reach populations. Additional research is required to optimise the diagnosis of TB at MMUs and to increase rates of TB treatment initiation. PMID:26767177

  1. Comparative Evaluation of Sloppy Molecular Beacon and Dual-Labeled Probe Melting Temperature Assays to Identify Mutations in Mycobacterium tuberculosis Resulting in Rifampin, Fluoroquinolone and Aminoglycoside Resistance.

    Directory of Open Access Journals (Sweden)

    Sandy S Roh

    Full Text Available Several molecular assays to detect resistance to Rifampin, the Fluoroquinolones, and Aminoglycosides in Mycobacterium tuberculosis (M. tuberculosis have been recently described. A systematic approach for comparing these assays in the laboratory is needed in order to determine the relative advantage of each assay and to decide which ones should be advanced to evaluation. We performed an analytic comparison of a Sloppy Molecular Beacon (SMB melting temperature (Tm assay and a Dual labeled probe (DLP Tm assay. Both assays targeted the M. tuberculosis rpoB, gyrA, rrs genes and the eis promoter region. The sensitivity and specificity to detect mutations, analytic limit of detection (LOD and the detection of heteroresistance were tested using a panel of 56 clinical DNA samples from drug resistant M. tuberculosis strains. Both SMB and DLP assays detected 29/29 (100% samples with rpoB RRDR mutations and 3/3 (100% samples with eis promoter mutations correctly. The SMB assay detected all 17/17 gyrA mutants and 22/22 rrs mutants, while the DLP assay detected 16/17 (94% gyrA mutants and 12/22 (55% rrs mutants. Both assays showed comparable LODs for detecting rpoB and eis mutations; however, the SMB assay LODs were at least two logs better for detecting wild type and mutants in gyrA and rrs targets. The SMB assay was also moderately better at detecting heteroresistance. In summary, both assays appeared to be promising methods to detect drug resistance associated mutations in M. tuberculosis; however, the relative advantage of each assay varied under each test condition.

  2. Evaluation of the Antimicrobial Efficacy of a Novel Rifampin/Minocycline-Coated, Noncrosslinked Porcine Acellular Dermal Matrix Compared With Uncoated Scaffolds for Soft Tissue Repair. (United States)

    Majumder, Arnab; Scott, Jeffrey R; Novitsky, Yuri W


    Background Despite meticulous aseptic technique and systemic antibiotics, bacterial colonization of mesh remains a critical issue in hernia repair. A novel minocycline/rifampin tyrosine-coated, noncrosslinked porcine acellular dermal matrix (XenMatrix AB) was developed to protect the device from microbial colonization for up to 7 days. The objective of this study was to evaluate the in vitro and in vivo antimicrobial efficacy of this device against clinically isolated methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli. Methods XenMatrix AB was compared with 5 existing uncoated soft tissue repair devices using in vitro methods of zone of inhibition (ZOI) and scanning electron microscopy (SEM) at 24 hours following inoculation with MRSA or E coli These devices were also evaluated at 7 days following dorsal implantation and inoculation with MRSA or E coli (60 male New Zealand white rabbits, n = 10 per group) for viable colony-forming units (CFU), abscess formation and histopathologic response, respectively. Results In vitro studies demonstrated a median ZOI of 36 mm for MRSA and 16 mm for E coli for XenMatrix AB, while all uncoated devices showed no inhibition of bacterial growth (0 mm). SEM also demonstrated no visual evidence of MRSA or E coli colonization on the surface of XenMatrix AB compared with colonization of all other uncoated devices. In vivo XenMatrix AB demonstrated complete inhibition of bacterial colonization, no abscess formation, and a reduced inflammatory response compared with uncoated devices. Conclusion We demonstrated that XenMatrix AB possesses potent in vitro and in vivo antimicrobial efficacy against clinically isolated MRSA and E coli compared with uncoated devices.

  3. Rapid direct detection of multiple rifampin and isoniazid resistance mutations in Mycobacterium tuberculosis in respiratory samples by real-time PCR. (United States)

    Marín, Mercedes; García de Viedma, Darío; Ruíz-Serrano, María Jesús; Bouza, Emilio


    Rapid detection of resistance in Mycobacterium tuberculosis can optimize the efficacy of antituberculous therapy and control the transmission of resistant M. tuberculosis strains. Real-time PCR has minimized the time required to obtain the susceptibility pattern of M. tuberculosis strains, but little effort has been made to adapt this rapid technique to the direct detection of resistance from clinical samples. In this study, we adapted and evaluated a real-time PCR design for direct detection of resistance mutations in clinical respiratory samples. The real-time PCR was evaluated with (i) 11 clinical respiratory samples harboring bacilli resistant to isoniazid (INH) and/or rifampin (RIF), (ii) 10 culture-negative sputa spiked with a set of strains encoding 14 different resistance mutations in 10 independent codons, and (iii) 16 sputa harboring susceptible strains. The results obtained with this real-time PCR design completely agreed with DNA sequencing data. In all sputa harboring resistant M. tuberculosis strains, the mutation encoding resistance was successfully detected. No mutation was detected in any of the susceptible sputa. The test was applied only to smear-positive specimens and succeeded in detecting a bacterial load equivalent to 10(3) CFU/ml in sputum samples (10 acid-fast bacilli/line). The analytical specificity of this method was proved with a set of 14 different non-M. tuberculosis bacteria. This real-time PCR design is an adequate method for the specific and rapid detection of RIF and INH resistance in smear-positive clinical respiratory samples.

  4. Locked Nucleic Acid Probe-Based Real-Time PCR Assay for the Rapid Detection of Rifampin-Resistant Mycobacterium tuberculosis.

    Directory of Open Access Journals (Sweden)

    Yong Zhao

    Full Text Available Drug-resistant Mycobacterium tuberculosis can be rapidly diagnosed through nucleic acid amplification techniques by analyzing the variations in the associated gene sequences. In the present study, a locked nucleic acid (LNA probe-based real-time PCR assay was developed to identify the mutations in the rpoB gene associated with rifampin (RFP resistance in M. tuberculosis. Six LNA probes with the discrimination capability of one-base mismatch were designed to monitor the 23 most frequent rpoB mutations. The target mutations were identified using the probes in a "probe dropout" manner (quantification cycle = 0; thus, the proposed technique exhibited superiority in mutation detection. The LNA probe-based real-time PCR assay was developed in a two-tube format with three LNA probes and one internal amplification control probe in each tube. The assay showed excellent specificity to M. tuberculosis with or without RFP resistance by evaluating 12 strains of common non-tuberculosis mycobacteria. The limit of detection of M. tuberculosis was 10 genomic equivalents (GE/reaction by further introducing a nested PCR method. In a blind validation of 154 clinical mycobacterium isolates, 142/142 (100% were correctly detected through the assay. Of these isolates, 88/88 (100% were determined as RFP susceptible and 52/54 (96.3% were characterized as RFP resistant. Two unrecognized RFP-resistant strains were sequenced and were found to contain mutations outside the range of the 23 mutation targets. In conclusion, this study established a sensitive, accurate, and low-cost LNA probe-based assay suitable for a four-multiplexing real-time PCR instrument. The proposed method can be used to diagnose RFP-resistant tuberculosis in clinical laboratories.

  5. Locked Nucleic Acid Probe-Based Real-Time PCR Assay for the Rapid Detection of Rifampin-Resistant Mycobacterium tuberculosis. (United States)

    Zhao, Yong; Li, Guilian; Sun, Chongyun; Li, Chao; Wang, Xiaochen; Liu, Haican; Zhang, Pingping; Zhao, Xiuqin; Wang, Xinrui; Jiang, Yi; Yang, Ruifu; Wan, Kanglin; Zhou, Lei


    Drug-resistant Mycobacterium tuberculosis can be rapidly diagnosed through nucleic acid amplification techniques by analyzing the variations in the associated gene sequences. In the present study, a locked nucleic acid (LNA) probe-based real-time PCR assay was developed to identify the mutations in the rpoB gene associated with rifampin (RFP) resistance in M. tuberculosis. Six LNA probes with the discrimination capability of one-base mismatch were designed to monitor the 23 most frequent rpoB mutations. The target mutations were identified using the probes in a "probe dropout" manner (quantification cycle = 0); thus, the proposed technique exhibited superiority in mutation detection. The LNA probe-based real-time PCR assay was developed in a two-tube format with three LNA probes and one internal amplification control probe in each tube. The assay showed excellent specificity to M. tuberculosis with or without RFP resistance by evaluating 12 strains of common non-tuberculosis mycobacteria. The limit of detection of M. tuberculosis was 10 genomic equivalents (GE)/reaction by further introducing a nested PCR method. In a blind validation of 154 clinical mycobacterium isolates, 142/142 (100%) were correctly detected through the assay. Of these isolates, 88/88 (100%) were determined as RFP susceptible and 52/54 (96.3%) were characterized as RFP resistant. Two unrecognized RFP-resistant strains were sequenced and were found to contain mutations outside the range of the 23 mutation targets. In conclusion, this study established a sensitive, accurate, and low-cost LNA probe-based assay suitable for a four-multiplexing real-time PCR instrument. The proposed method can be used to diagnose RFP-resistant tuberculosis in clinical laboratories.

  6. Comparison of clinical characteristics between rifampin-dependent and rifampin-resistant patients with pulmonary tuberculosis%依赖利福平与耐利福平结核杆菌肺结核的临床特点比较

    Institute of Scientific and Technical Information of China (English)

    李艳; 谭守勇; 罗春明; 黎燕琼; 覃红娟; 冯志宇


    Objective To compare the clinical characteristics of rifampin-dependent (R-dependent Mycobacterium tuberculosis) and rifampin-resistant (R-resistant Mycobacterium tuberculosis) patients with pulmonary tuberculosis. Methods The clinical data including the demographic data, age groups, course of disease, history of chemotherapy with anti-TB drugs, and results of drug susceptibility test were collected from 61 cases of R-dependent pulmonary tuberculosis and 148 cases of R-resistant pulmonary tuberculosis treated between October, 2008 and January, 2012. Results Most of the R-dependent and R-resistant patients were between 30 and 44 years of age. The R-dependent patients included 12 receiving the first treatment patients and 49 with previous treatments, and the R-resistant patients included 11 without and 137 with previous treatments. The multi-drug resistant rate was 80.3% in R-dependent group, as compared to 92.6% in R-resistant group. Conclusion Most of the patients infected with R-dependent Mycobacterium tuberculosis are young or middle-aged, often having serious disease conditions. Detecting rifampin dependence is important for patients with initial treatment failure. Multi-drug resistance therapy guideline should be applied to patients infected with R-dependent Mycobacterium tuberculosis to improve the cure rate.%目的 分析比较依赖利福平结核杆菌(依赖R菌)与耐利福平结核杆菌(耐R菌)肺结核发病特点.方法 2008年10月~2012年1月在我院住院或门诊的61例依赖R菌肺结核和148例耐R菌肺结核患者,记录人口学资料、年龄分组、抗结核药化疗史、药敏试验结果.结果 (1)依赖R菌与耐R菌肺结核均以30~44岁年龄组为主;(2)依赖R菌肺结核初治12例(12/61=19.7%),复治49例;耐R菌肺结核初治11例(11/148=7.4%),复治137例;(3)依赖R菌与耐R菌肺结核发生耐多药率分别是80.3%和92.6%.结论 依赖R菌肺结核患者以中青年为主,病情重.对初治肺结

  7. Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas. (United States)

    Solera, J; Rodríguez-Zapata, M; Geijo, P; Largo, J; Paulino, J; Sáez, L; Martínez-Alfaro, E; Sánchez, L; Sepulveda, M A; Ruiz-Ribó, M D


    Brucellosis is a common zoonosis in many parts of the world; the best regimen for the treatment of brucellosis has not been clearly determined. We have carried out a multicenter, open, controlled trial in five general hospitals in Spain to compare the efficacy and safety of doxycycline and rifampin (DR) versus doxycycline and streptomycin (DS) for the treatment of human brucellosis. The study included 194 ambulatory or hospitalized patients with acute brucellosis, without endocarditis or neurobrucellosis. The diagnostic criterion was isolation of Brucella species from blood or other tissues (n = 120) or a standard tube agglutination titer of 1/160 or more for anti-Brucella antibodies with compatible clinical findings (n = 74). Patients were randomly assigned to receive either 100 mg of doxycycline twice daily plus rifampin, 900 mg/day, in a single morning dose for 45 days (DR group) or the same dose of doxycycline for 45 days plus streptomycin, 1 g/day, intramuscularly for 14 days (DS group). A lack of therapeutic efficacy developed in 8 of the 100 patients in the DR group (8%) and in 2 of the 94 patients in the DS group (2%)(P = 0.10). Relapses occurred in 16 of the 100 patients in the DR group (16%) but in only 5 of the 94 patients in the DS group (5.3%) (P = 0.02). When relapse was considered in combination with initial lack of efficacy, 26 patients in the DR group (24%) and 7 patients in the DS group (7.45%) failed to respond to therapy (P = 0.0016). In general, therapy was well tolerated and only four patients (4%) in the DR group and two (2%) in the DS group had episodes of adverse effects necessitating discontinuation of treatment (P> 0.2). We conclude that a doxycycline-and-rifampin regimen is less effective than the doxycycline-and-streptomycin regimen in patients with acute brucellosis.

  8. [Evaluation of the genotype MTBDR assay for rapid detection of rifampin and isoniazid resistance in clinical Mycobacterium tuberculosis complex clinical isolates]. (United States)

    Aslan, Gönül; Tezcan, Seda; Emekdaş, Gürol


    Rapid identification of resistant Mycobacterium tuberculosis complex isolates is quite important for the establishment of early and appropriate therapy. The Genotype MTBDR (Hain Lifescience, Nehren, Germany) is a commercially available DNA strip assay designed for the rapid detection of rpoB and katG gene mutations in clinical isolates. This study was conducted to determine the mutation types of phenotypically drug resistant 26 M. tuberculosis complex clinical isolates [15 isoniazid (INH), 1 rifampin (RMP) and 10 INH and RMP resistant] by Genotype MTBDR (G-MTBDR) DNA strip assay and to compare the diagnostic performance of this test. Sixteen of 25 (64%) INH-resistant and 9 of 11 (81.8%) RMP-resistant clinical isolates were correctly identified with the presence of hybridization in mutation probe or lack of hybridization at least by one of the wild type probes, by G-MTBDR assay. Hybridization with mutation probes was detected in only 5 of the RMP resistant isolates. We observed rpoB MUT3 (S531L, Ser-->4Leu) mutation in 4 and rpoB MUT1 (D516V) in one of these isolates. In 56% (14/25) of the INH-resistant isolates, katG T1 (S315T1) hybridization pattern was observed at katG mutation probe. G-MTBDR assay couldn't identify two of the 11 (18.2%) RMP-resistant isolates and one of these iSolates was shown to have a mutation at codon 531 (TCG-GCG) and the other at codon 545 (CTG-->ATG), possibly not associated with resistance, by sequence analysis. In four of the eight (8/25; 32%) INH-resistant isolates not identified by G-MTBDR assay, DNA cycle sequencing revealed different nucleotide changes outside the most common mutation zone. One of these were at codon 293 (GCT-->ACT) in katG, one with dual mutation at 279 (GGC-->ACC) in katG and at 15th C-->T in inhA gene, one at 15th C-->T in inhA gene and one at 279 (GGC-->ACC) in katG gene region. DNA membrane strip assay can be a use ful tool for the rapid detection of resistant M. tuberculosis complex isolates and therefore

  9. Evaluation of the Xpert MTB/RIF assay for diagnosis of tuberculosis and rifampin resistance in county-level laboratories in Hunan province, China

    Institute of Scientific and Technical Information of China (English)

    Hu Peilei; Bai Liqiong; Liu Fengping; Ou Xichao; Zhang Zhiying; Yi Songlin; Chen Zhongnan


    Background The Xpert MTB/RIF showed high sensitivity and specificity in previous studies carried out in different epidemiological and geographical settings and patient populations in high-burden tuberculosis (TB) countries.However,there were little data obtained by validation or demonstration study of the assay in China.In this study,the performance of Xpert MTB/RIF was investigated in two county-level laboratories in Hunan Province,China.Methods Consecutive patients with suspected pulmonary tuberculosis (PTB) and suspicion for multidrug-resistant tuberculosis (MDR-TB) were enrolled.For each patient suspected to have PTB,three sputum specimens (one spot sputum,one night sputum,and one morning sputum) were collected and each sputum was tested with smear microscopy,L(o)wenstein-Jensen (LJ) culture,and Xpert MTB/RIF test.For comparison across subgroups and testing methods,95% confidence intervals were calculated.All analyses were done with SPSS 16.0,and P <0.05 was regarded as significant.Results For case detection,the sensitivity of Xpert MTB/RIF was 100% for smear-and culture-positive TB and 88.6% for smear-negative and culture-positive TB; the overall sensitivity was 94.5% for all culture-positive patients.The specificity was 99.8%.The sensitivity of Xpert MTB/RIF assay was 22.0% in clinical TB patients and the specificity reached 100.0% in the group of patients who are infected with nontuberculous mycobacteria.For the detection of rifampin resistance,the sensitivity of MTB/RIF RIF-resistance detection was 92.9%,and the specificity was 98.7%.Of the 26 Xpert MTB/RIF-positive and RIF-resistant patients confirmed by LJ proportion tests,20 (76.9%) patients were infected by MDR-TB.Conclusions The Xpert MTB/RIF assay is a highly sensitive and specific method for diagnosis of TB and RIF resistance,which will enable it to have the potential to be used in county-level laboratories and lead to the reduction of the infectious pool and improvements in TB

  10. Combined real-time PCR and rpoB gene pyrosequencing for rapid identification of Mycobacterium tuberculosis and determination of rifampin resistance directly in clinical specimens. (United States)

    Halse, Tanya A; Edwards, Justine; Cunningham, Phyllis L; Wolfgang, William J; Dumas, Nellie B; Escuyer, Vincent E; Musser, Kimberlee A


    Our laboratory has developed a rapid, sensitive, and specific molecular approach for detection in clinical specimens, within 48 h of receipt, of both Mycobacterium tuberculosis complex (MTBC) DNA and mutations within the 81-bp core region of the rpoB gene that are associated with rifampin (RIF) resistance. This approach, which combines an initial real-time PCR with internal inhibition assessment and a pyrosequencing assay, was validated for direct use with clinical specimens. To assess the suitability of real-time PCR for use with respiratory, nonrespiratory, acid-fast bacillus (AFB)-positive and AFB-negative specimens, we evaluated specimens received in our laboratory between 11 October 2007 and 30 June 2009. With culture used as the "gold standard," the sensitivity, specificity, and positive and negative predictive values were determined for 1,316 specimens to be as follows: for respiratory specimens, 94.7%, 99.9%, 99.6%, and 98.6%, respectively; for nonrespiratory specimens, 88.5%, 100.0%, 100.0%, and 96.9%, respectively; for AFB-positive specimens, 99.6%, 100.0%, 100.0%, and 97.7%, respectively; and for AFB-negative specimens, 75.4%, 99.9%, 98.0%, and 98.4%, respectively. PCR inhibition was determined to be minimal in this assay, occurring in 0.2% of tests. The rpoB gene pyrosequencing assay was evaluated in a similar prospective study, in which 148 clinical specimens positive for MTBC DNA by real-time PCR were tested. The final results revealed that the results of direct testing of clinical specimens by the pyrosequencing assay were 98.6% concordant with the results of conventional testing for susceptibility to RIF in liquid culture and that our assay displayed adequate sensitivity for 96.6% of the clinical specimens tested. Used together, these assays provide reliable results that aid with the initial management of patients with suspected tuberculosis prior to the availability of the results for cultured material, and they also provide the ability to predict

  11. Comparative evaluation of the Nitrate Reductase Assay and the Resazurin Microtitre Assay for drug susceptibility testing of Mycobacterium tuberculosis against first line anti-tuberculosis drugs Avaliação comparative dos métodos Nitrato Redutase e Microdiluição com Resazurina para testar a sensibilidade do Mycobacterium tuberculosis frente aos anti-tuberculosos de primeira linha

    Directory of Open Access Journals (Sweden)

    Karine O. Sanchotene


    Full Text Available Tuberculosis remains as a serious infection disease of worldwide distribution, with high morbidity and mortality, mainly in low socio-economic condition countries. The state of emergency of tuberculosis caused by the resistant and multidrug-resistant (MDR strains, became the main threat to the tuberculosis treatment and control programs. A fast detection method for the resistant strains will allow the implementation of an adequate treatment and contribute for controlling the dissemination of these resistant strains. This study evaluated the performance of the nitrate reductase assay in solid (NRA-LJ and liquid (NRA-7H9 media, to determine the susceptibility to first line anti-tuberculosis drugs: isoniazid (INH, rifampicin (RMP, ethambutol (EMB and streptomycin (SMR. Both methods NRA-LJ and NRA-7H9 were evaluated among 18 strains with a known susceptibility profile. The resazurin microtiter assay (REMA was performed as a reference method. One hundred percent of accordance was observed between NRA-7H9 and REMA for the four tested drugs. When the NRA-LJ method was compared to REMA, the sensitivity and the specificity to INH, RMP, EMB and SMR were 100%, 100 %, 85.7%, 76.9% and 80%, 100%, 75% and 80%, respectively. From the 57 clinical isolates of M. tuberculosis evaluated by NRA-7H9 and REMA, 56 (98.2% were sensitive to all antibiotics tested (INH, RMP, EMB and SMR by the NRA-7H9 method, while three of these strains were resistant to INH by REMA. One strain showed resistance to INH and RMP for both methods, and MIC of 1.0 µg/ml to INH for both methods, while MIC of 1.0 and 2.0 µg/ml to RMP for REMA and NRA-7H9, respectively. The three assays showed a high level of agreement for rapid detection of rifampicin and isoniazid resistance. Regarding rapidness, the detection of color change in the NRA method is within instants as compared to the overnight incubation required for the REMA test. NRA might represent an inexpensive and alternative assay for

  12. Study on the relationship between the gene polymorphisms of cytochrome P450 1A1 or glutathione transferase P1 and anti-tuberculosis drug-induced liver injury%CYP1 A1和 GSTP1基因多态性与抗结核药物性肝损伤的关系

    Institute of Scientific and Technical Information of China (English)

    贺蕾; 高丽; 史哲; 李世明; 张朋; 郑国颖; 李云; 胡泊; 冯福民


    Objective To retrospectively investigate the relationship be-tween the gene polymorphisms of cytochrome P450 1 A1 \\glutathione transferase P1 ( CYP1 A1 or GSTP1 ) and anti -tuberculosis drug -induced liver injury ( ADLI).Methods Total 127 cases and 127 con-trols were collected in 1∶1 match.Their exposure data of data and blood samples were collected. The genotypes were detected by polymerase chain reaction and restriction fragment length polymorphism technique ( PCR -RFLP ) method SPSS 17.0 software was used to do Logistic regression analysis on environmental factors and genotype univariate and multivariate analysis.Results The allele frequencies of gene CYP1 A1 genes in two groups had no statistical difference.While the frequencies of AA, AG and GG genotypes at Ile105 Val site of GSTP1 gene were 55.91%, 32.28%, 11.81% in case group and 70.08%, 26.77%, 3.15%in control group.The analysis demonstrated that the frequencies of GSTP1 gene Ile105 Val genotypes in case group were significantly higher than those in control group ( P<0.05 ) .Univariate Logistic re-gression analysis showed that alcohol was the risk factor of ADLI, and after the regulation of certain factor in multivariate analysis, the GG genotype at Ile105 Val site of GSTP1 gene was still the risk factor of ADLI.Conclusion The polymorphim of Ile105 Val site of GSTP1 gene is correlated with the occur-rence of ADLI and GG carriers are considered as risk population.%目的:分析细胞色素P4501A1(CYP1A1)和谷胱甘肽转移酶P1(GSTP1)基因多态性与抗结核药物性肝损伤( ADLI )的相关性。方法抗结核治疗致肝损伤的结核病患者127例为病例组,127例无肝损伤者为对照组,收集其环境因素暴露资料及静脉血。 CYP1A1基因Msp I位点和GSTP1基因 Ile105 Val位点多态性检测用聚合酶链反应限制性片段长度多态法( PCR-RFLP )。用SPSS 17.0软件对环境因素和基因型进行单因素和多因素条件Logistic

  13. Abortion - medical (United States)

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

  14. Oral Medication (United States)

    ... Size: A A A Listen En Español Oral Medication The first treatment for type 2 diabetes blood ... new — even over-the-counter items. Explore: Oral Medication How Much Do Oral Medications Cost? Save money ...

  15. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter


    Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...

  16. Medical Management (United States)

    ... email share facebook twitter google plus linkedin Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

  17. Medication safety. (United States)

    Keohane, Carol A; Bates, David W


    Patient safety is a state of mind, not a technology. The technologies used in the medical setting represent tools that must be properly designed, used well, and assessed on an on-going basis. Moreover, in all settings, building a culture of safety is pivotal for improving safety, and many nontechnologic approaches, such as medication reconciliation and teaching patients about their medications, are also essential. This article addresses the topic of medication safety and examines specific strategies being used to decrease the incidence of medication errors across various clinical settings.

  18. 沙眼衣原体临床株对利福平的体外敏感性及rpoB基因耐药突变检测%In vitro activity of rifampin against and rpoB mutations in Chlamydia trachomatis clinical isolates

    Institute of Scientific and Technical Information of China (English)

    江勇; 杨丽娜; 刘原君; 侯淑萍; 齐蔓莉; 刘全忠


    目的 检测沙眼衣原体临床株对利福平的体外敏感性,探讨rpoB基因突变与临床耐药的关系.方法 采用微量细胞培养法确定利福平对52株沙眼衣原体临床株的最低抑菌浓度.扩增所有临床株以及标准株rpoB基因,然后进行单链构象多态性分析.并随机选取两株临床株进行测序.结果 52株临床菌株中未检出耐药株,利福平的最低抑菌浓度是0.004 ~ 0.030 mg/L.SSCP和测序均未发现rpoB耐药突变.结论 利福平治疗沙眼衣原体失败患者未检测到rpoB基因突变,利福平治疗失败与多种因素有关.%Objective To evaluate the susceptibility of Chlamydia trachomatis clinical isolates to rifampin, and assess the relationship between rpoB mutations and antibiotic resistance in them.Methods A microculture method was used to determine the minimal inhibitory concentration (MIC) of rifampin in 52 Chlamydia trachomatis clinical isolates.The rpoB gene was amplified from all the clinical isolates and a standard strain of Chlamydia trachomatis followed by single-strand conformation polymorphism (SSCP)analysis.Sequencing of PCR products was carried out for two clinical isolates.Results No rifampin-resistant strain was found among these clinical isolates.The MIC of rifampin varied from 0.004 to 0.030 mg/L Neither SSCP analysis nor sequencing showed rpoB mutations.Conclusions No rpoB mutations were found in Chlamydia trachomatis isolates from patients unresponsive to rifampin.The unresponsiveness to rifampin may be attributed to multiple factors.

  19. Medical Scientists (United States)

    ... Projected Employment, 2024 Change, 2014-24 Employment by Industry Percent Numeric SOURCE: U.S. Bureau of Labor Statistics, Employment Projections program Medical scientists, except epidemiologists 19- ...

  20. Medical Malpractice

    DEFF Research Database (Denmark)

    Grembi, Veronica


    MM first came to the attention of policy makers primarily in the USA where, from the 1970s, healthcare providers denounced problems in getting insurance for medical liability, pointing out to a crisis in the MM insurance market (Sage WM (2003) Understanding the first malpractice crisis of the 21th...... in the last decades also among European countries (Hospitals of the European Union (HOPE) (2004) Insurance and malpractice, final report. Brussels,; OECD (2006) Medical malpractice, insurance and coverage options, policy issues in insurance n.11; EC (European Commission, D.G. Sanco) (2006) Special...... eurobarometer medical errors)...

  1. Cardiac Medications (United States)

    ... for Medication For the treatment of heart failure Beta Blockers (Also known as Beta-Adrenergic Blocking Agents) Commonly ... have had a heart attack. Combined alpha and beta-blockers Combined alpha and beta-blockers are used as ...

  2. Medical Illustration (United States)

    ... Accredited programs prepare students for a career in academic or research health science centers, industry, or consulting. As members of the health career profession with strong communication skills, medical illustrators work closely with clients to interpret ...

  3. Medical education. (United States)

    Krishnan, P


    In theory, the Medical Council of India (MCI) determines the standards and qualifications of medical schools. It also sanctions curricula and ensures standards. Yet no standards exist on the mode of selection in medical schools, duration of study, course content, student stipends or period of internship. It takes 4.5 years to finish medical school. Students undergo preclinical, paraclinical, and clinical training. Most courses are in English which tends to favor the urban elite. Students cannot always communicate with patients in local languages. Textbooks often provide medical examples unrelated to India. Pedagogy consists mainly of lectures and rote learning predominates. Curricula tend not to provide courses in community health. Students pick up on the elitist attitudes of the faculty. For example, faculty do not put much emphasis on community health, individual health, equity in health care delivery, and teamwork. Further the education system is not patient oriented, but hospital or disease oriented. Faculty should train students in creating sanitation programs, knowing local nutritious foods, and in making community diagnoses. Yet they tend to be practitioners 1st then educators. Further faculty are not paid well and are not always invited to take part in improving curriculum, so morale is often low. Moreover experience in health planning and management issues is not required for administrators. In addition, medical schools are not well equipped with learning aids, libraries, or teaching staff. Tax revenues finance medical education. 75% of graduating physicians set up a private practice. Further many physicians go to urban areas. 34-57% emigrate to other countries. The problems of medical education will not be solved until the political and economic system becomes more responsive to the health needs of the people.

  4. Medical Renaissance. (United States)

    Toledo-Pereyra, Luis H


    The Medical Renaissance started as the regular Renaissance did in the early 1400s and ended in the late 1600s. During this time great medical personalities and scholar humanists made unique advances to medicine and surgery. Linacre, Erasmus, Leonicello and Sylvius will be considered first, because they fit the early classic Renaissance period. Andreas Vesalius and Ambroise Paré followed thereafter, making outstanding anatomical contributions with the publication of the "Human Factory" (1543) by Vesalius, and describing unique surgical developments with the publication of the "The Apologie and Treatise of Ambroise Paré." At the end of the Renaissance and beginning of the New Science, William Harvey, noted British medical doctor and cardiovascular researcher, discovered the general circulation. He published his findings in "The Motu Cordis" in 1628 (Figure 1). The Medical Renaissance, in summary, included a great number of accomplished physicians and surgeons who made especial contributions to human anatomy; Vesalius assembled detailed anatomical information; Paré advanced surgical techniques; and Harvey, a medical genius, detailed the circulatory anatomy and physiology.

  5. Medical emplotment

    DEFF Research Database (Denmark)

    Mønsted, Troels Sune

    ’. Theoretically the project departs from Computer Supported Cooperative Work and Participatory Design and is informed by Medical Informatics, Design Research and Science and Technology Studies. Methodically the project is founded on collaborative prototyping, ethnographic studies, and design interventions...... philosophy and building on theory on narrative reasoning, the dissertation offers the notions of emplotment and re-emplotment to describe how physicians marshal information from various sources, including the medical record, the patient and coSummary to form a narrative, when making sense of patients...

  6. Medical leasing. (United States)

    Holden, Elizabeth A


    Leases for medical space can have far-reaching (and sometimes unintentional) consequences for the future of the practice and the costs of the business. In order to prevent hardship and expense down the line, it is especially important to review the lease to make sure that it reflects the practice's goals, needs, and structure. This article provides a number of provisions that are especially crucial to review and negotiate when leasing medical space, including use restrictions, assignment and subleasing clauses, build-out terms, and legal compliance requirements.

  7. Medical Applications

    CERN Document Server

    Biscari, C


    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field.

  8. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter


    is the study of the sociocultural paragons that conceptually underlie the phenomenology of physician’s coming to take themselves as autonomous social agents. The paper relies on Hegel’s Phenomenology of Spirit and investigates dilemmas pertaining to first objectivist versus subjectivist views and second...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...

  9. Glaucoma medications. (United States)

    Chae, Bora; Cakiner-Egilmez, Tulay; Desai, Manishi


    Glaucoma is a common eye condition that affects millions of individuals worldwide, making it the second-leading cause of blindness. Because glaucoma is associated with increased IOP level, the primary goal in treatment of glaucoma includes lowering IOP to prevent further progression of the disease. While various surgical interventions exist, medical therapy is currently the first line of treatment. Medical treatment of glaucoma includes topical beta-blockers, alpha-2 agonists, prostaglandins, parasympathomimetics and CAIs. Anti-glaucoma agents help reduce IOP by affecting the production of aqueous humor or increasing the outflow of aqueous through the trabecular or uveoscleral pathway. Choosing an appropriate medical regimen can be challenging and various factors such as efficacy, safety, cost and patient compliance must be considered. First-line treatment is often topical beta-blockers or prostaglandin analogs. However, beta-blocking agents can be associated with systemic side effects and need to be used cautiously in patients with serious concomitant cardiopulmonary disease. Alpha-2 agonists and parasympathomimetics are often considered second- or third-line treatment options but good adjunctive agents. Oral CAIs are often indicated for patients with elevated IOP in an acute setting or for patients resistant to other glaucoma medications and patients who are not good surgical candidates.

  10. Medic Bleep. (United States)


    Medic Bleep is a secure instant messaging app that enables clinicians to discuss patient care quickly, securely and legally. It looks and feels like WhatsApp, but has been designed for the healthcare market to enable staff to communicate with each other, and to help speed up conversations between clinicians to increase efficiency.

  11. Medication Errors - A Review


    Vinay BC; Nikhitha MK; Patel Sunil B


    In this present review article, regarding medication errors its definition, medication error problem, types of medication errors, common causes of medication errors, monitoring medication errors, consequences of medication errors, prevention of medication error and managing medication errors have been explained neatly and legibly with proper tables which is easy to understand.

  12. Pyrosequencing for rapid detection of resistance to rifampin, isoniazid, ofloxacin and amikacin in Mycobacterium tuberculosis%焦磷酸测序技术检测结核分枝杆菌四种药物耐药性

    Institute of Scientific and Technical Information of China (English)

    郑瑞娟; 秦莲花; 周燕; 王洁; 乐军; 胡忠义


    Objective To develop an assay to determine Mycobacterium tuberculosis resistance to rifampin, isoniazid, ofloxacin and amikacin by pyrosequencing and evaluate the value of this method in clinical application. Methods Eighty-nine clinical isolates of Mycobacterium tuberculosis from tuberculosis patients were collected from Shanghai Pulmonary Hospital during 2008 to 2009. All strains were isolated from decontaminated sputum, cultured on Lowenstein-Jensen media and identified by traditional biochemical tests with standard methods. Ten Mycobacterium tuberculosis were selected from the strain bank of Shanghai Pulmonary Hospital. The optimal conditions of detection of rpoB, katG, gyrA and rrs gene by pyroseuencing were determined, using the 10 Mycobacterium tuberculosis strains whose drug susceptibility of Bactec 960 and sequence of rpoB, katG, gyrA, rrs gene were known. Then the drug susceptibility of 89 Mycobacterium tuberculosis clinical isolate strains were detected by pyrosequencing using this conditions and the results were compared with that of the Bactec 960 methods. Results The pyrosequencing program of sequence analysis was suitable for the detection of the mutations of rpoB and gyrA genes, and the program of single nucleotide polymorphism was suitable for katG and rrs genes. Among the 89 Mycobacterium tuberculosis clinical isolates,when using the drug susceptibility of Bactec 960 as the standard, the sensitivity of rifampin, isoniazid,ofloxacin and amikacin is 98.0%, 64. 1%, 79.5%, 78. 3% respectively, the specificity is 97.5%,100. 0%, 90. 0%, 100. 0% respectively, the accuracy is 97.8%, 77. 5%, 85.4%, 94. 4% respectively,tested by pyrosequencing. The results of the detection of resistance to rifampin, isoniazid, ofloxacin and amikacin in Mycobacterium tuberculosis using pyrosequencing technique were almost the same with that of Bactec 960, and Kappa ≥0. 7 in each detection. Conclusion Pyrosequencing is thus a rapid, accurate and high throughput method for

  13. Medical imaging

    CERN Document Server

    Townsend, David W


    Since the introduction of the X-ray scanner into radiology almost 25 years ago, non-invasive imaging has become firmly established as an essential tool in the diagnosis of disease. Fully three-dimensional imaging of internal organs is now possible, b and for studies which explore the functional status of the body. Powerful techniques to correlate anatomy and function are available, and scanners which combine anatomical and functional imaging in a single device are under development. Such techniques have been made possible through r ecent technological and mathematical advances. This series of lectures will review both the physical basis of medical imaging techniques using X-rays, gamma and positron emitting radiosiotopes, and nuclear magnetic resonance, and the mathematical methods used to reconstruct three-dimentional distributions from projection data. The lectures will trace the development of medical imaging from simple radiographs to the present-day non-invasive measurement of in vivo biochemistry. They ...

  14. Direct Application of the INNO-LiPA Rif.TB Line-Probe Assay for Rapid Identification of Mycobacterium tuberculosis Complex Strains and Detection of Rifampin Resistance in 360 Smear-Positive Respiratory Specimens from an Area of High Incidence of Multidrug-Resistant Tuberculosis (United States)

    Viveiros, Miguel; Leandro, Clara; Rodrigues, Liliana; Almeida, Josefina; Bettencourt, Rosário; Couto, Isabel; Carrilho, Lurdes; Diogo, José; Fonseca, Ana; Lito, Luís; Lopes, João; Pacheco, Teresa; Pessanha, Mariana; Quirim, Judite; Sancho, Luísa; Salfinger, Max; Amaral, Leonard


    The INNO-LiPA Rif.TB assay for the identification of Mycobacterium tuberculosis complex strains and the detection of rifampin (RIF) resistance has been evaluated with 360 smear-positive respiratory specimens from an area of high incidence of multidrug-resistant tuberculosis (MDR-TB). The sensitivity when compared to conventional identification/culture methods was 82.2%, and the specificity was 66.7%; the sensitivity and specificity were 100.0% and 96.9%, respectively, for the detection of RIF resistance. This assay has the potential to provide rapid information that is essential for the effective management of MDR-TB. PMID:16145166

  15. Medical revolution in Argentina. (United States)

    Ballarin, V L; Isoardi, R A


    The paper discusses the major Argentineans contributors, medical physicists and scientists, in medical imaging and the development of medical imaging in Argentina. The following are presented: history of medical imaging in Argentina: the pioneers; medical imaging and medical revolution; nuclear medicine imaging; ultrasound imaging; and mathematics, physics, and electronics in medical image research: a multidisciplinary endeavor.

  16. Medical History: Compiling Your Medical Family Tree (United States)

    ... family medical history, sometimes called a medical family tree, is a record of illnesses and medical conditions ... to consult family documents, such as existing family trees, baby books, old letters, obituaries or records from ...

  17. Smoking cessation medications (United States)

    Smoking cessation - medications; Smokeless tobacco - medications; Medications for stopping tobacco ... Creating a plan to help you deal with smoking urges. Getting support from a doctor, counselor, or ...

  18. Medical Physics


    Voto Bernales, Juan; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú


    Medical Physics is to study the physical phenomena that occur in the body and exert action on the agents. It also addresses the manner taught natural agents in the study and exploration of the human body and in the way in the same agents for use in the treatment of disease can be used. La Física Médica tiene por objeto estudiar los fenómenos físicos que se realizan en el organismo y la acción que sobre el ejercen los agentes. Se ocupa, además, de enseñar la manera cómo pueden utilizarse lo...

  19. Medical robotics

    CERN Document Server

    Troccaz, Jocelyne


    In this book, we present medical robotics, its evolution over the last 30 years in terms of architecture, design and control, and the main scientific and clinical contributions to the field. For more than two decades, robots have been part of hospitals and have progressively become a common tool for the clinician. Because this domain has now reached a certain level of maturity it seems important and useful to provide a state of the scientific, technological and clinical achievements and still open issues. This book describes the short history of the domain, its specificity and constraints, and

  20. Medical robotics. (United States)

    Ferrigno, Giancarlo; Baroni, Guido; Casolo, Federico; De Momi, Elena; Gini, Giuseppina; Matteucci, Matteo; Pedrocchi, Alessandra


    Information and communication technology (ICT) and mechatronics play a basic role in medical robotics and computer-aided therapy. In the last three decades, in fact, ICT technology has strongly entered the health-care field, bringing in new techniques to support therapy and rehabilitation. In this frame, medical robotics is an expansion of the service and professional robotics as well as other technologies, as surgical navigation has been introduced especially in minimally invasive surgery. Localization systems also provide treatments in radiotherapy and radiosurgery with high precision. Virtual or augmented reality plays a role for both surgical training and planning and for safe rehabilitation in the first stage of the recovery from neurological diseases. Also, in the chronic phase of motor diseases, robotics helps with special assistive devices and prostheses. Although, in the past, the actual need and advantage of navigation, localization, and robotics in surgery and therapy has been in doubt, today, the availability of better hardware (e.g., microrobots) and more sophisticated algorithms(e.g., machine learning and other cognitive approaches)has largely increased the field of applications of these technologies,making it more likely that, in the near future, their presence will be dramatically increased, taking advantage of the generational change of the end users and the increasing request of quality in health-care delivery and management.

  1. [A case of MRSA infection in multiple artificial joints successfully treated with conservative medical treatment]. (United States)

    Nemoto, Takaaki; Yamasaki, Yukitaka; Torikai, Keito; Ishii, Osamu; Fujitani, Shigeki; Matsuda, Takahide


    We report herein on a case with multiple MRSA prosthetic arthritis and osteomyelitis successfully treated medically. Our patient was a 64-year-old Japanese woman with a previous medical history of malignant rheumatoid arthritis and multiple surgical interventions with an atlantoaxial fixation in 2003, artificial joint replacement of both knee joints in 2006, and of the right hip joint in September, 2007. She was initially hospitalized due to MRSA arthritis in the right hip in October, 2007. Thereafter, multiple joint infections occurred sequentially in the right knee joint in January 2008 and the left hip joint in June 2008. More recently, the patient was re-admitted in January 2009 due to cervical osteomyelitis with MRSA infection. The patient had been treated with a combination of vancomycin and rifampin for 17 weeks and followed by sulfamethoxazole/trimetoprim in the out-patient setting up to the present. Although the complete resolution of multiple deep MRSA infections with prosthetic arthritis and osteomyelitis is not expected without removing the infectious sources, our patient was successfully treated with chronic antibiotic suppressive therapy. Therefore, we report on our case with a literature review.

  2. Medication/Drug Allergy (United States)

    ... Science Education & Training Home Conditions Medication/Drug Allergy Medication/Drug Allergy Make an Appointment Find a Doctor ... immediate or delayed. What Is an Allergy to Medication/Drugs? Allergies to drugs/medications are complicated, because ...

  3. [MEDICAL CANNABIS]. (United States)

    Naftali, Timna


    The cannabis plant has been known to humanity for centuries as a remedy for pain, diarrhea and inflammation. Current research is inspecting the use of cannabis for many diseases, including multiple sclerosis, epilepsy, dystonia, and chronic pain. In inflammatory conditions cannabinoids improve pain in rheumatoid arthritis and:pain and diarrhea in Crohn's disease. Despite their therapeutic potential, cannabinoids are not free of side effects including psychosis, anxiety, paranoia, dependence and abuse. Controlled clinical studies investigating the therapeutic potential of cannabis are few and small, whereas pressure for expanding cannabis use is increasing. Currently, as long as cannabis is classified as an illicit drug and until further controlled studies are performed, the use of medical cannabis should be limited to patients who failed conventional better established treatment.

  4. Medical telesensors (United States)

    Ferrell, Trinidad L.; Crilly, P. B.; Smith, S. F.; Wintenberg, Alan L.; Britton, Charles L., Jr.; Morrison, Gilbert W.; Ericson, M. N.; Hedden, D.; Bouldin, Donald W.; Passian, A.; Downey, Todd R.; Wig, A. G.; Meriaudeau, Fabrice


    Medical telesensors are self-contained integrated circuits for measuring and transmitting vital signs over a distance of approximately 1-2 meters. The circuits are unhoused and contain a sensor, signal processing and modulation electronics, a spread-spectrum transmitter, an antenna and a thin-film battery. We report on a body-temperature telesensor, which is sufficiently small to be placed on a tympanic membrane in a child's ear. We also report on a pulse-oximeter telesensor and a micropack receiver/long- range transmitter unit, which receives form a telesensor array and analyzes and re-transmits the vital signs over a longer range. Signal analytics are presented for the pulse oximeter, which is currently in the form of a finger ring. A multichip module is presented as the basic signal-analysis component. The module contains a microprocessor, a field=programmable gate array, memory elements and other components necessary for determining trauma and reporting signals.

  5. Effects of rifampin-chitosan-calcium alginate sustained release microspheres in spinal tuberculosis models in rabbits%利福平-壳聚糖-海藻酸钙缓释微球在兔脊柱结核模型中的作用

    Institute of Scientific and Technical Information of China (English)

    尚博; 方继锋; 侯耀鹏; 李庆富; 王先泉


    目的 观察利福平-壳聚糖(CS)-海藻酸钙(CA)纳米缓释微球在体内外释药效果及对兔脊柱结核模型的治疗作用.方法 合成利福平-CS-CA纳米缓释微球,对该微球进行形态学观察和测定其分布.取新西兰大白兔60只,随机分为A、B、C3组,通过兔腰椎椎体钻孔植入结核标准菌株H37Rv,建立兔脊柱结核模型.A组为对照组,不予用药.B组每只兔灌喂利福平每天12 mg/kg;C组每只兔灌喂利福平12 mg/(kg·d),于第十腰椎旁给予缓释利福平微球(含利福平75 mg/kg),观察3组兔模型在体内的释药性质及抗结核的作用效果.结果 (1)利福平缓释微球表面光滑,球体均匀度好,无粘连现象.(2)利福平微球的载药量为(34.58±1.47)%,包封率为(56.23±1.55)%.(3)A组兔模型腰5、6椎体均有明显破坏,椎间隙变窄,1只出现明显后凸畸形.5只兔腰大肌肿胀,腰大肌内可见低密度暗区.B组兔模型中6只兔腰5椎体和腰6椎体有较明显破坏,2只兔腰大肌肿胀.C组中7只兔腰6椎体上部有轻度骨质破坏,腰5、6椎间隙无明显改变,另3只兔观察至术后12周仍无明显影像学改变.(4)体内实验结果显示,将利福平微球按含利福平75 mg/kg的剂量植入C组兔模型椎旁后,椎旁肌和椎体内利福平浓度可维持在结核菌最低抑菌浓度(MCI)以上,持续到术后49 d.结论 通过椎体钻孔植入结核菌的方法可以建立兔脊柱结核模型,利福平-CS-CA纳米缓释微球的控释化疗可增加椎旁局部药物浓度,有效抑制结核杆菌生长.%Objective To investigate the drug release effect of rifampin (RFP)-chitosan (CS)-calcium alginate (CA) sustained release microspheres (Ms) in vivo and in vitro in the treatment of spinal tuberculosis model in rabbits.Methods RFP-CS-CA nano microspheres were synthesized,and their morphology was observer,and distribution was determined.Sixty New Zealand rabbits were randomly divided into three groups.the rabbit lumbar

  6. Essential Medical Capabilities and Medical Readiness (United States)


    15-001098 Copy Essential Medical Capabilities and Medical Readiness John E. Whitley Joseph F. Adams Joseph J. Angello Jennifer T. Brooks Sarah K...other national challenges. Essential Medical Capabilities and Medical Readiness John E. Whitley Joseph F. Adams Joseph J. Angello Jennifer T. Brooks...noted that the ability of the Military Health System to provide operational healthcare is measured by the readiness of its medical personnel and

  7. Medical muddle. (United States)

    Gartrell, Nanette


    Nanette Gartrell, MD, is a psychiatrist and researcher whose investigations have documented the mental health and psychological well-being of lesbian, gay, bisexual, and transgender (LGBT) people over the past four decades. Nanette is the principal investigator of an ongoing longitudinal study of lesbian families in which the children were conceived by donor insemination. Now in its 27th year, this project has been cited internationally in the debates over equality in marriage, foster care, and adoption. Previously on the faculty at Harvard Medical School and the University of California, San Francisco, Nanette is currently a Visiting Distinguished Scholar at the Williams Institute, UCLA School of Law. In 2013, Nanette received the Association of Women Psychiatrists Presidential Commendation Award for "selfless and enduring vision, leadership, wisdom, and mentorship in the fields of women's mental health, ethics, and gender research." At the age of 63, Nanette experienced a 3 ½ month period of intractable, incapacitating dizziness for which there was never a clear diagnosis.

  8. Biliary tuberculosis causing cicatricial stenosis after oral anti-tuberculosis therapy

    Institute of Scientific and Technical Information of China (English)

    Tomohisa Iwai; Mitsuhiro Kida; Yoshiki Kida; Nobuaki Shikama; Akitaka Shibuya; Katsunori Saigenji


    A 36-year-old Philippine woman presented with dark urine and yellow sclera. Endoscopic retrograde cholangiopancreatography (ERCP) confirmed dilatation of the intrahepatic bile ducts and also showed an irregular stricture of the common hepatic duct at the liver hilum. Histological examination of biopsies from the bile duct revealed epithelioid cell granulomas and caseous necrosis. Tubercle bacilli were then detected on polymerase chain reaction (PCR) testing of the bile, giving the diagnosis of biliary tuberculosis. Although microbiological cure was confirmed, the patient developed cicatricial stenosis of the hepatic duct. She underwent repeated treatments with endoscopic biliary drainage (EBD) tubes and percutaneous transhepatic biliary drainage (PTBD) tubes, and the stenosis was corrected after 6 years. We present a case of tuberculous biliary stricture, a condition that requires careful differentiation from the more common malignancies and needs long-term follow-up due to the risk of posttreatment cicatricial stenosis, although it is rare.

  9. Natural Compounds from Mexican Medicinal Plants as Potential Drug Leads for Anti-Tuberculosis Drugs

    Directory of Open Access Journals (Sweden)


    Full Text Available ABSTRACT In Mexican Traditional Medicine 187 plant species are used in the treatment of respiratory conditions that may be associated with tuberculosis. In this contribution, we review the ethnobotany, chemistry and pharmacology of 63 species whose extracts have been assayed for antimycobacterial activity in vitro. Among these, the most potent is Aristolochia brevipes (MIC= 12.5 µg/mL, followed by Aristolochia taliscana, Citrus sinensis, Chrysactinia mexicana, Persea americana, and Olea europaea (MIC 95%, 50 µg/mL include: Amphipterygium adstringens, Larrea divaricata, and Phoradendron robinsoni. Several active compounds have been identified, the most potent are: Licarin A (isolated from A. taliscana, and 9-amino-9-methoxy-3,4-dihydro-2H-benzo[h]-chromen-2-one (transformation product of 9-methoxytariacuripyrone isolated from Aristolochia brevipes, both with MIC= 3.125 µg/mL, that is 8-fold less potent than the reference drug Rifampicin (MIC= 0.5 µg/mL. Any of the compounds or extracts here reviewed has been studied in clinical trials or with animal models; however, these should be accomplished since several are active against strains resistant to common drugs.

  10. Natural Compounds from Mexican Medicinal Plants as Potential Drug Leads for Anti-Tuberculosis Drugs. (United States)

    Gómez-Cansino, Rocio; Guzmán-Gutiérrez, Silvia Laura; Campos-Lara, María Guadalupe; Espitia-Pinzón, Clara Ines; Reyes-Chilpa, Ricardo


    In Mexican Traditional Medicine 187 plant species are used in the treatment of respiratory conditions that may be associated with tuberculosis. In this contribution, we review the ethnobotany, chemistry and pharmacology of 63 species whose extracts have been assayed for antimycobacterial activity in vitro. Among these, the most potent is Aristolochia brevipes (MIC= 12.5 µg/mL), followed by Aristolochia taliscana, Citrus sinensis, Chrysactinia mexicana, Persea americana, and Olea europaea (MIC 95%, 50 µg/mL) include: Amphipterygium adstringens, Larrea divaricata, and Phoradendron robinsoni. Several active compounds have been identified, the most potent are: Licarin A (isolated from A. taliscana), and 9-amino-9-methoxy-3,4-dihydro-2H-benzo[h]-chromen-2-one (transformation product of 9-methoxytariacuripyrone isolated from Aristolochia brevipes), both with MIC= 3.125 µg/mL, that is 8-fold less potent than the reference drug Rifampicin (MIC= 0.5 µg/mL). Any of the compounds or extracts here reviewed has been studied in clinical trials or with animal models; however, these should be accomplished since several are active against strains resistant to common drugs.

  11. Theophylline-7-acetic acid derivatives with amino acids as anti-tuberculosis agents. (United States)

    Voynikov, Yulian; Valcheva, Violeta; Momekov, Georgi; Peikov, Plamen; Stavrakov, Georgi


    A series of amides were synthesized by condensation of theophylline-7-acetic acid and eight commercially available amino acid methyl ester hydrochlorides. Consecutive hydrolysis of six of the amido-esters resulted in the formation of corresponding amido-acids. The newly synthesized compounds were evaluated for their in vitro activity against Mycobacterium tuberculosis H37Rv. The activity varied depending on the amino acid fragments and in seven cases exerted excellent values with MICs 0.46-0.26 μM. Assessment of the cytotoxicity revealed that the compounds were not cytotoxic against the human embryonal kidney cell line HEK-293T. The theophylline-7-acetamides containing amino acid moieties appear to be promising lead compounds for the development of antimycobacterial agents.

  12. Factors Associated with Fatality during the Intensive Phase of Anti-Tuberculosis Treatment (United States)

    Casals, M.; Caminero, J. A.; García-García, J. M.; Jiménez-Fuentes, M. A.; Medina, J. F.; Millet, J. P.; Ruiz-Manzano, J.; Caylá, J.


    Objective To determine the case-fatality rate (CFR) at the end of the intensive phase of tuberculosis (TB) treatment, and factors associated with fatality. Methods TB patients diagnosed between 2006 and 2013 were followed-up during treatment. We computed the CFR at the end of the intensive phase of TB treatment, and the incidence of death per 100 person-days (pd) of follow-up. We performed survival analysis using the Kaplan-Meier method and Cox regression, and calculate hazard ratios (HR) and 95% confidence intervals (CI). Results A total of 5,182 patients were included, of whom 180 (3.5%) died; 87 of these deaths (48.3%) occurred during the intensive phase of treatment, with a CFR of 1.7%. The incidence of death was 0.028/100 pd. The following factors were associated with death during the intensive phase: being >50 years (HR = 36.9;CI:4.8–283.4); being retired (HR = 2.4;CI:1.1–5.1); having visited the emergency department (HR = 3.1;CI:1.2–7.7); HIV infection (HR = 3.4;CI:1.6–7.2); initial standard treatment with 3 drugs (HR = 2.0;CI:1.2–3.3) or non-standard treatments (HR = 2.68;CI:1.36–5.25); comprehension difficulties (HR = 2.8;CI:1.3–6.1); and smear-positive sputum (HR = 2.3-CI:1.0–4.8). Conclusion There is a non-negligible CFR during the intensive phase of TB, whose reduction should be prioritised. The CFR could be a useful indicator for evaluating TB programs. PMID:27487189

  13. Clinical significance of 2 h plasma concentrations of first-line anti-tuberculosis drugs

    DEFF Research Database (Denmark)

    Prahl, Julie B; Johansen, Isik S; Cohen, Arieh S;


    OBJECTIVES: To study 2 h plasma concentrations of the first-line tuberculosis drugs isoniazid, rifampicin, ethambutol and pyrazinamide in a cohort of patients with tuberculosis in Denmark and to determine the relationship between the concentrations and the clinical outcome. METHODS: After 6......-207 days of treatment (median 34 days) 2 h blood samples were collected from 32 patients with active tuberculosis and from three patients receiving prophylactic treatment. Plasma concentrations were determined using LC-MS/MS. Normal ranges were obtained from the literature. Clinical charts were reviewed...... failure occurred more frequently when the concentrations of isoniazid and rifampicin were both below the normal ranges (P = 0.013) and even more frequently when they were below the median 2 h drug concentrations obtained in the study (P = 0.005). CONCLUSIONS: At 2 h, plasma concentrations of isoniazid...

  14. Anti-tuberculosis drug resistance in Sub-Saharan Africa: The case of Uganda

    NARCIS (Netherlands)

    Lukoye, D.


    This thesis reports findings of six studies including two tuberculosis (TB) drug resistance surveys, a comparative study of HIV infection rates among patients enrolled in the survey and those under routine TB/HIV surveillance, two TB molecular epidemiological analyses and a systematic review and met

  15. Syntheses and studies of hydantoin derivatives as potential anti-tuberculosis inhibitors

    Institute of Scientific and Technical Information of China (English)

    Yan Liu; Wu Zhong; Song Li


    A short and efficient synthesis of (Z)-2-substituted-5-(4-((2-substitued-5-oxoimidazolidin-4-ylidene)methyl)benzamido)benzoic acid derivatives (8a-g) as potential type of FabH inhibitors is described.Their structures were confirmed by MS,NOE and 1H.

  16. Synthesis and Anti-Tuberculosis Activity of the Marine Natural Product Caulerpin and Its Analogues

    Directory of Open Access Journals (Sweden)

    Cristina I. Canché Chay


    Full Text Available Caulerpin (1a, a bis-indole alkaloid from the marine algal Caulerpa sp., was synthesized in three reaction steps with an overall yield of 11%. The caulerpin analogues (1b–1g were prepared using the same synthetic pathway with overall yields between 3% and 8%. The key reaction involved a radical oxidative aromatic substitution involving xanthate (3 and 3-formylindole compounds (4a–4g. All bis-indole compounds synthesized were evaluated against the Mycobacterium tuberculosis strain H37Rv, and 1a was found to display excellent activity (IC50 0.24 µM.

  17. Synthesis and Anti-Tuberculosis Activity of the Marine Natural Product Caulerpin and Its Analogues (United States)

    Canché Chay, Cristina I.; Gómez Cansino, Rocío; Espitia Pinzón, Clara I.; Torres-Ochoa, Rubén O.; Martínez, Roberto


    Caulerpin (1a), a bis-indole alkaloid from the marine algal Caulerpa sp., was synthesized in three reaction steps with an overall yield of 11%. The caulerpin analogues (1b–1g) were prepared using the same synthetic pathway with overall yields between 3% and 8%. The key reaction involved a radical oxidative aromatic substitution involving xanthate (3) and 3-formylindole compounds (4a–4g). All bis-indole compounds synthesized were evaluated against the Mycobacterium tuberculosis strain H37Rv, and 1a was found to display excellent activity (IC50 0.24 µM). PMID:24681629

  18. Turkish Medical Information System and Medical Librarianship

    Directory of Open Access Journals (Sweden)

    Huriye Çolaklar


    Full Text Available In Turkey, medical information is supported at state level according to national policies. However, although the history of medical libraries in Turkey goes back to the 13th century in Anatolia, modern medical library applications adopted since the 1950s have not received much state support. In the past thirteen years a few medical libraries joined forces under ÜNAK (the Association of University and Research Librarians to contribute to the organization and development of Turkish Medical Information through the establishment of a "Medical Working Group" in 2000.

  19. Medical alert bracelet (image) (United States)

    People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will be able to find. Medical identification products can help ensure proper treatment in an ...

  20. Implantable Medical Devices (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Implantable Medical Devices Updated:Sep 16,2016 For Rhythm Control ... a Heart Attack Introduction Medications Surgical Procedures Implantable Medical Devices • Life After a Heart Attack • Heart Attack ...

  1. When Medication Is Prescribed (United States)

    ... page please turn Javascript on. Feature: Depression When Medication Is Prescribed Past Issues / Fall 2009 Table of ... you have about the medicine. —NIMH Types of Medications There are several types of medications used to ...

  2. Medication Use during Pregnancy (United States)

    ... What's this? Submit Button Past Emails CDC Features Medication Use During Pregnancy Recommend on Facebook Tweet Share ... are taking only medications that are necessary. What Medications Can Cause Birth Defects? We know that taking ...

  3. Medications (for IBS)

    Medline Plus

    Full Text Available ... Anthony J. Lembo, MD, Instructor of Medicine, Harvard Medical School; Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA. Last modified on February 23, ...


    Directory of Open Access Journals (Sweden)

    Abdolreza Sotoodeh Jahromi


    Full Text Available Training physicians who are expert in many medical aspects is the most improtant mission of medical universities. One of these aspects, is professional behavior achievement. One of the important goals in training of ethics, is recognition of conflicts in different parts of ethics and having logical viewpoint for resolving and analyzing these conflicts. This descriptive and analytical study was done to evaluate the efficacy of medical ethics education in medical students´ professional attitudes improvement. One hundred and two medical students were selected randomly in different steps of education and were questioned and their opinions correlation with stage of education and gender were evaluated. There was a significant difference between female viewpoint (in roles of ethic course which is presented in preclinical step in professional attitude improvement (P = 0.009 and also a significant difference was seen in the viewpoint score between student stage with intern stage (P = 0.031. Medical students in educational student stage believe ethic course improve medical professionalism. Since there is no special course to train medical students in professionalism, some interventions are required in this field to improve this aspect of physicians' professional life.

  5. Medical Informatics For Medical Students And Medical Practitioners

    Directory of Open Access Journals (Sweden)

    Jai MOHAN


    Full Text Available The importance of incorporating medical (or healthinformatics into the education of medical students andmedical practitioners is being increasingly recognised.The advances in information and communicationtechnology and the pervasion of the Internet intoeveryday life have important implications forhealthcare services and medical education.Students and practitioners should learn to utilisebiomedical information for problem solving anddecision making based on evidence. The extensiveintroduction of electronic health information systemsinto hospitals and clinics and at the enterprise level inMalaysia and elsewhere is driving a demand for healthprofessionals who have at least basic skills in andappreciation of the use of these technologies.The essential clinical informatics skills have beenidentified and should be incorporated into theundergraduate medical curriculum. It is recommendedthat these be introduced in stages and integrated intoexisting programmes rather than taught as a separatemodule. At the same time, medical schools shouldsupport the integration of e-learning in the educationalprocess in view of the numerous potential benefits.

  6. Machine medical ethics

    CERN Document Server

    Pontier, Matthijs


    The essays in this book, written by researchers from both humanities and sciences, describe various theoretical and experimental approaches to adding medical ethics to a machine in medical settings. Medical machines are in close proximity with human beings, and getting closer: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. In such contexts, machines are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for e...

  7. Medical Physics Panel Discussion (United States)

    Guèye, Paul; Avery, Steven; Baird, Richard; Soares, Christopher; Amols, Howard; Tripuraneni, Prabhakar; Majewski, Stan; Weisenberger, Drew


    The panel discussion will explore opportunities and vistas in medical physics research and practice, medical imaging, teaching medical physics to undergraduates, and medical physics curricula as a recruiting tool for physics departments. Panel members consist of representatives from NSBP (Paul Guèye and Steven Avery), NIH/NIBIB (Richard Baird), NIST (Christopher Soares), AAPM (Howard Amols), ASTRO (Prabhakar Tripuraneni), and Jefferson Lab (Stan Majewski and Drew Weisenberger). Medical Physicists are part of Departments of Radiation Oncology at hospitals and medical centers. The field of medical physics includes radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. It also ranges from basic researcher (at college institutions, industries, and laboratories) to applications in clinical environments.

  8. Teaching Medical Sociology in Medical Schools. (United States)

    Hunt, Gerard J.; Sobal, Jeffery


    Provides 11 teaching guidelines for presentation of sociological material to medical students and addresses the problems of dense scheduling and competition for time in a medical school curriculum. Considers career implications for sociologists in this setting as well as resources available. (NL)

  9. 慈菇对异烟肼和利福平致大鼠肝损伤的保护作用%Protective effect of Cigu (Sagittaria Sagittifolia) on liver damaged by isoniazid and rifampin in rats

    Institute of Scientific and Technical Information of China (English)

    廖艳; 孙奇; 彭桂英; 李根茂; 葛东宇; 林殷


    Objective To study the protective effect of Cigu ( Sagittaria Sagittifolia) on liver damaged by isoniazid (INH) combining rifampin (RFP) in rats, and discuss the mechanism. Methods Male Wistar rats were randomly divided into 5 groups including control group, model group and high-dose, mid-dose and low-dose Cigu groups ( high-dose group, mid-dose group and low-dose group, each n = 8). Except of control group, other four groups were intragastrically given INH (50 mg/kg) and RFP (50 mg/kg) every day, and after two hours, given respectively distilled water, low-dose Cigu (5 g/kg) , mid-dose Cigu (10 g/kg) and high-dose Cigu (15 g/kg) once a day and 20 mL/kg each time for 28 days. After the last giving of medicinals for 16 hours, the liver index, content of malondialdehyde (MDA) in liver homogenate and activities of superoxide dismutase ( SOD) and glutathione transferase ( GST) were detected. The pathological changes of liver tissue were observed. Results In high-dose group, mid-dose group and low-dose group, the content of MDA decreased significantly and degeneration and necrosis of liver tissue were relieved, and especially in high-dose group, the liver index was significantly decreased, the activities of SOD and GST were significantly increased, and pathological changes of liver tissue were relieved. The activity of GST was increased in mid-dose group too. Conclusion Cigu can protect liver from the injury induced by INH combining RFP in rats, which may be related to that Cigu has anti-lipid peroxidation.%目的 研究慈菇对异烟肼(INH)和利福平(RFP)合用致大鼠肝损伤的保护作用并探讨其作用机制.方法 选取雄性Wistar大鼠,随机分成5组:正常对照组,模型组,慈菇低、中、高剂量组,每组8只.除正常对照组外其余4组每天同时灌胃异烟肼(50 mg/kg)和利福平(50 mg/kg),2h后分别灌胃蒸馏水、低剂量(5 g/kg)、中剂量(10 g/kg)和高剂量(15 g/kg)慈菇,每次灌胃20 mL/kg,每天1次,连续给药28 d

  10. Matching Medical Websites to Medical Guidelines

    Directory of Open Access Journals (Sweden)

    Dusan Rak


    Full Text Available The quality of medical texts provided to general public on the Internet is a serious issue nowadays. Unfortunately the only feasible way to approve the adequacy of the medical information content is human verification today. Best practices in medicine are systematically captured by medical guidelines (MGLs, which are provided by renowned medical societies. We propose a simple approach to exploiting MGL content as ’gold standard’ for the assessment of content quality in medical web sites (WS, based on the idea that the information content is reflected in the domain terminology used. Concept candidates discovered in a MGL and in the tested web pages are matched to the UMLS terminological system. In a small case study, MGLs and WSs have been analyzed for similarity at term and concept level. The research is a step towards automated evaluation of WS content on the basis of MGLs as the quality standard.

  11. Medical spa marketing. (United States)

    Sadick, Neil S; Dinkes, Adam; Oskin, Larry


    Medical spas are different. We are not just selling medical and dermatology services; we are offering clients viable new solutions to their skin care, body care, and hair care challenges. Traditional medical marketing becomes blurred today, as the expansion and acceptance of medical spas helps you to effectively compete with traditional skin care clinics, salons, and spas, while offering more therapeutic treatments from professionally licensed doctors, nurses, aestheticians, massage therapists, spa professionals, and medical practitioners. We recommend that you make the choice to successfully and competitively become a market-driven medical spa with an annual strategic plan, rather than an operationally driven business.

  12. Medical Care during Pregnancy (United States)

    ... 1- to 2-Year-Old Medical Care During Pregnancy KidsHealth > For Parents > Medical Care During Pregnancy A ... both moms and their babies. Prenatal Care Before Pregnancy Prenatal care should start before you get pregnant. ...

  13. Medications for Memory Loss (United States)

    ... by state Home > Alzheimer's Disease > Treatments > Medications for Memory Overview What Is Dementia? What Is Alzheimer's? Younger/ ... Interactive Tour Risk Factors Diagnosis Treatments Medications for Memory Treatments for Behavior For Sleep Changes Alternative Treatments ...

  14. Medications (for IBS) (United States)

    ... IBS Pain IBS Global Treatments IBS Diet Low FODMAP Diet Complimentary or Alt Treatments Medications Psychological Treatments ... IBS Pain IBS Global Treatments IBS Diet Low FODMAP Diet Complimentary or Alt Treatments Medications Psychological Treatments ...

  15. Medications (for IBS)

    Medline Plus

    Full Text Available ... depression, but rather likely to effects on the brain and the gut. Antidepressant medications can reduce the intensity of pain signals going from gut to brain. Read more about antidepressant medications. Newer IBS-Targeted ...

  16. Polymyositis: Medical Management (United States)

    ... email share facebook twitter google plus linkedin Medical Management Polymyositis (PM) is a highly treatable disease. Some ... PM) Signs and Symptoms Diagnosis Causes/Inheritance Medical Management Research Find your MDA Care Center Current Clinical ...

  17. Medical Device Safety (United States)

    A medical device is any product used to diagnose, cure, or treat a condition, or to prevent disease. They ... may need one in a hospital. To use medical devices safely Know how your device works. Keep ...

  18. Medical Treatments for Fibroids (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Medical Treatments for Fibroids Skip sharing on social media ... Page Content Your health care provider may suggest medical treatments to reduce the symptoms of fibroids or ...

  19. American Medical Association (United States)

    ... AMA provides to help members save money. Residency & Career Planning Find out resources for a range of medical ... clinical questions using our reference tool View the Career Planning Resource Refinance your medical student loans Find leadership ...

  20. Choosing Your Medical Specialty (United States)

    ... AMA provides to help members save money. Residency & Career Planning Find resources for a range of medical career ... Fellowships Back to top Home Life & Career Residency & Career Planning Choosing a Medical Specialty Back to top Choosing ...

  1. Medications (for IBS)

    Medline Plus

    Full Text Available ... to physician counseling and dietary manipulations. What's a medication? Anything you take for a therapeutic effect counts ... the drug package or on your prescription label. Medications for IBS First line treatment has traditionally been ...

  2. Giving Medication to Children (United States)

    ... For Consumers Home For Consumers Consumer Updates Giving Medication to Children Share Tweet Linkedin Pin it More ... the upper limit. back to top Q: Are medications that are intended for children clinically tested on ...

  3. Understanding Medical Research (United States)

    ... you hear about the results of a new medical research study. Sometimes the results of one study ... when reading or listening to reports of new medical findings. Some questions that can help you evaluate ...

  4. Medications (for IBS)

    Medline Plus

    Full Text Available ... Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us About IBS Twitter ... Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us Medications Details Medications ...

  5. [Perspectives in medical liability]. (United States)

    Pizarro W, Carlos


    The progressive increase of medical negligence law suits requires an updated analysis of the current situation of medical liability in Chile. The application of a new criminal procedure will avoid criminal prosecution of doctors, transferring to the civil courts the pecuniary sanctions for malpractice. Medical negligence and damage inflicted by doctors that require compensation are explained. The most likely evolution of medical liability is proposed, through an increase in civil liability insurance and the necessary standardization of rules applicable to professional liability.

  6. Advanced Medication Dispenser



    Medication dispensing is an important activity that can have major implications if done improperly. Dispensing must be done in the correct time interval, at the correct user, with the correct drug and dose. We propose a smart medication dispenser that can satisfy these needs and provide a mechanism for supervision. In order to ensure that the dispensing process is error free, the concept of a new smart medication container is used. A smart medication container is “smart” ...

  7. Implantable electronic medical devices

    CERN Document Server

    Fitzpatrick, Dennis


    Implantable Electronic Medical Devices provides a thorough review of the application of implantable devices, illustrating the techniques currently being used together with overviews of the latest commercially available medical devices. This book provides an overview of the design of medical devices and is a reference on existing medical devices. The book groups devices with similar functionality into distinct chapters, looking at the latest design ideas and techniques in each area, including retinal implants, glucose biosensors, cochlear implants, pacemakers, electrical stimulation t


    Directory of Open Access Journals (Sweden)



    Full Text Available The offer of medical services depends on medical personnel and more than this, on the management in the medical field since any resource not managed well or not managed at all is only a lost one, regardless its value. Management is therefore the key, the

  9. Mission Medical Information System (United States)

    Johnson-Throop, Kathy A.; Joe, John C.; Follansbee, Nicole M.


    This viewgraph presentation gives an overview of the Mission Medical Information System (MMIS). The topics include: 1) What is MMIS?; 2) MMIS Goals; 3) Terrestrial Health Information Technology Vision; 4) NASA Health Information Technology Needs; 5) Mission Medical Information System Components; 6) Electronic Medical Record; 7) Longitudinal Study of Astronaut Health (LSAH); 8) Methods; and 9) Data Submission Agreement (example).

  10. Conducting the Medical History (United States)

    Finkel, Martin A.; Alexander, Randell A.


    A key portion of the medical evaluation of child sexual abuse is the medical history. This differs from interviews or histories obtained by other professionals in that it is focuses more on the health and well-being of the child. Careful questions should be asked about all aspects of the child's medical history by a skilled, compassionate,…

  11. Medical Physics Data Book, (United States)

    The Medical Physics Data Book is a collection of physical and chemical data useful in medical physics . The information has been extracted from other...ionizing Radiation. Carried out by the Medical Physics Data Group of the American Association of Physicists in Medicine, this compilation is meant to

  12. Your Medical Records (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Your Medical Records KidsHealth > For Teens > Your Medical Records A ... Records? en español Tus historias clínicas What Are Medical Records? Each time you climb up on a ...

  13. Medical Assisting Program Guide. (United States)

    Georgia Univ., Athens. Dept. of Vocational Education.

    This guide presents the standard curriculum for technical institutes in Georgia. The curriculum addresses the minimum competencies for a medical assisting program. The program guide is designed to relate primarily to the development of those skills needed by individuals in the medical assisting field, such as medical law and ethics, typing,…

  14. Marijuana: Modern Medical Chimaera (United States)

    Lamarine, Roland J.


    Marijuana has been used medically since antiquity. In recent years there has been a resurgence of interest in medical applications of various cannabis preparations. These drugs have been cited in the medical literature as potential secondary treatment agents for severe pain, muscle spasticity, anorexia, nausea, sleep disturbances, and numerous…

  15. HIV Medication Adherence (United States)

    HIV Treatment HIV Medication Adherence (Last updated 3/2/2017; last reviewed 3/2/2017) Key Points Medication adherence means sticking firmly to ... Before and After Starting HIV Medicines . What is medication adherence? Adherence means “to stick firmly.” So for ...

  16. [Research in medical education

    DEFF Research Database (Denmark)

    Ringsted, Charlotte Vibeke


    Research in medical education is a relatively new discipline. Over the past 30 years, the discipline has experienced a tremendous growth, which is reflected in an increase in the number of publications in both medical education journals and medical science journals. However, recent reviews...... of articles on medical education studies indicate a need for improvement of the quality of medical education research in order to contribute to the advancement of educational practice as well as educational research. In particular, there is a need to embed studies in a conceptual theoretical framework...

  17. Advanced Medication Dispenser

    Directory of Open Access Journals (Sweden)

    A.I. Alexan


    Full Text Available Medication dispensing is an important activity that can have major implications if done improperly. Dispensing must be done in the correct time interval, at the correct user, with the correct drug and dose. We propose a smart medication dispenser that can satisfy these needs and provide a mechanism for supervision. In order to ensure that the dispensing process is error free, the concept of a new smart medication container is used. A smart medication container is “smart” as it holds the medication dispensing parameters for the drugs it contains: dispensing time and date and name. Based on this information, the actual dispensing is done.

  18. Technologies for Medical Sciences

    CERN Document Server

    Tavares, João; Barbosa, Marcos; Slade, AP


    This book presents novel and advanced technologies for medical sciences in order to solidify knowledge in the related fields and define their key stakeholders.   The fifteen papers included in this book were written by invited experts of international stature and address important technologies for medical sciences, including: computational modeling and simulation, image processing and analysis, medical imaging, human motion and posture, tissue engineering, design and development medical devices, and mechanic biology. Different applications are treated in such diverse fields as biomechanical studies, prosthesis and orthosis, medical diagnosis, sport, and virtual reality.   This book is of interest to researchers, students and manufacturers from  a wide range of disciplines related to bioengineering, biomechanics, computational mechanics, computational vision, human motion, mathematics, medical devices, medical image, medicine and physics.

  19. [Unravelling medical leadership]. (United States)

    Voogt, Judith J; van Rensen, Elizabeth L J; Noordegraaf, Mirko; Schneider, Margriet M E


    Medical leadership is a popular topic in the Netherlands, and several interest groups now incorporate medical leadership into postgraduate medical education. However, there is no consensus on what this concept entails. By conducting a discourse analysis, a qualitative method which uses language and text to reveal existing viewpoints, this article reveals three perspectives on medical leadership: administrative leadership, leadership within organisations and leadership within each doctor's daily practice. Text analysis shows that the first two perspectives refer to medical leadership mainly in a defensive manner: by demonstrating medical leadership doctors could 'take the lead' once again; patient care only seems to play a small part in the process. These perspectives are not free of consequences, they will determine how the medical profession is constructed. For this reason, it is argued that there should be more emphasis on the third perspective, in which the quality of care for patients is of primary importance.


    Institute of Scientific and Technical Information of China (English)

    张海英; 高会霞; 许怡


    目的 使用基因芯片结合仪器法液体快速培养分析耐多药(multidrug resistant,MDR)结核分枝杆菌(mycobacterium tuberculosis,MTB)的耐药基因和表型特征.方法 应用聚合酶链反应(polymerase chain reaction,PCR)扩增-基因芯片杂交法检测耐多药结核分枝杆菌(multidrug resistant tuberculosis,MDR-TB)菌株中利福平(rifampin,RFP)和异烟肼(isoniazid,INH)耐药基因的突变位点及类型,平行用BD MGIT960系统检测所选菌株对RFP和INH的敏感性.结果 以MGIT960药敏结果作为参考标准,34株MDR-TB中,基因芯片检测MTB对RFP、INH药的符合率分别为85.29%和94.11%;32株RFP耐药突变株中22株为rpoB 基因531位密码子突变,29株INH耐药突变株中24株为katG基因315位密码子突变.结论 基因芯片技术可快速、有效地检出MDR-TB,可以在未获得传统细菌表型药敏结果前指导临床用药治疗.%Objective To analyze the characteristics of phenotype and genotype of multidrug resistant tuberculosis ( MDR - TB ) by gene chip and liquid culture. Methods Gene chip MDR - TB kits were used for identifying the types of rifampin ( RFP ) and isoniazid ( INH )antituberculosis drug resistant genes partly and BD MGIT960 was used for detecting the drug susceptibility. Results Compared with MGIT960,the coincidence rate of gene chip MTBDR plus was 85. 29% and 94. 11% in RFP - resistant strain and INH resistant strain in 34 MDR - TB strains; Among 32 RFP - resistant mutation strains, S531L of rpoB gene accounted for 22 strains. MTB resistant to INH was caused by the mutation of katG chiefly and the S315T1 accounted for 24 strains in 29 INH - resistant strains. Conclusion Gene chip might be a rapid and effective method for the detection of MDR -TB. So,it could be used as an assistant method to guide the therapy on clinic.

  1. Medical Physicists and AAPM (United States)

    Amols, Howard


    The American Association of Physicists in Medicine (AAPM), a member society of the AIP is the largest professional society of medical physicists in the world with nearly 5700 members. Members operate in medical centers, university and community hospitals, research laboratories, industry, and private practice. Medical physics specialties include radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. The majority of AAPM members are based in hospital departments of radiation oncology or radiology and provide technical support for patient diagnosis and treatment in a clinical environment. Job functions include support of clinical care, calibration and quality assurance of medical devices such as linear accelerators for cancer therapy, CT, PET, MRI, and other diagnostic imaging devices, research, and teaching. Pathways into a career in medical physics require an advanced degree in medical physics, physics, engineering, or closely related field, plus clinical training in one or more medical physics specialties (radiation therapy physics, imaging physics, or radiation safety). Most clinically based medical physicists also obtain certification from the American Board of Radiology, and some states require licensure as well.

  2. Effects of Medications on Voice (United States)

    ... ENT Doctor Near You Effects of Medications on Voice Effects of Medications on Voice Patient Health Information ... . Could Your Medication Be Affecting Your Voice? Some medications including prescription, over-the-counter, and ...

  3. Medication Use Before Your Operation (United States)

    ... Surgical Support Groups Recursos en Español (Spanish Resources) Medication Use Before Your Operation Your medications may have ... restart taking these drugs. (See list.) List of medications that affect blood clotting:* Antiplatelet Medication: Anagrelide (Agrylin®), ...

  4. Medical design anthropology

    DEFF Research Database (Denmark)

    Ventura, Jonathan; Gunn, Wendy

    Barnard and Spencer define medical anthropology in the Encyclopedia of Social and Cultural Anthropology as "Medical anthropology is, as the phrase implies, unavoidably concerned with the paradigm of modern Western medicine, whether implicitly or explicitly" (2002: 541). Recently there is a new...... focus in medical sociology and anthropology, which is patient's practices and influence on wider global health environment (see for example vol. 36(2) of Sociology of Health & Illness). While various social science theoreticians have written about agentic abilities of objects, there is a gap...... in literature concerning various levels of socio-cultural influence of the medical environment through medical products. In our research we have outlined the importance of medical design anthropology (MDA) to the practice and theory of design (Ventura and Gunn, 2016). In this paper, we study the ways in which...

  5. Medical education in Malaysia. (United States)

    Lim, Victor K E


    Malaysia has a long history of medical education, with Singapore becoming the first medical school to serve the region after its foundation in 1905. The first school to be established in Kuala Lumpur after independence from the British was the Faculty of Medicine at the University of Malaya in 1963. Whilst today there are 21 public and private medical schools, all offering a 5 year undergraduate programme, some private schools have diversified by developing international collaboration and conduct twinning or credit-transfer programmes. All medical schools require accreditation by the National Accreditation Board and the Malaysian Medical Council. Although the criteria for accreditation is comprehensive and covers a broad range of areas of assessment, it is debatable whether it always matches the needs of the country. The dramatic increase in medical schools in the last two decades has posed challenges in terms of maintenance of quality, physical infrastructure and suitably qualified faculty.

  6. Organising medication discontinuation

    DEFF Research Database (Denmark)

    Nixon, Michael; Kousgaard, Marius Brostrøm


    Background: Discontinuing medications is a complex decision making process and an important medical practice. It is a tool in reducing polypharmacy, reducing health system expenditure and improving patient quality of life. Few studies have looked at how general practitioners (GPs) discontinue...... a medication, in agreement with the patients, from a professional perspective. Three research questions were examined in this study: when does medication discontinuation occur in general practice, how is discontinuing medication handled in the GP’s practice and how do GPs make decisions about discontinuing...... medication? Methods: Twenty four GPs were interviewed using a maximum variation sample strategy. Participant observations were done in three general practices, for one day each, totalling approximately 30 consultations. Results: The results show that different discontinuation cues (related to the type...

  7. Restructuring Military Medical Care (United States)


    personnel—rapid deployment physicians, general or specialized surgeons from all services (including the reserves), senior medics, and nurses —would...for more than 1,500 medical personnel—such as nurses or physicians—assuming that about 12 military medical personnel are rotated annually at each...Displacement Without Myelopathy, Lumbar 21. Calculus of Gallbladder with Other Cholecystitis 22. Alcohol Dependence, Other and Unspecified, Unspecified Use

  8. Medical tourism in India. (United States)

    Gupta, Vijay; Das, Poonam


    The term 'medical tourism' is under debate because health care is a serious business and rarely do patients combine the two. India is uniquely placed by virtue of its skilled manpower, common language, diverse medical conditions that doctors deal with, the volume of patients, and a large nonresident Indian population overseas. Medical tourism requires dedicated services to alleviate the anxiety of foreign patients. These include translation, currency conversion, travel, visa, posttreatment care system,and accommodation of patient relatives during and after treatment.

  9. Fundamentals of Medical Ultrasonics

    CERN Document Server

    Postema, Michiel


    This book sets out the physical and engineering principles of acoustics and ultrasound as used for medical applications. It covers the basics of linear acoustics, wave propagation, non-linear acoustics, acoustic properties of tissue, transducer components, and ultrasonic imaging modes, as well as the most common diagnostic and therapeutic applications. It offers students and professionals in medical physics and engineering a detailed overview of the technical aspects of medical ultrasonic imaging, whilst serving as a reference for clinical and research staff.


    CERN Multimedia

    Medical Service


    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the nurses: on telephone: 73802 by e-mail: Medical Service

  11. Reminder from Medical Service

    CERN Multimedia

    Medical Service


    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the nurses on telephone: 73802 by e-mail: Medical Service

  12. Medical waste management plan.

    Energy Technology Data Exchange (ETDEWEB)

    Lane, Todd W.; VanderNoot, Victoria A.


    This plan describes the process for managing research generated medical waste at Sandia National Laboratories/California. It applies to operations at the Chemical and Radiation Detection Laboratory (CRDL), Building 968, and other biosafety level 1 or 2 activities at the site. It addresses the accumulation, storage, treatment and disposal of medical waste and sharps waste. It also describes the procedures to comply with regulatory requirements and SNL policies applicable to medical waste.

  13. Medical Certification System - (United States)

    Department of Transportation — Provides automated risk-based decision making capability in support of medical certification and clearances processing associated fees and supporting surveillance of...

  14. Medical equipment management

    CERN Document Server

    Willson, Keith; Tabakov, Slavik


    Know What to Expect When Managing Medical Equipment and Healthcare Technology in Your Organization As medical technology in clinical care becomes more complex, clinical professionals and support staff must know how to keep patients safe and equipment working in the clinical environment. Accessible to all healthcare professionals and managers, Medical Equipment Management presents an integrated approach to managing medical equipment in healthcare organizations. The book explains the underlying principles and requirements and raises awareness of what needs to be done and what questions to ask. I

  15. Cannabinoids: Medical implications. (United States)

    Schrot, Richard J; Hubbard, John R


    Herbal cannabis has been used for thousands of years for medical purposes. With elucidation of the chemical structures of tetrahydrocannabinol (THC) and cannabidiol (CBD) and with discovery of the human endocannabinoid system, the medical usefulness of cannabinoids has been more intensively explored. While more randomized clinical trials are needed for some medical conditions, other medical disorders, like chronic cancer and neuropathic pain and certain symptoms of multiple sclerosis, have substantial evidence supporting cannabinoid efficacy. While herbal cannabis has not met rigorous FDA standards for medical approval, specific well-characterized cannabinoids have met those standards. Where medical cannabis is legal, patients typically see a physician who "certifies" that a benefit may result. Physicians must consider important patient selection criteria such as failure of standard medical treatment for a debilitating medical disorder. Medical cannabis patients must be informed about potential adverse effects, such as acute impairment of memory, coordination and judgment, and possible chronic effects, such as cannabis use disorder, cognitive impairment, and chronic bronchitis. In addition, social dysfunction may result at work/school, and there is increased possibility of motor vehicle accidents. Novel ways to manipulate the endocannbinoid system are being explored to maximize benefits of cannabinoid therapy and lessen possible harmful effects.

  16. Medical Equipment Maintenance Programme Overview WHO Medical device technical series

    CERN Document Server

    Organization, World Health


    WHO and partners have been working towards devising an agenda an action plan tools and guidelines to increase access to appropriate medical devices. This document is part of a series of reference documents being developed for use at the country level. The series will include the following subject areas: . policy framework for health technology . medical device regulations . health technology assessment . health technology management . needs assessment of medical devices . medical device procurement . medical equipment donations . medical equipment inventory management . medical equipment maint

  17. The Intersection of Medical Child Abuse and Medical Complexity. (United States)

    Petska, Hillary W; Gordon, John B; Jablonski, Debra; Sheets, Lynn K


    Children with medical complexity and victims of medical child abuse may have similar clinical presentations. Atypical or unexplained signs and symptoms due to rare diseases may lead providers to suspect medical child abuse when not present. Conversely, medical child abuse may be the cause of or coexist with medical complexity. Careful consideration of whether or not medical child abuse is present is essential when assessing a child with medical complexity since either diagnosis has significant consequences for children and families.

  18. Medical Services: Medical, Dental, and Veterinary Care (United States)


    Aeromedical Epidemiological Data Repository to support research and clinical studies for aircrew medical standards and policy. (5) Be the designated...Edentulous areas requiring prostheses but not on an immediate basis. (4) Periodontal disease or periodontium exhibiting: (a) Requirement for oral...materials but for which protective coverage is indicated. (3) Periodontal diseases or periodontium exhibiting: (a) Acute gingivitis or pericoronitis. (b

  19. Essential Medical Capabilities and Medical Readiness (United States)


    Only the first task in Table 7, AFT, appears to relate to the delivery of medical services . The definition of the task in the AFTL is not...9 2. Requirements Definition and Analysis ........................................................12 3. Assessment of...MTFs deliver a healthcare benefit to Active Duty Service members, Active Duty family members, retirees, and other eligible beneficiaries. A. The

  20. Your Medical Records (United States)

    ... family doctor. When it comes to asking for medical records, different health care providers have different ways of doing things. Some might ... are needed faster — like when a patient needs medical treatment — the health care provider holding the records usually releases them immediately. If ...

  1. Ending pregnancy with medications (United States)

    ... or an emergency room. Getting Ready for a Medical Abortion The health care provider will: Do a physical exam and ultrasound Go ... vaginal intercourse for about a week after a medical abortion. You can ... care provider about what birth control to use. You should ...

  2. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.


    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  3. Continuing medical education. (United States)

    Todd, D


    With the rapid advances in medical science and increasing complexities of patient care, the need for continuing medical education (CME) is widely accepted by the profession. CME follows general and higher professional training, and should be a life long process. Teaching hospitals and postgraduate professional institutions play vital roles in organising, promoting, and monitoring this activity. CME directorates should be established. University authorities must recognise the important role of medical teachers in postgraduate and continuing medical education, and the staff establishment and terms of service should be held regularly. Medical libraries should have easy borrowing facilities. Self-assessment and audio-visual material are particularly helpful to the busy practitioner and inexpensive local or regional journals of quality can provide pertinent and up-to-date information. All charges for attending scientific meetings and educational material should be tax deductible or subsidized. The effectiveness of CME is difficult to assess and participation is almost impossible to enforce. Much depends on the standard of medical practice wanted by society. Recertification of general practitioners or specialists poses many problems. On the other hand, completion of self-assessment programmes, active participation at medical meetings, contributions to scientific literature, and membership of medical societies with built-in peer review could be monitored and regularly used to evaluate professional status.

  4. Catastrophic Medical Expenditure Risk

    NARCIS (Netherlands)

    G. Flores (Gabriela); O.A. O'Donnell (Owen)


    textabstractMedical expenditure risk can pose a major threat to living standards. We derive decomposable measures of catastrophic medical expenditure risk from reference-dependent utility with loss aversion. We propose a quantile regression based method of estimating risk exposure from cross-section

  5. Spectator Medical Care. (United States)

    Carlson, L


    Recent world events-including the fear of terrorism during last year's Super Bowl-illustrate how vulnerable spectators can be to medical emergencies during sporting events. A physician who studies and coordinates crowd care for events ranging from the Super Bowl to local fairs gives tips on planning and executing a spectator medical plan.

  6. Medicalized weapons & modern war. (United States)

    Gross, Michael L


    "Medicalized" weapons--those that rely on advances in neuroscience, physiology, and pharmacology--offer the prospect of reducing casualties and protecting civilians. They could be especially useful in modern asymmetric wars in which conventional states are pitted against guerrilla or insurgent forces. But may physicians and other medical workers participate in their development?


    Institute of Scientific and Technical Information of China (English)


    The purpose of the China Medical Abstracts (Internal Medicine) is to promote international exchange of works done by the Chinese medical profession in the field of internal medicine. The papers selected from journals represent the newest and most important advances and progress in various specialities in internal medicine.

  8. History of Medical Physics. (United States)

    Laughlin, John S.


    Traces the development of basic radiation physics that underlies much of today's medical physics and looks separately at the historical development of two major subfields of medical physics: radiation therapy and nuclear medicine. Indicates that radiation physics has made important contributions to solving biomedical problems in medical…


    CERN Multimedia

    Service Médical


    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor.For information, call the Nurses- on Telephone73802- by electronic mailInfirmary.Service@cern.chMarion.Diedrich@cern.chJanet.Doody@cern.chMireille.Vosdey@cern.chMedical Service

  10. Medical Information Systems. (United States)

    Smith, Kent A.


    Description of information services from the National Library of Medicine (NLM) highlights a new system for retrieving information from NLM's databases (GRATEFUL MED); a formal Regional Medical Library Network; DOCLINE; the Unified Medical Language System; and Integrated Academic Information Management Systems. Research and development and the…

  11. Maintaining medical competence

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated at 150 words. I recently renewed my Arizona medical license and meet all the requirements. I far exceed the required CME hours and have no Medical Board actions, removal of hospital privileges, lawsuits, or felonies. None of the bad things are likely since I have not seen patients since July 1, 2011 and I no longer have hospital privileges. However, this caused me to pause when I came to the question of “Actively practicing”? A quick check of the status of several who do not see patients but are administrators, retired or full time editors of other medical journals revealed they were all listed as “active”. I guess that “medical journalism” is probably as much a medical activity as “administrative medicine” which is recognized by the Arizona Medical Board. This got me to thinking about competence and the Medical Board’s obligation to ensure competent physicians. Medical boards focused on preventing the unlicensed practice …

  12. Commercial Crew Medical Ops (United States)

    Heinbaugh, Randall; Cole, Richard


    Provide commercial partners with: center insight into NASA spaceflight medical experience center; information relative to both nominal and emergency care of the astronaut crew at landing site center; a basis for developing and sharing expertise in space medical factors associated with returning crew.

  13. Medical Virtual Public Services

    Directory of Open Access Journals (Sweden)

    Iulia SURUGIU


    Full Text Available The healthcare enterprises are very disconnected. This paper intends to propose a solution that will provide citizens, businesses and medical enterprises with improved access to medical virtual public services. Referred medical services are based on existing national medical Web services and which support medically required services provided by physicians and supplementary health care practitioners, laboratory services and diagnostic procedures, clinics and hospitals’ services. Requirements and specific rules of these medical services are considered, and personalization of user preferences will to be supported. The architecture is based on adaptable process management technologies, allowing for virtual services which are dynamically combined from existing national medical services. In this way, a comprehensive workflow process is set up, allowing for service-level agreements, an audit trail and explanation of the process to the end user. The process engine operates on top of a virtual repository, providing a high-level semantic view of information retrieved from heterogeneous information sources, such as national sources of medical services. The system relies on a security framework to ensure all high-level security requirements are met. System’s architecture is business oriented: it focuses on Service Oriented Architecture - SOA concepts, asynchronously combining Web services, Business Process Management – BPM rules and BPEL standards.

  14. [Ethics in medical journals. (United States)

    Lifshitz, Alberto


    The title of this reflection evokes several contents that may encompass from ethics in research; fraud in science; ethics in medical advertising and relations between sponsors and science; and, finally, papers related to ethic content. This paper is limited to the ethic responsibilities of the medical writers or "scriptwriters."

  15. Medical negligence: Criminal prosecution of medical professionals, importance of medical evidence: Some guidelines for medical practitioners

    Directory of Open Access Journals (Sweden)

    M S Pandit


    Full Text Available The changing doctor-patient relationship and commercialization of modern medical practice has affected the practice of medicine. On the one hand, there can be unfavorable results of treatment and on the other hand the patient suspects negligence as a cause of their suffering. There is an increasing trend of medical litigation by unsatisfied patients. The Supreme Court has laid down guidelines for the criminal prosecution of a doctor. This has decreased the unnecessary harassment of doctors. As the medical profession has been brought under the provisions of the Consumer Protection Act, 1986, the patients have an easy method of litigation. There should be legal awareness among the doctors that will help them in the proper recording of medical management details. This will help them in defending their case during any allegation of medical negligence.


    Directory of Open Access Journals (Sweden)

    Jorge L. Palés Argullós


    Full Text Available In last twenty years, we are seeing increasingly widespread use of simulations in the training of doctors and other professionals of health sciences at the different stages of their educational continuum (undergraduate, postgraduate and continuing medical education. So much so that the concept of simulations-based medical education has emerged and it is now recognized as a vital tool to ensure the learning of medical students and doctors, and to improve patient safety. This article will describe the reasons for the introduction and development of this new methodology, its advantages and the different models and currently available resources. We will describe also the characteristics of so-called simulation centres or clinical skills laboratories that have been developed worldwide, where the simulation-based medical education take place. Moreover, we will refer briefly to the situation in our country and finally to the principles of a good development of the simulation-based medical education.

  17. Medication-overuse headache

    DEFF Research Database (Denmark)

    Westergaard, Maria Lurenda; Munksgaard, Signe Bruun; Bendtsen, Lars;


    Medication-overuse headache (MOH) is a debilitating condition in which frequent and prolonged use of medication for the acute treatment of pain results in the worsening of the headache. The purpose of this paper is to review the most recent literature on MOH and discuss future avenues for research....... MOH accounts for a substantial share of the global burden of disease. Prevalence is often reported as 1-2% but can be as high as 7% overall, with higher proportions among women and in those with a low socioeconomic position. Management consists of withdrawing pain medication, focusing on prophylactic...... and nonmedical treatments, and limiting acute symptomatic medication. Stress reduction and lifestyle interventions may support the change towards rational pain medication use. Support, follow up, and education are needed to help patients through the detoxification period. There is fertile ground for research...

  18. Designated Medical Directors for Emergency Medical Services: Recruitment and Roles (United States)

    Slifkin, Rebecca T.; Freeman, Victoria A.; Patterson, P. Daniel


    Context: Emergency medical services (EMS) agencies rely on medical oversight to support Emergency Medical Technicians (EMTs) in the provision of prehospital care. Most states require EMS agencies to have a designated medical director (DMD), who typically is responsible for the many activities of medical oversight. Purpose: To assess rural-urban…

  19. Medication counselling: physicians' perspective. (United States)

    Bonnerup, Dorthe Krogsgaard; Lisby, Marianne; Eskildsen, Anette Gjetrup; Saedder, Eva Aggerholm; Nielsen, Lars Peter


    Medication reviews have the potential to lower the incidence of prescribing errors. To benefit from a medication review, the prescriber must adhere to medication counselling. Adherence rates vary from 39 to 100%. The aim of this study was to examine counselling-naive hospital physicians' perspectives and demands to medication counselling as well as study factors that might increase adherence to the counselling. The study was conducted as a questionnaire survey among physicians at Aarhus University Hospital, Denmark. The questionnaire was developed based on focus group interviews and literature search, and was pilot-tested among 30 physicians before being sent to 669 physicians. The questionnaire consisted of 35 items divided into four categories: attitudes (19 items), behaviours (3 items), assessment (8 items) and demographics (5 items). The response rate was 60% (400/669). Respondents were employed at psychiatric, medical or surgical departments. Eighty-five per cent of respondents agreed that patients would benefit of an extra medication review, and 72% agreed that there was a need for external medication counselling. The most important factor that could increase adherence was the clinical relevance of the counselling as 78% rated it of major importance. The most favoured method for receiving counselling was via the electronic patient record.

  20. Medical marijuana: medical necessity versus political agenda. (United States)

    Clark, Peter A; Capuzzi, Kevin; Fick, Cameron


    Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government's stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights.

  1. Medical devices: US medical device regulation. (United States)

    Jarow, Jonathan P; Baxley, John H


    Medical devices are regulated by the US Food and Drug Administration (FDA) within the Center for Devices and Radiological Health. Center for Devices and Radiological Health is responsible for protecting and promoting the public health by ensuring the safety, effectiveness, and quality of medical devices, ensuring the safety of radiation-emitting products, fostering innovation, and providing the public with accurate, science-based information about the products we oversee, throughout the total product life cycle. The FDA was granted the authority to regulate the manufacturing and marketing of medical devices in 1976. It does not regulate the practice of medicine. Devices are classified based on complexity and level of risk, and "pre-1976" devices were allowed to remain on the market after being classified without FDA review. Post-1976 devices of lower complexity and risk that are substantially equivalent to a marketed "predicate" device may be cleared through the 510(k) premarket notification process. Clinical data are typically not needed for 510(k) clearance. In contrast, higher-risk devices typically require premarket approval. Premarket approval applications must contain data demonstrating reasonable assurance of safety and efficacy, and this information typically includes clinical data. For novel devices that are not high risk, the de novo process allows FDA to simultaneously review and classify new devices. Devices that are not legally marketed are permitted to be used for clinical investigation purposes in the United States under the Investigational Device Exemptions regulation.

  2. Medical Virology in Malaysia

    Institute of Scientific and Technical Information of China (English)

    Kaw Bing Chua


    Virology is a branch of biological science dealing with the study of viruses, and medical virology focuses on the study and control of diseases due to viruses that is of medical importance. The development of medical virology in Malaysia has its beginning in the Institute for Medical Research (IMR), following the establishment of the Division of Medical Zoology and Virus Research in the institute on 23 March 1953. The second institution in the country to establish diagnostic and research work in medical virology was Department of Medical Microbiology, Faculty of Medicine, University Malaya. This was followed by University Kebangsaan Malaysia, University Sains Malaysia and University of Sarawak Malaysia. The National Public Health Laboratory (NPHL) is the latest institution to establish a laboratory in 2003 for virus isolation and services to support country surveillance and outbreak investigation of infectious diseases due to viruses. In the field of medical virology, Malaysia contributed substantially in the areas of virus diagnostic services, development and research ranging from survey and documentation on the existence and prevalence of viruses causing diseases in Malaysia, clinical presentation and epidemiological features of virus diseases, evaluation of new diagnostic tests to pathogenesis of viral diseases. Malaysia contributed to the discoveries of at least 12 new viruses in the world. ASEAN plus Three (China, Japan, Republic of Korea) Emerging Infectious Programme was established to overcome the challenges and impact of emerging and re-emerging infectious diseases in this region. Malaysia as the co-ordinator of the laboratory component of the programme, contributed to strengthen the regional laboratory capability, capacity, laboratory-based surveillance and networking. The future of medical virology in Malaysia in terms of integration of diagnostic, reference and research to support the country's need will be enhanced and strengthened with the on

  3. Promote translational medical research and report high quality medical studies

    Institute of Scientific and Technical Information of China (English)

    ZHAORI Getu


    @@ Translational medical research, an emerging new important component of medical research, is now attracting attention of more and more researchers, experts and physicians in universities, medical research institutes,hospitals and relevant officers in government agencies.

  4. Medical Therapy of Acromegaly

    Directory of Open Access Journals (Sweden)

    U. Plöckinger


    Full Text Available This paper outlines the present status of medical therapy of acromegaly. Indications for permanent postoperative treatment, postirradiation treamtent to bridge the interval until remission as well as primary medical therapy are elaborated. Therapeutic efficacy of the different available drugs—somatostatin receptor ligands (SRLs, dopamine agonists, and the GH antagonist Pegvisomant—is discussed, as are the indications for and efficacy of their respective combinations. Information on their mechanism of action, and some pharmakokinetic data are included. Special emphasis is given to the difficulties to define remission criteria of acromegaly due to technical assay problems. An algorithm for medical therapy in acromegaly is provided.

  5. Medical instruments in museums

    DEFF Research Database (Denmark)

    Söderqvist, Thomas; Arnold, Ken


    This essay proposes that our understanding of medical instruments might benefit from adding a more forthright concern with their immediate presence to the current historical focus on simply decoding their meanings and context. This approach is applied to the intriguingly tricky question of what...... actually is meant by a "medical instrument." It is suggested that a pragmatic part of the answer might lie simply in reconsidering the holdings of medical museums, where the significance of the physical actuality of instruments comes readily to hand....

  6. Medical marijuana and children. (United States)

    Stubblefield, Sam


    Medical marijuana is legal for use by minors in many states, but not Delaware. Anecdotes have accumulated suggesting efficacy in managing seizures in children and several other conditions in adults. Currently well-designed studies in children are lacking. Challenges to effective pediatric medical marijuana use remain at the level of biochemistry, the individual patient, and society. Appropriate and effective use of medical marijuana in children will require significant legislative changes at the state and federal level, as well as high-quality research and standardization of marijuana strains.

  7. Medical Service Information

    CERN Multimedia

    GS Department


    The Medical Service is pleased to inform you that a psychologist specialising in psychotherapy (member of the Swiss Federation of Psychologists- FSP), Mrs Sigrid Malandain, will be starting work at the CERN on 1 November 2010, in the premises of the Medical Service, Building 57-1-024. Members of CERN personnel can request individual consultations, by appointment, in French or in English, on Tuesdays and Thursdays by calling 78435 (Medical Service secretariat) or sending an e-mail to

  8. Promising Medicated Diet

    Institute of Scientific and Technical Information of China (English)

    Yang Wei


    @@ The founding conference of World Federation of Chinese Medicine Societies-Special Committee of Medicated Diet & Dietotherapy(WFCMS-SCMDAD).and the first world medicated diet and life nurturing academic seminar was held in the Great Hall of the People.Beijing,China,on August 11.A total of 400 experts and professors on medicated diet and life nurturing from 17 countries and regions including Japan,ROK,U.S.,Canada,U.K.,ect.Honorary President Professor Cai Guangxian delivered a welcoming speech to declare the organization's found.

  9. Medication wrong-route administrations in relation to medical prescriptions


    GIMENES, Fernanda Raphael Escobar; Marques, Tatiane Cristina; Teixeira,Thalyta Cardoso Alux; MOTA, Maria Lurdemiler Sabóia; Silva,Ana Elisa Bauer de Camargo; Cassiani, Silvia Helena De Bortoli


    This study analyzes the influence of medical prescriptions' writing on the occurrence of medication errors in the medical wards of five Brazilian hospitals. This descriptive study used data obtained from a multicenter study conducted in 2005. The population was composed of 1,425 medication errors and the sample included 92 routes through which medication was wrongly administered. The pharmacological classes most frequently involved in errors were cardiovascular agents (31.5%), medication that...

  10. Medications (for IBS)

    Medline Plus

    Full Text Available ... Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome ( ... limited by prescription only. It might be a drug or a supplement; manufactured or "natural." It might ...

  11. Color Medical Image Analysis

    CERN Document Server

    Schaefer, Gerald


    Since the early 20th century, medical imaging has been dominated by monochrome imaging modalities such as x-ray, computed tomography, ultrasound, and magnetic resonance imaging. As a result, color information has been overlooked in medical image analysis applications. Recently, various medical imaging modalities that involve color information have been introduced. These include cervicography, dermoscopy, fundus photography, gastrointestinal endoscopy, microscopy, and wound photography. However, in comparison to monochrome images, the analysis of color images is a relatively unexplored area. The multivariate nature of color image data presents new challenges for researchers and practitioners as the numerous methods developed for monochrome images are often not directly applicable to multichannel images. The goal of this volume is to summarize the state-of-the-art in the utilization of color information in medical image analysis.

  12. MDR (Medical Device Reporting) (United States)

    U.S. Department of Health & Human Services — This database allows you to search the CDRH's database information on medical devices which may have malfunctioned or caused a death or serious injury during the...

  13. Catastrophic medical expenditure risk. (United States)

    Flores, Gabriela; O'Donnell, Owen


    We propose a measure of household exposure to particularly onerous medical expenses. The measure can be decomposed into the probability that medical expenditure exceeds a threshold, the loss due to predictably low consumption of other goods if it does and the further loss arising from the volatility of medical expenses above the threshold. Depending on the choice of threshold, the measure is consistent with a model of reference-dependent utility with loss aversion. Unlike the risk premium, the measure is only sensitive to particularly high expenses, and can identify households that expect to incur such expenses and would benefit from subsidised, but not actuarially fair, insurance. An empirical illustration using data from seven Asian countries demonstrates the importance of taking account of informal insurance and reveals clear differences in catastrophic medical expenditure risk across and within countries. In general, risk is higher among poorer, rural and chronically ill populations.

  14. Emergency Medical Services (United States)

    ... and need help right away, you should use emergency medical services. These services use specially trained people and specially equipped facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  15. Other Injectable Medications (United States)

    ... July 17, 2013 Last Edited: February 22, 2017 Articles from Diabetes Forecast® magazine: cg-infusion-sets,meds-bg-injectables,cg-injection-aids, In this section Treatment and Care Medication Insulin & ...

  16. Medical problems in pregnancy. (United States)

    Narayan, Bhaskar; Nelson-Piercy, Catherine


    The prevalence of medical problems in pregnancy is increasing because of a complex interplay between demographic and lifestyle factors, and developments in modern medicine. Maternal mortality and morbidity resulting from treatable medical conditions, such as venous thromboembolism, epilepsy and autoimmune disease, have not decreased in recent years. This is despite a marked decrease in overall maternal mortality. It is vital that all physicians acquire a basic knowledge and understanding of medical problems in pregnancy. This includes prepregnancy measures such as counselling and optimisation of medical therapy, as well as multidisciplinary management throughout pregnancy and the postpartum period. Prompt recognition and treatment of acute and chronic illness is of clear benefit, and most drugs and many radiological investigations may be used in pregnancy.

  17. Medical Issues: Orthopedics (United States)

    ... joint contractures will have a different course of treatment than a “stander” with contractures. The Musculoskeletal Team As with all medical issues in SMA, decisions on treatment of musculoskeletal problems should be made with an ...

  18. Atrial Fibrillation Medications (United States)

    ... won't go away Heart Rate Controlling Medications Beta blockers . These are drugs used to slow the heart ... their heart rate is controlled. Read more about beta blockers . Some examples may include: Atenolol Bisoprolol Carvedilol Metoprolol ...

  19. Understanding Medical Words (United States)

    ... Bar Home Current Issue Past Issues Understanding Medical Words Past Issues / Summer 2009 Table of Contents For ... Medicine that teaches you about many of the words related to your health care Do you have ...

  20. Asthma Medications and Pregnancy (United States)

    ... correctly. Other Asthma Related Medication Treatment Annual influenza vaccine (flu shot) The annual flu shot is recommended for ... second or third trimester. Read more about the flu vaccine . Immunotherapy (allergy shots) Allergy shots should not be ...

  1. How About Medical Physics? (United States)

    Ellis, R. E.


    Cites the increasing need for physicists in medicine. Sketches the qualifications needed to pursue a Master of Science degree (MS) in medical physics fields and provides a brief discussion of Ph.D programs in the field. (CP)

  2. Medical Issues in Adoption (United States)

    ... kids, particularly those who have been living in poverty, to get colds, minor infections, upset stomachs, and ... better you'll be able to make informed decisions about medical care and ease the transition into ...

  3. Medical Issues: Nutrition (United States)

    ... support & care > living with sma > medical issues > nutrition Nutrition Good nutrition is essential to health and growth. ... must make decisions based on their own needs. Nutrition Considerations Since we are still waiting for clinical ...

  4. Medications for Arrhythmia (United States)

    ... child about this before the doctor visit. Medicine Management Tools For Patients Keeping Track / Developing a System ... while you're out. Some pharmacists will prepare blister packs for daily or weekly medications. Ask your ...

  5. Secure medical digital libraries. (United States)

    Papadakis, I; Chrissikopoulos, V; Polemi, D


    In this paper, a secure medical digital library is presented. It is based on the CORBA specifications for distributed systems. The described approach relies on a three-tier architecture. Interaction between the medical digital library and its users is achieved through a Web server. The choice of employing Web technology for the dissemination of medical data has many advantages compared to older approaches, but also poses extra requirements that need to be fulfilled. Thus, special attention is paid to the distinguished nature of such medical data, whose integrity and confidentiality should be preserved at all costs. This is achieved through the employment of Trusted Third Parties (TTP) technology for the support of the required security services. Additionally, the proposed digital library employs smartcards for the management of the various security tokens that are used from the above services.

  6. Medications (for IBS)

    Medline Plus

    Full Text Available ... IBS Awareness Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us About ... IBS Awareness Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us Medications ...

  7. Mental Health Medications (United States)

    ... The most common anti-anxiety medications are called benzodiazepines. Benzodiazepines can treat generalized anxiety disorder. In the case ... panic disorder or social phobia (social anxiety disorder), benzodiazepines are usually second-line treatments, behind SSRIs or ...

  8. Strengthening Medical Ties

    Institute of Scientific and Technical Information of China (English)


    Mainland and Taiwan negotiators settle on health care cooperation chinese mainland and Taiwan negotiators signed a medical and health care I cooperation agreement in Taipei on December 21 in a move to jointly

  9. Kinking of medical tubes. (United States)

    Ingles, David


    The phenomenon of kinking in medical tubing remains a problem for some applications, particularly critical ones such as transporting gasses or fluids. Design features are described to prevent its occurrence.

  10. Medical coding in clinical trials

    Directory of Open Access Journals (Sweden)

    Deven Babre


    Full Text Available Data generated in all clinical trial are recorded on the data collection instrument Case report Form / Electronic Case Report Form by investigators located at various sites in various countries. In multicentric clinical trials since different investigator or medically qualified experts are from different sites / centers recording the medical term(s uniformly is a big challenge. Medical coders from clinical data management team process these terms and perform medical coding. Medical coding is performed to categorize the medical terms reported appropriately so that they can be analyzed/reviewed. This article describes process which is used for medical coding in clinical data management and two most commonly used medical dictionaries MedDRA and WHO-DDE in brief. It is expected to help medical coders to understand the process of medical coding in clinical data management. Few common issues which the medical coder faces while performing medical coding, are also highlighted.

  11. Intracranial Hypertension: Medication and Surgery (United States)

    ... Intracraneal en Espanol. STORE Shop the IHRF Store Medication and Surgery Medication and Surgery Both drugs and surgery are used ... to treat the headache that accompanies chronic IH. Medications for chronic headache like tricyclic anti-depressants, beta- ...

  12. The Medical NBC Battlebook (United States)


    within 3 days). (4) Antigen detection via enzyme immunoassay or other sensitive assay methods . (5) Genome detection employing DNA probes. (6) Detection...0.1% benzalkonium chloride . The medical effects and treatment of CS are detailed in Chapter 7 of FM 8-9 (Part III). 7. Medical Effects of CN. The... methods , including grenades, candles, smoke pots, cartridges, and air bombs. Zinc chloride is a severe respiratory tract irritant and inhalation can

  13. Reducing medication errors. (United States)

    Nute, Christine


    Most nurses are involved in medicines management, which is integral to promoting patient safety. Medicines management is prone to errors, which depending on the error can cause patient injury, increased hospital stay and significant legal expenses. This article describes a new approach to help minimise drug errors within healthcare settings where medications are prescribed, dispensed or administered. The acronym DRAINS, which considers all aspects of medicines management before administration, was devised to reduce medication errors on a cardiothoracic intensive care unit.

  14. Medical Information Security


    William C. Figg, Ph.D.; Hwee Joo Kam, M.S.


    Modern medicine is facing a complex environment, not from medical technology but rather government regulations and information vulnerability. HIPPA is the government’s attempt to protect patient’s information yet this only addresses traditional record handling. The main threat is from the evolving security issues. Many medical offices and facilities have multiple areas of information security concerns. Physical security is often weak, office personnel are not always aware of security needs an...

  15. The Automated Medical Office



    With shock and surprise many physicians learned in the 1980s that they must change the way they do business. Competition for patients, increasing government regulation, and the rapidly escalating risk of litigation forces physicians to seek modern remedies in office management. The author describes a medical clinic that strives to be paperless using electronic innovation to solve the problems of medical practice management. A computer software program to automate information management in a c...

  16. Medical management of obesity. (United States)

    Klein, S


    Obesity has become a major health problem in many countries because of its high prevalence and causal relationship with serious medical complications. Many of the medical complications associated with obesity improve with intentional weight in a dose-dependent fashion, and even a modest weight loss of 50% of initial weight has beneficial effects. This article reviews the nonsurgical approaches for achieving weight loss in obese persons.


    CERN Multimedia


    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the nurses - on telephone: 73802 - by e-mail:Service.Mé Medical Service

  18. Reminder from Medical Service

    CERN Multimedia


    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, contact the nurses on telephone: 73802 by e-mail: Service.Mé Medical Service


    CERN Multimedia

    Medical Service


    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor.For information, call the Nurses on Telephone: 73802 or by electronic Mireille.Vosdey@cern.chMedicalService


    CERN Multimedia


    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the nurses - on telephone: 73802 - by e-mail: Service.Mé Medical Service


    CERN Multimedia

    Service médical


    For medical problems, we would like to remind all personnel working on the CERN sites,be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor.For information, call the Nurseson telephone: electronic mail Mireille.Vosdey@cern.chMedicalService


    CERN Multimedia

    Service Médical


    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on telephone: 73802. by electronic mail to: Medical Service

  3. Medication safety during your hospital stay (United States)

    Five-rights - medication; Medication administration - hospital; Medical errors - medication; Patient safety - medication safety ... Medication safety means you get the right medicine, the right dose, at the right times. During your ...

  4. Osteoporosis Treatment: Medications Can Help (United States)

    Osteoporosis treatment: Medications can help Osteoporosis treatment may involve medication along with lifestyle change. A Mayo Clinic specialist answers some of the most common questions about osteoporosis ...

  5. 实时聚合酶链反应熔解曲线法快速检测耐多药结核分枝杆菌%Rapid detection of rifampin- and isoniazid-resistant Mycobacterium tuberculosis using real-time PCR and melting curve analysis

    Institute of Scientific and Technical Information of China (English)

    王峰; 崔运勇; 胡思玉; 桂静; 杨慧; 李庆阁; 刘小立


    Objective To evaluate the application of a real-time PCR and melting curve analysis assay for rapid detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis ( M.tuberculosis).Methods A total of 311 clinical isolates of M.tuberculosis obtained from Shenzhen Center for Chronic Disease Control (SZCCC) were included in the study.These isolates were collected originally from national baseline survey on drug-resistant tuberculosis,project for drug resistance surveillance in Shenzhen and clinical patients in SZCCC between 2007 and 2009.rpoB gene resistance-determining region,ahpC promoter (-44 to -30 and -15 to -3),inhA promoter (-17 to -8),inhA 94 and katG 315 were detected by melting curve analysis after real-time PCR,and the results were compared with that of proportion method and DNA sequencing.The performances of the assay in detecting the resistance of rifampin and isoniazid were compared to that of reference proportion method drug susceptibility test.Results Real-time PCR and melting analysis was a closed-tube assay that could be completed within 2 -3 h.Compared to the results of the proportion method,the sensitivity,specificity and accuracy of the assay for rifampin resistance were 97.8%,97.1% and 97.4% respectively,and for isoniazid resistance were 86.6%,98.7% and 92.6% respectively.Conclusions Real-time PCR and melting analysis is a rapid,accurate and closed-tube method that can be used as a screening test for rapid identification of Multidrug-resistant tuberculosis.%目的 应用实时PCR熔解曲线法快速检测MTB对利福平和异烟肼的耐药性,并与比例法检测结果进行比较.方法 收集深圳市2007-2009年耐药监测项目、全国耐药基线调查项目和深圳市慢性病防治中心门诊患者临床分离株311株,采用实时PCR熔解曲线法检测rpoB基因耐药突变热点区、ahpC启动子区(-44 -30及-15~3位点)、inhA启动子区(-17~8位点)、inhA 94和katG 315位耐药突变,并与

  6. Accounting for Medication Particularities: Designing for Everyday Medication Management

    DEFF Research Database (Denmark)

    Dalgaard, Lea Gulstav; Grönvall, Erik; Verdezoto, Nervo


    Several projects have shown that self-management of medication in private homes can be challenging. Many projects focused on specific illness-related approaches (e.g. diabetes) or practical issues such as how to handle medication while travelling. However, designing for everyday medication...... management involves more than just specific illness-related strategies and should take into account the broad set of activities conforming people’s everyday life. This study investigates how older adults manage their medication in everyday life. To inform the design of pervasive healthcare medication...... management systems (PHMMS), the study calls for attention to medication-specific particularities that account for: according to need medication, the heterogeneous care network, the substitute medication, the medication informational order, the shared responsibility and the adjustment of medication intake...

  7. Polymeric materials in medication

    CERN Document Server

    Carraher, Charles


    The art of using chemical agents for medication dates back into antiquity, although most of the earliest examples used plants, herbs, and other natural materials. The old Egyptian medical papyri, which date from before 1400 B. C. , contain dozens of examples of such medicinal plants and animal extracts. In the Old Testament of the Bible, we can find references to using oil to soften the skin and sores (Isaiah 1:6), the use of tree leaves for medicine (Ezekiel 47:12) and various medical balms (Jeremiah 8:22). Not all these recipes were effective in curing the ailments for which they were used and sometimes the treatment was worse than the disease. Nevertheless, the art of using chemical derived agents for medicines continued to develop and received great impetus during the present century with the rise of synthetic organic chemistry. One of the most vexing problems has always been to achieve specifici­ ty with the medications. While some medical agents do indeed possess a relatively high degree of specificity...

  8. Financing medical education. (United States)

    Petersdorf, R G


    The cost of a medical education may dissuade qualified young people from entering the medical profession or may so load them with debt that they cannot pursue relatively low-paid careers in primary care or clinical investigation. Three aspects of this problem are examined: (1) the cost of medical school, (2) the magnitude of student indebtedness, and (3) the effects of this indebtedness on career choices. High tuition and fees require many students to assume sizable educational debts, some of which are so large that the trainees will be unable to repay them unless they enter highly remunerative specialties. Also, high levels of indebtedness may increase default levels once graduates feel the full impact of scheduled repayments. Several steps would help to alleviate this problem, but are unlikely to solve it. First, medical schools should lower tuition or at least declare a moratorium on increases. Second, limits should be imposed on the amount of total education debt a student is allowed to assume. Third, hospitals with extensive residency programs should assume some responsibility for helping trainees manage their finances. Fourth, the government should institute a loan forgiveness program that addresses the need for physician-investigators, primary care physicians, those willing to practice in underserved areas, and those from underrepresented minorities. And fifth, all institutions involved in medical training and its finance should work together to advise students on managing their debts.

  9. Medical education in Sweden. (United States)

    Lindgren, Stefan; Brännström, Thomas; Hanse, Eric; Ledin, Torbjörn; Nilsson, Gunnar; Sandler, Stellan; Tidefelt, Ulf; Donnér, Jakob


    Undergraduate medical education in Sweden has moved from nationally regulated, subject-based courses to programmes integrated either around organ systems or physiological and patho-physiological processes, or organised around basic medical science in conjunction with clinical specialities, with individual profiles at the seven medical schools. The national regulations are restricted to overall academic and professional outcomes. The 5½ year long university undergraduate curriculum is followed by a mandatory 18 months internship, delivered by the County Councils. While quality control and accreditation for the university curriculum is provided by the Swedish National Agency for Higher Education, no such formal control exists for the internship; undergraduate medical education is therefore in conflict with EU directives from 2005. The Government is expected to move towards 6 years long university undergraduate programmes, leading to licence, which will facilitate international mobility of both Swedish and foreign medical students and doctors. Ongoing academic development of undergraduate education is strengthened by the Bologna process. It includes outcome (competence)-based curricula, university Masters level complying with international standards, progression of competence throughout the curriculum, student directed learning, active participation and roles in practical clinical education and a national assessment model to assure professional competence. In the near future, the dimensioning of Swedish undergraduate education is likely to be decided more by international demands and aspects of quality than by national demands for doctors.

  10. Medical Practitioners Act 2007: the increased medical record burden.

    LENUS (Irish Health Repository)

    Byrne, D


    New medical record keeping obligations are implemented by the Medical Practitioners Act (2007), effective July 2009. This audit, comprising review of 347 medical entries in 257 charts on one day, investigated compliance with the Act together with the general standard of medical record keeping. The Medical Council requirement was absent all but 3 (0.9%) of entries; there was no unique identifier or signature in 28 (8%) and 135 (39%) of entries respectively. The case for change is discussed.

  11. Decay kinetics of an interferon gamma release assay with anti-tuberculosis therapy in newly diagnosed tuberculosis cases.

    Directory of Open Access Journals (Sweden)

    Ifedayo M O Adetifa

    Full Text Available BACKGROUND: Qualitative and quantitative changes in IGRA response offer promise as biomarkers to monitor Tuberculosis (TB drug therapy, and for the comparison of new interventions. We studied the decay kinetics of TB-specific antigen T-cell responses measured with an in-house ELISPOT assay during the course of therapy. METHODS: Newly diagnosed sputum smear positive TB cases with typical TB chest radiographs were recruited. All patients were given standard anti-TB treatment. Each subject was followed up for 6 months and treatment outcomes were documented. Blood samples were obtained for the ESAT-6 and CFP-10 (EC ELISPOT at diagnosis, 1-, 2-, 4- and 6-months. Qualitative and quantitative reversion of the ELISPOT results were assessed with McNemar test, conditional logistic regression and mixed-effects hierarchical Poisson models. RESULTS: A total of 116 cases were recruited and EC ELISPOT was positive for 87% (95 of 109 at recruitment. There was a significant decrease in the proportion of EC ELISPOT positive cases over the treatment period (p<0.001. Most of the reversion occurred between the start and first month of treatment and at completion at 6 months. ESAT-6 had higher median counts compared to CFP-10 at all time points. Counts for each antigen declined significantly with therapy (p<0.001. Reverters had lower median SFUs at the start of treatment compared to non-Reverters for both antigens. Apart from the higher median counts for non-Reverters, no other risk factors for non-reversion were found. CONCLUSIONS: TB treatment induces qualitative and quantitative reversion of a positive in-house IGRA in newly diagnosed cases of active TB disease. As this does not occur reliably in the majority of cured individuals, qualitative and quantitative reversion of an IGRA ELISPOT has limited clinical utility as a surrogate marker of treatment efficacy.

  12. Development of a prediction system for anti-tuberculosis drug-induced liver injury in Japanese patients (United States)

    Mushiroda, Taisei; Yanai, Hideki; Yoshiyama, Takashi; Sasaki, Yuka; Okumura, Masao; Ogata, Hideo; Tokunaga, Katsushi


    Drug-induced liver injury (DILI) is a common adverse drug reaction in patients receiving antituberculosis (anti-TB) treatment. Among the anti-TB agents, isoniazid (INH) is the primary drug that causes hepatotoxicity in TB patients with DILI. Previous reports in several populations have consistently demonstrated an association between polymorphisms in the N-acetyltransferase 2 (NAT2) gene, which is responsible for INH hepatic metabolism, and a risk of DILI in TB patients. In this study, the genetic and baseline clinical data from 366 Japanese patients with TB (73 patients with DILI and 293 without DILI) were used to develop a system to predict DILI risk due to anti-TB agents. The distribution of the NAT2 acetylator status among the TB patients with DILI was 31 (42.5%), 29 (39.7%), and 13 (17.8%) for rapid, intermediate, and slow acetylators, respectively. A significant association was observed between NAT2 slow acetylators and DILI risk (odds ratio 4.32, 95% confidence interval 1.93–9.66, P value=5.56×10−4). A logistic regression model based on age and NAT2 genotype revealed that the area under the curve for the receiver-operating characteristic curve was 0.717. The findings demonstrated that slow NAT2 acetylator status is a significant predictor of the risk of DILI by anti-TB agents, and a personalized anti-TB treatment approach may aid in making treatment decisions and reducing the incidence of DILI. PMID:27340556

  13. Computational medicinal chemistry for rational drug design: Identification of novel chemical structures with potential anti-tuberculosis activity. (United States)

    Koseki, Yuji; Aoki, Shunsuke


    Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis and is a common infectious disease with high mortality and morbidity. The increasing prevalence of drug-resistant strains of TB presents a major public health problem. Due to the lack of effective drugs to treat these drug-resistant strains, the discovery or development of novel anti-TB drugs is important. Computer-aided drug design has become an established strategy for the identification of novel active chemicals through a combination of several drug design tools. In this review, we summarise the current chemotherapy for TB, describe attractive target proteins for the development of antibiotics against TB, and detail several computational drug design strategies that may contribute to the further identification of active chemicals for the treatment of not only TB but also other diseases.

  14. 2,3-Bifunctionalized Quinoxalines: Synthesis, DNA Interactions and Evaluation of Anticancer, Anti-tuberculosis and Antifungal Activity

    Directory of Open Access Journals (Sweden)

    Tom Ellis


    Full Text Available A variety of 2,3-bifunctionalized quinoxalines (6-14 have been prepared by the condensation of 1,6-disubstituted-hexan-1,3,4,6-tetraones (1-4 with o-phenylenediamine, (R,R-1,2-diaminocyclohexane and p-nitro-o-phenylenediamine. It is concluded that strong intramolecular N-H----O bonds in the favoured keto-enamine form may be responsible for the minimal biological activities observed in DNA footprinting, antitubercular, anti-fungal and anticancer tests with these hyper π-conjugated quinoxaline derivatives. However, subtle alteration by addition of a nitro group affecting the charge distribution confers significant improvements in biological effects and binding to DNA.

  15. Application of Fluorescent Protein Expressing Strains to Evaluation of Anti-Tuberculosis Therapeutic Efficacy In Vitro and In Vivo.

    Directory of Open Access Journals (Sweden)

    Ying Kong

    Full Text Available The slow growth of Mycobacterium tuberculosis (Mtb, the causative agent of tuberculosis (TB, hinders development of new diagnostics, therapeutics and vaccines. Using non-invasive real-time imaging technologies to monitor the disease process in live animals would facilitate TB research in all areas. We developed fluorescent protein (FP expressing Mycobacterium bovis BCG strains for in vivo imaging, which can be used to track bacterial location, and to quantify bacterial load in live animals. We selected an optimal FP for in vivo imaging, by first cloning six FPs: tdTomato, mCherry, mPlum, mKate, Katushka and mKeima, into mycobacteria under either a mycobacterial Hsp60 or L5 promoter, and compared their fluorescent signals in vitro and in vivo. Fluorescence from each FP-expressing strain was measured with a multimode reader using the optimal excitation and emission wavelengths for the FP. After normalizing bacterial numbers with optical density, the strain expressing L5-tdTomato displayed the highest fluorescence. We used the tdTomato-labeled M. bovis BCG to obtain real-time images of pulmonary infections in living mice and rapidly determined the number of bacteria present. Further comparison between L5-tdTomato and Hsp60-tdTomato revealed that L5-tdTomato carried four-fold more tdTomato gene copies than Hsp60-tdTomato, which eventually led to higher protein expression of tdTomato. Evaluating anti-TB efficacy of rifampicin and isoniazid therapy in vitro and in vivo using the L5-tdTomato strain demonstrated that this strain can be used to identify anti-TB therapeutic efficacy as quickly as 24 h post-treatment. These M. bovis BCG reporter strains represent a valuable new tool for evaluation of therapeutics, vaccines and virulence.

  16. Reinforcing the membrane-mediated mechanism of action of the anti-tuberculosis candidate drug thioridazine with molecular simulations (United States)

    Kopec, Wojciech; Khandelia, Himanshu


    Thioridazine is a well-known dopamine-antagonist drug with a wide range of pharmacological properties ranging from neuroleptic to antimicrobial and even anticancer activity. Thioridazine is a critical component of a promising multi-drug therapy against M. tuberculosis. Amongst the various proposed mechanisms of action, the cell membrane-mediated one is peculiarly tempting due to the distinctive feature of phenothiazine drug family to accumulate in selected body tissues. In this study, we employ long-scale molecular dynamics simulations to investigate the interactions of three different concentrations of thioridazine with zwitterionic and negatively charged model lipid membranes. Thioridazine partitions into the interfacial region of membranes and modifies their structural and dynamic properties, however dissimilarly so at the highest membrane-occurring concentration, that appears to be obtainable only for the negatively charged bilayer. We show that the origin of such changes is the drug induced decrease of the interfacial tension, which ultimately leads to the significant membrane expansion. Our findings support the hypothesis that the phenothiazines therapeutic activity may arise from the drug-membrane interactions, and reinforce the wider, emerging view of action of many small, bioactive compounds.

  17. Reinforcing the membrane-mediated mechanism of action of the anti-tuberculosis candidate drug thioridazine with molecular simulations

    DEFF Research Database (Denmark)

    Kopec, Wojciech; Khandelia, Himanshu


    mechanisms of action, the cell membrane-mediated one is peculiarly tempting due to the distinctive feature of phenothiazine drug family to accumulate in selected body tissues. In this study, we employ long-scale molecular dynamics simulations to investigate the interactions of three different concentrations......Thioridazine is a well-known dopamine-antagonist drug with a wide range of pharmacological properties ranging from neuroleptic to antimicrobial and even anticancer activity. Thioridazine is a critical component of a promising multi-drug therapy against M. tuberculosis. Amongst the various proposed...... for the negatively charged bilayer. We show that the origin of such changes is the drug induced decrease of the interfacial tension, which ultimately leads to the significant membrane expansion. Our findings support the hypothesis that the phenothiazines therapeutic activity may arise from the drug...

  18. The Structure of the Anti-tuberculosis Antibiotics Viomycin and Capreomycin Bound to the 70S Ribosome

    Energy Technology Data Exchange (ETDEWEB)

    Stanley, R.; Blaha, G; Grodzicki, R; Strickler, M; Steitz, T


    Viomycin and capreomycin belong to the tuberactinomycin family of antibiotics, which are among the most effective antibiotics against multidrug-resistant tuberculosis. Here we present two crystal structures of the 70S ribosome in complex with three tRNAs and bound to either viomycin or capreomycin at 3.3- and 3.5-{angstrom} resolution, respectively. Both antibiotics bind to the same site on the ribosome, which lies at the interface between helix 44 of the small ribosomal subunit and helix 69 of the large ribosomal subunit. The structures of these complexes suggest that the tuberactinomycins inhibit translocation by stabilizing the tRNA in the A site in the pretranslocation state. In addition, these structures show that the tuberactinomycins bind adjacent to the binding sites for the paromomycin and hygromycin B antibiotics, which may enable the development of new derivatives of tuberactinomycins that are effective against drug-resistant strains.

  19. The structures of the anti-tuberculosis antibiotics viomycin and capreomycin bound to the 70S ribosome

    Energy Technology Data Exchange (ETDEWEB)

    Stanley, Robin E.; Blaha, Gregor; Grodzicki, Robert L.; Strickler, Michael D.; Steitz, Thomas A. (Yale)


    Viomycin and capreomycin belong to the tuberactinomycin family of antibiotics, which are among the most effective antibiotics against multidrug-resistant tuberculosis. Here we present two crystal structures of the 70S ribosome in complex with three tRNAs and bound to either viomycin or capreomycin at 3.3- and 3.5-{angstrom} resolution, respectively. Both antibiotics bind to the same site on the ribosome, which lies at the interface between helix 44 of the small ribosomal subunit and helix 69 of the large ribosomal subunit. The structures of these complexes suggest that the tuberactinomycins inhibit translocation by stabilizing the tRNA in the A site in the pretranslocation state. In addition, these structures show that the tuberactinomycins bind adjacent to the binding sites for the paromomycin and hygromycin B antibiotics, which may enable the development of new derivatives of tuberactinomycins that are effective against drug-resistant strains.

  20. Adolf Hitler's medical care. (United States)

    Doyle, D


    For the last nine years of his life Adolf Hitler, a lifelong hypochondriac had as his physician Dr Theodor Morell. Hitler's mood swings, Parkinson's disease, gastro-intestinal symptoms, skin problems and steady decline until his suicide in 1945 are documented by reliable observers and historians, and in Morell's diaries. The bizarre and unorthodox medications given to Hitler, often for undisclosed reasons, include topical cocaine, injected amphetamines, glucose, testosterone, estradiol, and corticosteroids. In addition, he was given a preparation made from a gun cleaner, a compound of strychnine and atropine, an extract of seminal vesicles, and numerous vitamins and 'tonics'. It seems possible that some of Hitler's behaviour, illnesses and suffering can be attributed to his medical care. Whether he blindly accepted such unorthodox medications or demanded them is unclear.

  1. Photosensitizing medications and photocarcinogenesis. (United States)

    O'Gorman, Susan M; Murphy, Gillian M


    Photosensitivity is an exaggerated or abnormal response to ultraviolet (UV) or visible light exposure. Many current medications are known photosensitizers; however, the effects of the sensitization can be subclinical and go unnoticed by the person affected. While some of these drugs are used for short and defined periods, others are used indefinitely for the treatment of chronic disease. The question of whether either of these practices translates into an increased risk of skin cancer is an important one. Numerous medications have real, distinct and well-elucidated mechanisms that potentiate the development of skin cancer, while with some medications the mechanism for the observed carcinogenesis remains unclear. In this article we will discuss the clinical, mechanistic and epidemiological evidence supporting photochemical genotoxicity and carcinogenesis.

  2. The medicalization of love. (United States)

    Earp, Brian D; Sandberg, Anders; Savulescu, Julian


    Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. Although such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to the 'medicalization' of human love and heartache--for some, a source of a serious concern. In this essay, we argue that the medicalization of love need not necessarily be problematic, on balance, but could plausibly be expected to have either good or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help to direct the course of love's medicalization--should it happen to occur--more toward the 'good' side than the 'bad.'

  3. Medical database security evaluation. (United States)

    Pangalos, G J


    Users of medical information systems need confidence in the security of the system they are using. They also need a method to evaluate and compare its security capabilities. Every system has its own requirements for maintaining confidentiality, integrity and availability. In order to meet these requirements a number of security functions must be specified covering areas such as access control, auditing, error recovery, etc. Appropriate confidence in these functions is also required. The 'trust' in trusted computer systems rests on their ability to prove that their secure mechanisms work as advertised and cannot be disabled or diverted. The general framework and requirements for medical database security and a number of parameters of the evaluation problem are presented and discussed. The problem of database security evaluation is then discussed, and a number of specific proposals are presented, based on a number of existing medical database security systems.

  4. Personalized Medical Alert System

    Directory of Open Access Journals (Sweden)

    Juan Pablo Suarez Coloma


    Full Text Available The continuous increasing needs in telemedicine and healthcare, accentuate the need of well-adapted medical alert systems. Such alert systems may be used by a variety of patients and medical actors, and should allow monitoring a wide range of medical variables. This paper proposes Tempas, a personalized temporal alert system. It facilitates customized alert configuration by using linguistic trends. The trend detection algorithm is based on data normalization, time series segmentation, and segment classification. It improves state of the art by treating irregular and regular time series in an appropriate way, thanks to the introduction of an observation variable valid time. Alert detection is enriched with quality and applicability measures. They allow a personalized tuning of the system to help reducing false negatives and false positives alerts.

  5. Exploring medical identity theft. (United States)

    Mancilla, Desla; Moczygemba, Jackie


    The crime of medical identity theft is a growing concern in healthcare institutions. A mixed-method study design including a two-stage electronic survey, telephone survey follow-up, and on-site observations was used to evaluate current practices in admitting and registration departments to reduce the occurrence of medical identity theft. Survey participants were chief compliance officers in acute healthcare organizations and members of the Health Care Compliance Association. Study results indicate variance in whether or how patient identity is confirmed in healthcare settings. The findings of this study suggest that information systems need to be designed for more efficient identity management. Admitting and registration staff must be trained, and compliance with medical identity theft policies and procedures must be monitored. Finally, biometric identity management solutions should be considered for stronger patient identification verification.

  6. Medical Yoga Therapy (United States)

    Stephens, Ina


    Medical yoga is defined as the use of yoga practices for the prevention and treatment of medical conditions. Beyond the physical elements of yoga, which are important and effective for strengthening the body, medical yoga also incorporates appropriate breathing techniques, mindfulness, and meditation in order to achieve the maximum benefits. Multiple studies have shown that yoga can positively impact the body in many ways, including helping to regulate blood glucose levels, improve musculoskeletal ailments and keeping the cardiovascular system in tune. It also has been shown to have important psychological benefits, as the practice of yoga can help to increase mental energy and positive feelings, and decrease negative feelings of aggressiveness, depression and anxiety. PMID:28208599

  7. Medical uses of nitinol

    Energy Technology Data Exchange (ETDEWEB)

    Pelton, A.R.; Stoeckel, D.; Duering, T.W. [Nitinol Devices and Components - Cordis Corp., Fremont, CA (United States)


    The growth of nitinol in the medical industries has exploded in the past ten years. Patients and care providers have encouraged the transition from traditional open-surgical procedures, which require long hospital stays, to less-invasive techniques, which are often performed in out-patient clinics. This demand for minimally invasive procedures has allowed novel instrumentation and implants to be designed. An increasing number of these devices use nitinol as the critical component. Examples of medical applications range from orthodontic archwires and endoscopic instruments to endovascular stents. This paper will focus on key performance attributes of nitinol that make it an ideal material for medical applications. Specific applications will be introduced through their use of the enabling features. (orig.)

  8. Political and medical views on medical marijuana and its future. (United States)

    Rubens, Muni


    The policies, laws, politics, public opinions, and scientific inferences of medical marijuana are rapidly changing as the debate on medical use of marijuana has always been political, rather than scientific. Federal law has barred the use of medical marijuana though 18 state governments and Washington, DC, support the medical use of marijuana. Unfortunately, not many studies exist on medical marijuana to back these laws and policies. The judiciary, on the other hand, has elicited a diverse response to medical marijuana through its rulings over several decades. Some rulings favored the federal government's opinion, and others supported the larger public view and many state governments with legalized medical marijuana. Public opinion on legalizing medical marijuana has always favored the use of medical marijuana. The movement of scientific knowledge of medical marijuana follows an erratic, discontinuous pathway. The future place of medical marijuana in U.S. society remains unknown. The three forces-scientific knowledge, social-political acceptance, and laws-play a role in the direction that medical marijuana takes in society. Overcoming political-social forces requires a concerted effort from the scientific community and political leaders. The results of scientific research must guide the decisions for laws and medical use of marijuana. This article aims to trace the political dilemma and contradictory views shared by federal and state governments and predict the future of medical marijuana by tracing the past history of medical marijuana with its bumpy pathway in the social-political arena.

  9. Primary Medical Care in Chile

    DEFF Research Database (Denmark)

    Scarpaci, Joseph L.

    Primary medical care in Chile: accessibility under military rule [Front Cover] [Front Matter] [Title Page] Contents Tables Figures Preface Chapter 1: Introduction Chapter 2: The Restructuring of Medical Care Financing in Chile Chapter 3: Inflation and Medical Care Accessibility Chapter 4: Help......-Seeking Behavior of the Urban Poor Chapter 5: Spatial Organization and Medical Care Accessibility Chapter 6: Conclusion...

  10. Religion and medical ethics. (United States)

    Green, Ronald M


    Religious traditions of medical ethics tend to differ from more secular approaches by stressing limitations on autonomous decision-making, by more positively valuing the experience of suffering, and by drawing on beliefs and values that go beyond empiric verification. I trace the impact of these differences for some of the world's great religious traditions with respect to four issues: (1) religious conscientious objection to medical treatments; (2) end-of life decision-making, including euthanasia, physician-assisted suicide, and the withholding or withdrawing of life-sustaining treatments; (3) definitions of moral personhood (defining life's beginning and end); and (4) human sexuality.

  11. Merton and medical sociology


    Nunes E.D.


    The article is about the main contributions of the North-American sociologist Robert King Merton (1910-2003), particularly those related to the field of medical sociology. Merton was first to conduct research on medical education, and the working team he formed was fundamental for the introduction of social thought in the medicine field (Patrícia Kendall, Renée Fox, Samuel Bloom and others). Of particular importance are Merton's vocation for sociology and the unique trajectory of his research...

  12. Classification in Medical Imaging

    DEFF Research Database (Denmark)

    Chen, Chen

    Classification is extensively used in the context of medical image analysis for the purpose of diagnosis or prognosis. In order to classify image content correctly, one needs to extract efficient features with discriminative properties and build classifiers based on these features. In addition...... to segment breast tissue and pectoral muscle area from the background in mammogram. The second focus is the choices of metric and its influence to the feasibility of a classifier, especially on k-nearest neighbors (k-NN) algorithm, with medical applications on breast cancer prediction and calcification...

  13. Readmissions of medical patients

    DEFF Research Database (Denmark)

    Cooksley, T.; Nanayakkara, P. W. B.; Nickel, C. H.


    of readmission but have not been validated in international populations. AIM: To perform an external independent validation of the HOSPITAL and LACE scores. DESIGN: An unplanned secondary cohort study. METHODS: Patients admitted to the medical admission unit at the Hospital of South West Jutland (10...... power of both scores decreased with increasing age. CONCLUSION: Readmissions are a complex phenomenon with not only medical conditions contributing but also system, cultural and environmental factors exerting a significant influence. It is possible that the heterogeneity of the population and health...

  14. The automated medical office. (United States)

    Petreman, M


    With shock and surprise many physicians learned in the 1980s that they must change the way they do business. Competition for patients, increasing government regulation, and the rapidly escalating risk of litigation forces physicians to seek modern remedies in office management. The author describes a medical clinic that strives to be paperless using electronic innovation to solve the problems of medical practice management. A computer software program to automate information management in a clinic shows that practical thinking linked to advanced technology can greatly improve office efficiency.

  15. Medical pedagogical resources management. (United States)

    Pouliquen, Bruno; Le Duff, Franck; Delamarre, Denis; Cuggia, Marc; Mougin, Fleur; Le Beux, Pierre


    The main objective of this work is to help the management of training resources for students using a pedagogical network available at the Medical School of Rennes. With the increase of the number of connections and the number of medical documents available on this network, the management of new contents requires a lot of efforts for the webmaster. In order to improve the management of the resources, we implemented an automatic web engine for teachers, able to manage the links for the most interesting resources for their practice.

  16. Medical ultrasound imaging

    DEFF Research Database (Denmark)

    Jensen, Jørgen Arendt


    The paper gives an introduction to current medical ultrasound imaging systems. The basics of anatomic and blood flow imaging are described. The properties of medical ultrasound and its focusing are described, and the various methods for two- and three-dimensional imaging of the human anatomy...... are shown. Both systems using linear and non-linear propagation of ultrasound are described. The blood velocity can also be non-invasively visualized using ultrasound and the basic signal processing for doing this is introduced. Examples for spectral velocity estimation, color flow maging and the new vector...

  17. Medical applications of accelerators

    CERN Document Server

    Rossi, Sandro


    At Present, about five thousands accelerators are devoted to biomedical applications. They are mainly used in radiotherapy, research and medical radioisotopes production. In this framework oncological hadron-therapy deserves particular attention since it represents a field in rapid evolution thanks to the joint efforts of laboratories with long experiences in particle physics. It is the case of CERN where the design of an optimised synchrotron for medical applications has been pursued. These lectures present these activities with particular attention to the new developments which are scientifically interesting and/or economically promising.

  18. Medical Products Research (United States)


    Ventrex Laboratories, Inc. develops, manufactures and markets a line of medical diagnostic assays based on biochemical techniques, in particular immunochemical techniques. Their products are sold worldwide to hospitals and medical laboratories for use in testing blood samples and other biological fluids. Analysis of a patient's body fluids, compared with normal values, aids a physician in confirming or otherwise diagnosing a suspected disease condition. NERAC's rapid information retrieval has provided Ventrex invaluable up-to-date information, and has permitted large scale savings. NERAC's service was particularly important in the development of a new product in the company's Ventre/Sep line, which is used in radioimmunoassays.

  19. Paternalism and medical ethics. (United States)

    Gillon, R


    In one of a series of articles on philosophical medical ethics, Gillon considers various moral arguments in support of medical paternalism. He maintains that the utilitarian principle of maximizing happiness by improving health, minimizing suffering, and prolonging life is not promoted by granting physicians the authority to deceive patients or to make decisions for them in areas of moral and subjective choice. If one wants to do good for a patient, one generally needs to find out what the patient wants one to do. Gillon concludes that many utilitarians agree with deontologists that respect for autonomy is required if human welfare really is to be maximized.

  20. Medication Overuse Headache

    DEFF Research Database (Denmark)

    Munksgaard, Signe B; Jensen, Rigmor H


    BACKGROUND: Medication overuse headache (MOH) affects between 1% and 2% of the general population but is present in up to 50% of patients seen in headache centers. There are currently no internationally accepted guidelines for treatment of MOH. METHODS: A review of the current literature on MOH...... treatment and pathophysiology. RESULTS: We conclude that headache frequency can be reduced to episodic headache in more than 50% of the patients by simple detoxification and information. Approximately half the patients will not have need for prophylactic medication after withdrawal. Pain perception...

  1. Self‐medication patterns among medical students in South India

    Directory of Open Access Journals (Sweden)

    Nitasha Bhat


    Full Text Available BackgroundSelf-medication results in wastage of resources, increases resistance of pathogens and generally causes serious health hazards such as adverse drug reactions, prolonged suffering and drug dependence. This study was undertaken to determine the reasons for self-medication and the pattern of self-medication among medical students.MethodThis cross-sectional descriptive study was conducted at the K.S. Hegde Medical Academy, Mangalore. The participants were medical students from first to final year. Medical students were selected through convenience sampling. The data was collected using a pre-tested semi-structured questionnaire. The data was analysed using SPSS version 16 and the results expressed as proportions.ResultsA total of 200 students, 121 (60.5% female and 79 (39.5% male, were included in the study. Of the medical students surveyed, self-medication was reported among 92%. The respondents who used self-medication found it to be time-saving in providing relief from minor ailments. The most common ailments for which self-medication were used were: the common cold (69%, fever (63% and headache (60%. The students consulted their textbooks (39% and seniors or classmates (38% for the medications. Antipyretics (71%, analgesics (65%, antihistamines (37% and antibiotics (34% were the most common self-medicated drugs. Of the respondents, 33% were unaware of the adverse effects of the medication and 5% had experienced adverse reactions. The majority (64% of students advised medications to others, more often to family and friends.ConclusionThe prevalence of self-medication among medical students is high, facilitated by the easy availability of drugs and information from textbooks or seniors. A significant number of students are unaware of the adverse effects of the medication that they themselves take and suggest to others. Therefore, potential problems of self-medication should be emphasised to the students.

  2. Shipboard Medical Backpack: Engineering Drawings. (United States)


    7 A-36804 SHIPBOARD MEDICAL BACKPACK : ENGINEERING DRAWINGS(U) 1/l NAVAL OCEAN SYSTEMS CENTER SAN DIEGO CA R W KATAOKA JUN 83 NOSC/Tfl-603...Document 603 SHIPBOARD MEDICAL BACKPACK : ENGINEERING DRAWINGS R. W. Kataoka June 1983 Prepared for Naval Medical Research and Development Command CL. (Code...Commande Technical Director ADMINISTRATIVE INFORMATION This report is one in a series on the Shipboard Medical Backpack sponsored by the Naval Medical

  3. Features of Medical English Vocabulary

    Institute of Scientific and Technical Information of China (English)



    Medical English is relatively more difficult than general English,especially its vocabulary.Those medical English words are long and complex,making it hard to remember.But medical English vocabulary has its own features,which would help us in learning vocabulary.On the basis of many medical English materials,the paper explores the features of etymology,affixes and roots of medical English.

  4. Features of Medical English Vocabulary

    Institute of Scientific and Technical Information of China (English)



    Medical English is relatively more difficult than general English,especially its vocabulary.Those medical English words are long and complex,making it hard to remember. But medical English vocabulary has its own features,which would help us in learning vocabulary.On the basis of many medical English materials,the paper explores the features of etymology,affixes and roots of medical English.

  5. [straus: The Two Medical Sociologies].


    Nunes, Everardo Duarte


    Robert Straus' pioneer work, The nature and status of Medical Sociology, written in 1957, was reviewed. Straus, one of the founders of medical sociology, made major contributions to this field and created the first department of behavior sciences in a medical school. In the work reviewed, Straus establishes the differences between sociology in medicine and medical sociology. Comments are made on the current perspective of medical sociology and about the author.

  6. Architecture and Design of Medical Processor Units for Medical Networks

    CERN Document Server

    Ahamed, Syed V; 10.5121/ijcnc.2010.2602


    This paper introduces analogical and deductive methodologies for the design medical processor units (MPUs). From the study of evolution of numerous earlier processors, we derive the basis for the architecture of MPUs. These specialized processors perform unique medical functions encoded as medical operational codes (mopcs). From a pragmatic perspective, MPUs function very close to CPUs. Both processors have unique operation codes that command the hardware to perform a distinct chain of subprocesses upon operands and generate a specific result unique to the opcode and the operand(s). In medical environments, MPU decodes the mopcs and executes a series of medical sub-processes and sends out secondary commands to the medical machine. Whereas operands in a typical computer system are numerical and logical entities, the operands in medical machine are objects such as such as patients, blood samples, tissues, operating rooms, medical staff, medical bills, patient payments, etc. We follow the functional overlap betw...

  7. Mycetoma medical therapy.


    Oliverio Welsh; Hail Mater Al-Abdely; Mario Cesar Salinas-Carmona; Ahmed Hassan Fahal


    Medical treatment of mycetoma depends on its fungal or bacterial etiology. Clinically, these entities share similar features that can confuse diagnosis, causing a lack of therapeutic response due to inappropriate treatment. This review evaluates the response to available antimicrobial agents in actinomycetoma and the current status of antifungal drugs for treatment of eumycetoma.

  8. Mycetoma medical therapy.

    Directory of Open Access Journals (Sweden)

    Oliverio Welsh


    Full Text Available Medical treatment of mycetoma depends on its fungal or bacterial etiology. Clinically, these entities share similar features that can confuse diagnosis, causing a lack of therapeutic response due to inappropriate treatment. This review evaluates the response to available antimicrobial agents in actinomycetoma and the current status of antifungal drugs for treatment of eumycetoma.

  9. Fomepizole (orphan medical). (United States)

    Hantson, P


    Orphan Medical has developed fomepizole as a potential treatment for both ethylene glycol and methanol poisoning. The drug was launched as Antizol in January 1998 for the treatment of ethylene glycol poisoning [273949] after US marketing approval was grantedin December 1997 [271563]. It has also received US approval for methanol poisoning [393217] and UK approval for ethylene glycol poisoning [329495]. In 1999, Orphan Medical's partner, Cambridge Laboratories, intended to pursue European approval under the mutual recognition procedure [329495]. However, by September 2000, Cambridge Laboratories had discontinued their involvement with fomepizole and IDIS World Medicines had licensed the rights to distribute the drug in the UK [412142]. In February 2000, the Canadian Therapeutic Products Programme (TPP) granted fomepizole Priority Review, provided that an NDA was submitted by March 14, 2000 [354665]. In August 2000, the TPP accepted this NDA and set a target date for approval in the fourth quarter of 2000 [379474]. The TPP granted fomepizole a Notice of Compliance permitting the sale of fomepizole in Canada in December 2000. The company's marketing partner in Canada, Paladin Labs had launched fomepizole by January 2001 [396953]. In June 2000, Tucker Anthony Cleary Gull stated that the Orphan Drug status which Orphan Medical had obtained for fomepizole would provide marketing exclusivity through December 2004. The analysts also stated that fomepizole had accounted for 40% of Orphan Medical's revenue in financial year 1999, although +/- 30% of sales were estimated to be due to stockpiling [409606].

  10. Professionalism in Medical Education (United States)

    Hilton, Sean; Southgate, Lesley


    Medical professionalism in today's society requires the exhibition of a range of qualities deployed in the service of patients, rather than more traditionally defined aspects such as mastery, autonomy and self-regulation. These qualities incorporate demonstrated clinical competence; aspiring to excellence in practice while demonstrating humility…

  11. Innovation of Medical Products

    DEFF Research Database (Denmark)

    Spindler, Per; Bach, Karin Friis; Schmiegelow, Merete


    , the pharmaceutical industry, universities, payers, and patient organizations. Regulatory science is the science of developing new tools, standards, and approaches to evaluate the efficacy, safety, quality, and performance of medical products in order to assess benefit/risk and facilitate a sound and transparent...

  12. Medical data breaches

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick


    The EU and the United States have implemented data breach notification rules that cover the health sectors. Nevertheless, data breach incidents involving medical data continue to rise, especially in the US and the UK. The HITECH Act, Pub. L. 111-5 Title XIII is the first federal health breach...

  13. A Medical Delivery Device

    DEFF Research Database (Denmark)


    The present invention relates to a medical delivery device comprising at least two membrane electrode assembly units each of which comprises three layers: an upper and a lower electrode and a selective ionic conductive membrane provided there-between. At least one of the three layers are shared...

  14. Medical Spending in Denmark

    DEFF Research Database (Denmark)

    Christensen, Bent Jesper; Gørtz, Mette; Kallestrup-Lamb, Malene


    Using full population longitudinal data from merged administrative registers for Denmark, we document that medical spending is highly concentrated in the population, and persistent through time at the individual level. In addition, we provide overviews of institutional details of the Danish health...

  15. Pain medications - narcotics (United States)

    ... it can make the pain difficult to control. Taking narcotics to control the pain of cancer or other medical problems does not itself lead to dependence. Store narcotics safely and securely ... When taking a narcotic, do not drink alcohol, drive, or ...

  16. Medical Art Therapy

    Directory of Open Access Journals (Sweden)

    Birgul Aydin


    Full Text Available Art therapy is a form of expressive therapy that uses art materials. Art therapy combines traditional psychotherapeutic theories and techniques with an understanding of the psychological aspects of the creative process, especially the affective properties of the different art materials. Medical art therapy has been defined as the clinical application of art expression and imagery with individuals who are physically ill, experiencing physical trauma or undergoing invasive or aggressive medical procedures such as surgery or chemotherapy and is considered as a form of complementary or integrative medicine. Several studies have shown that patients with physical illness benefit from medical art therapy in different aspects. Unlike other therapies, art therapy can take the patients away from their illness for a while by means of creative activities during sessions, can make them forget the illness or lost abilities. Art therapy leads to re-experiencing normality and personal power even with short creative activity sessions. In this article definition, influence and necessity of medical art therapy are briefly reviewed.

  17. Medical nutrition therapy planning

    Directory of Open Access Journals (Sweden)

    Torović Ljilja


    Full Text Available Introduction. Diet has vital, preventive and therapeutic functions. Medical nutrition therapy is a part of the Standardized Nutrition Care Process integrated in health care systems. Material and methods. An overview of the Nutrition Care Process model and the application of nutrition guidelines based on literature, reports, documents and programmes of international health, food and physical activity authorities was done. Results. The Nutrition Care Process model requires registered dieticians, standardized terminology as well as nutrition diagnosis categorization. It consists of four distinct, but interrelated and connected steps: (a nutrition assessment, (b nutrition diagnosis, (c nutrition intervention, and (d nutrition monitoring and evaluation. An individual approach is essential for successful medical nutrition therapy. Nutrition guidelines facilitate the process of understanding and application of medical nutrition therapy. Conclusion. The Nutrition Care process provides dietetic professionals information on high-quality client nutrition care. The success of medical nutrition therapy rests not only upon the advice of the dietician, but also upon the client’s compliance.

  18. [Medical emergency teams

    DEFF Research Database (Denmark)

    Bunkenborg, G.; Lund, C.; Petersen, John Asger


    The aim of medical emergency teams (MET) is to identify and treat deteriorating patients on general wards, and to avoid cardiac arrest, unplanned intensive care unit admission and death. The effectiveness of METs has yet to be proven, as the only two randomised, controlled trials on the subject...

  19. Tactical emergency medical support. (United States)

    Rinnert, Kathy J; Hall, William L


    As increases in criminal activity collide with more aggressive law enforcement postures, there is more contact between police officers and violent felons. Civilian law enforcement special operations teams routinely engage suspects in these violent, dynamic, and complex interdiction activities. Along with these activities comes the substantial and foreseeable risk of death or grievous harm to law officers, bystanders, hostages, or perpetrators. Further, law enforcement agencies who attempt to apprehend dangerous, heavily armed criminals with a special operations team that lacks the expertise to treat the medical consequences that may arise from such a confrontation may be negligent of deliberate indifference. Meanwhile, evidence exists within the military, civilian law enforcement, and medical literature that on-scene TEMS serves to improve mission success and team safety and health, while decreasing morbidity and mortality in the event of an injury or illness suffered during operations. National professional organizations within law enforcement and emergency medicine have identified and support the fundamental need for mission safety and the development of a standard model to train and incorporate TEMS into law enforcement special operations. The overall objective of TEMS is to minimize the potential for injury and illness and to promote optimal medical care from the scene of operations to a definitive care facility. The design, staffing, and implementation of a TEMS program that maximally uses the community resources integrates previously disparate law enforcement, EMS, and emergency medical/trauma center functions to form a new continuum of care [55].

  20. Motivation in medical students

    NARCIS (Netherlands)

    Kusurkar, R.A.


    Introduction The importance of motivation in learning behaviour and education is well-researched and proven in general education, but much less in medical education. There is sometimes focus on increasing the quantity of motivation, but the how and why need more evidence. The aims of this thesis wer

  1. Communication in medical encounters.

    NARCIS (Netherlands)

    Bensing, J.M.; Verhaak, P.F.M.


    The aim of this chapter is to provide a theoretical and empirical basis for the concept of communication as the core instrument in the medical encounter. Adequate communication, embedded in a warm and caring relationship, has always been recognized as essential to the concept of good doctoring, but


    CERN Multimedia

    Medical Service


    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on Telephone: 73802. by electronic mail:


    CERN Multimedia

    Service Médical


    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on Telephone: 73802. by electronic mail:


    CERN Multimedia

    Medical Service


    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on telephone: 73802. by electronic mail:

  5. [Medical mythology and etymologies]. (United States)

    Albou, Philippe


    The lecture is an allusion to Sournia's work and his book "Mythologies de la médecine moderne". (P.U.F 1969). The author evokes the origins of medical terms such as psyche, hermaphrodite, nymphomania, aphrodisiac, marcissism, hypnotism, etc.

  6. Medical imaging systems (United States)

    Frangioni, John V


    A medical imaging system provides simultaneous rendering of visible light and diagnostic or functional images. The system may be portable, and may include adapters for connecting various light sources and cameras in open surgical environments or laparascopic or endoscopic environments. A user interface provides control over the functionality of the integrated imaging system. In one embodiment, the system provides a tool for surgical pathology.

  7. Medical decision making

    NARCIS (Netherlands)

    Stiggelbout, A.M.; Vries, M. de; Scherer, L.


    This chapter presents an overview of the field of medical decision making. It distinguishes the levels of decision making seen in health-care practice and shows how research in judgment and decision making support or improve decision making. Most of the research has been done at the micro level, par

  8. Antidepressant medications and osteoporosis

    DEFF Research Database (Denmark)

    Rizzoli, R; Cooper, C; Reginster, J-Y


    Use of antidepressant medications that act on the serotonin system has been linked to detrimental impacts on bone mineral density (BMD), and to osteoporosis. This article reviews current evidence for such effects, and identifies themes for future research. Serotonin receptors are found in all major...

  9. Medications: Using Them Safely (United States)

    ... young children. Store a medication syringe in a safe place out of the reach of kids. Other options ... Keep this number posted in an easily visible place in case you need it. Safe Disposal Do not give leftover medicine to others. ...

  10. Misconduct in medical students. (United States)

    Vengoechea, Jaime; Moreno, Socorro; Ruiz, Alvaro


    Medical students, subject to unique challenges and stressors, frequently engage in misconduct. In this observational study, carried out in a medical school in Colombia, we developed a survey to explore the association between misconduct and stress, potential stressors and other possible contributing factors, such as sex, age and academic year. Of the 433 students that responded to our survey, 97.9% did not fully disagree with at least one of the mentioned misconducts and 99.8% admitted to at least one transgression. Based on a scale we developed, 61.4% of the students consistently agreed with misconduct and 44.9% frequently engaged in misconduct. A logistic regression model suggests that being male (OR 1.90, CI 95% 1.27-2.84) and stress (OR 1.04, CI 95% 1.01-1.06) may increase the likelihood of misconduct. In a subgroup of students, excluding those in their last year of studies, higher academic semester (OR 1.25, CI 95%: 1.10-1.42) may also be a risk factor for misconduct. Most of the observed variation in the data, however, is not explained by these factors. Other modifiers, such as student personality and sub-culture, may play a greater role in determining misconduct. The proportion of medical students that engage in misconduct is very high and warrants the attention of the medical education community.

  11. Denying Medical Students' Emotions. (United States)

    USA Today, 1984


    Medical educators nationwide are questioning the process that leads to the denial of the emotional side of medicine by its practitioners. Emotional dilemmas are often verbally suppressed by most students, but they surface in many ways, such as depression, insomnia, loss of appetite, and anxiety. (RM)

  12. Medications and International Travel

    Centers for Disease Control (CDC) Podcasts


    This podcast answers a listener's question about her medications and an international trip she's planning.  Created: 4/12/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/12/2011.

  13. Medical Errors Reduction Initiative (United States)


    additional37 subjects were consented. The research with the bedside medication administration system has revealed an increase of near miss well as documentation changes for the nurse. These efforts have resulted in a significant decrease in near miss occuiTences as well as a 50

  14. Advances in Medical Engineering

    CERN Document Server

    Buzug, Thorsten M


    Presents research and development trends of physics, engineering, mathematics and computer sciences in biomedical engineering. This work uses contributions from industry, clinics, universities and research labs with foci on medical imaging, computer-assisted surgery, and others to give insight to engineering, clinical and mathematical studies.

  15. The Medical Physics Workforce. (United States)

    Newhauser, Wayne D


    The medical physics workforce comprises approximately 24,000 workers worldwide and approximately 8,200 in the United States. The occupation is a recognized, established, and mature profession that is undergoing considerable growth and change, with many of these changes being driven by scientific, technical, and medical advances. Presently, the medical physics workforce is adequate to meet societal needs. However, data are emerging that suggest potential risks of shortages and other problems that could develop within a few years. Some of the governing factors are well established, such as the increasing number of incident cancers thereby increasing workload, while others, such as the future use of radiation treatments and changes in healthcare economic policies, are uncertain and make the future status of the workforce difficult to forecast beyond the next several years. This review examines some of the major factors that govern supply and demand for medical physicists, discusses published projections and their uncertainties, and presents other information that may help to inform short- and long-term planning of various aspects of the future workforce. It includes a description of the general characteristics of the workforce, including information on its size, educational attainment, certification, age distribution, etc. Because the supply of new workers is governed by educational and training pathways, graduate education, post-doctoral training, and residency training are reviewed, along with trends in state and federal support for research and education. Selected professional aspects of the field also are considered, including professional certification and compensation. We speculate on the future outlook of the workforce and provide recommendations regarding future actions pertaining to the future medical physics workforce.

  16. Automated Medical Literature Retrieval

    Directory of Open Access Journals (Sweden)

    David Hawking


    Full Text Available Background The constantly growing publication rate of medical research articles puts increasing pressure on medical specialists who need to be aware of the recent developments in their field. The currently used literature retrieval systems allow researchers to find specific papers; however the search task is still repetitive and time-consuming. Aims In this paper we describe a system that retrieves medical publications by automatically generating queries based on data from an electronic patient record. This allows the doctor to focus on medical issues and provide an improved service to the patient, with higher confidence that it is underpinned by current research. Method Our research prototype automatically generates query terms based on the patient record and adds weight factors for each term. Currently the patient’s age is taken into account with a fuzzy logic derived weight, and terms describing blood-related anomalies are derived from recent blood test results. Conditionally selected homonyms are used for query expansion. The query retrieves matching records from a local index of PubMed publications and displays results in descending relevance for the given patient. Recent publications are clearly highlighted for instant recognition by the researcher. Results Nine medical specialists from the Royal Adelaide Hospital evaluated the system and submitted pre-trial and post-trial questionnaires. Throughout the study we received positive feedback as doctors felt the support provided by the prototype was useful, and which they would like to use in their daily routine. Conclusion By supporting the time-consuming task of query formulation and iterative modification as well as by presenting the search results in order of relevance for the specific patient, literature retrieval becomes part of the daily workflow of busy professionals.

  17. Social accountability of medical education

    DEFF Research Database (Denmark)

    Lindgren, Stefan; Karle, Hans


    Medical doctors constitute a profession which embraces trust from and accountability to society. This responsibility extends to all medical educational institutions. Social accountability of medical education means a willingness and ability to adjust to the needs of patients and health care systems...... accountability of medical education must be included in all accreditation processes at all levels. The global standards programme by World Federation for Medical Education (WFME) provides tools for national or regional accreditation but also guidance for reforms and quality improvement. The standards are used....... In 2011, a revision of the standards for undergraduate education has been instituted. Strengthening of aspects on social accountability of medical education will be a particular concern....

  18. Status of medical mycology education. (United States)

    Steinbach, William J; Mitchell, Thomas G; Schell, Wiley A; Espinel-Ingroff, Ana; Coico, Richard F; Walsh, Thomas J; Perfect, John R


    The number of immunocompromised patients and subsequent invasive fungal infections continues to rise. However, the education of future medical mycologists to engage this growing problem is diminishing. While there are an increasing number of publications and grants awarded in mycology, the time and detail devoted to teaching medical mycology in United States medical schools are inadequate. Here we review the history in medical mycology education and the current educational opportunities. To accurately gauge contemporary teaching we also conducted a prospective survey of microbiology and immunology departmental chairpersons in United States medical schools to determine the amount and content of contemporary education in medical mycology.

  19. Optimization of Medical Teaching Methods

    Directory of Open Access Journals (Sweden)

    Wang Fei


    Full Text Available In order to achieve the goal of medical education, medicine and adapt to changes in the way doctors work, with the rapid medical teaching methods of modern science and technology must be reformed. Based on the current status of teaching in medical colleges method to analyze the formation and development of medical teaching methods, characteristics, about how to achieve optimal medical teaching methods for medical education teachers and management workers comprehensive and thorough change teaching ideas and teaching concepts provide a theoretical basis.

  20. Architecture and Design of Medical Processor Units for Medical Networks

    Directory of Open Access Journals (Sweden)

    Syed V. Ahamed


    Full Text Available This paper1 introduces analogical and deductive methodologies for the design medical processor units(MPUs. From the study of evolution of numerous earlier processors, we derive the basis for thearchitecture of MPUs. These specialized processors perform unique medical functions encoded as medicaloperational codes (mopcs. From a pragmatic perspective, MPUs function very close to CPUs. Bothprocessors have unique operation codes that command the hardware to perform a distinct chain of subprocessesupon operands and generate a specific result unique to the opcode and the operand(s. Inmedical environments, MPU decodes the mopcs and executes a series of medical sub-processes and sendsout secondary commands to the medical machine. Whereas operands in a typical computer system arenumerical and logical entities, the operands in medical machine are objects such as such as patients, bloodsamples, tissues, operating rooms, medical staff, medical bills, patient payments, etc. We follow thefunctional overlap between the two processes and evolve the design of medical computer systems andnetworks.


    Directory of Open Access Journals (Sweden)

    Cosma Sorin Cosmin


    Full Text Available The purpose of these studies was to improve the design and manufacturing process by selective laser melting, of new medical implants. After manufacturing process, the implants were measured, microscopically and mechanical analyzed. Implants manufactured by AM can be an attractive option for surface coatings to improve the osseointegration process. The main advantages of customized implants made by AM process are: the precise adaptation to the region of implantation, better cosmesis, reduced surgical times and better performance over their generic counterparts. These medical manufacturing changes the way that the surgeons are planning surgeries and engineers are designing custom implant. AM process has eliminated the constraints of shape, size, internal structure and mechanical properties making it possible for fabrication of implants that conform to the physical and mechanical requirements of implantation according to CT images. This article will review some custom implants fabricated in DME using biocompatible titanium.

  2. Medical therapy in acromegaly.

    LENUS (Irish Health Repository)

    Sherlock, Mark


    Acromegaly is a rare disease characterized by excess secretion of growth hormone (GH) and increased circulating insulin-like growth factor 1 (IGF-1) concentrations. The disease is associated with increased morbidity and premature mortality, but these effects can be reduced if GH levels are decreased to <2.5 μg\\/l and IGF-1 levels are normalized. Therapy for acromegaly is targeted at decreasing GH and IGF-1 levels, ameliorating patients\\' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, radiotherapy and medical therapies, such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant. Medical therapy is currently most widely used as secondary treatment for persistent or recurrent acromegaly following noncurative surgery, although it is increasingly used as primary therapy. This Review provides an overview of current and future pharmacological therapies for patients with acromegaly.

  3. Medical consequences of obesity. (United States)

    Lawrence, Victor J; Kopelman, Peter G


    The obese are subject to health problems directly relating to the carriage of excess adipose tissue. These problems range from arthritis, aches and pains, sleep disturbance, dyspnea on mild exertion, and excessive sweating to social stigmatization and discrimination, all of which may contribute to low quality of life and depression (Table 1). The most serious medical consequences of obesity are a result of endocrine and metabolic changes, most notably type 2 diabetes mellitus, cardiovascular disease, and increased risk of cancer. Not all obesity comorbidities are fully reversed by weight loss. The degree and duration of weight loss required may not be achievable by an individual patient. Furthermore, "weight cycling" may be more detrimental to both physical and mental health than failure to achieve weight loss targets with medical and lifestyle advice.

  4. Bulimia Nervosa - medical complications. (United States)

    Mehler, Philip S; Rylander, Melanie


    As with anorexia nervosa, there are many medical complications associated with bulimia nervosa. In bulimia nervosa, these complications are a direct result of both the mode and the frequency of purging behaviours. For the purposes of this article, we will review in detail the many complications of the two major modes of purging, namely, self-induced vomiting and laxative abuse; these two account for more than 90% of purging behaviours in bulimia nervosa. Some of these complications are potentially extremely dangerous and need to be well understood to effectively treat patients with bulimia nervosa. Other methods of purging, such as diuretic abuse, are much less frequently utilized and will only be mentioned briefly. In a subsequent article, the treatments of these medical complications will be presented.

  5. [Medical quality assurance today]. (United States)

    Schäfer, Robert D


    Both the quality and performance of health systems are strongly influenced by the number and the qualification of the professional staff. Quality assurance programs help to analyse causalities which are responsible for medical malpractice. On the basis of the experiences gained by the performance of established Quality Assurance Programs (QAP) in the North Rhine area since 1982 various aspects of the efficiency of these programs will be discussed. The implementation of legal regulations making these programs mandatory is criticised not only for its bureaucratic effect but also for the attempt to exclude professional experts from the interpretation of results. It is recommended to liberalize these regulations in order to facilitate improvement of methods and participation of the medical profession.

  6. Nonsecular Medical Anthropology. (United States)

    Whitmarsh, Ian; Roberts, Elizabeth F S


    A nonsecular medical anthropology insists on the ways medicine and science have constituted 'the secular' itself through the 'secular self'-how medical knowing has been used to craft the secular political subject. As James Boon noted, too often in social theory, "religion gets safely tucked away-restricted theoretically to 'meaning' rather than power" (1998:245). The authors of the six articles in this special issue 'untuck' religiosity from within the norms and numbers of medicine itself, and examine how 'secular' medicine has relied on religious traditions to produce political secularity. These articles demonstrate that 'secular' medicine relies on religious others whose exclusion bespeaks latent religious commitments of citizenship in the modern political realm of health.

  7. Whatever happened to medical politics? (United States)

    Emmerich, Nathan


    This paper argues the case for coming to see 'medical politics' as a topic or subject within medical education. First, its absence is noted from the wide array of paramedical subjects (medical ethics, history of medicine, the medical humanities, etc) currently given attention in both the medical education literature and in specific curricula. Second the author suggests that 'the political' is implicitly recognisable in the historical roots of medical ethics education, specifically in certain of the London Medical Group's activities, and also that the medical profession, or indeed any profession, cannot be understood as an apolitical form of social organisation either in its institutional or scientific (epistemic) forms. Some brief suggestions for introductory and advanced topics in medical politics are discussed and the degree to which medical politics ought to be taken seriously and delivered as part of medical education is considered. Ultimately the author concludes that medical politics might be considered a useful subject within medical education, but it is perhaps best understood as a perspective or approach that can contribute to the development of a more expansive perspective within the extant paramedical subjects.

  8. [The mandatory medical insurance through eyes of medical personnel]. (United States)

    Semenov, V Yu; Lakunin, K Yu; Livshits, S A


    The article considers the results of sociological survey carries out among medical personnel of the Moscowskaya oblast in August-September 2013. The purpose of the study was to examine opinions of medical personnel about system of mandatory insurance in conditions of implementation of the new law regulating system of mandatory medical insurance during last three years. The sampling included 932 respondents that corresponds approximately 1% of all medical personnel in the oblast. It is established that even 20 years later after the moment of organization of the system of mandatory medical insurance not all medical personnel is oriented in it. More than 70% of respondents consider this system too convoluted and over bureaucratized and only 22.2% of respondents assume that medical insurance organizations defense interests of patient and 25.8% feel no impact of mandatory medical insurance funds on functioning of medical organizations. Most of respondents consider functions of mandatory medical insurance organizations and mandatory medical insurance funds as controlling only. Only 31% of respondents support the actual system of mandatory medical insurance.

  9. Medical Readers' Theater: Relevance to Geriatrics Medical Education (United States)

    Shapiro, Johanna; Cho, Beverly


    Medical Readers' Theater (MRT) is an innovative and simple way of helping medical students to reflect on difficult-to-discuss topics in geriatrics medical education, such as aging stereotypes, disability and loss of independence, sexuality, assisted living, relationships with adult children, and end-of-life issues. The authors describe a required…

  10. Medical School Research Pipeline: Medical Student Research Experience in Psychiatry (United States)

    Balon, Richard; Heninger, George; Belitsky, Richard


    Objective: The authors discuss the importance of introducing research training in psychiatry and neurosciences to medical students. Methods: A review of existing models of research training in psychiatry with focus on those providing research training to medical students is presented. Results: Two research-training models for medical students that…

  11. Justice and medical ethics. (United States)

    Gillon, R


    Justice, in the sense of fair adjudication between conflicting claims, is held to be relevant to a wide range of issues in medical ethics. Several differing concepts of justice are briefly described, including Aristotle's formal principle of justice, libertarian theories, utilitarian theories, Marxist theories, the theory of John Rawls, and the view--held, for example, by W.D. Ross--that justice is essentially a matter of reward for individual merit.

  12. Emergency Medical Service (United States)


    Lewis Research Center helped design the complex EMS Communication System, originating from space operated telemetry, including the telemetry link between ambulances and hospitals for advanced life support services. In emergency medical use telemetry links ambulances and hospitals for advanced life support services and allows transmission of physiological data -- an electrocardiogram from an ambulance to a hospital emergency room where a physician reads the telemetered message and prescribes emergency procedures to ambulance attendants.

  13. Branding your medical practice. (United States)

    Maley, Catherine; Baum, Neil


    Branding is the process of differentiating your medical practice from all other practices in the industry. Branding takes into account the "look and feel" of your office, you and your staff your materials, and every other detail that gives your patients clues as to who you are and what you value. This article will review the strategies that go into building your own solid brand so your existing patients, as well as prospective ones, are attracted and loyal to you and your brand.


    CERN Multimedia

    Medical Service


    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on Telephone: 73802 by electronic mail:  


    CERN Multimedia

    Service Médical


    iFor medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on Telephone: 73802. by electronic mail:

  16. Commercializing medical technology


    Scanlon, Kevin J.; Lieberman, Mark A.


    As medicine moves into the 21st century, life saving therapies will move from inception into medical products faster if there is a better synergy between science and business. Medicine appears to have 50-year innovative cycles of education and scientific discoveries. In the 1880’s, the chemical industry in Germany was faced with the dilemma of modernization to exploit the new scientific discoveries. The solution was the spawning of novel technical colleges for training in these new chemical i...

  17. Medical emergencies in Goa

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo


    Full Text Available Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa′s roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%, which were mainly of the nature of accidents or assaults (17% and fever related (17%. Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa.

  18. Medical genetics in Paraguay. (United States)

    Ascurra de Duarte, Marta


    Paraguay is a developing country with low levels of health coverage, with 81% of the population without health insurance, a proportion that reaches 98.1% among the poor, 93% among the rural population and 91.7% among the mainly Guarani-speaking population. The infant mortality rate is 19.4 per 1,000, although there is gross under-reporting. Maternal mortality rate is alarmingly high at 110.9 per 100,000 livebirths, reaching 420.5 in rural areas. There are only two clinical geneticists and four biochemists trained in human genetics, and virtually all genetic services in the country are concentrated in the 'Instituto de Investigaciones en Ciencias de la Salud' (IICS) from the National University. The teaching of medical genetics in medical schools is included in physiology and pathology courses, while at the postgraduate level, training in medical genetics is limited to pediatrics and gynecology. In 1999, a pilot newborn screening program was initiated to determine the frequency of congenital hypothyroidism and phenylketonuria and to provide early treatment for affected babies. Another pilot project recently launched by the Ministry of Health is the Program for the Prevention of Neural Tube Defects, mandating folic acid fortification of flour, but as of the end of 2003 it had not been implemented. Paraguay lacks adequate resources to provide accurate diagnoses and treatment of genetic conditions.

  19. [Merton and medical sociology]. (United States)

    Nunes, Everardo Duarte


    The article is about the main contributions of the North-American sociologist Robert King Merton (1910-2003), particularly those related to the field of medical sociology. Merton was first to conduct research on medical education, and the working team he formed was fundamental for the introduction of social thought in the medicine field (Patrícia Kendall, Renée Fox, Samuel Bloom and others). Of particular importance are Merton's vocation for sociology and the unique trajectory of his research, which was marked by studies on subjects that were not common in the early XX century, particularly the relationships between science, technology, and society. We provide the most important theoretical ad conceptual contribution brought by the author, as well as the expressions he created and which were soon adopted by researchers, such as 'focused interview', 'Matthew effects, 'Pygmalion effect', 'nonplanned consequences of social actions', 'manifest function', and 'latent function'. The highlight in the field of medical sociology is his work on the socialization process of the student of medicine.

  20. Medical treatment of hirsutism. (United States)

    Blume-Peytavi, Ulrike; Hahn, Susanne


    Hirsutism is usually the result of an underlying adrenal, ovarian, or central endocrine abnormality mainly due to polycystic ovary syndrome but may also be idiopathic or drug induced. The aim of medical treatment of hirsutism is to rectify any causal hormonal balance, slow down or stop excessive hair growth, and improve the aesthetic appearance of hirsutism, thereby positively affecting the patient's quality of life. Today, for the majority of women, a monotherapy with oral contraceptives that have antiandrogenic activity is recommended as a first-line treatment for hirsutism. Combining an oral contraceptive pill with an antiandrogen is recommended if clinical improvement of hirsutism is insufficient after 6-9 months' monotherapy. In women who present with hirsutism, hyperandrogenism, and insulin resistance, insulin sensitizers are effective for the hirsutism as well as the hyperinsulinemia, hyperandrogenism, and infertility but there is no convincing evidence that they are effective for hirsutism alone. Topical eflornithine is a medical therapy that can be a useful adjuvant for hirsutism when used in conjunction with systemic medications or with laser/photoepilation.

  1. Radioisotopes for medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Carr, S. [Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW (Australia). Radiopharmaceuticals Division


    For more than 3 decades, the Australian Nuclear Science and Technology Organisation has been the country`s main supplier of radioisotopes for medical applications. The use of radioisotopes in medicine has revolutionised the diagnosis, management and treatment of many serious diseases such as cancer, heart disease and stroke. It is also beginning to play a key role in neurological disorders such as Parkinson and Alzheimers disease and epilepsy. More recently there has been considerable growth in the application of nuclear medicine to treat sport-related injuries - especially wrist, ankle and knees where more common techniques do not always enable accurate diagnosis. Australia is a recognised leader in nuclear medicine. This can be partially attributed to the close relationship between ANSTO and the medical community in providing opportunities to develop and evaluate new agents to support more effective patient care. A list of commercial isotopes produced in the reactor or the cyclotron and used in medical applications is given. Nuclear medicine plays an important role in the clinical environment and the timely supply of radioisotopes is a key element. ANSTO will continue to be the premier supplier of currently available and developing isotopes to support the health and well being of the Australian community 2 tabs., 1 fig.

  2. Medical complications of anorexia nervosa. (United States)

    Shuttleworth, E; Sharma, S; Lal, S; Allan, P J


    Anorexia nervosa is a psychiatric disorder with potential life-threatening medical sequelae. This article reviews the principal medical complications associated with anorexia nervosa, highlights associated diagnostic pitfalls and emphasizes the importance of a multidisciplinary approach to management.

  3. Medical Microbiology: Deficits and Remedies (United States)

    Gabridge, Michael G.


    Microbiology is a typical medical science in which basic information can have direct application. Yet, surveys and questionnaires of recent medical school graduates indicate a serious lack of retentiion in regard to basic biological science. (Author)

  4. Medical Research for All Americans (United States)

    Skip Navigation Bar Home Current Issue Past Issues Medical Research for All Americans Past Issues / Summer 2009 Table ... information that is based on the very best medical research conducted by and for the National Institutes of ...

  5. Managing High Blood Pressure Medications (United States)

    ... can make to work with your medication. Medicine Management Tools For Patients Keeping Track / Developing a System ... while you're out. Some pharmacists will prepare blister packs for daily or weekly medications. Ask your ...

  6. Medical Dictionary: MedlinePlus (United States)

    ... of this page: Medical Dictionary To use the sharing features on this ... Search term GO GO Visit the tutorial, Understanding Medical Words You may also be interested in these ...

  7. Medical Encyclopedia: MedlinePlus (United States)

    ... of this page: Medical Encyclopedia To use the sharing features on this ... please enable JavaScript. The A.D.A.M. Medical Encyclopedia includes over 4,000 articles about diseases, ...

  8. Exploration Medical System Technical Development (United States)

    McGuire, K.; Middour, C.; Cerro, J.; Burba, T.; Hanson, A.; Reilly, J.; Mindock, J.


    The Exploration Medical Capability (ExMC) Element systems engineering goals include defining the technical system needed to implement exploration medical capabilities for Mars. This past year, scenarios captured in the medical system concept of operations laid the foundation for systems engineering technical development work. The systems engineering team analyzed scenario content to identify interactions between the medical system, crewmembers, the exploration vehicle, and the ground system. This enabled the definition of functions the medical system must provide and interfaces to crewmembers and other systems. These analyses additionally lead to the development of a conceptual medical system architecture. The work supports the ExMC community-wide understanding of the functional exploration needs to be met by the medical system, the subsequent development of medical system requirements, and the system verification and validation approach utilizing terrestrial analogs and precursor exploration missions.

  9. Hyperglycemia and antipsychotic medications. (United States)

    Haupt, D W; Newcomer, J W


    Type 2 diabetes mellitus and impaired glucose tolerance are associated with antipsychotic treatment. Risk factors for type 2 diabetes and impaired glucose tolerance include abdominal adiposity, age, ethnic status, and certain neuropsychiatric conditions. While impaired glucose metabolism was first described in psychotic patients prior to the introduction of antipsychotic medications, treatment with antipsychotic medications is associated with impaired glucose metabolism, exacerbation of existing type 1 and 2 diabetes, new-onset type 2 diabetes mellitus, and diabetic ketoacidosis, a severe and potentially fatal metabolic complication. The strength of the association between antipsychotics and diabetes varies across individual medications, with the largest number of reports for chlorpromazine, clozapine, and olanzapine. Recent controlled studies suggest that antipsychotics can impair glucose regulation by decreasing insulin action, although effects on insulin secretion are not ruled out. Antipsychotic medications induce weight gain, and the potential for weight gain varies across individual agents with larger effects observed again for agents like chlorpromazine, clozapine, and olanzapine. Increased abdominal adiposity may explain some treatment-related changes in glucose metabolism. However, case reports and recent controlled studies suggest that clozapine and olanzapine treatment may also be associated with adverse effects on glucose metabolism independent of adiposity. Dyslipidemia is a feature of type 2 diabetes, and antipsychotics such as clozapine and olanzapine have also been associated with hypertriglyceridemia, with agents such as haloperidol, risperidone, and ziprasidone associated with reductions in plasma triglycerides. Diabetes mellitus is associated with increased morbidity and mortality due to both acute (e.g., diabetic ketoacidosis) and long-term (e.g., cardiovascular disease) complications. A progressive relationship between plasma glucose levels and

  10. Commercializing medical technology. (United States)

    Scanlon, Kevin J; Lieberman, Mark A


    As medicine moves into the 21st century, life saving therapies will move from inception into medical products faster if there is a better synergy between science and business. Medicine appears to have 50-year innovative cycles of education and scientific discoveries. In the 1880's, the chemical industry in Germany was faced with the dilemma of modernization to exploit the new scientific discoveries. The solution was the spawning of novel technical colleges for training in these new chemical industries. The impact of those new employees and their groundbreaking compounds had a profound influence on medicine and medical education in Germany between 1880 and 1930. Germany dominated international science during this period and was a training center for scientists worldwide. This model of synergy between education and business was envied and admired in Europe, Asia and America. British science soon after evolved to dominate the field of science during the prewar and post World War (1930's-1970's) because the German scientists fled Hitler's government. These expatriated scientists had a profound influence on the teaching and training of British scientists, which lead to advances in medicine such as antibiotics. After the Second World War, the US government wisely funded the development of the medical infrastructure that we see today. British and German scientists in medicine moved to America because of this bountiful funding for their research. These expatriated scientists helped drive these medical advances into commercialized products by the 1980's. America has been the center of medical education and advances of biotechnology but will it continue? International scientists trained in America have started to return to Europe and Asia. These American-trained scientists and their governments are very aware of the commercial potential of biotechnology. Those governments are now more prepared to play an active role this new science. Germany, Ireland, Britain, Singapore

  11. Thromboprophylaxis in immobilized medical patients. (United States)

    Vaitkus, Paul T


    Venous thromboembolism accounts for a large number of preventable deaths. The majority of these events occur in medical patients, but medical thromboprophylaxis remains underutilised in this population. The purpose of this review is to examine the results of recent clinical trials of low molecular weight heparins in the prevention of venous thromboembolic disease in medical patients. The available data make a compelling case in favor of widespread use of low molecular weight heparin in medical patients.

  12. Regression methods for medical research

    CERN Document Server

    Tai, Bee Choo


    Regression Methods for Medical Research provides medical researchers with the skills they need to critically read and interpret research using more advanced statistical methods. The statistical requirements of interpreting and publishing in medical journals, together with rapid changes in science and technology, increasingly demands an understanding of more complex and sophisticated analytic procedures.The text explains the application of statistical models to a wide variety of practical medical investigative studies and clinical trials. Regression methods are used to appropriately answer the

  13. Beyond "medical tourism": Canadian companies marketing medical travel

    Directory of Open Access Journals (Sweden)

    Turner Leigh


    Full Text Available Abstract Background Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, “Liberation therapy” for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Methods Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1 where in Canada these businesses are located; 2 the destination countries and health care facilities that they market; 3 the medical procedures they promote; 4 core marketing messages; and 5 whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Results Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism

  14. Burnout among Dutch medical residents

    NARCIS (Netherlands)

    Prins, J.T.; Hoekstra-Weebers, J.E.; Van De Wiel, H.B.; Gazendam-Donofrio, S.M.; Sprangers, F.; Jaspers, F.C.; van der Heijden, F.M.


    We examined levels of burnout and relationships between burnout, gender, age, years in training, and medical specialty in 158 medical residents working at the University Medical Center Groningen, the Netherlands. Thirteen percent of the residents met the criteria for burnout, with the highest percen

  15. Blended Learning in Medical Education (United States)

    Zayapragassarazan, Z.; Kumar, Santosh


    The ongoing pedagogical advancements in medical education across the globe have gained the attention of academicians for the preparation of well-educated and competent physicians to address the healthcare issues facing today. The integration of technology into medical pedagogy has proved effective in many ways. This has made the medical education…

  16. Community-Oriented Medical Education (United States)

    Hays, Richard


    Community-orientated medicine is a topical area for debate in the current discussions about medical education, but it can be argued that medical education has always been in the community because medical practice is located therein. It is widely accepted that community settings provide a wealth of learning opportunities for students and trainees…

  17. Medical Technology Base Master Plan (United States)


    action of candidate mnedical1 countermeasures - Analysis and characterization of candidate compounds and their inetabolites - Application of molecular ...expected that research in molecular biology will lead to medical ,.vphylaes and treatments that ofter improved speclicity and potency, thus increasing...Disease Hazards Research (Inlectious Disease, Medical Biologia Defense, and Military AIDS), Conbat Casualty Care Research, Medical Chem"ca Defense Research

  18. Medical Care and Your Newborn (United States)

    ... Old Feeding Your 1- to 2-Year-Old Medical Care and Your Newborn KidsHealth > For Parents > Medical Care and Your Newborn A A A What's ... doctor of the birth. If you had any medical problems during pregnancy, if your baby might have ...

  19. Emergency Medical Services Program Guide. (United States)

    Georgia Univ., Athens. Dept. of Vocational Education.

    This program guide contains the standard emergency medical services curriculum for technical institutes in Georgia. The curriculum encompasses the minimum competencies required for entry-level workers in the emergency medical services field, and includes job skills in six emergency medical services divisions outlined in the national curriculum:…

  20. [Discussion on logistics management of medical consumables]. (United States)

    Deng, Sutong; Wang, Miao; Jiang, Xiali


    Management of medical consumables is an important part of modern hospital management. In modern medical behavior, drugs and medical devices act directly on the patient, and are important factors affecting the quality of medical practice. With the increasing use of medical materials, based on practical application, this article proposes the management model of medical consumables, and discusses the essence of medical materials logistics management.

  1. Three Suggestions to Improve Medical English Teaching

    Institute of Scientific and Technical Information of China (English)



    As a kind of ESP,medical English teaching has an important impact on both English teachers and medical students.A good medical English teaching can help the medical students to improve themselves smoothly and easily in the medical area.In this article,three suggestions were provided for the medical English teachers to improve their English teaching in medical field.

  2. [Involvement of medical representatives in team medical care]. (United States)

    Hirotsu, Misaki; Sohma, Michiro; Takagi, Hidehiko


    In recent years, chemotherapies have been further advanced because of successive launch of new drugs, introduction of molecular targeting, etc., and the concept of so-called Team Medical Care ,the idea of sharing interdisciplinary expertise for collaborative treatment, has steadily penetrated in the Japanese medical society. Dr. Naoto Ueno is a medical oncologist at US MD Anderson Cancer Center, the birthplace of the Team Medical Care. He has advocated the concept of ABC of Team Oncology by positioning pharmaceutical companies as Team C. Under such team practice, we believe that medical representatives of a pharmaceutical company should also play a role as a member of the Team Medical Care by providing appropriate drug use information to healthcare professionals, supporting post-marketing surveillance of treated patients, facilitating drug information sharing among healthcare professionals at medical institutions, etc.

  3. The Medical Ethics Curriculum in Medical Schools: Present and Future. (United States)

    Giubilini, Alberto; Milnes, Sharyn; Savulescu, Julian


    In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students' levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three main challenges for medical ethics education: counteracting the bad effects of the "hidden curriculum," teaching students how to apply ethical knowledge and critical thinking to real cases in clinical practice, and shaping future doctors' right character through ethics education. We suggest ways in which these challenges could be addressed. On the basis of this analysis, we propose practical guidelines for designing, implementing, teaching, and assessing a medical ethics program within a four-year medical course.

  4. Stability Analysis of ISS Medications (United States)

    Wotring, V. E.


    It is known that medications degrade over time, and that extreme storage conditions will hasten their degradation. The temperature and humidity conditions of the ISS have been shown to be within the ideal ranges for medication storage, but the effects of other environmental factors, like elevated exposure to radiation, have not yet been evaluated. Current operational procedures ensure that ISS medications are re-stocked before expiration, but this may not be possible on long duration exploration missions. For this reason, medications that have experienced long duration storage on the ISS were returned to JSC for analysis to determine any unusual effects of aging in the low- Earth orbit environment. METHODS Medications were obtained by the JSC Pharmacy from commercial distributors and were re-packaged by JSC pharmacists to conserve up mass and volume. All medication doses were part of the ISS crew medical kit and were transported to the International Space Station (ISS) via NASA's Shuttle Transportation System (Space Shuttle). After 568 days of storage, the medications were removed from the supply chain and returned to Earth on a Dragon (SpaceX) capsule. Upon return to Earth, medications were transferred to temperature and humidity controlled environmental chambers until analysis. Nine medications were chosen on the basis of their availability for study. The medications included several of the most heavily used by US crewmembers: 2 sleep aids, 2 antihistamines/decongestants, 3 pain relievers, an antidiarrheal and an alertness medication. Each medication was available at a single time point; analysis of the same medication at multiple time points was not possible. Because the samples examined in this study were obtained opportunistically from medical supplies, there were no control samples available (i.e. samples aged for a similar period of time on the ground); a significant limitation of this study. Medications were analyzed using the HPLC/MS methods described in

  5. The role of medical museums in contemporary medical education. (United States)

    Marreez, Yehia M A-H; Willems, Luuk N A; Wells, Michael R


    From the early 19th century until the most recent two decades, open-space and satellite museums featuring anatomy and pathology collections (collectively referred to as "medical museums") had leading roles in medical education. However, many factors have caused these roles to diminish dramatically in recent years. Chief among these are the great advances in information technology and web-based learning that are currently at play in every level of medical training. Some medical schools have abandoned their museums while others have gradually given away their museums' contents to devote former museum space to new classrooms, lecture halls, and laboratories. These trends have accelerated as medical school enrollment has increased and as increasing interest in biological and biomedical research activities have caused medical schools to convert museum space into research facilities. A few medical schools, however, have considered the contents of their museums as irreplaceable resources for modern medicine and medical education and the space these occupy as great environments for independent and self-directed learning. Consequently, some medical schools have updated their medical museums and equipped them with new technologies. The Anatomical Museum of Leiden University Medical Center in The Netherlands and the Medical Museum of Kawasaki Medical School in Kurashiki, Okayama, Japan, are two examples of such upgraded museums. Student surveys at Leiden University have indicated that all students (100%) found audio-guided museum tours to be useful for learning and majorities of them found guided tours to be clinically relevant (87%). However, 69% of students felt that museum visits should be optional rather than compulsory within the medical training curriculum.

  6. Medical device regulation for manufacturers. (United States)

    McAllister, P; Jeswiet, J


    Manufacturers of medical devices are held to a higher standard than manufacturers of many other products due to the potential severity of the consequences of introducing inferior or unsafe products to the market-place. In Canada, the medical device industry is regulated by Health Canada under the Medical Device Regulations of the Food and Drug Act. The Medical Device Regulations define requirements of medical device design, development and manufacture to ensure that products reaching the public are safe and effective. Health Canada also requires that medical device manufacturers maintain distribution records to ensure that devices can be traced to the source and consumers can be contacted successfully in the event that a device is recalled. Medical devices exported from Canada must be compliant with the regulations of the country of import. The Canadian Medical Device Regulations were based on the Medical Device Directives of the European Union thus facilitating approval of Canadian devices for the European market. The United States Food and Drug Administration has separate and distinct requirements for safety and quality of medical devices. While effort has been made to facilitate approval and trade of Canadian medical devices in the United States and the European Union, obtaining approval from multiple regulatory bodies can result in increased device development time and cost. The Global Harmonization Task Force is an organization composed of members from Japanese, Australian, European, Canadian and American medical device regulatory bodies. This organization was formed with the objective of harmonizing medical device regulations in an effort to facilitate international trade and standardize the quality of medical devices available to all countries. This paper discusses the requirements that must be met by manufacturers when designing and manufacturing medical devices.

  7. Electronic medical record and glaucoma medications: connecting the medication reconciliation with adherence

    Directory of Open Access Journals (Sweden)

    Bacon TS


    Full Text Available Thomas S Bacon, Kenneth C Fan, Manishi A Desai Department of Ophthalmology, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA Purpose: To evaluate consistency in documentation of glaucoma medications in the electronic medical record and identify which regimen patients adhere to when inconsistencies exist. Factors contributing to medication nonadherence are also explored.Methods: Retrospective chart review of medication adherence encompassing 200 patients from three glaucoma physicians at a tertiary referral center over a 1-month period. Adherence was determined by the consistency between a patients stated medication regimen and either the active medication list in the electronic medical record, or the physicians planned medication regimen in the preceding clinic visit. Patient charts were also reviewed for patient sex, age, primary language, race, and total number of medications.Results: A total of 160 charts showed consistency in documentation between the physician note and electronic medication reconciliation. Of those patients, 83.1% reported adherence with their glaucoma medication schedule. When there was a discrepancy in documentation (40 charts, 72.5% patients followed the physician-stated regimen vs 20% who followed neither vs 7.5% who followed the medical record (P<0.01. No difference in adherence was observed based on sex (P=0.912 or total number of medications taken (P=0.242. ­Language, both English- (P=0.075 and Haitian (P=0.10 -speaking populations, as well as race, ­Caucasian (P=0.31, African-American (P=0.54, and Hispanic (P=0.58, had no impact on medication adherence. Patients over 80 years of age were more nonadherent as compared to other decades (P=0.04.Conclusion: Inconsistent documentation between the electronic medical record physician note and medication regimen may contribute to patient medication nonadherence. Patients over 80 years of age were associated with higher rates of nonadherence

  8. Medical writing, revising and editing

    DEFF Research Database (Denmark)

    Pilegaard, Morten


    The globalization of science makes medical writing, editing and revision a rapidly growing field of linguistic study and practice. Medical science texts are written according to uniform, general guidelines and medical genres have become highly conventionalized in terms of structure and linguistic...... form. Medical editing often takes the form of peer review and mainly addresses issues of contents and overall validity. Medical revision incorporates the checking of the macrostructure and the microstructure of the text, its language and style and its suitability for the target reader or client...

  9. New Zealand's medical manslaughter. (United States)

    Collins, D B


    Doctors in New Zealand may be prosecuted for manslaughter if patients die as a consequence of the doctor's failure to exercise reasonable knowledge, skill and care. The requirement to use reasonable knowledge, skill and care has been held to be breached in New Zealand if a doctor is merely careless. No distinction is made between 'criminal negligence' and the negligence standard applicable in civil law. This article examines New Zealand's law relating to medical manslaughter with particular reference to the case of R v Yogasakaran [1990] 1 NZLR 399 which was the subject of a petition to the Privy Council on 30 January 1991.

  10. [Crisis in medical ethics]. (United States)

    Stellamor, K


    There is a disproportion between diagnostic and therapeutic medical achievements and the doctor/patient relationship. Are we allowed to do everything we are able to do in medicine? People are concerned and worried (genetic technology, invasive medicine, embryos in test tubes etc.). The crisis of ethics in medicine is evident. The analysis of the situation shows one of the causes in the shift of the paradigma-modern times to postmodern following scientific positivism-but also a loss of ethics in medicine due to an extreme secularism and to modern philosophical trends (Hans Jonas and the responsibility for the future and on the other hand modern utilitarism).

  11. [Medical and surgical language]. (United States)

    Asensi-Pérez, Josep; Villalba-Ferrer, Francisco; Roig-Vila, José V


    Medical language contains many faults. One of them is the use of cultured and elegant words without knowing its proper significance. A second error is the recourse to using foreign words or phrases (foreignisms), particularly Anglicisms, both in their original spelling (raw foreignisms) and Hispanicised (adapted word); an overlapping mode of foreignism are so-called "calques" or loan translations. Thirdly, there is the use of words that do not exist in Spanish, palabros. Finally, the words are not correctly pronounced. In this article some examples of these errors are demonstrated and it is directed towards the appropriate use of language.

  12. Preventing medical device recalls

    CERN Document Server

    Raheja, Dev


    Introduction to Medical Device RequirementsIntroductionThe ChallengesSources of ErrorsUnderstanding the Science of Safety     Overview of FDA Quality System Regulation     Overview of Risk Management Standard ISO 14971     Overview of FDA Device Approval Process     Overview of Regulatory Requirements for Clinical TrialsSummaryReferencesPreventing Recalls during Specification WritingIntroductionConduct Requirements Analysis to Identify Missing RequirementsSpecifications for Safety, Durability, and

  13. 国产复方利福平片与进口 rifater在中国志愿者的药动学与相对生物利用度的研究%Studies on the pharmacokinetics and relative bioavailability of domestic compound rifampin tablet and imported rifater in Chinese volunteers

    Institute of Scientific and Technical Information of China (English)

    洪诤; 王浴生; 夏培元; 王正荣


    本试验对12名男性志愿受试者签署知情同意书,按随机双交叉设计口服国产复方利福平片(华北制药康欣有限公司研制,含利福平120mg,异烟肼80mg,吡嗪酰胺250mg)与相同处方的美国进口rifater片各4片后,定时抽取血样并分别对利福平、异烟肼和吡嗪酰胺的血药浓度和药代动力学参数进行比较.血药浓度用HPLC法检测,用3P87和NDST程序,按非室模型进行药代动力学分析,结果表明,口服国产复方利福平片(又称异福酰胺片)和进口rifater片各4片后,利福平的AUC分别为(73.90±23.41)与(72.84±25.58)mg·h/L,Cmax为(16.7±3.6)与(16.6士3.6)mg/L,Tmax为(1.8士0.3)与(1.8土0.2)h;异烟肼的AUC分别(40.74±16.11)与(43.26±17.99)mg·h/L,Cmax为(9.9±3.4)与(10.0±2.8)mg/L,Tmax为(1.7±0.4)与(1.7±0.4)h;吡嗪酰胺的AUC分别为(499.35士194.35)与(515.69±198.931)mg·h/L,Cmax为(40.4士13.2)与(40.6土12.4)mg/L,Tmax为(1.6±0.4)与(1.6±0.4)h.以进口的rifater片为100%,华北制药康欣有限公司提供的利福平三联片口服后三成分的相对生物利用度:利福平为101.45%-异烟肼为94.17%和吡嗪酰胺为96.83%.结果提示,对结核病患者国产复方利福平片的治疗剂量与疗程可以与进口rifater相同.%ABSTRACT The ingredients of domestic antituberculous compound rifampin tablets (CRFP) were the same as US-made rifater (USRF) which is composed of rifampin (R) 120mg, isoniazid (H) 80mg and pyrazinamide (P) 250mg. Twelve Chinese healthy volunteers [(20.9±1.0)y, (61.9±3.5)kgJ participating in this study after providing informed consent were given a single dose of 4 tablets orally according to a double-cross design. The plasma drug concentrations of each ingredient were measured by HPLC assay individually. The plasma concentration-time curves of them could be well described by an open one compartment model.Results revealed that the pharmacokinetic parameters of R, H, and P in CRFP and USRF were very similar.AUC: R, (73

  14. Real-time fluorescence PCR-molecular beacon assay for detecting mutations in rpoB genes of rifampin-resistant Mycobacterium tuberculosis%实时荧光PCR分子信标检测耐利福平结核分枝杆菌印rpoB基因

    Institute of Scientific and Technical Information of China (English)

    孙桂芝; 高铁杰; 钟镐镐; 康丽军; 张治国; 衡万杰; 吴秉铨; 刘威


    Objective To establish a rapid method to detect mutations in rpoB genes of rifampin-resistant Mycobacterium tubereulosis in dinical specimens using Real-time fluorescence PCR molecular beacon assay.Methods 174 strains of Mvcobacterium tuberculosis clinical isolates were analyzed using real-time fluorescence PCR molecular beacon assay foilowed with DNA sequencing while 12 strains of NTM and 4 strains of bacteria other than Mycobacterium tuberculosis were used as the contrast.Results Eighty-two 89.1 of 92 rifampin (RIF)-resistant strains and 3 of 82 RIF-sensitive strains were found to harbor mutation in the rpoB gene using real-time fluorescence PCR-molecular beacon assay.The specificity, sensitivity,and accuracy of this assay were 96.3%,89.1%,and 92.5%,respectively-Eithty-three of 92 RIF-resistant strains and 1 of 82 RIF-sensitive strains were found to harbor mutation in the rpoB gene using the direct DNA sequencing.The specificity,sensitivity,and accuracy of the direct DNA sequencing were 98.8,90.2%,and 94.2%,respectively.As compared with real-time PCR molecular beacon assay,171 of 174(98.3%)strains of myeobactefium tuberculosis clinical isolates had the salne results.Conclusion Real-time fluorescence PCR-molecular beacon assay can be used as a rapid screen method to detect RIF-resistant isolates.%目的 应用实时荧光PCR分子信标技术,建立快速检测临床标本中结核分枝杆菌利福平rpoB相关耐药突变点方法,探讨其缩短耐药实验报告时间的临床应用价值.方法 以分枝杆菌药物敏感性实验绝对浓度法为标准,12株非结核分枝杆菌、4株非分枝杆菌作对照,对174例结核患者临床分离株应用实时荧光PCR分子信标方法,检测利福平rpoB核心区域的耐药突变点并将结果与直接测序进行比较.结果 (1)实时荧光PCR分子信标方法:82例结核分枝杆菌利福平敏感菌株中,3例发生rpoB基因突变,特异度为96.3%;92例结核分枝杆菌利福平耐药菌株中,82

  15. Prioritising interventions against medication errors

    DEFF Research Database (Denmark)

    Lisby, Marianne; Pape-Larsen, Louise; Sørensen, Ann Lykkegaard


    Abstract Authors: Lisby M, Larsen LP, Soerensen AL, Nielsen LP, Mainz J Title: Prioritising interventions against medication errors – the importance of a definition Objective: To develop and test a restricted definition of medication errors across health care settings in Denmark Methods: Medication...... errors constitute a major quality and safety problem in modern healthcare. However, far from all are clinically important. The prevalence of medication errors ranges from 2-75% indicating a global problem in defining and measuring these [1]. New cut-of levels focusing the clinical impact of medication...... errors are therefore needed. Development of definition: A definition of medication errors including an index of error types for each stage in the medication process was developed from existing terminology and through a modified Delphi-process in 2008. The Delphi panel consisted of 25 interdisciplinary...

  16. Quo Vadis, Medical Genetics? (United States)

    Czeizel, Andrew E.

    The beginning of human genetics and its medical part: medical genetics was promising in the early decades of this century. Many genetic diseases and defects with Mendelian origin were identified and it helped families with significant genetic burden to limit their child number. Unfortunately this good start was shadowed by two tragic events. On the one hand, in the 1930s and early 1940s the German fascism brought about the dominance of an unscientific eugenics to mask vile political crimes. People with genetic diseases-defects were forced to sterilisation and several of them were killed. On the other hand, in the 1950s lysenkoism inhibitied the evolution of genetics in the Soviet Union and their satelite countries. Lysenko's doctrine declared genetics as a product of imperialism and a guilty science, therefore leading geneticists were ousted form their posts and some of them were executed or put in prison. Past decades genetics has resulted fantastic new results and achieved a leading position within the natural sciences. To my mind, however, the expected wider use of new eugenics indicates a new tragedy and this Cassandra's prediction is the topic of this presentation.

  17. The medicalization of beauty

    Directory of Open Access Journals (Sweden)

    Paulo Poli Neto


    Full Text Available Concern with body image and medical interventions related to physical beauty has greatly increased in the past few years. The purpose of this study is to investigate how medicine is dealing with the theme of beauty. The 2003/2004 editions of the periodicals Aesthetic Surgery Journal and Aesthetic Plastic Surgery were analyzed, in order to investigate the rationality buttressing their discourse. Three categories were prioritized for this study: definition of aesthetic plastic surgery's study object; beauty patterns guiding interventions; and understanding popular demand for aesthetic corrections. Discourse is sustained by biomedical rationality, structured around a disease theory and a dual construction between normal and pathological, with emphasis on biology. In the articles, the beauty patterns guiding therapeutic practices are anchored in biological norms defined through several anthropometric measures, which refer to abstract concepts of beauty, harmony, proportionality and symmetry. In this discourse, there are no references to patterns or to social norms of beauty; motivation for aesthetic intervention appears to be rooted in low self-esteem related to the aging process or to some bodily nonconformity. As per the meaning of 'medicalization' adopted herein, biomedical rationality appropriates variations or anomalies of physical appearance, thus allowing the theme to be dealt with in terms of health and disease, normal and pathological.


    CERN Multimedia

    Service Médical


    IN URGENT NEED OF A DOCTOR GENEVA: EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME: Open 24h/24h 748-49-50 AMG- Association Of Geneva Doctors: Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin 719-61-11 EMERGENCIES 719-61-11 CHILDREN'S EMERGENCIES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112   FRANCE: EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ...

  19. Proteomics in medical microbiology. (United States)

    Cash, P


    The techniques of proteomics (high resolution two-dimensional electrophoresis and protein characterisation) are widely used for microbiological research to analyse global protein synthesis as an indicator of gene expression. The rapid progress in microbial proteomics has been achieved through the wide availability of whole genome sequences for a number of bacterial groups. Beyond providing a basic understanding of microbial gene expression, proteomics has also played a role in medical areas of microbiology. Progress has been made in the use of the techniques for investigating the epidemiology and taxonomy of human microbial pathogens, the identification of novel pathogenic mechanisms and the analysis of drug resistance. In each of these areas, proteomics has provided new insights that complement genomic-based investigations. This review describes the current progress in these research fields and highlights some of the technical challenges existing for the application of proteomics in medical microbiology. The latter concern the analysis of genetically heterogeneous bacterial populations and the integration of the proteomic and genomic data for these bacteria. The characterisation of the proteomes of bacterial pathogens growing in their natural hosts remains a future challenge.

  20. Medical ultrasound systems. (United States)

    Powers, Jeff; Kremkau, Frederick


    Medical ultrasound imaging has advanced dramatically since its introduction only a few decades ago. This paper provides a short historical background, and then briefly describes many of the system features and concepts required in a modern commercial ultrasound system. The topics addressed include array beam formation, steering and focusing; array and matrix transducers; echo image formation; tissue harmonic imaging; speckle reduction through frequency and spatial compounding, and image processing; tissue aberration; Doppler flow detection; and system architectures. It then describes some of the more practical aspects of ultrasound system design necessary to be taken into account for today's marketplace. It finally discusses the recent explosion of portable and handheld devices and their potential to expand the clinical footprint of ultrasound into regions of the world where medical care is practically non-existent. Throughout the article reference is made to ways in which ultrasound imaging has benefited from advances in the commercial electronics industry. It is meant to be an overview of the field as an introduction to other more detailed papers in this special issue.

  1. Wavelets in medical imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zahra, Noor e; Sevindir, Huliya A.; Aslan, Zafar; Siddiqi, A. H. [Sharda University, SET, Department of Electronics and Communication, Knowledge Park 3rd, Gr. Noida (India); University of Kocaeli, Department of Mathematics, 41380 Kocaeli (Turkey); Istanbul Aydin University, Department of Computer Engineering, 34295 Istanbul (Turkey); Sharda University, SET, Department of Mathematics, 32-34 Knowledge Park 3rd, Greater Noida (India)


    The aim of this study is to provide emerging applications of wavelet methods to medical signals and images, such as electrocardiogram, electroencephalogram, functional magnetic resonance imaging, computer tomography, X-ray and mammography. Interpretation of these signals and images are quite important. Nowadays wavelet methods have a significant impact on the science of medical imaging and the diagnosis of disease and screening protocols. Based on our initial investigations, future directions include neurosurgical planning and improved assessment of risk for individual patients, improved assessment and strategies for the treatment of chronic pain, improved seizure localization, and improved understanding of the physiology of neurological disorders. We look ahead to these and other emerging applications as the benefits of this technology become incorporated into current and future patient care. In this chapter by applying Fourier transform and wavelet transform, analysis and denoising of one of the important biomedical signals like EEG is carried out. The presence of rhythm, template matching, and correlation is discussed by various method. Energy of EEG signal is used to detect seizure in an epileptic patient. We have also performed denoising of EEG signals by SWT.

  2. Medical Image Analysis Facility (United States)


    To improve the quality of photos sent to Earth by unmanned spacecraft. NASA's Jet Propulsion Laboratory (JPL) developed a computerized image enhancement process that brings out detail not visible in the basic photo. JPL is now applying this technology to biomedical research in its Medical lrnage Analysis Facility, which employs computer enhancement techniques to analyze x-ray films of internal organs, such as the heart and lung. A major objective is study of the effects of I stress on persons with heart disease. In animal tests, computerized image processing is being used to study coronary artery lesions and the degree to which they reduce arterial blood flow when stress is applied. The photos illustrate the enhancement process. The upper picture is an x-ray photo in which the artery (dotted line) is barely discernible; in the post-enhancement photo at right, the whole artery and the lesions along its wall are clearly visible. The Medical lrnage Analysis Facility offers a faster means of studying the effects of complex coronary lesions in humans, and the research now being conducted on animals is expected to have important application to diagnosis and treatment of human coronary disease. Other uses of the facility's image processing capability include analysis of muscle biopsy and pap smear specimens, and study of the microscopic structure of fibroprotein in the human lung. Working with JPL on experiments are NASA's Ames Research Center, the University of Southern California School of Medicine, and Rancho Los Amigos Hospital, Downey, California.

  3. Initiatives for Medical Education Research at the International Medical University

    Directory of Open Access Journals (Sweden)

    Ramesh Chandra Jutti


    Full Text Available Medical Education research is a relativelynew field but one that is progressing rapidly worldwide.This article is an attempt to take stock of the currentstatus of Medical Education research in InternationalMedical University and to explore the various factorsthat have influenced its direction. It also shares some ofthe initiatives that have been instituted or intended tobe instituted at our university.

  4. Accounting for Medication Particularities: Designing for Everyday Medication Management


    Dalgaard, Lea Gulstav; Grönvall, Erik; Verdezoto, Nervo


    Several projects have shown that self-management of medication in private homes can be challenging. Many projects focused on specific illness-related approaches (e.g. diabetes) or practical issues such as how to handle medication while travelling. However, designing for everyday medication management involves more than just specific illness-related strategies and should take into account the broad set of activities conforming people’s everyday life. This study investigates how older adults ma...

  5. "Assessment of different bioequivalent metrics in Rifampin bioequivalence study "

    Directory of Open Access Journals (Sweden)

    "Rouini MR


    Full Text Available The use of secondary metrics has become special interest in bioequivalency studies. The applicability of partial area method, truncated AUC and Cmax/AUC has been argued by many authors. This study aims to evaluate the possible superiority of these metrics to primary metrics (i.e. AUCinf, Cmax and Tmax. The suitability of truncated AUC for assessment of absorption extent as well as Cmax/AUC and partial AUC for the evaluation of absorption rate in bioequivalency determination was investigated following administration of same product as test and reference to 7 healthy volunteers. Among the pharmacokinetic parameters obtained, Cmax/AUCinf was a better indicator or absorption rate and the AUCinf was more sensitive than truncated AUC in evaluation of absorption extent.

  6. "Assessment of different bioequivalent metrics in Rifampin bioequivalence study "


    "Rouini MR; Tajer Zadeh H; Valad Khani M "


    The use of secondary metrics has become special interest in bioequivalency studies. The applicability of partial area method, truncated AUC and Cmax/AUC has been argued by many authors. This study aims to evaluate the possible superiority of these metrics to primary metrics (i.e. AUCinf, Cmax and Tmax). The suitability of truncated AUC for assessment of absorption extent as well as Cmax/AUC and partial AUC for the evaluation of absorption rate in bioequivalency determination was investigated ...

  7. Conflicting medication information: prevalence, sources, and relationship to medication adherence. (United States)

    Carpenter, Delesha M; Elstad, Emily A; Blalock, Susan J; DeVellis, Robert F


    Conflicting medication information has been defined as contradictory information about a medication topic from two or more sources. The objective of this study was to determine whether arthritis patients are exposed to conflicting medication information, to document sources of conflicting information, and to explore whether conflicting information is associated with sociodemographic factors, clinical characteristics, and medication adherence. Using an online survey, arthritis patients (N = 328) reported how often they received conflicting information about 12 medication topics as well as sources of conflicting information, demographic/clinical characteristics, and medication adherence. A linear regression model, which controlled for various demographic/clinical factors, determined whether conflicting information was associated with medication adherence. The majority of patients (80.1%) received conflicting information and were most likely to receive conflicting information about medication risks. Physicians, media sources, and the Internet were the most common sources of conflicting information. Less conflicting information (B =-0.13, p information source use (B = 0.22, p information is pervasive, comes from a variety of sources, and may negatively affect patient health outcomes. To potentially decrease exposure to conflicting information, providers should direct patients to high-quality medication information sources.

  8. Advanced medical video services through context-aware medical networks. (United States)

    Doukas, Charalampos N; Maglogiannis, Ilias; Pliakas, Thomas


    The aim of this paper is to present a framework for advanced medical video delivery services, through network and patient-state awareness. Under this scope a context-aware medical networking platform is described. The developed platform enables proper medical video data coding and transmission according to both a) network availability and/or quality and b) patient status, optimizing thus network performance and telediagnosis. An evaluation platform has been developed based on scalable H.264 coding of medical videos. Corresponding results of video transmission over a WiMax network have proved the effectiveness and efficiency of the platform providing proper video content delivery.

  9. Medical Spending in Denmark

    DEFF Research Database (Denmark)

    Christensen, Bent Jesper; Kallestrup-Lamb, Malene; Gørtz, Mette


    Using full population longitudinal data from merged administrative registers for Denmark, we document that medical spending is highly concentrated in the population, and persistent through time at the individual level. In addition, we provide overviews of institutional details of the Danish health...... care system, aggregate trends in health care expenditures, and the relevant register data. Nearly two thirds of expenditures are on hospitals and one fifth on long-term care, with the remainder roughly equally split between primary care and prescription drugs. Health expenditures are higher for men...... is responsible for more than twice as much spending on health as the richest, and this reverse social gradient is even stronger for long-term care and is stronger among men than among women, especially in hospital expenses. Expenditures in the year (over the three years) before death are nearly 12 times...

  10. [Gaubius and medical chemistry]. (United States)

    van Gijn, Jan; Gijselhart, Joost P


    Hieronymus David Gaub (1705-1780) was the son of a protestant cloth merchant in Heidelberg. Disliking a pietistic boarding school in Halle, Germany, he came to stay with a paternal uncle who was a physician in Amsterdam. Hieronymus studied medicine in Harderwijk and in Leiden, under the guidance of Herman Boerhaave (1668-1738). In 1731 he was appointed reader (and in 1734 professor) in chemistry at the Leiden medical faculty. After Boerhaave's death he also taught medicine, but without access to hospital beds. Gaubius correctly envisaged that chemistry would become an important discipline in medicine, but was limited by the technical constraints of his time. In his textbook of general pathology (1758) he attributed disease to disturbances of not only fluids, but also solid parts, although symptoms remained the basis of his classification. The book would remain influential for several decades, until the advent of pathological anatomy.

  11. Medical Litigation Across Specialties

    LENUS (Irish Health Repository)

    Murphy, JFA


    Medical negligence is a major cause of fear and anxiety for doctors. The threat of malpractice consists of 3 factors, the risk of a claim, the probability of a claim leading to a payment, and the size of the payment. The Clinical Indemnity Scheme (CIS) insures against indemnity payments but it cannot protect the doctor against the indirect consequences of litigation including stress, the long hours mounting a defence against the allegation, and the damage to one’s reputation. The adversarial tort system focuses on punishment, blame and compensation. The emotional anguish and potential damage to the doctor’s reputation can be considerable. Doctors subjected to malpractice suits regardless of the outcome may experience depression, anger, frustration and excessive use of alcohol

  12. Medical Image Fusion

    Directory of Open Access Journals (Sweden)

    Mitra Rafizadeh


    Full Text Available Technological advances in medical imaging in the past two decades have enable radiologists to create images of the human body with unprecedented resolution. MRI, PET,... imaging devices can quickly acquire 3D images. Image fusion establishes an anatomical correlation between corresponding images derived from different examination. This fusion is applied either to combine images of different modalities (CT, MRI or single modality (PET-PET."nImage fusion is performed in two steps:"n1 Registration: spatial modification (eg. translation of model image relative to reference image in order to arrive at an ideal matching of both images. Registration methods are feature-based and intensity-based approaches."n2 Visualization: the goal of it is to depict the spatial relationship between the model image and refer-ence image. We can point out its clinical application in nuclear medicine (PET/CT.

  13. Medical Research System (United States)


    Based on Johnson Space Flight Center's development of a rotating bioreactor cell culture apparatus for Space Shuttle medical research, Johnson Space Flight Center engineers who worked on the original project formed a company called Synthecon, with the intention of commercializing the bioreactor technology. Synthecon grows three dimensional tissues in the bioreactor. These are superior to previous two-dimensional tissue samples in the study of human cell growth. A refined version of the Johnson Space Center technology, Synthecon's Rotary Cell Culture System includes a cell culture chamber that rotates around a horizontal axis. The cells establish an orbit that approximates free fall through the liquid medium in the chamber. The technology has significant applications for cancer research and treatment as well as AIDS research.

  14. Medical Sensor Network Infrastructures

    DEFF Research Database (Denmark)

    Andersen, Jacob

    researchers have been developing power-efficient security mechanisms for sensor networks. However, most of this work ignores the special usability demands from the clinical use-scenarios: set-up must be fast, and key pre-distribution is problematic if disposable sensors are discarded after being used for only...... a decade, most sensors are still quite big, heavy and difficult to operate, and a lot of research is revolving around minimising the instruments and making them easier to use. Several research experiments have demonstrated the utility of such sensors, but few of these experiments consider security...... a short while. This tension between simple use and security in a low-power clinical environment is the main theme of this dissertation. Un-secure medical equipment will never pass official certification by national health authorities, but on the other hand, experience shows that if using the equipment...

  15. The importance of associations in the struggle against tuberculosis in Turkey. (United States)

    Aksu, Murat; Toprak, Sadık


    Tuberculosis is a disease as old as human history and has affected every area of human life. The struggle against tuberculosis had been started by non-governmental organizations and achieved success after second world war. In Anatolia as well as all over the world fight against tuberculosis, with the leading names in medicine, started during the Ottoman Empire. In the following years of struggle within the executive team will host association (Istanbul Anti-tuberculosis Association) was founded in 1918. Due to political developments that occurred shortly after standing association studies, in 1923, the Republic of Turkey in Izmir during the re-started. In the 1925 and 1927 a national medical congress, tuberculosis as the main election issue, was organized, and then in 1928 in Istanbul Tuberculosis Association again take action in the fight against decisive role in association studies have begun to undertake. In the years 1953-1973, UNICEF, Ministry of Health and later efforts Turkish National Anti-tuberculosis Association jointly significant results were obtained in the fight against tuberculosis. These positive statements given the lethargy environment, economic and political crises in the last 10 years, in parallel with the increase of tuberculosis around the world experiencing, there was an increase in Turkey. In 1986, the National Anti-Tuberculosis Federation was founded by Anti-Tuberculosis Associations. The Anti-Tuberculosis Federation has put in practice DOTS programme in 2005 in Turkey. In conclusion, we evaluate that the Anti-Tuberculosis Associations in Turkey have played a major role in struggle against tuberculosis in Turkey since the last century.

  16. [Euthanasia and medical act]. (United States)


    Right to life -as the prohibition of intentionally and arbitrarily taking life, even with authorization of the concerned one- is an internationally recognized right. In many countries, debate regarding euthanasia is more centered in its convenience, social acceptability and how it is regulated, than in its substantial legitimacy. Some argue that euthanasia should be included as part of clinical practice of health professionals, grounded on individual's autonomy claims-everyone having the liberty to choose how to live and how to die. Against this, others sustain that life has a higher value than autonomy, exercising autonomy without respecting the right to life would become a serious moral and social problem. Likewise, euthanasia supporters some-times claim a 'right to live with dignity', which must be understood as a personal obligation, referred more to the ethical than to the strictly legal sphere. In countries where it is already legalized, euthanasia practice has extended to cases where it is not the patient who requests this but the family or some healthcare professional, or even the legal system-when they think that the patient is living in a condition which is not worthy to live. Generalization of euthanasia possibly will end in affecting those who need more care, such as elder, chronically ill or dying people, damaging severely personal basic rights. Nature, purpose and tradition of medicine rule out the practice of euthanasia, which ought not be considered a medical act or legitimately compulsory for physicians. Today's medicine counts with effective treatments for pain and suffering, such as palliative care, including sedative therapy, which best preserves persons dignity and keeps safe the ethos of the medical profession.

  17. Satellite medical centers project (United States)

    Aggarwal, Arvind


    World class health care for common man at low affordable cost: anywhere, anytime The project envisages to set up a national network of satellite Medical centers. Each SMC would be manned by doctors, nurses and technicians, six doctors, six nurses, six technicians would be required to provide 24 hour cover, each SMC would operate 24 hours x 7 days. It would be equipped with the Digital telemedicine devices for capturing clinical patient information and investigations in the form of voice, images and data and create an audiovisual text file - a virtual Digital patient. Through the broad band connectivity the virtual patient can be sent to the central hub, manned by specialists, specialists from several specialists sitting together can view the virtual patient and provide a specialized opinion, they can see the virtual patient, see the examination on line through video conference or even PCs, talk to the patient and the doctor at the SMC and controlle capturing of information during examination and investigations of the patient at the SMC - thus creating a virtual Digital consultant at the SMC. Central hub shall be connected to the doctors and consultants in remote locations or tertiary care hospitals any where in the world, thus creating a virtual hub the hierarchical system shall provide upgradation of knowledge to thedoctors in central hub and smc and thus continued medical education and benefit the patient thru the world class treatment in the smc located at his door step. SMC shall be set up by franchisee who shall get safe business opportunity with high returns, patients shall get Low cost user friendly worldclass health care anywhere anytime, Doctors can get better meaningful selfemplyment with better earnings, flexibility of working time and place. SMC shall provide a wide variety of services from primary care to world class Global consultation for difficult patients.

  18. Radiation physics for medical physicists

    CERN Document Server

    Podgorsak, Ervin B


    This book summarizes the radiation physics knowledge that professionals working in medical physics need to master for efficient and safe dealings with ionizing radiation. It contains eight chapters, each chapter covering a specific group of subjects related to radiation physics and is intended as a textbook for a course in radiation physics in medical-physics graduate programs. However, the book may also be of interest to the large number of professionals, not only medical physicists, who in their daily occupations deal with various aspects of medical physics and find a need to improve their understanding of radiation physics. The main target audience for this book is graduate students studying for M.Sc. and Ph.D. degrees in medical physics, who have to possess the necessary physics and mathematics background knowledge to be able to follow and master the complete textbook. Medical residents, technology students and biomedical engineering students may find certain sections too challenging or esoteric, yet they...

  19. Medical applications of artificial intelligence

    CERN Document Server

    Agah, Arvin


    Enhanced, more reliable, and better understood than in the past, artificial intelligence (AI) systems can make providing healthcare more accurate, affordable, accessible, consistent, and efficient. However, AI technologies have not been as well integrated into medicine as predicted. In order to succeed, medical and computational scientists must develop hybrid systems that can effectively and efficiently integrate the experience of medical care professionals with capabilities of AI systems. After providing a general overview of artificial intelligence concepts, tools, and techniques, Medical Ap

  20. Sensor Networks for Medical Care


    Shnayder, Victor; Chen, Bor-rong; Lorincz, Konrad; Fulford-Jones, Thaddeus R. F.; Welsh, Matt


    Sensor networks have the potential to greatly impact many aspects of medical care. By outfitting patients with wireless, wearable vital sign sensors, collecting detailed real-time data on physiological status can be greatly simplified. However, there is a significant gap between existing sensor network systems and the needs of medical care. In particular, medical sensor networks must support multicast routing topologies, node mobility, a wide range of data rates and high degrees of reliabilit...

  1. Fostering international undergraduate medical education

    Directory of Open Access Journals (Sweden)

    James D Smith


    Full Text Available The severe lack of human resources in the health care field in many countries has resulted in avid interest in global undergraduate medical education. Christian medical missionaries have, thus, a unique opportunity to contribute to transformative, holistic development through the training of future physicians for resource-limited settings. Starting a new medical school is, however, a complex process which requires significant resources and intellectual investment. This paper outlines some of the challenges encountered in faith-based individuals’ engagement in undergraduate medical education, as well as suggesting some practical solutions and recommendations.

  2. Medical Secretaries’ Care of Records

    DEFF Research Database (Denmark)

    Bossen, Claus; Jensen, Lotte Groth; Witt, Flemming


    We describe the cooperative work of medical secretaries at two hospital departments, during the implementation of an electronic health record system. Medical secretaries' core task is to take care of patient records by ensuring that also do information gatekeeping and articulation work. The EHR...... implementation stressed their importance to the departments' work arrangements, coupled their work more tightly to that of other staff, and led to task drift among professions. information is complete, up to date, and correctly coded. Medical secretaries While medical secretaries have been relatively invisible...

  3. [Medical applications of systems biology]. (United States)

    Demongeot, Jacques


    We illustrate in this review some applications of systems biology in the medical and biological areas. After a brief summary of time scales experienced by medical -observations and of the general scheme of dynamic systems, we describe how some techniques underlying the complex systems theory can be applied to model medical issues in immunology, medical genetics, developmental morphogenesis, biochemistry, epidemiology, telemedecine and multiple platforms of expertise. In concluding, we will discuss the issue of "clinomics" coupling clinical and -omics data in a unique patient-specific file.

  4. Medical applications of artificial olfactometry (United States)

    Lewis, Nathan S. (Inventor); Severin, Erik J. (Inventor); Wong, Bernard (Inventor); Kelso, David M. (Inventor); Munoz, Beth C. (Inventor)


    The present invention provides methods for detecting the presence of an analyte indicative of various medical conditions, including halitosis, periodontal disease and other diseases are also disclosed.

  5. Medication use among Canadian seniors. (United States)

    McPherson, Mark; Ji, Hong; Hunt, Jordan; Ranger, Rob; Gula, Cheryl


    As they age, many seniors develop a progressively more complex mix of health conditions. Multiple prescription medications are often required to help manage these conditions and control symptoms, with the goal of maintaining seniors' health for as long as possible. This article explores trends in the number and types of medications used by seniors on public drug programs in Canada. Our findings suggest that a high proportion of Canadian seniors are taking several medications, highlighting the need for medication management systems focusing on this population.

  6. Introducing the Medical Ethics Bowl. (United States)

    Merrick, Allison; Green, Rochelle; Cunningham, Thomas V; Eisenberg, Leah R; Hester, D Micah


    Although ethics is an essential component of undergraduate medical education, research suggests that current medical ethics curricula face considerable challenges in improving students' ethical reasoning. This article discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised: the Medical Ethics Bowl (MEB). Finally, we suggest the pedagogical advantages of the MEB when compared to other ethics curricula.

  7. Medical emergencies in dental practice.

    LENUS (Irish Health Repository)

    Wilson, M H


    Serious medical emergencies are fortunately a rare occurrence in the dental practice environment; however, if an emergency situation is encountered a delay in treatment may result in potentially avoidable consequences. The risk of mortality or serious morbidity can be reduced by ensuring that basic emergency equipment and medications are in place, and that the dental team is appropriately trained in basic life support measures. This article aims to provide an overview of the basic emergency medications and equipment that should be present in dental practices, and to discuss specific responses to some of the more common adverse medical events that can present while providing dental treatment.

  8. Emergency Medical Technicians and Paramedics (United States)

    ... Projected Employment, 2024 Change, 2014-24 Employment by Industry Percent Numeric SOURCE: U.S. Bureau of Labor Statistics, Employment Projections program Emergency medical technicians and paramedics ...

  9. Competency-based medical education in postgraduate medical education

    NARCIS (Netherlands)

    Iobst, William F.; Sherbino, Jonathan; Ten Cate, Olle; Richardson, Denyse L.; Dath, Deepak; Swing, Susan R.; Harris, Peter; Mungroo, Rani; Holmboe, Eric S.; Frank, Jason R.


    With the introduction of Tomorrow's Doctors in 1993, medical education began the transition from a time-and process-based system to a competency-based training framework. Implementing competency-based training in postgraduate medical education poses many challenges but ultimately requires a demonstr

  10. The Role of Medical Museums in Contemporary Medical Education (United States)

    Marreez, Yehia M. A-H.; Willems, Luuk N. A.; Wells, Michael R.


    From the early 19th century until the most recent two decades, open-space and satellite museums featuring anatomy and pathology collections (collectively referred to as "medical museums") had leading roles in medical education. However, many factors have caused these roles to diminish dramatically in recent years. Chief among these are the great…

  11. The Current State of Medical Education in Chinese Medical Schools (United States)

    Kosik, Russell Oliver; Huang, Lei; Cai, Qiaoling; Xu, Guo-Tong; Zhao, Xudong; Guo, Li; Tang, Wen; Chen, Qi; Fan, Angela Pei-Chen


    Today's doctor is as much a humanist as a scientist. Medical schools have responded to this change by introducing a variety of courses, most notably those concerning the humanities and ethics. Thus far, no one has examined the extent of use of these subjects in Chinese medical schools. The goal of this study is to determine how many and in…

  12. The Impact of the Clinical Medical Librarian on Medical Education. (United States)

    Sarkis, Jeanne; Hamburger, Stephen


    A University of Missouri-Kansas City School of Medicine team approach is described that combines the knowledge and skills of the physician, nurse, clinical pharmacist, clinical medical librarian, etc., into a cooperative unit to provide health education and health care delivery. The impact of the clinical medical librarian is discussed. (MLW)

  13. A Review of Medical Education and Medical Informatics. (United States)

    Haynes, R. Brian; And Others


    Information technology may help physicians to manage information more effectively through more accessible clinical indexes, databases of diagnostic test characteristics, computerized audits of clinical activities, on-line access to medical literature, etc. Medical informatics, a new discipline dedicated to the solution of information problems in…

  14. GenoType MTBDRplus assay for rapid detection of rifampin and isoniazid resistance,in Mycobacterium tuberculosis in Sichuan%分子线性探针技术分析四川地区结核分枝杆菌耐药情况

    Institute of Scientific and Technical Information of China (English)

    多丽娜; 王婷婷; 宋兴勃; 谢轶; 陆小军; 范红; 应斌武; 王兰兰; 张磊


    Objective To explore the molecular and epidemic characteristics of rifampin (RFP) and isoniazid (INH) resistance of mycobacterium tuberculosis (MTB) in Sichuan. Methods GenoType · MTBDRplus Assay Gtplus was used to examine 68 clinical isolates of MTB and 105 clinical specimens for mutations in rpoB, katG and inhA genes related to RFP and INH resistance. Results Of the 151 valid tests obtained, 44 (29.14%) and 26 (17.22%) showed drug resistance and multidrug resistance, respectively. Resistance to RFP and INH was found in 21.85% (33/151) and 24.50% (37/151) of the samples, respectively. The most prevalent mutations were rpoB S531L, katG S315T1 and inhA C-15T. The multidrug resistance rate in the sputum specimens was significantly higher than that in the non-respiratory samples (19.35% vs 7.41%). Conclusion Drug-resistant, especially multidrug-resistant tuberculosis is highly prevalent in Sichuan. The multidrug-resistant bacteria most frequently show rpoB S531L combined with katG S315T1 mutations, suggesting the necessity of developing rapid clinical identification methods for drug-resistant MTB to control the spread of the resistant strains.%目的 应用分子线性探针Geno Type(R)MTBDRplus Assay(Gtplus)试剂盒检测四川地区耐多药结核分枝杆菌(MTB)株的基因型特征,并初步了解耐药结核病的流行情况.方法 选取结核确诊患者105份临床标本和68株临床分离株,应用Gtplus试剂盒检测MTB耐利福平和异烟肼相关的rpoB、katG、inhA基因的突变,推测其对利福平和异烟肼的耐药性.结果 151例样本的Gtplus结果有效,总耐药率和耐多药率分别为29.14%(44/151)和17.22%(26/151);耐利福平和高、低水平耐异烟肼的突变菌株分别为21.85%(33/151)、21.19%(32/151)和3.31%(5/151);突变型以rpoB S531L、katGS315T1和inhA C-15T为主.痰标本组的耐多药菌株比率明显高于肺外标本组.结论 四川地区MTB耐药形势严峻,尤以耐多药结核病的情

  15. 西安市耐利福平结核分枝杆菌rpoB基因的突变型分析%Molecular analysis of rpoB gene mutations of rifampin-resistant Mycobacterium tuberculosis clinical isolates in Xi'an City

    Institute of Scientific and Technical Information of China (English)

    杜蓬; 李峰; 董兆麟; 陈超


    目的 西安市结核分枝杆菌临床分离株rpoB基因RRDR的基因型分析.方法 采用PCR-单链构象多态性(PCR-SSCP)分析32株结核分枝杆菌耐RFP株和10株RFP敏感株的rpoB基因PCR产物,并对8株具有代表性的菌株rpoB基因片段通过DNA测序进行验证.结果 rpoB基因PCR-SSCP分析灵敏度为56.3%(18/32),特异性为80%(8/10).8株结核分枝杆菌rpoB基因经测序,6株耐RFP菌株中有5株的rpoB基因突变均发生在531或526密码子上.其中有两株在526密码子均发生了双碱基突变;1株PCR-SSCP呈现阴性的耐RFP结核分枝杆菌存在513密码子突变;两株RFP敏感株出现PCR-SSCP假阳性,其rpoB基因均涉及2~3个密码子的突变,其中518密码子突变型AAC→GAC为首次报道.结论 531和526密码子除了单点突变之外,亦出现同密码子双碱基突变型;RFP敏感株多密码子突变型值得关注.%Objective To genotype the rifampin (RFP)-resistance-determining region (RRDR) of rpoB gene of clinical Mycobacterium tuberculosis isolates in Xi'an by PCR single-strand conformation polymorphism (PCR-SSCP) combined with DNA sequencing. Methods The rpoB gene of 32 RFP-resistant and 10 RFP-susceptible Mycobacterium tuberculosis strains was analyzed by PCR-SSCP within the 157 bp (Ala5oo to Val550) region covers RRDR, and the PCR products of rpoB gene of 8 strains, which have representative patterns of PCR-SSCP combined with drug sensitive testing, were sequenced subsequently. Results The sensitivity and specificity of PCR-SSCP in detected rpoB gene were 56. 3% (18/32) and 80% (8/10), respectively. Mutations in codon 531 or 526 were observed in 5 of 6 RFP-resistant isolates by DNA sequencing, and double-base mutations in codon 526 were found in 2 of 6 RFP-resistant isolates. One mutation in codon 513 with false-negative PCR-SSCP result was also unfolded. Two false-positive PCR-SSCP results were revealed among the RFP-susceptible strains with mutations covered Leu511 , Asp5i6

  16. [Medical imaging: its medical economics and recent situation in Japan.]. (United States)

    Imai, Keiko


    Two fields of radiology, medical imaging and radiation therapy, are coded separately in medical fee system, and the health care statistics of 2003 shows that expenditure on the former was 5.2% of the whole medical cost and the latter 0.28%. Introduction of DPC, an abbreviation of Diagnostic Procedure Combination, was carried out in 2003, which was an essential reform of medical fee payment system that have been managed on fee-for-service base throughout, and 22% of beds for acute patients care are under the control of DPC payment in 2006. As medical imaging procedures are basically classified in inclusive payment in DPC system, their accurate statistics cannot be figured out because of the lack of description of individual procedures in DPC bills. Policy-making of medical economics will suffer a great loss from the deficiency of detailed data in published statistics. Important role in clinical diagnoses of CT and MR results an increase of fee paid for them up to more than half of total expenditure on medical imaging. So, dominant reduction of examination fee has been done for MR imaging, especially in 2002, to reduce the total cost of medical imaging. Follows could be featured as major topics of medical imaging in health insurance system, (a) fee is newly assigned for electronic handling of CT-and-MR images, and nuclear medicine, and (b) there is still a mismatch between actual payment and quality of medical facilities. As matters related to medical imaging, the followings should be stressed; (a) numbers of CT and MR units per population are dominantly high among OECD countries, but, those controlled by qualified radiologists are at the average level of those countries, (b) there is a big difference of MR examination quality among medical facilities, and (c) 76% of newly-installed high-end MR units are supplied by foreign industries. Hopefully, there will be an increase in the concern to medical fee payment system and health care cost because they possibly

  17. Radiation physics for medical physicists

    Energy Technology Data Exchange (ETDEWEB)

    Podgorsak, E.B. [McGill Univ. Health Centre, Montreal, QC (Canada). Dept. of Medical Physics


    This book summarizes the radiation physics knowledge that professionals working in medical physics need to master for efficient and safe dealings with ionizing radiation. It contains eight chapters, each chapter covering a specific group of subjects related to radiation physics and is intended as a textbook for a course in radiation physics in medical-physics graduate programs. However, the book may also be of interest to the large number of professionals, not only medical physicists, who in their daily occupations deal with various aspects of medical physics and find a need to improve their understanding of radiation physics. The main target audience for this book is graduate students studying for M.Sc. and Ph.D. degrees in medical physics, who have to possess the necessary physics and mathematics background knowledge to be able to follow and master the complete textbook. Medical residents, technology students and biomedical engineering students may find certain sections too challenging or esoteric, yet they will find many sections interesting and useful in their studies. Candidates preparing for professional certification exams in any of the medical physics subspecialties should find the material useful, and some of the material would also help candidates preparing for certification examinations in medical dosimetry or radiation-related medical specialties. Numerous textbooks are available covering the various subspecialties of medical physics but they generally make a transition from the elementary basic physics directly into the intricacies of the given medical physics subspecialty. The intent of this textbook is to provide the missing link between the elementary physics on the one hand and the physics of the subspecialties on the other hand. (orig.)

  18. Consultation of medical narratives in the electronic medical record. (United States)

    Tange, H J


    This article presents an overview of a research project concerning the consultation of medical narratives in the electronic medical record (EMR). It describes an analysis of user needs, the design and implementation of a prototype EMR system, and the evaluation of the ease of consultation of medical narratives when using this system. In a questionnaire survey, 85 hospital physicians judged the quality of their paper-based medical record with respect to data entry, information retrieval and some other aspects. Participants were more positive about the paper medical record than the literature suggests. They wished to maintain the flexibility of data entry but indicated the need to improve the retrieval of information. A prototype EMR system was developed to facilitate the consultation of medical narratives. These parts were divided into labeled segments that could be arranged source-oriented and problem-oriented. This system was used to evaluate the ease of information retrieval of 24 internists and 12 residents at a teaching hospital when using free-text medical narratives divided at different levels of detail. They solved, without time pressure, some predefined problems concerning three voluminous, inpatient case records. The participants were randomly allocated to a sequence that was balanced by patient case and learning effect. The division of medical narratives affected speed, but not completeness of information retrieval. Progress notes divided into problem-related segments could be consulted 22% faster than when undivided. Medical history and physical examination divided into segments at organ-system level could be consulted 13% faster than when divided into separate questions and observations. These differences were statistically significant. The fastest divisions were also appreciated as the best combination of easy searching and best insight in the patient case. The results of our evaluation study suggest a trade-off between searching and reading: too much

  19. Medical waste: a minimal hazard. (United States)

    Keene, J H


    Medical waste is a subset of municipal waste, and regulated medical waste comprises less than 1% of the total municipal waste volume in the United States. As part of the overall waste stream, medical waste does contribute in a relative way to the aesthetic damage of the environment. Likewise, some small portion of the total release of hazardous chemicals and radioactive materials is derived from medical wastes. These comments can be made about any generated waste, regulated or unregulated. Healthcare professionals, including infection control personnel, microbiologists, public health officials, and others, have unsuccessfully argued that there is no evidence that past methods of treatment and disposal of regulated medical waste constitute any public health hazard. Historically, discovery of environmental contamination by toxic chemical disposal has followed assurances that the material was being disposed of in a safe manner. Therefore, a cynical public and its elected officials have demanded proof that the treatment and disposal of medical waste (i.e., infectious waste) do not constitute a public health hazard. Existent studies on municipal waste provide that proof. In order to argue that the results of these municipal waste studies are demonstrative of the minimal potential infectious environmental impact and lack of public health hazard associated with medical waste, we must accept the following: that the pathogens are the same whether they come from the hospital or the community, and that the municipal waste studied contained waste materials we now define as regulated medical waste.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Medical Models and Bayesian Networks

    DEFF Research Database (Denmark)

    Olesen, Kristian Grønborg


    Proc. of a Workshop Held during the Joint European Conf. on Artificial Intelligence in Medicine and Medical Decision Making : AIMDM'99, Aalborg, Denmark, June 1999......Proc. of a Workshop Held during the Joint European Conf. on Artificial Intelligence in Medicine and Medical Decision Making : AIMDM'99, Aalborg, Denmark, June 1999...