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Sample records for anti-tuberculosis medications rifampin

  1. Factors Associated with Anti-Tuberculosis Medication Adverse Effects: A Case-Control Study in Lima, Peru

    OpenAIRE

    Kocfa Chung-Delgado; Alejandro Revilla-Montag; Sonia Guillen-Bravo; Eduardo VelezSegovia; Andrea Soria-Montoya; Alexandra Nun˜ ez-Garbin; Wilmer Silva-Caso; Antonio Bernabe-Ortiz

    2011-01-01

    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 a...

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

    Science.gov (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

    2015-12-01

    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. PMID:26260983

  3. 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.;

    2001-01-01

    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...... OUTCOME MEASURES: Congenital abnormalities in newborn infants and fetuses diagnosed prenatally during the second and third trimesters, and postnatally from birth to the age of one year. RESULTS: Of 38,151 controls, 29 (0.08%) were exposed to anti-tuberculosis drug treatment during pregnancy; the...... 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...

  4. Drug-induced Hepatotoxicity of Anti-tuberculosis Drugs and Their Serum Levels

    OpenAIRE

    Jeong, Ina; Park, Jong-Sun; Cho, Young-Jae; Yoon, Ho Il; Song, Junghan; Lee, Choon-Taek; Lee, Jae-Ho

    2015-01-01

    The correlation between serum anti-tuberculosis (TB) drug levels and the drug-induced hepatotoxicity (DIH) remains unclear. The purpose of this study was to investigate whether anti-TB DIH is associated with basal serum drug levels. Serum peak levels of isoniazid (INH), rifampicin (RMP), pyrazinamide (PZA), and ethambutol (EMB) were analyzed in blood samples 2 hr after the administration of anti-TB medication. Anti-TB DIH and mild liver function test abnormality were diagnosed on the basis of...

  5. Fresh Air and Good Food: Children and the Anti-Tuberculosis Campaign in the Netherlands c.1900-1940

    Science.gov (United States)

    Bakker, Nelleke

    2010-01-01

    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 author…

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    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...... representative sample of 30 treatment units was randomly selected. All patient treatment cards enrolled in these units were obtained, and data were double-entered and validated before calculating the adequacy of the individual drug prescriptions. RESULTS: Of 3412 tuberculosis treatment cards, 3225 (94.5%) had...

  7. 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

    2016-06-01

    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

  8. The search for new sterilizing anti-tuberculosis drugs.

    Science.gov (United States)

    Mitchison, Denis A

    2004-05-01

    To be of use in the control of tuberculosis, any new drug must be capable of shortening the duration of treatment by accelerating sterilizing activity, that is the rate at which Mycobacterium tuberculosis is killed in the lesions. The most difficult to kill are the extra-cellular bacilli in cavities. Persistence during therapy arises because there is a proportion of slowly metabolising bacilli (persisters) in the cavitary bacterial population at the start of treatment. Bacterial growth is slowed by low oxygen tension, quorum sensing and old age, but probably not by cellular immunity, since there are few professional phagocytic cells in cavities. The degree of phenotypic resistance to the bactericidal action of drugs can go through several stages: (i) the non-replicating stages 1 and 2 of micro-aerophilic adaptation, described by Wayne; (ii) a "tolerant" population that survives exposure to high rifampicin concentrations and is capable of growth in liquid medium but not on solid medium; and (iii) a population found in the sterile state of Cornell model mice which cannot grow initially in either liquid or solid medium but will eventually cause re-activation of tuberculosis. In all of these stages the bacilli are phenotypically resistant; there is no selection for genomic drug resistance. Rifampicin and pyrazinamide are the two drugs largely responsible for sterilizing activity during current treatment. Pyrazinamide is unique amongst anti-tuberculosis drugs in having no genomic site of action and having greater bactericidal activity as bacillary metabolism slows down; it is remarkably effective in human disease. The development of a new drug with a similar mode of activity might be very fruitful, especially if there were no need for an acid environment. Current methods advocated for drug development pass through a number of complex stages: choice of a genomic target, development of an in vitro assay, high throughput screening and identification of lead compounds

  9. Duration of Anti-Tuberculosis Therapy and Timing of Antiretroviral Therapy Initiation: Association with Mortality in HIV-Related Tuberculosis

    Science.gov (United States)

    Cortes, Claudia P.; Wehbe, Firas H.; McGowan, Catherine C.; Shepherd, Bryan E.; Duda, Stephany N.; Jenkins, Cathy A.; Gonzalez, Elsa; Carriquiry, Gabriela; Schechter, Mauro; Padgett, Denis; Cesar, Carina; Madero, Juan Sierra; Pape, Jean W.; Masys, Daniel R.; Sterling, Timothy R.

    2013-01-01

    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/mm3, 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. PMID:24066096

  10. Influence of rifampin on fleroxacin pharmacokinetics.

    OpenAIRE

    Schrenzel, J.; Dayer, P; Leemann, T; Weidekamm, E; Portmann, R; Lew, D P

    1993-01-01

    Staphylococcus aureus infections have been successfully treated in animal models with the combination of fleroxacin and rifampin. We studied the influence of rifampin, a potent cytochrome P-450 inducer, on the pharmacokinetics and biotransformation of fleroxacin in 14 healthy young male volunteers. Subjects were given 400 mg of fleroxacin orally once a day for 3 days to reach steady state. After a wash-out period of 2 days, the same subjects received 600 mg of rifampin orally once daily for 7...

  11. THE QUESTIONS OF ALLERGY AND ANTI-TUBERCULOSIS IMMUNITY IN THE WORKS OF М.М. TSEHNOVITSER

    OpenAIRE

    Kuchma Y.U; Moiseenko T.M

    2014-01-01

    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 microb...

  12. 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

    2015-09-01

    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.

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

    Science.gov (United States)

    Bobadilla-del Valle, Miriam; Torres-González, Pedro; Cervera-Hernández, Miguel Enrique; Martínez-Gamboa, Areli; Crabtree-Ramirez, Brenda; Chávez-Mazari, Bárbara; Ortiz-Conchi, Narciso; Rodríguez-Cruz, Luis; Cervantes-Sánchez, Axel; Gudiño-Enríquez, Tomasa; Cinta-Severo, Carmen; Sifuentes-Osornio, José; Ponce de León, Alfredo

    2015-01-01

    Background 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. Methodology/Principal Findings 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 (X2trend, 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). Conclusions/Significance 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. PMID:26421930

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

    OpenAIRE

    Cobelens, F.G.J.; Joloba, M.L.; Lukoye, D

    2015-01-01

    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 meta-analysis of drug-resistant TB in sub-Saharan Africa. It provides a general introduction to anti-tuberculosis drug resistance in the world and associated risk factors. Results from the drug resist...

  15. Non-Adherence of New Pulmonary Tuberculosis Patients to Anti-Tuberculosis Treatment

    OpenAIRE

    Kulkarni, PY; Akarte, SV; Mankeshwar, RM; Bhawalkar, JS; A. Banerjee; Kulkarni, AD

    2013-01-01

    Background: Non-adherence to anti-tuberculosis (TB) treatment adversely affects treatment success rate. It increases disease morbidity and mortality. Also, it contributes significantly to the development of drug resistance. Aim: To identify risk factors for non-adherence to anti-TB treatment by new pulmonary TB patients. Subjects and Methods: It is a prospective cohort study at 21 TB treatment centres in E ward of Mumbai Municipal Corporation. All sputum smear positive new pulmonary TB patien...

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

    Directory of Open Access Journals (Sweden)

    Muthusamy Ravichandiran

    2013-11-01

    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.

  17. In vitro testing of daptomycin plus rifampin againstmethicillin-resistant Staphylococcus aureus resistant to rifampin

    International Nuclear Information System (INIS)

    Objective was to test for synergy between daptomycin (DAP) and rifampin(RIF) against RIF-resistant methicillin-resistant Staphylococcus aureus(MRSA) isolates. Synergy testing using time-kill assay (TKA) was performed on6 clinically and genetically unique RIF-resistant MRSA isolates. The isolateswere identified out of 489 (1.2%) samples collected during April 2003 toAugust 2006, from patients at the Ochsner Medical Center in New Orleans,Louisiana, United States of America. Synergy testing of DAP plus RIF by TKAshowed that 5 isolates were different, but one isolate was antagonistic. Ourin-vitro study failed to demonstrate synergy between DAP plus RIF, againstour RIF-resistant MRSA isolates. Clinical failure of this combination shouldprompt the clinician to consider antagonism as one of the potential causes.(author)

  18. Comparative cytotoxic and anti-tuberculosis activity of Aplysina caissara marine sponge crude extracts.

    Science.gov (United States)

    Azevedo, Luciana G; Muccillo-Baisch, Ana L; Filgueira, Daza de M V B; Boyle, Robert T; Ramos, Daniela F; Soares, Andrea D; Lerner, Clea; Silva, Pedro A; Trindade, Gilma S

    2008-01-01

    Three crude extracts of Aplysina caissara, a marine sponge endemic to Brazil, were tested against a hepatoma cell line and Mycobacterium tuberculosis. The results demonstrate that all extracts are toxic and capable of inhibiting cellular growth. Additionally, the extracts produced morphological aberrations and inhibited cell attachment to culture substrates. These effects were dose/time dependent. Our results also suggest that reactive oxygen species (ROS) production is not involved in the cytotoxic processes levied by the extracts employed in this study and that active metabolites are likely to be present in the polar fractions of the crude extracts. Finally, our results indicate that all three extracts exhibit a moderate anti-tuberculosis capacity, and that the removal of an extract's lipid fraction appears to diminish this activity. PMID:17826358

  19. Monitoring the ingestion of anti-tuberculosis drugs by simple non-invasive methods.

    Science.gov (United States)

    Sirgel, F A; Maritz, J S; Venter, A; Langdon, G; Smith, P J; Donald, P R

    2006-01-13

    This investigation retrospectively assessed inexpensive non-invasive qualitative methods to monitor the ingestion of anti-tuberculosis drugs isoniazid, rifampicin and rifapentine. Results showed that commercial test strips detected the isoniazid metabolites isonicotinic acid and isonicotinylglycine as efficiently as the isonicotinic acid method in 150 urine samples. The presence of rifamycins in urine samples (n=1085) was detected by microbiological assay techniques and the sensitivity compared to the n-butanol extraction colour test in 91 of these specimens. The proportions detected by the two methods were significantly different and the sensitivity of the n-butanol procedure was only 63.8% (95% CL 51.2-76.4%) as compared to that of the superior microbiological method. Final validation (n=691) showed that qualitative assays measure isoniazid and rifamycin ingestion with an efficiency similar to high-performance liquid chromatography. The qualitative procedures may therefore be valuable in clinical trials and in tuberculosis clinics to confirm drug ingestion. PMID:16303269

  20. Efficacy Of Anti-Tuberculosis Treatment Alone On Resolution Of Tuberculosis Pleural Effusions

    Directory of Open Access Journals (Sweden)

    V S Selvarajah

    2007-12-01

    Full Text Available To determine the degree of resolution in pleuraleffusions treated with anti-tuberculosis treatment alonewithout thoracentesis, 62 eligible adult cases [mean age(SD, 46 (17 yrs; 77% male] of tuberculosis pleuraleffusions treated in two urban-based university teachinghospitals were retrospectively reviewed for changes ineffusion size at 2, 6 and 12 months after initiation oftreatment. The proportions of patients in whomresolution were complete, partial and unchanged were64.5%, 27.4% and 8.1%. Effusions with size smallerthan three tenth of hemithorax were at three-foldincreased likelihood of complete resolution, comparedwith those with larger effusions [Odds ratio (95% CI:3.295 (1.033 to 10.514; p=0.04]. Consideration forthoracentesis is therefore still important in certainpatients.

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

    KAUST Repository

    Coll, Francesc

    2015-05-27

    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.

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

    Directory of Open Access Journals (Sweden)

    Binoo Divakaran

    2011-03-01

    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

  3. Penetration of Rifampin through Staphylococcus epidermidis Biofilms

    OpenAIRE

    Zheng, Zhilan; Philip S. Stewart

    2002-01-01

    Rifampin penetrated biofilms formed by Staphylococcus epidermidis but failed to effectively kill the bacteria. Penetration was demonstrated by a simple diffusion cell bioassay and by transmission electron microscopic observation of antibiotic-affected cells at the distal edge of the biofilm.

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

    OpenAIRE

    Padmapriyadarsini C; Chandrabose J; Victor L; Hanna L; Arunkumar N; Swaminathan Soumya

    2006-01-01

    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 R...

  5. Evaluation of anti-tuberculosis antibodies in healthy contact and non-contacts persons

    International Nuclear Information System (INIS)

    This study was conducted to see the presence of the antimycobacterial antibodies in healthy household contacts of tuberculosis patients and healthy normal subjects who have never been in contact with tuberculosis patients. A total of 200 subjects, 120 with history of household contact and 80 without such history were included in the study. Routine Haematological investigations were performed and all the sera of 200 subjects were tested who 19M, 19G and IgA anti tuberculosis antibodies using ELISA technique. There was no difference in the average age of the household contacts and non-contacts. The complaints of pyrexia, night sweats and loss of weight was more in house hold contacts as compared to non-contacts. The awareness about BCG vaccination was equal among the household contacts and non-contacts. The combined serological positivity of the household contacts was 65.8% and the combined serological positivity for non-contacts was 34.1%. There was no statistically significant difference in the presence of 19M among household contacts as compared to non-contacts. However both IgG and 19A were present in significantly higher number of household contacts as compared to non contacts. This study concludes that the persons living in the house with a patient suffering from active pulmonary tuberculosis (household contact) have more chances of being infected with Mycobacterium tuberculosis as compared to the healthy non-contacts. (author)

  6. 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

    2008-01-01

    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.

  7. 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.

  8. Difficulties in anticoagulation management during coadministration of warfarin and rifampin.

    Science.gov (United States)

    Lee, C R; Thrasher, K A

    2001-10-01

    The clinical significance of rifampin's induction of warfarin metabolism is well documented, but no published studies or case reports have quantified this interaction with respect to the international normalized ratio (INR). A patient receiving concomitant rifampin and warfarin to treat a mycobacterial infection and intraventricular thrombus, respectively, underwent routine INR testing at a pharmacist-managed anticoagulation clinic to assess his anticoagulation regimen. A 233% increase in warfarin dosage over 4 months proved insufficient to attain a therapeutic INR during long-term rifampin therapy More aggressive titration of the warfarin dosage was needed. In addition, a gradual 70% reduction in warfarin dosage over 4-5 weeks was necessary to maintain a therapeutic INR after rifampin discontinuation, demonstrating the clinically significant offset of this drug interaction. Extensive changes in warfarin dosage are required to attain and maintain a therapeutic INR during the initiation, maintenance, and discontinuation of rifampin. PMID:11601670

  9. Rifampin reduces oral morphine absorption: a case of transdermal buprenorphine selection based on morphine pharmacokinetics.

    Science.gov (United States)

    Fudin, Jeffrey; Fontenelle, Dania Vanesta; Payne, Annette

    2012-12-01

    A 51-year-old male was referred to the Stratton Veterans Affairs Medical Center Pain Service after hospital admission for endocarditis with a history of heroin use and chronic low back pain. During his hospital stay he experienced a reduction in his serum morphine level ostensibly as a result of concomitant rifampin administration. We hypothesize that diminished absorption was from rifampin-mediated intestinal P-glycoprotein induction, ultimately decreasing serum free morphine and metabolites. The case became more complex in an attempt to balance managed pain, history of substance abuse, completion of antibiotic therapy, and a reasonable pain regimen upon discharge. Ultimately, the patient was titrated onto a buprenorphine transdermal patch, the initiation of which was based on serum free morphine and an extrapolated oral morphine dose by calculation. PMID:23216174

  10. Impact of glutathione S-transferase M1 and T1 on anti-tuberculosis drug-induced hepatotoxicity in Chinese pediatric patients.

    Directory of Open Access Journals (Sweden)

    Fang Liu

    Full Text Available Anti-tuberculosis drug induced hepatotoxicity (ATDH is a major adverse drug reaction associated for anti-tuberculosis therapy. The glutathione S-transferases (GST plays a crucial role in the detoxification of hepatotoxic metabolites of anti-tuberculosis drugs.An association between GSTM1/GSTT1 null mutations and increased risk of ATDH has been demonstrated in adults. Given the ethnic differences and developmental changes, our study aims to investigate the potential impacts of GSTM1/GSTT1 genotypes on the development of ATDH in Han Chinese children treated with anti-tuberculosis therapy.Children receiving anti-tuberculosis therapy with or without evidence of ATDH were considered as the cases or controls, respectively. The GSTM1 and GSTT1 genotyping were performed using the polymerase chain reaction.One hundred sixty-three children (20 cases and 143 controls with a mean age of 4.7 years (range: 2 months-14.1 years were included. For the GSTM1, 14 (70.0% cases and 96 (67.1% controls had homozygous null mutations. For the GSTT1, 13 (65.0% cases and 97 (67.8% controls had homozygous null mutations. Neither the GSTM1, nor the GSTT1 polymorphism was significantly correlated with the occurrence of ATHD.Our results did not support the GSTM1 and GSTT1 polymorphisms as the predictors of ADTH in Chinese Han children treated with anti-tuberculosis drugs. An age-related association between pharmacogenetics and ATHD need to be confirmed in the further study.

  11. Global isoniazid resistance patterns in rifampin-resistant and rifampin-susceptible tuberculosis

    OpenAIRE

    Smith, Sarah E.; Kurbatova, Ekaterina V.; Cavanaugh, Joseph S.; Cegielski, J Peter

    2012-01-01

    Following WHO’s endorsement of the Xpert® MTB/RIF assay, which rapidly and simultaneously diagnoses tuberculosis (TB) and detects resistance to rifampin (RIF), the question arises to what extent RIF resistance is an adequate marker for multidrug-resistant (MDR) TB. A retrospective analysis of data from >81 countries and subnational settings demonstrated that >40% of RIF resistant isolates from new TB cases did not display resistance to isoniazid (INH) in settings with relatively low MDR-TB pr...

  12. Global Chemical Composition and Antioxidant and Anti-Tuberculosis Activities of Various Extracts of Globularia alypum L. (Globulariaceae Leaves

    Directory of Open Access Journals (Sweden)

    François Couderc

    2011-12-01

    Full Text Available In this work, an evaluation of the biological activities of Globularia alypum L. extracts and their global chemical composition was realized. Extracts from G. alypum were obtained by two extraction methods. The composition of polyphenols (8.5–139.95 g gallic acid equivalent/Kg of dry mass, tannins (1.39–18.65 g catechin equivalent/Kg of dry mass, anthocyanins (8.17–70.69 mg cyanidin equivalent/Kg of dry mass and flavonoids (0.31–19.28 g quercetin equivalent/Kg of dry mass was evaluated. The samples were subjected to a screening for their antioxidant activities using the DPPH· and ABTS·+ assays. For the first time, the anti-tuberculosis activity (H37Rv for G. alypum was tested against Mycobacterium tuberculosis. The strongest antioxidant activity was obtained for the methanol extract (IC50 = 15.58 ± 0.168 mg/L and the best anti-tuberculosis activity was obtained for the petroleum ether extract (IC50 = 77 mg/L. We have found a positive correlation between the total phenolics content and the antioxidant activity R2 = 0.88 (DPPH· and R2 = 0.97 (ABTS·+. We have found also a positive correlation between the flavonoid content and the antioxidant activity R2 = 0.91 (DPPH· and R2 = 0.91 (ABTS·+.

  13. Efficacy of Microencapsulated Rifampin in Mycobacterium tuberculosis-Infected Mice

    OpenAIRE

    Quenelle, Debra C.; Staas, Jay K.; Winchester, Gary A.; Barrow, Esther L. W.; Barrow, William W.

    1999-01-01

    Rifampin is a first-line drug useful in the treatment of tuberculosis. By using biocompatible polymeric excipients of lactide and glycolide copolymers, two microsphere formulations were developed for targeted and sustained delivery of rifampin, with minimal dosing. A small-microsphere formulation, with demonstrated ability to inhibit intracellularly replicating Mycobacterium tuberculosis H37Rv, was tested along with a large-microsphere formulation in an infected mouse model. Results revealed ...

  14. Bioautography with TLC-MS/NMR for Rapid Discovery of Anti-tuberculosis Lead Compounds from Natural Sources

    Science.gov (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.

    2016-01-01

    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 mc27000 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.

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

    KAUST Repository

    Phelan, Jody

    2016-03-23

    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

  16. Host Immune Responses Differ between M. africanum- and M. tuberculosis-Infected Patients following Standard Anti-tuberculosis Treatment.

    Directory of Open Access Journals (Sweden)

    Leopold D Tientcheu

    2016-05-01

    Full Text Available Epidemiological differences exist between Mycobacterium africanum (Maf- and Mycobacterium tuberculosis (Mtb-infected patients, but to date, contributing host factors have not been characterised. We analysed clinical outcomes, as well as soluble markers and gene expression profiles in unstimulated, and ESAT6/CFP-10-, whole-Maf- and Mtb-stimulated blood samples of 26 Maf- and 49 Mtb-HIV-negative tuberculosis patients before, and after 2 and 6 months of anti-tuberculosis therapy. Before treatment, both groups had similar clinical parameters, but differed in few cytokines concentration and gene expression profiles. Following treatment the body mass index, skinfold thickness and chest X-ray scores showed greater improvement in the Mtb- compared to Maf-infected patients, after adjusting for age, sex and ethnicity (p = 0.02; 0.04 and 0.007, respectively. In addition, in unstimulated blood, IL-12p70, IL12A and TLR9 were significantly higher in Maf-infected patients, while IL-15, IL-8 and MIP-1α were higher in Mtb-infected patients. Overnight stimulation with ESAT-6/CFP-10 induced significantly higher levels of IFN-γ and TNF-α production, as well as gene expression of CCL4, IL1B and TLR4 in Mtb- compared to Maf-infected patients. Our study confirms differences in clinical features and immune genes expression and concentration of proteins associated with inflammatory processes between Mtb- and Maf-infected patients following anti-tuberculosis treatment These findings have public health implications for treatment regimens, and biomarkers for tuberculosis diagnosis and susceptibility.

  17. Possible implications of doxycycline-rifampin interaction for treatment of brucellosis.

    OpenAIRE

    Colmenero, J D; Fernández-Gallardo, L C; Agúndez, J. A.; Sedeño, J; Benítez, J; Valverde, E

    1994-01-01

    We studied the possible interaction between rifampin and doxycycline in 20 patients with brucellosis treated randomly with either doxycycline and streptomycin or doxycycline and rifampin. The doxycycline levels in the plasma of patients in the group treated with rifampin were significantly lower than those in the plasma of patients treated with doxycycline and streptomycin. Furthermore, clearance in patients treated with rifampin was significantly higher than that in patients treated with dox...

  18. A new method for identifying causal genes of schizophrenia and anti-tuberculosis drug-induced hepatotoxicity.

    Science.gov (United States)

    Huang, Tao; Liu, Cheng-Lin; Li, Lin-Lin; Cai, Mei-Hong; Chen, Wen-Zhong; Xu, Yi-Feng; O'Reilly, Paul F; Cai, Lei; He, Lin

    2016-01-01

    Schizophrenia (SCZ) may cause tuberculosis, the treatments for which can induce anti-tuberculosis drug-induced hepatotoxicity (ATDH) and SCZ-like disorders. To date, the causal genes of both SCZ and ATDH are unknown. To identify them, we proposed a new network-based method by integrating network random walk with restart algorithm, gene set enrichment analysis, and hypergeometric test; using this method, we identified 500 common causal genes. For gene validation, we created a regularly updated online database ATDH-SCZgenes and conducted a systematic meta-analysis of the association of each gene with either disease. Till now, only GSTM1 and GSTT1 have been well studied with respect to both diseases; and a total of 23 high-quality association studies were collected for the current meta-analysis validation. Finally, the GSTM1 present genotype was confirmed to be significantly associated with both ATDH [Odds Ratio (OR): 0.71, 95% confidence interval (CI): 0.56-0.90, P = 0.005] and SCZ (OR: 0.78, 95% CI: 0.66-0.92, P = 0.004) according to the random-effect model. Furthermore, these significant results were supported by "moderate" evidence according to the Venice criteria. Our findings indicate that GSTM1 may be a causal gene of both ATDH and SCZ, although further validation pertaining to other genes, such as CYP2E1 or DRD2, is necessary. PMID:27580934

  19. Improvement of the productivity of ecumicin, a novel anti-tuberculosis agent, from new Nonomuraea sp. MJM5123.

    Science.gov (United States)

    Jin, Ying-Yu; Kim, Jin-Yong; Yang, Seung Hwan; Lee, Hanki; Suh, Joo-Won

    2016-05-01

    Ecumicin is a novel anti-tuberculosis agent produced by Nonomuraea sp. MJM5123 as a new strain of actinomycetes. First, in order to increase the cell mass of Nonomuraea sp. MJM5123, we optimized the culture conditions with regard to carbon and nitrogen sources. The cell mass of Nonomuraea sp. MJM5123 increased by approximately twofold when glucose and soybean flour were used as carbon and nitrogen sources, respectively. For maximum production of ecumicin, we optimized the culture conditions by adding amino acids as building blocks for ecumicin, by adding vegetable oils and by controlling the temperature and pH. Ecumicin production was two times higher with the addition of valine as the building blocks for ecumicin compared with the production in the absence of valine. Interestingly, with the addition of 1% corn oil, the production of ecumicin increased by 4.6-fold compared with the production in the absence of corn oil. Finally, by controlling the pH and temperature, we established an optimized culture condition in which Nonomuraea sp. MJM5123 produced 576 mg ecumicin per litre of medium, which is about 50 times higher than in the control medium at 30 °C and pH 7.0. PMID:26648116

  20. Sensitivity Pattern of Second Line Anti-Tuberculosis Drugs against Clinical Isolates of Multidrug Resistant Mycobacterium Tuberculosis

    International Nuclear Information System (INIS)

    Objective:To determine the current sensitivity pattern of second line anti-tuberculosis drugs against clinical isolates of Multidrug Resistant Mycobacterium tuberculosis (MDR-TB). Study Design: A cross-sectional study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from November 2011 to April 2013. Methodology: Samples received during the study period were processed on BACTEC MGIT 960 system for Mycobacterium tuberculosis (MTB) culture followed by first line drugs susceptibility testing of culture proven MTB isolates. On the basis of resistance to rifampicin and isoniazid, 100 clinical isolates of MDR-TB were further subjected to susceptibility testing against amikacin (AMK), capreomycin (CAP), ofloxacin (OFL) and ethionamide (ETH) as per standard BACTEC MGIT 960 instructions. Results: Out of 100 MDR-TB isolates, 62% were from male patients and 38% from female patients. 97% were sensitive to AMK, 53% to OFL, 87% to CAP; and 87% were sensitive to ETH. Conclusion: The majority of the MDR-TB isolates showed excellent sensitivity against AMK, CAP and ETH. However, sensitivity of MDR-TB isolates against fluoroquinolones like OFL was not encouraging. (author)

  1. 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

    2006-01-01

    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

  2. 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

    2011-01-01

    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.

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

    OpenAIRE

    Nglazi Mweete D; Bekker Linda-Gail; Wood Robin; Hussey Gregory D; Wiysonge Charles S

    2013-01-01

    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 mes...

  4. Study of the Rifampin Monoresistance Mechanism in Mycobacterium tuberculosis

    OpenAIRE

    Pang, Yu; Lu, Jie; Wang, Yufeng; Song, Yuanyuan; Wang, Shengfen; Zhao, Yanlin

    2013-01-01

    Rifampin (RIF) susceptibility is a key factor in determining the treatment effectiveness of the standardized treatment regimens. In Mycobacterium tuberculosis, both target gene mutation and the efflux pump play major roles in the resistance to antituberculosis drugs. By eliminating RIF-resistant strains with rpoB mutation, the choice of RIF-monoresistant strains may allow us to identify the RIF-specific efflux pump genes. This study explored the RIF monoresistance mechanism in M. tuberculosis...

  5. Effects of Rifampin and Multidrug Resistance Gene Polymorphism on Concentrations of Moxifloxacin▿

    OpenAIRE

    Weiner, Marc; Burman, William; Luo, Chi-Cheng; Peloquin, Charles A.; Engle, Melissa; Goldberg, Stefan; Agarwal, Vipin; Vernon, Andrew

    2007-01-01

    Treatment regimens combining moxifloxacin and rifampin for drug-susceptible tuberculosis are being studied intensively. However, rifampin induces enzymes that transport and metabolize moxifloxacin. We evaluated the effect of rifampin and the human multidrug resistance gene (MDR1) C3435T polymorphisms (P-glycoprotein) on moxifloxacin pharmacokinetic parameters. This was a single-center, sequential design study with 16 volunteers in which sampling was performed after four daily oral doses of mo...

  6. Therapy of experimental murine brucellosis with streptomycin, co-trimoxazole, ciprofloxacin, ofloxacin, pefloxacin, doxycycline, and rifampin.

    OpenAIRE

    Shasha, B; Lang, R.; Rubinstein, E

    1992-01-01

    Mice infected with Brucella melitensis were treated with streptomycin, co-trimoxazole, ciprofloxacin, doxycycline, and rifampin intraperitoneally and with ciprofloxacin, ofloxacin, pefloxacin, doxycycline, and rifampin orally for 14 to 21 days. Doxycycline- and rifampin-treated animals (either route) demonstrated a cure rate significantly better than that of controls. Longer therapy periods were associated with a significantly better outcome. Therapy failure was observed in all mice treated w...

  7. Rifampin-associated tubulointersititial nephritis and Fanconi syndrome presenting as hypokalemic paralysis

    OpenAIRE

    2013-01-01

    Background Rifampin is one of the most important drugs in first-line therapies for tuberculosis. The renal toxicity of rifampin has been reported sporadically and acute tubulointerstitial nephritis (ATIN) is a frequent histological finding. We describe for the first time a case of ATIN and Fanconi syndrome presenting as hypokalemic paralysis, associated with the use of rifampin. Case presentation A 42-year-old man was admitted with sudden-onset lower extremity paralysis and mild renal insuffi...

  8. Enhanced elimination of ciprofloxacin after multiple-dose administration of rifampin to rabbits.

    OpenAIRE

    Barriere, S L; Kaatz, G W; Seo, S M

    1989-01-01

    The combination of ciprofloxacin and rifampin is potentially useful for the treatment of selected infections. However, rifampin may induce the metabolism of ciprofloxacin. Ciprofloxacin was given in single doses to healthy rabbits before and after six daily doses of intramuscular rifampin. Total clearance of ciprofloxacin increased from 0.96 +/- 0.32 (standard deviation) to 1.57 +/- 0.63 liters/h per kg (P less than 0.05). This change in elimination is potentially significant for the outcome ...

  9. Anti-Tuberculosis Drug Induced Hepatotoxicity among TB/HIV Co-Infected Patients at Jimma University Hospital, Ethiopia: Nested Case-Control Study

    OpenAIRE

    Alima Hassen Ali; Tefera Belachew; Alemeshet Yami; Wubeante Yenet Ayen

    2013-01-01

    BACKGROUND: This study was carried out to determine the incidence and predictors of anti-tuberculosis drug induced hepatotoxicity among TB/HIV co-infected patients at Jimma University Hospital, Ethiopia. METHODS/PRINCIPAL FINDINGS: A nested case-control study was conducted by reviewing charts of all TB/HIV co-infected patients who commenced anti-TB treatment from January 2008 to December 2011 at Jimma University Hospital. Patients who had developed hepatotoxicity after at least 5 days of stan...

  10. Role of polymorphic bile salt export pump (BSEP, ABCB11) transporters in anti-tuberculosis drug-induced liver injury in a Chinese cohort

    OpenAIRE

    Ru Chen; Jing Wang; Shaowen Tang; Yuan Zhang; Xiaozhen Lv; Shanshan Wu; Zhirong Yang; Yinyin Xia; Dafang Chen; Siyan Zhan

    2016-01-01

    Evidence indicates that the polymorphisms in bile salt export pump (BSEP, encoded by ABCB11) may play an important role in the development of anti-tuberculosis drug-induced liver injury (ATDILI) and we aim to investigate the association between genetic variants of ABCB11 and the risk of ATDILI in a Chinese cohort. A total of 89 tuberculosis patients with ATDILI and 356 matched ATDILI -free patients constituted cases and controls. Genetic polymorphisms of ABCB11 were determined by TaqMan singl...

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

    Directory of Open Access Journals (Sweden)

    Nglazi Mweete D

    2013-01-01

    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

  12. Improved consistency in dosing anti-tuberculosis drugs in Taipei, Taiwan.

    Directory of Open Access Journals (Sweden)

    Chen-Yuan Chiang

    Full Text Available BACKGROUND: It was reported that 35.5% of tuberculosis (TB cases reported in 2003 in Taipei City had no recorded pre-treatment body weight and that among those who had, inconsistent dosing of anti-TB drugs was frequent. Taiwan Centers for Disease Control (CDC have taken actions to strengthen dosing of anti-TB drugs among general practitioners. Prescribing practices of anti-TB drugs in Taipei City in 2007-2010 were investigated to assess whether interventions on dosing were effective. METHODOLOGY/PRINCIPAL FINDINGS: Lists of all notified culture positive TB cases in 2007-2010 were obtained from National TB Registry at Taiwan CDC. A medical audit of TB case management files was performed to collect pretreatment body weight and regimens prescribed at commencement of treatment. Dosages prescribed were compared with dosages recommended. The proportion of patients with recorded pre-treatment body weight was 64.5% in 2003, which increased to 96.5% in 2007-2010 (p<0.001. The proportion of patients treated with consistent dosing of a 3-drug fixed-dose combination (FDC increased from 73.9% in 2003 to 87.7% in 2007-2010 (p<0.001, and that for 2-drug FDC from 76.0% to 86.1% (p = 0.024, for rifampicin (RMP from 62.8% to 85.5% (p<0.001, and for isoniazid from 87.8% to 95.3% (p<0.001. In 2007-2010, among 2917 patients treated with either FDCs or RMP in single-drug preparation, the dosage of RMP was adequate (8-12 mg/kg in 2571(88.1% patients, too high in 282(9.7%, too low in 64(2.2%. In multinomial logistic regression models, factors significantly associated with adequate dosage of RMP were body weight and preparations of RMP. Patients weighting <40 kg (relative risk ratio (rrr 6010.5, 95% CI 781.1-46249.7 and patients weighting 40-49 kg (rrr 1495.3, 95% CI 200.6-11144.6 were more likely to receive higher-than-recommended dose of RMP. CONCLUSIONS/SIGNIFICANCE: Prescribing practice in the treatment of TB in Taipei City has remarkably improved after health

  13. Role of polymorphic bile salt export pump (BSEP, ABCB11) transporters in anti-tuberculosis drug-induced liver injury in a Chinese cohort.

    Science.gov (United States)

    Chen, Ru; Wang, Jing; Tang, Shaowen; Zhang, Yuan; Lv, Xiaozhen; Wu, Shanshan; Yang, Zhirong; Xia, Yinyin; Chen, Dafang; Zhan, Siyan

    2016-01-01

    Evidence indicates that the polymorphisms in bile salt export pump (BSEP, encoded by ABCB11) may play an important role in the development of anti-tuberculosis drug-induced liver injury (ATDILI) and we aim to investigate the association between genetic variants of ABCB11 and the risk of ATDILI in a Chinese cohort. A total of 89 tuberculosis patients with ATDILI and 356 matched ATDILI -free patients constituted cases and controls. Genetic polymorphisms of ABCB11 were determined by TaqMan single-nucleotide polymorphism (SNP) genotyping assay. Odds ratio (OR) with 95% confidence intervals (CIs) was estimated by conditional logistic regression model. There were no significant differences in genotype frequencies of ABCB11 between cases and controls. In the subgroup analysis, polymorphisms of rs2287616 were found to be associated with cholestatic/mixed pattern of liver injury under dominant and addictive model (OR = 3.84, 95% CI:1.16-12.75, P = 0.028 and OR = 2.51, 95% CI:1.12-5.62, P = 0.025, respectively), however the significance disappeared after Bonferroni correction. This study suggested that genetic variants of ABCB11 gene might contribute to anti-tuberculosis drug-induced cholestatic liver injury in Chinese patients. Studies in larger, varied populations are required to confirm these findings. PMID:27293027

  14. Anti-tuberculosis Drugs with Novel Mechanism of Action%具有新型作用机制的抗结核药物

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Tuberculosis is one of major health problems worldwide. Approximately 1.8 mil ion people died from Tuberculosis each year which has become a global public health issue. Recently the emergence of drug resistant strains and HIV co-infection has resulted in a high incidence. As a result, there is an urgent need for us to understand the resistance mechanism and discover new anti-tuberculosis drugs. A number of new potential anti-tuberculosis drug candidates with novel modes of action have entered clinical trials in recent years. These agents are most likely to be effective against resistant strains. The paper summarized structure-activity relationships, in vitro and in vivo activity, pharmacokinetics, mechanism of action and combination regimens about several novel anti-tuberculosis drugs.%  结核病(Tuberculosis)是世界范围里的主要疾病之一,近年来,每年约有180万人死于结核病,结核病已经成为全球性的公众健康问题。近年来药物耐受以及伴有 HIV 感染的结核病发病率急剧增加,迫切需要深入了解目前抗结核药物的作用机制及耐药机制,以指导开发对持留菌和耐药菌更加有效的新型药物。近年来,一批具有全新作用机制的抗结核候选药物相继进入了临床研究,并且这些药物对耐药株表现出有效的抑制活性。文章对几类新型抗结核药物的化学结构、作用机制、构效关系、抗结核活性以及临床应用进行了综述。

  15. Reagent Precoated Targets for Rapid In-Tissue Derivatization of the Anti-Tuberculosis Drug Isoniazid Followed by MALDI Imaging Mass Spectrometry

    Science.gov (United States)

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

    2011-08-01

    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.

  16. Rifampin-associated tubulointersititial nephritis and Fanconi syndrome presenting as hypokalemic paralysis

    Directory of Open Access Journals (Sweden)

    Min Hong Ki

    2013-01-01

    Full Text Available Abstract Background Rifampin is one of the most important drugs in first-line therapies for tuberculosis. The renal toxicity of rifampin has been reported sporadically and acute tubulointerstitial nephritis (ATIN is a frequent histological finding. We describe for the first time a case of ATIN and Fanconi syndrome presenting as hypokalemic paralysis, associated with the use of rifampin. Case presentation A 42-year-old man was admitted with sudden-onset lower extremity paralysis and mild renal insufficiency. He had been treated for pulmonary tuberculosis with isoniazid, rifampin, and ethambutol for 2 months. Laboratory tests revealed proteinuria, profound hypokalemia, hyperchloremic metabolic acidosis with a normal anion gap, positive urine anion gap, hypophosphatemia with hyperphosphaturia, hypouricemia with hyperuricosuria, glycosuria with normal serum glucose level, generalized aminoaciduria, and β2-microglobulinuria. A kidney biopsy revealed findings typical of ATIN and focal granular deposits of immunoglubulin A and complement 3 in the glomeruli and tubules. Electron microscopy showed epithelial foot process effacement and electron-dense deposits in the subendothelial and mesangial spaces. Cessation of rifampin resolved the patient’s clinical presentation of Fanconi syndrome, and improved his renal function and proteinuria. Conclusion This case demonstrates that rifampin therapy can be associated with Fanconi syndrome presenting as hypokalemic paralysis, which is a manifestation of ATIN. Kidney function and the markers of proximal tubular injury should be carefully monitored in patients receiving rifampin.

  17. Activity of glycopeptides in combination with amikacin or rifampin against Staphylococcus epidermidis biofilms on plastic catheters.

    Science.gov (United States)

    Pascual, A; Ramirez de Arellano, E; Perea, E J

    1994-06-01

    The in vitro activity of vancomycin and teicoplanin (fourfold the MBC), alone and in combination with amikacin (16 mg/l) or rifampin (1 mg/l), against Staphylococcus epidermidis (slime-producing and non slime-producing strains) biofilms on different plastic catheters was evaluated. The addition of amikacin or rifampin significantly increased the activity of glycopeptides against sessile bacteria. With the slime-producing strain, these combinations were able to sterilize the surface of Vialon and polyvinylchloride catheters. It is concluded that the in vitro activity of glycopeptides against Staphylococcus epidermidis biofilms on plastic catheters can be increased by the addition of amikacin or rifampin. PMID:7957277

  18. Ciprofloxacin and rifampin, alone and in combination, for therapy of experimental Staphylococcus aureus endocarditis.

    OpenAIRE

    Kaatz, G W; Seo, S M; Barriere, S L; Albrecht, L M; Rybak, M J

    1989-01-01

    The therapeutic activities of ciprofloxacin (25 mg/kg every 8 h), rifampin (10 mg/kg every 24 h), ciprofloxacin plus rifampin, and vancomycin (17.5 mg/kg every 6 h) were compared by using the rabbit model of Staphylococcus aureus endocarditis. Animals infected with one of two test strains (SA1199 or SA487) were randomized into treatment groups and received 6 days of therapy. For SA1199, ciprofloxacin plus rifampin was most effective at reducing vegetation bacterial counts. For SA487, ciproflo...

  19. Rifampin phosphotransferase is an unusual antibiotic resistance kinase.

    Science.gov (United States)

    Stogios, Peter J; Cox, Georgina; Spanogiannopoulos, Peter; Pillon, Monica C; Waglechner, Nicholas; Skarina, Tatiana; Koteva, Kalinka; Guarné, Alba; Savchenko, Alexei; Wright, Gerard D

    2016-01-01

    Rifampin (RIF) phosphotransferase (RPH) confers antibiotic resistance by conversion of RIF and ATP, to inactive phospho-RIF, AMP and Pi. Here we present the crystal structure of RPH from Listeria monocytogenes (RPH-Lm), which reveals that the enzyme is comprised of three domains: two substrate-binding domains (ATP-grasp and RIF-binding domains); and a smaller phosphate-carrying His swivel domain. Using solution small-angle X-ray scattering and mutagenesis, we reveal a mechanism where the swivel domain transits between the spatially distinct substrate-binding sites during catalysis. RPHs are previously uncharacterized dikinases that are widespread in environmental and pathogenic bacteria. These enzymes are members of a large unexplored group of bacterial enzymes with substrate affinities that have yet to be fully explored. Such an enzymatically complex mechanism of antibiotic resistance augments the spectrum of strategies used by bacteria to evade antimicrobial compounds. PMID:27103605

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

    Institute of Scientific and Technical Information of China (English)

    王峰

    2013-01-01

    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

  1. Rapid detection of rifampin resistance in Mycobacterium tuberculosis isolates from India and Mexico by a molecular beacon assay.

    Science.gov (United States)

    Varma-Basil, Mandira; El-Hajj, Hiyam; Colangeli, Roberto; Hazbón, Manzour Hernando; Kumar, Sujeet; Bose, Mridula; Bobadilla-del-Valle, Miriam; García, Lourdes García; Hernández, Araceli; Kramer, Fred Russell; Osornio, Jose Sifuentes; Ponce-de-León, Alfredo; Alland, David

    2004-12-01

    We assessed the performance of a rapid, single-well, real-time PCR assay for the detection of rifampin-resistant Mycobacterium tuberculosis by using clinical isolates from north India and Mexico, regions with a high incidence of tuberculosis. The assay uses five differently colored molecular beacons to determine if a short region of the M. tuberculosis rpoB gene contains mutations that predict rifampin resistance in most isolates. Until now, the assay had not been sufficiently tested on samples from countries with a high incidence of tuberculosis. In the present study, the assay detected mutations in 16 out of 16 rifampin-resistant isolates from north India (100%) and in 55 of 64 rifampin-resistant isolates from Mexico (86%) compared to results with standard susceptibility testing. The assay did not detect mutations (a finding predictive of rifampin susceptibility) in 37 out of 37 rifampin-susceptible isolates from India (100%) and 125 out of 126 rifampin-susceptible isolates from Mexico (99%). DNA sequencing revealed that none of the nine rifampin-resistant isolates from Mexico, which were misidentified as rifampin susceptible by the molecular beacon assay, contained a mutation in the region targeted by the molecular beacons. The one rifampin-susceptible isolate from Mexico that appeared to be rifampin resistant by the molecular beacon assay contained an S531W mutation, which is usually associated with rifampin resistance. Of the rifampin-resistant isolates that were correctly identified in the molecular beacon assay, one contained a novel L530A mutation and another contained a novel deletion between codons 511 and 514. Overall, the molecular beacon assay appears to have sufficient sensitivity (89%) and specificity (99%) for use in countries with a high prevalence of tuberculosis. PMID:15583274

  2. Tuftsin-bearing liposomes as rifampin vehicles in treatment of tuberculosis in mice.

    OpenAIRE

    Agarwal, A.; Kandpal, H; Gupta, H. P.; N. B. Singh; Gupta, C M

    1994-01-01

    The antitubercular activity of rifampin was considerably increased when it was encapsulated in egg phosphatidylcholine liposomes. A further increase in the activity was observed when the macrophage activator tetrapeptide tuftsin was grafted on the surface of the drug-loaded liposomes. Intermittent treatments (twice weekly) with these preparations were significantly more effective than the continuous treatments. Rifampin delivered twice weekly for 2 weeks in tuftsin-bearing liposomes was at le...

  3. Multiple-dose pharmacokinetics of concurrent oral ciprofloxacin and rifampin therapy in elderly patients.

    OpenAIRE

    Chandler, M H; Toler, S M; Rapp, R P; Muder, R R; Korvick, J A

    1990-01-01

    The purpose of this clinical study was to investigate the influence of concomitant drug therapy with ciprofloxacin and rifampin on the individual pharmacokinetic profile of each agent in elderly patients. Twelve nursing home patients (age, 74 +/- 7 years), colonized with methicillin-resistant Staphylococcus aureus, were randomized to receive 14-day therapy with oral ciprofloxacin (750 mg every 12 h) (group A; n = 6) or ciprofloxacin (750 mg every 12 h) and oral rifampin (300 mg every 12 h) (g...

  4. Rifampin pharmacokinetics in children, with and without human immunodeficiency virus infection, hospitalized for the management of severe forms of tuberculosis

    OpenAIRE

    McIlleron Helen; Hussey Gregory D; Maritz Johannes; Labadarios Demetre; Cilliers Karien; Willemse Marianne; Schaaf Hendrik; Smith Peter; Donald Peter

    2009-01-01

    Abstract Background Rifampin is a key drug in antituberculosis chemotherapy because it rapidly kills the majority of bacilli in tuberculosis lesions, prevents relapse and thus enables 6-month short-course chemotherapy. Little is known about the pharmacokinetics of rifampin in children. The objective of this study was to evaluate the pharmacokinetics of rifampin in children with tuberculosis, both human immunodeficiency virus type-1-infected and human immunodeficiency virus-uninfected. Methods...

  5. 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

    2016-06-01

    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.

  6. Analysis of IL-6, STAT3 and HSPA1L gene polymorphisms in anti-tuberculosis drug-induced hepatitis in a nested case-control study.

    Directory of Open Access Journals (Sweden)

    Jing Wang

    Full Text Available To investigate the association of IL-6, STAT3 and HSPA1L polymorphisms with the risk of anti-tuberculosis drug-induced hepatitis (ATDH in Chinese Han population.The study was designed as a nested case-control study within a prospective cohort. Each case was matched with four controls by sex, age at baseline (±5 years, treatment history, disease severity, drug dosage and place of sample collection. Genetic polymorphisms of IL-6, STAT3 and HSPA1L were determined blindly by TaqMan single-nucleotide polymorphism (SNP genotyping assay. Odds ratio (OR with 95% confidence intervals (CIs was estimated by conditional logistic regression model to measure the association between selected SNPs and the risk of ATDH.A total of 89 incident ATDH cases and 356 ATDH-free controls were genotyped for IL-6 (rs2066992, rs2069837, rs1524107, STAT3 (rs1053004, rs1053023, rs1053005 and HSPA1L (rs2227956. In genotype analysis, no significant difference was observed in genotypes frequencies of the seven selected SNPs between case and control group after Bonferroni correction. In haplotype analysis, carriers with STAT3 GAT and AGC (rs1053023-rs1053005-rs1053004 haplotypes had a significantly higher risk of ATDH compared with wild-type haplotype (P<0.0001.This study suggested that genetic variants of STAT3 might contribute to ATDH susceptibility in Chinese Han population. Studies in larger, varied populations are required to confirm these findings.

  7. Expression of Mycobacterium tuberculosis NLPC/p60 family protein Rv0024 induce biofilm formation and resistance against cell wall acting anti-tuberculosis drugs in Mycobacterium smegmatis.

    Science.gov (United States)

    Padhi, Avinash; Naik, Sumanta Kumar; Sengupta, Srabasti; Ganguli, Geetanjali; Sonawane, Avinash

    2016-04-01

    Bacterial species are capable of living as biofilm and/or planktonic forms. Role of biofilms in the pathogenesis of several human pathogens is well established. However, in case of Mycobacterium tuberculosis (Mtb) infection the role of biofilms and the genetic requirements for biofilm formation remains largely unknown. We herein report that ectopic expression of Mtb Rv0024, encoding a putative peptidoglycan amidase, in non-pathogenic Mycobacterium smegmatis(Msm) strain (MsmRv0024) confer at least 10-fold increase in resistance against two prominent anti-tuberculosis drugs isoniazid and pyrazinamide. We further report that the development of resistance was due to significant increase in biofilm formation by Rv0024. Transmission electron microscopy revealed differences in cell surface architecture of MsmRv0024 when compared with Msm wild-type (WT) and vector control Msm pSMT3 (pSMT3) strains and this aggregation pattern was due to increased cell wall hydrophobicity, as determined by Bacterial adhesion to hydrocarbons assay (BATH). Confocal microscopy study showed increased adherence of MsmRv0024 bacteria to lung epithelial cells as compared to pSMT3 strain. However, infection studies showed no differences in host cell invasion and intracellular survival in mouse macrophages. We envision that Rv0024 may play a critical role in initial infection process, adherence to host cells and drug resistance. Thus, Rv0024 may be considered as a potential drug target for the treatment of tuberculosis. PMID:26706821

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

    Science.gov (United States)

    Couto, Rosa A S; Quinaz, Maria Beatriz

    2016-01-01

    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. PMID:27376291

  9. Genotyping of rifampin-resistant Mycobacterium tuberculosis isolates from Western Turkey

    International Nuclear Information System (INIS)

    Although the rate of multiple drug resistance is high there is no published data on the transmission rate of drug-resistant strains of Mycobacterium tuberculosis in the Aegean region of Western Turkey that are based on molecular methods. IS6110 and pTBN12 restriction fragment lengthpolymorphism (RFLP) methods were used for typing Mycobacterium tuberculosis isolated from 26 sputum samples from 26 patients. 19 of rifampin-resistant isolates (73.1%) contained 6 to 11 copies of 156110. Eighteen different IS6110 DNA fingerprint patterns were observed in the 26 rifampin resistant isolates. 23 of the 26 rifampin-resistant isolates were also resistant to isoniazid. When evaluated together, both methods yielded 21 (80.9%) different banding patterns and the level of clustering was 34.6%. The average number per pattern was 1.23 (26/21). IS6110 fingerprinting suggests that the rifampin-resistant isolates obtained from the Aegean region had a relatively high clustering rate and were clonally related. These findings showed that the rifampin-resistant isolates are actively transmitted between patients. Urgent measures should be taken to prevent the spread of these resistant strains. (author)

  10. Effect of Rifampin on the Disposition of Brivaracetam in Human Subjects: Further Insights into Brivaracetam Hydrolysis.

    Science.gov (United States)

    Stockis, Armel; Watanabe, Shikiko; Scheen, André J; Tytgat, Dominique; Gerin, Brigitte; Rosa, Maria; Chanteux, Hugues; Nicolas, Jean-Marie

    2016-06-01

    Brivaracetam (BRV) is a high-affinity synaptic vesicle protein 2A ligand developed for the treatment of uncontrolled partial-onset seizures. The present phase I, open-label, two-way crossover study was designed to assess the effect of rifampin on the pharmacokinetics of BRV and its hydroxy (BRV-OH), acid (BRV-AC), and hydroxy acid (BRV-OHAC) metabolites. Twenty-six healthy subjects received BRV (150-mg single oral dose) either alone or following 5 days of rifampin 600 mg/day. BRV and its metabolites were examined for their plasma profiles and urinary excretion. Pharmacokinetic modeling was developed to estimate the rate constants of the various metabolic routes. Parallel in vitro assays were conducted to characterize the hydrolysis of BRV to BRV-AC as well as to identify any potential effect of rifampin on the hydrolysis reaction. Rifampin did not significantly affect the maximum plasma concentration (Cmax) of BRV, but decreased its area under the curve (AUC) by 45%. In addition, rifampin significantly increased the AUC of BRV-OH (+109%), decreased the AUC of BRV-AC (-53%), but had little effect on BRV-OHAC (-10%). In vitro assays showed that the major urinary metabolite BRV-AC (33% of the dose) was likely to be formed by amidase EC 3.5.1.4. In vitro data indicated that the enzyme was not significantly inhibited nor induced by rifampin. Modeling confirmed that all of the observed changes in vivo were secondary to the induction of the CYP2C19-mediated hydroxylation of BRV to BRV-OH (3.7-fold increase in the rate constant). PMID:27002062

  11. Mortality among tuberculosis patients with acquired resistance to second-line anti-tuberculosis drugs — United States, 1993–2008

    Science.gov (United States)

    Ershova, Julia V.; Kurbatova, Ekaterina V.; Moonan, Patrick K.; Cegielski, J. Peter

    2016-01-01

    Background Resistance to second-line anti-tuberculosis drugs (SLD) severely compromises treatment options of drug-resistant tuberculosis (TB). We assessed the association between acquisition of resistance (AR) to second-line injectable drugs (SLI) or fluoroquinolones (FQ) and mortality among TB cases confirmed by positive culture results with available initial and final drug susceptibility test (DST) results. Methods We analyzed data from U.S. National TB Surveillance System, 1993–2008. Acquired resistance was defined as drug susceptibility at initial DST but resistance to the same drug at final DST. We compared survival with Kaplan-Meier curves and analyzed the association between AR and mortality using a univariate extended Cox proportional hazards model adjusted for age. Results Of 2,329 cases with both initial and final DST to SLI, 49 (2.1%) acquired resistance; 13/49 (26.5%) had treatment terminated by death versus 222 (10.0%) of those without AR to SLI (P<0.001). Of 1,187 cases with both initial and final DST to FQ, 32 (2.8%) acquired resistance; 12/32 (37.5%) had treatment terminated by death versus 121 (10.9%) of those without AR to FQ (P=0.001). Controlling for age, mortality was significantly greater among cases with AR to SLD than among cases without AR (adjusted hazard ratio (aHR)[SLI], 2.8; 95% confidence interval (CI),1.4–5.4; aHR[FQ], 1.9; 95% CI,1.0–3.5). MDR TB at treatment initiation, positive HIV status, and extrapulmonary disease were also significantly associated with mortality. Conclusion Mortality was significantly greater among TB cases with AR to SLD. Providers should consider AR to SLD early in treatment, monitor DST results, and avoid premature deaths. PMID:24846639

  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

    2004-01-01

    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. Multiplex Assay of Second-Line Anti-Tuberculosis Drugs in Dried Blood Spots Using Ultra-Performance Liquid Chromatography-Tandem Mass Spectrometry.

    Science.gov (United States)

    Lee, Kyunghoon; Jun, Sun Hee; Han, Minje; Song, Sang Hoon; Park, Jong Sun; Lee, Jae Ho; Park, Kyoung Un; Song, Junghan

    2016-09-01

    As dried blood spots (DBSs) have various advantages over conventional venous blood sampling, some assays for detection of one or two anti-tuberculosis (TB) drugs in DBSs have been developed. However, there are no assays currently available for the simultaneous measurement of three or more anti-TB drugs in DBSs. In this study, we developed and evaluated a multiplex method for detecting nine anti-TB drugs including streptomycin, kanamycin, clarithromycin, cycloserine, moxifloxacin, levofloxacin, para-aminosalicylic acid, prothionamide, and linezolid in DBSs by using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Seventy-nine patient samples of DBS were analyzed on the UPLC-MS/MS system. All drug concentrations were determined within 4 min, and assay performance was evaluated. All drugs were clearly separated without ion suppression. Within-run and between-run precisions were 1.7-13.0% and 5.7-17.0%, respectively, at concentrations representing low and high levels for the nine drugs. Lower limits of detection and quantification were 0.06-0.6 and 0.5-5.0 μg/mL, respectively. Linearity was acceptable at five level concentrations for each drug. Correlations between drug concentrations in plasma and DBSs by using Passing-Bablock regression and Pearson's rho (ρ 0.798-0.989) were acceptable. In conclusion, we developed a multiplex assay to measure nine second-line anti-TB drugs in DBSs successfully. This assay provided convenient and rapid drug quantification and could have applications in drug monitoring during treatment. PMID:27374716

  14. Chemically amplified cytochrome P450-2E1 drug metabolism nanobiosensor for rifampicin anti-tuberculosis drug

    International Nuclear Information System (INIS)

    Fully susceptible tuberculosis (TB) develops secondary drug resistance during therapy due to inappropriate dosing of treatment drugs, inadequate treatment, non-adherence to the prescribed regimen or using low quality medication. Therefore, a fast and reliable method for the determination of a patient's metabolic profile for TB drugs is essential for appropriate dosing of these drugs. A nanobiosensor for the determination of the biotransformation of rifampicin (a TB drug) was developed using ethylene glycol bis(succinic acid N-hydroxysuccinimide ester) (EG)-modified cytochrome P450-2E1 (CYP2E1). The EG-CYP2EI enzyme system was electrodeposited on gold electrodes derivatised with polyvinylpyrrolidone/silver nanoparticles/poly(8-anilino-1-naphthalene sulphonic acid) (PVP-AgNPs/PANSA) nanocomposite. The electrochemical impedance spectroscopy (EIS) and transmission electron microscopy (TEM) analyses of the Au/PVP-AgNPs/PANSA/EG-CYP2E1 nanobiosensor system revealed that PVP-AgNPs/PANSA is a highly electroactive nanocomposite whose morphology and properties were suitable for the immobilisation of CYP2E1. The response profile of the nanobiosensor for rifampicin was studied by cyclic voltammetry (CV), differential voltammetry (DPV) and steady state amperometry under aerobic conditions. The dynamic linear range of the nanobiosensor (0.025 - 14 μM) covers the peak rifampicin serum level value of 0.045 μM

  15. In Vitro Synergy of Daptomycin plus Rifampin against Enterococcus faecium Resistant to both Linezolid and Vancomycin

    OpenAIRE

    Pankey, George; Ashcraft, Deborah; Patel, Nalini

    2005-01-01

    In vitro synergy testing of daptomycin plus rifampin was performed against 24 unique isolates of Enterococcus faecium resistant to both linezolid and vancomycin. Synergy testing showed that 21/24 (88%) were synergistic and 3/24 (12%) were indifferent by the Etest method. Time-kill assays revealed synergy for 18/24 (75%) and indifference for 6/24 (25%).

  16. Clinical Characteristics of 61 Patients with Pulmonary Tuberculosis Caused by Rifampin-dependent Mycobacterium tuberculosis.Guangzhou Chest Hospital,Guangdong%61例依赖利福平结核杆菌肺结核临床特点分析

    Institute of Scientific and Technical Information of China (English)

    李艳; 黄冬生; 罗春明; 冯志宇; 覃红娟; 黎燕琼

    2013-01-01

    目的:分析依赖利福平结核杆菌(简称依R菌)肺结核临床特点.方法:2008年10月至2012年1月在我院住院或门诊的61例依R菌肺结核患者,记录人口学资料、肺结核病程、抗结核药使用时间、结核病灶范围、是否合并空洞及数量、药敏试验结果、合并症.结果:61例依R菌肺结核患者中男 40例,女21 例.依R菌肺结核以中青年为主,30 ~ 44岁年龄组26例(42.62%).均发生于继发性肺结核,合并症多.肺结核病情重,病情分级:中度者 14例,重度41 例.61株依R菌有52(85.24%)株耐2种及以上抗结核药,至少耐HR耐多药结核分枝杆菌(MDR-TB)的达49例(80.3%).结论:依赖R菌肺结核患者以中青年为主,病情重.与耐多药肺结核的产生有相关性,需要早期发现依R菌肺结核,并实施合理正规化疗方案,才能控制依R菌肺结核的发展和蔓延.%Objective To analyze clinical characteristics of patients with pulmonary tuberculosis caused by rifampin-dependent Mycobacterium tuberculosis. Methods Patients with pulmonary tuberculosis caused by rifampindependent Mycobacterium tuberculosis in our hospital during October 2008 to January 2012 wereobserved. We recorded information including demographic data , course of pulmonary tuberculosis treatment time, size of nidus tuberculosis , numbers of pulmonary cavity, results of drug sensitive test, and complications. Results 61 patients were enrolled during the study period. The majority of patients were young to middle-aged There were 26 cases in the 30-44 age group (42.62%). All 61 patients got secondary pulmonary tuberculosis, and most of them experiencedcomplications. Of the 61 strains of rifampin-dependent Mycobacterium tuberculosis , 52 strains (85.24%) were resistant to two or more anti-tuberculosis drugs, and 49 strains (80.3%) were MDR-TB which were resistant to rifampin and isoniazide at least. Conclusion Rifampin-dependent Mycobacterium tuberculosis-infected patients are mainly young

  17. Efficacy of three-week oxytetracycline or rifampin monotherapy compared with a combination regimen against the filarial nematode Onchocerca ochengi.

    Science.gov (United States)

    Bah, Germanus S; Ward, Emma L; Srivastava, Abhishek; Trees, Alexander J; Tanya, Vincent N; Makepeace, Benjamin L

    2014-01-01

    Onchocerciasis (river blindness), caused by the filarial nematode Onchocerca volvulus, is a major cause of visual impairment and dermatitis in sub-Saharan Africa. As O. volvulus contains an obligatory bacterial symbiont (Wolbachia), it is susceptible to antibiotic chemotherapy, although current regimens are considered too prolonged for community-level control programs. The aim of this study was to compare the efficacies of oxytetracycline and rifampin, administered separately or in combination, against a close relative of O. volvulus (Onchocerca ochengi) in cattle. Six animals per group were treated with continuous or intermittent oxytetracycline regimens, and effects on adult worm viability, dermal microfilarial loads, and Wolbachia density in worm tissues were assessed. Subsequently, the efficacies of 3-week regimens of oxytetracycline and rifampin alone and a combination regimen were compared, and rifampin levels in plasma and skin were quantified. A 6-month regimen of oxytetracycline with monthly dosing was strongly adulticidal, while 3-week and 6-week regimens exhibited weaker adulticidal effects. However, all three regimens achieved >2-log reductions in microfilarial load. In contrast, rifampin monotherapy and oxytetracycline-rifampin duotherapy failed to induce substantive reductions in either adult worm burden or microfilarial load, although a borderline effect on Wolbachia density was observed following duotherapy. Dermal rifampin levels were maintained above the MIC for >24 h after a single intravenous dose. We conclude that oxytetracycline-rifampin duotherapy is less efficacious against O. ochengi than oxytetracycline alone. Further studies will be required to determine whether rifampin reduces oxytetracycline bioavailability in this system, as suggested by human studies using other tetracycline-rifampin combinations. PMID:24247133

  18. Rifampin and Rifaximin Resistance in Clinical Isolates of Clostridium difficile▿ †

    Science.gov (United States)

    O'Connor, Jennifer R.; Galang, Minerva A.; Sambol, Susan P.; Hecht, David W.; Vedantam, Gayatri; Gerding, Dale N.; Johnson, Stuart

    2008-01-01

    Rifaximin, a poorly absorbed rifamycin derivative, is a promising alternative for the treatment of Clostridium difficile infections. Resistance to this agent has been reported, but no commercial test for rifaximin resistance exists and the molecular basis of this resistance has not been previously studied in C. difficile. To evaluate whether the rifampin Etest would be a suitable substitute for rifaximin susceptibility testing in the clinical setting, we analyzed the in vitro rifaximin susceptibilities of 80 clinical isolates from our collection by agar dilution and compared these results to rifampin susceptibility results obtained by agar dilution and Etest. We found rifaximin susceptibility data to agree with rifampin susceptibility; the MICs of both antimicrobials for all isolates were either very low or very high. Fourteen rifaximin-resistant (MIC, ≥32 μg/ml) unique isolates from patients at diverse locations in three countries were identified. Molecular typing analysis showed that nine (64%) of these isolates belonged to the epidemic BI/NAP1/027 group that is responsible for multiple outbreaks and increased disease severity in the United Kingdom, Europe, and North America. The molecular basis of rifaximin and rifampin resistance in these isolates was investigated by sequence analysis of rpoB, which encodes the β subunit of RNA polymerase, the target of rifamycins. Resistance-associated rpoB sequence differences that resulted in specific amino acid substitutions in an otherwise conserved region of RpoB were found in all resistant isolates. Seven different RpoB amino acid substitutions were identified in the resistant isolates, which were divided into five distinct groups by restriction endonuclease analysis typing. These results suggest that the amino acid substitutions associated with rifamycin resistance were independently derived rather than disseminated from specific rifamycin-resistant clones. We propose that rifaximin resistance in C. difficile

  19. Anti-tuberculosis drug induced hepatotoxicity among TB/HIV co-infected patients at Jimma University Hospital, Ethiopia: nested case-control study.

    Directory of Open Access Journals (Sweden)

    Alima Hassen Ali

    Full Text Available BACKGROUND: This study was carried out to determine the incidence and predictors of anti-tuberculosis drug induced hepatotoxicity among TB/HIV co-infected patients at Jimma University Hospital, Ethiopia. METHODS/PRINCIPAL FINDINGS: A nested case-control study was conducted by reviewing charts of all TB/HIV co-infected patients who commenced anti-TB treatment from January 2008 to December 2011 at Jimma University Hospital. Patients who had developed hepatotoxicity after at least 5 days of standard doses of anti-TB drug therapy were labeled as "cases" and those without hepatotoxicity were "controls". Each case with anti-TB drug induced hepatotoxicity was compared with 3 controls selected randomly from the cohort. From a cohort of 296 TB/HIV co-infected patients 8 were excluded from the study as the causality between anti-TB drugs and hepatotoxicity was not confirmed, 33 had developed hepatotoxicity. On bivariate logistic regression analysis, body mass index (BMI <18.5 Kg/m(2 [P = 0.01; OR (95%CI: 3.6 (1.4-9.5], disseminated pulmonary TB [P = 0.00; OR (95%CI: 5.6 (2.2-14.6], CD4 count ≤50 [P = 0.016; OR (95%CI: 3.6(1.27-10.23] and WHO stage 4 [P = 0.004, OR (95%CI: 3.8 (1.68-8.77] were significantly associated with anti-TB drug induced hepatotoxicity. Predictor variables with p-value <0.05 by bivariate analysis were analyzed using multivariable logistic regression analysis and identified disseminated pulmonary TB [P = 0.001; AOR (95%CI = 5.6 (2.1-15.0] and BMI <18.5 [P = 0.014; AOR (95%CI= 3.6 (1.3-10.1] as independent predictors of anti-TB drug induced hepatotoxicity. CONCLUSIONS: The incidence of anti-TB drug induced hepatotoxicity was 11.5%. The results suggest that in the presence of disseminated pulmonary TB and/or BMI <18.5 Kg/m(2, TB/HIV co-infected patients should be closely followed for the occurrence of hepatotoxicity during the intensive phase of TB treatment to prevent morbidity and mortality.

  20. The epidemic status of drug-resistant tuberculosis and research progress of anti-tuberculosis drugs%耐药结核病流行现状及抗结核药物研究进展

    Institute of Scientific and Technical Information of China (English)

    许寅; 孟现民; 张永信

    2013-01-01

    China is one of the 22 countries with serious tuberculosis epidemic in the whole world and is also one of the 27 countries with the serious multidrug-resistant tuberculosis (MDR-TB). MDR-TB has become the tough problem of public health in many countries. It is an important link to study and develop the new anti-tuberculosis drugs to prevent and control tuberculosis and to improve their efficacy. This article introduces the tuberculosis, especially epidemic status of drug-resistant tuberculosis and research progress of anti-tuberculosis drugs.%  我国是全球22个结核病流行严重的国家之一,同时也是全球27个耐多药结核病流行严重的国家之一。耐多药结核病在许多国家已成为主要公共卫生问题,而研发新型抗结核药物是有效遏制结核病流行和提高结核病防治效果的重要环节之一。本文介绍结核病、尤其是耐多药结核病的流行现状以及抗结核药物研发的最新进展。

  1. Value of serum procalcitonin in anti-tuberculosis therapeutic effect evaluation for tuberculosis%血清降钙素原在肺结核抗结核治疗疗效评估中的价值

    Institute of Scientific and Technical Information of China (English)

    徐立; 金雪

    2013-01-01

    目的研究血清降钙素原在肺结核抗结核治疗疗效评估中的价值。方法选择2012年1月~2013年1月本科诊治的肺结核患者为研究对象(观察组),以同期未行抗结核治疗的肺结核患者为对照(对照组),比较两组患者治疗前后血清降钙素原的水平并分析不同水平降钙素原抗结核治疗疗效差异。结果观察组和对照组肺结核患者治疗前血清降钙素原差异无统计学意义,观察组患者治疗后1个月、3个月和6个月血清降钙素原显著降低( P<0.05),对照组治疗1个月、3个月和6个月血清降钙素原升高,观察组肺结核患者治疗1个月、3个月和6个月血清降钙素原均显著低于对照组(P<0.05)。治疗前降钙素原水平显著升高、轻度升高和正常患者治愈率依次降低(P<0.05)。结论肺结核患者血清降钙素原可作为其抗结核治疗疗效评估的标志物。%Objective To study the value of serum procalcitonin in anti-tuberculosis therapeutic effect evaluation for tuberculosis. Methods The patients with tuberculosis treated with anti-tuberculosis therapy in our department from January 2012 to January 2013 were selected as the observation group, while no anti-tuberculosis treatment patients with tuberculosis during the same period were selected as the control group. The level of serum procalcitonin in the two groups before and after the treatment were compared and the anti-tuberculosis therapeutic effect difference of different levels of procalcitonin were analyzed. Results There was not significant difference in the level of serum procalcitonin before the treatment between the observation group and the control group. The levels of serum procalcitonin in the observation group after the treatment of 1 month, 3 months and 6 months decreased significantly(P<0.05), while the levels of serum procalcitonin in the control group after the treatment of 1 month, 3 months and 6 months

  2. 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

    2004-01-01

    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.

  3. Rifampin and Rifaximin Resistance in Clinical Isolates of Clostridium difficile▿ †

    OpenAIRE

    O'Connor, Jennifer R.; Galang, Minerva A.; Sambol, Susan P.; Hecht, David W.; Vedantam, Gayatri; Gerding, Dale N; Johnson, Stuart

    2008-01-01

    Rifaximin, a poorly absorbed rifamycin derivative, is a promising alternative for the treatment of Clostridium difficile infections. Resistance to this agent has been reported, but no commercial test for rifaximin resistance exists and the molecular basis of this resistance has not been previously studied in C. difficile. To evaluate whether the rifampin Etest would be a suitable substitute for rifaximin susceptibility testing in the clinical setting, we analyzed the in vitro rifaximin suscep...

  4. Synergistic Activity of Colistin plus Rifampin against Colistin-Resistant KPC-Producing Klebsiella pneumoniae

    OpenAIRE

    Tascini, Carlo; Tagliaferri, Enrico; Giani, Tommaso; Leonildi, Alessandro; Flammini, Sarah; Casini, Beatrice; Lewis, Russell; Ferranti, Simone; Rossolini, Gian Maria; Menichetti, Francesco

    2013-01-01

    Infections caused by carbapenem-resistant KPC-producing Klebsiella pneumoniae are responsible for high rates of mortality and represent a major therapeutic challenge, especially when the isolates are also resistant to colistin. We used the checkerboard method to evaluate the synergistic activity of 10 antibiotic combinations against 13 colistin-resistant KPC-producing K. pneumoniae isolates (colistin MIC range of 8 to 128 mg/liter). Colistin plus rifampin was the only combination that demonst...

  5. Efficacy of Rifampin Plus Clofazimine in a Murine Model of Mycobacterium ulcerans Disease

    OpenAIRE

    Converse, Paul J.; Tyagi, Sandeep; Xing, Yalan; Li, Si-Yang; Kishi, Yoshito; Adamson, John; Nuermberger, Eric L.; Grosset, Jacques H.

    2015-01-01

    Treatment of Buruli ulcer, or Mycobacterium ulcerans disease, has shifted from surgical excision and skin grafting to antibiotic therapy usually with 8 weeks of daily rifampin (RIF) and streptomycin (STR). Although the results have been highly favorable, administration of STR requires intramuscular injection and carries the risk of side effects, such as hearing loss. Therefore, an all-oral, potentially less toxic, treatment regimen has been sought and encouraged by the World Health Organizati...

  6. Effect of rifampin on steady-state pharmacokinetics of atazanavir with ritonavir in healthy volunteers.

    OpenAIRE

    Burger, D.M.; Agarwala, S.; Child, M.; Been-Tiktak, A.; Wang, Y; Bertz, R.

    2006-01-01

    Mycobacterium tuberculosis is a concern in patients with human immunodeficiency virus (HIV) infection. Rifampin (RIF), an agent used against M. tuberculosis, is contraindicated with most HIV protease inhibitors. Atazanavir (ATV) has clinical efficacy comparable to a standard of care regimen in naive patients and, when dosed with low-dose ritonavir (RTV), also in treatment-experienced patients. We evaluated here the safety and pharmacokinetics of ATV, resulting from three regimens of ATV, RTV,...

  7. Interaction between rifampin and fusidic acid against methicillin-resistant coagulase-positive and -negative staphylococci.

    OpenAIRE

    Farber, B F; Yee, Y C; Karchmer, A. W.

    1986-01-01

    We studied the interaction between rifampin and fusidic acid against a group of staphylococci. Of the 20 coagulase-positive strains studied, checkerboard studies revealed synergy in 3 and indifference in 17; time-kill studies revealed synergy in 18 of 19 coagulase-positive strains at both 24 and 48 h. Of the 19 coagulase-negative strains, checkerboard studies revealed synergy in 6 and indifference in 13; time-kill studies revealed synergy in 6 of 18 coagulase-negative strains at 24 h and in 1...

  8. Bactericidal Activity of Rifampin-Amikacin against Mycobacterium ulcerans in Mice

    OpenAIRE

    Dega, Herve; Bentoucha, Abdelhalim; Robert, Jerome; Jarlier, Vincent; Grosset, Jacques

    2002-01-01

    To identify the most active curative treatment of Buruli ulcer, two regimens incorporating the use of rifampin (RIF) were compared with the use of RIF alone in a mouse footpad model of Mycobacterium ulcerans infection. Treatments began after footpad swelling from infection and continued for 12 weeks with five doses weekly of one of the following regimens: (i) 10 mg of RIF/kg alone; (ii) 10 mg of RIF/kg and 100 mg of amikacin (AMK)/kg; and (iii) 10 mg of RIF/kg, 100 mg of clarithromycin (CLR)/...

  9. Rifampin pharmacokinetics in children, with and without human immunodeficiency virus infection, hospitalized for the management of severe forms of tuberculosis

    Directory of Open Access Journals (Sweden)

    McIlleron Helen

    2009-04-01

    Full Text Available Abstract Background Rifampin is a key drug in antituberculosis chemotherapy because it rapidly kills the majority of bacilli in tuberculosis lesions, prevents relapse and thus enables 6-month short-course chemotherapy. Little is known about the pharmacokinetics of rifampin in children. The objective of this study was to evaluate the pharmacokinetics of rifampin in children with tuberculosis, both human immunodeficiency virus type-1-infected and human immunodeficiency virus-uninfected. Methods Fifty-four children, 21 human immunodeficiency virus-infected and 33 human immunodeficiency virus-uninfected, mean ages 3.73 and 4.05 years (P = 0.68, respectively, admitted to a tuberculosis hospital in Cape Town, South Africa with severe forms of tuberculosis were studied approximately 1 month and 4 months after commencing antituberculosis treatment. Blood specimens for analysis were drawn in the morning, 45 minutes, 1.5, 3.0, 4.0 and 6.0 hours after dosing. Rifampin concentrations were determined by liquid chromatography tandem mass spectrometry. For two sample comparisons of means, the Welch version of the t-test was used; associations between variables were examined by Pearson correlation and by multiple linear regression. Results The children received a mean rifampin dosage of 9.61 mg/kg (6.47 to 15.58 body weight at 1 month and 9.63 mg/kg (4.63 to 17.8 at 4 months after commencing treatment administered as part of a fixed-dose formulation designed for paediatric use. The mean rifampin area under the curve 0 to 6 hours after dosing was 14.9 and 18.1 μg/hour/ml (P = 0.25 1 month after starting treatment in human immunodeficiency virus-infected and human immunodeficiency virus-uninfected children, respectively, and 16.52 and 17.94 μg/hour/ml (P = 0.59 after 4 months of treatment. The mean calculated 2-hour rifampin concentrations in these human immunodeficiency virus-infected and human immunodeficiency virus-uninfected children were 3.9 and 4.8

  10. [A case of cerebral abscess due to methicillin-resistant Staphylococcus aureus which is treated with linezolid + rifampin combination].

    Science.gov (United States)

    Sipahi, Oğuz Reşat; Cağıran, Inanç; Yurtseven, Taşkın; Işıkgöz Taşbakan, Meltem; Arda, Bilgin; Tünger, Alper; Ulusoy, Sercan

    2010-10-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a rare cause of cerebral abscesses, however it is a relatively more common etiologic agent in post-neurosurgical abscesses and the main antibacterial therapy option is vancomycin. In this report, a case of brain abscess due to MRSA which did not respond neither to moxifloxacin + vancomycin nor vancomycin + rifampin combination therapies, and merely treated by linezolid + rifampin combination, has been presented. Fifty-one years old female patient who was operated 40 days ago for subarachnoid bleeding and aneurysm in middle cerebral artery bifurcation, was hospitalized due to purulent leakage from the operation area. She did not have fever and her physical examination, including the neurologic system, was normal. Computerized tomography revealed an approximately 1 cm lesion compatible with subdural empyema and cerebral abscess in the right frontoparietal area in supratentorial sections. The patient was operated for wound revision and moxifloxacin was initiated. Since the operation materials revealed MRSA growth, vancomycin (4 x 500 mg, IV) was added to the treatment. The isolate was identified by conventional methods, and antibiotic susceptibility test performed by disk diffusion method showed that it was susceptible to levofloxacin, linezolid, rifampin, vancomycin and teicoplanin. Since no clinical response was obtained in two weeks, moxifloxacin was switched to rifampin (300 mg 1 x 2). On the 10th day of vancomycin + rifampin therapy, radiological findings showed development of cerebritis and therefore vancomycin was changed with linezolid (2 x 600 mg, IV). The control CT of the patient revealed regression of the brain lesion and linezolid + rifampin treatment continued for six weeks. The patient did not develop any hematological, liver or renal toxicity during the therapy and the radiological findings regressed. No relapse were detected in the one year follow-up period. This case suggested that linezolid might

  11. Combination of Quinupristin-Dalfopristin (Synercid) and Rifampin Is Highly Synergistic in Experimental Staphylococcus aureus Joint Prosthesis Infection

    OpenAIRE

    Saleh-Mghir, Azzam; Ameur, Nourdine; Muller-Serieys, Claudette; Ismael, Farid; Lemaitre, Françoise; Massias, Laurent; Feger, Céline; Bléton, Rémy; Crémieux, Anne-Claude

    2002-01-01

    We compared the efficacies of quinupristin-dalfopristin (Q-D; 30 mg/kg of body weight every 8 h) and vancomycin (60 mg/kg twice daily), alone or in combination with rifampin (10 mg/kg twice daily), in a rabbit model of methicillin-resistant Staphylococcus aureus knee prosthesis infection. In contrast to vancomycin, Q-D significantly reduced the mean log10 CFU per gram of bone versus that for the controls. The combination of rifampin with either Q-D or vancomycin was significantly more effecti...

  12. Intestinal permeability and malabsorption of rifampin and isoniazid in active pulmonary tuberculosis

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    Valéria G. F. Pinheiro

    2006-12-01

    Full Text Available Low antimycobacterial drug concentrations have been observed in tuberculosis (TB patients under treatment. The lactulose/mannitol urinary excretion test (L/M, normally used to measure intestinal permeability, may be useful to assess drug absorption. The objective of this research was to study intestinal absorptive function and bioavailability of rifampin and isoniazid in TB patients. A cross sectional study was done with 41 patients and 28 healthy controls, using the L/M test. The bioavailabilities of rifampin (R and isoniazid (H were evaluated in 18 patients receiving full doses. Urinary excretion of mannitol and lactulose, measured by HPLC, was significantly lower in TB patients. The serum concentrations of the drugs were below the expected range for R (8-24 mcg/mL or H (3-6 mcg/mL in 16/18 patients. Analyzing the drugs individually, 12/18 patients had low serum concentrations of R, 13/18 for H and 8/18 for both drugs. We suggest that there is a decrease in the functional absorptive area of the intestine in TB patients, which would explain the reduced serum concentrations of antituberculosis drugs. There is a need for new approaches to improve drug bioavailability in TB patients.

  13. Efficacy and safety of Efavirenz in HIV patients on Rifampin for tuberculosis

    Directory of Open Access Journals (Sweden)

    Diana B. Pedral-Sampaio

    2004-06-01

    Full Text Available Forty-nine AIDS patients, most of who were antiretroviral therapy (ARV naïve, with active tuberculosis, were treated with Rifampin 600mg, Isoniazid 400mg and Pirazinamide 2g daily. They also received ARV, consisting of Efavirenz (600mg/day plus 2 NRTIs. All patients were prospectively followed for at least 24 months. Baselines were: male/female ratio 2:1, mean age 34.7 ± 9.4 yrs; weight 51 ± 9.0 kg, viral load 5.6 ± 0.6 logs, CD4 cell count 101 ± 128 cells/ mm³. Follow up mean values of data logs of VL and CD4+ cell /mm³ counts were: VL 1.7 and CD4+ 265; VL 1.3 and CD4+ 251; VL 1.4 and CD4+ 326 at 6, 12 and 24 months, respectively. Weight gain changes were: 5 ± 9.9 ± 12 and 21 ± 16 kg respectively at 6, 12 and 24 months. A non-concomitant ARV regimen was introduced at least three weeks after TB treatment initiation. Severe adverse reactions included rash (two, toxic hepatitis (six, Immune Reconstitution Syndrome (seven, and four deaths. We conclude that Efavirenz at a daily dose of 600 mg is sufficient and safe to treat HIV/TB patients using a Rifampin containing regimen.

  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; Brøsen, K; Gerstoft, J; Pedersen, C

    2004-01-01

    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...

  15. 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

    2010-08-01

    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.

  16. Molecular Identification of Mycobacterium Tuberculosis and Analysis of Its Resistance to Rifampin in Sputa from Tuberculosis Suspected Patients

    International Nuclear Information System (INIS)

    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. (author)

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

    Directory of Open Access Journals (Sweden)

    Pinsi Gabriele

    2009-08-01

    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

  18. Pharmacokinetic (PK) drug interaction studies of cabozantinib: Effect of CYP3A inducer rifampin and inhibitor ketoconazole on cabozantinib plasma PK and effect of cabozantinib on CYP2C8 probe substrate rosiglitazone plasma PK.

    Science.gov (United States)

    Nguyen, Linh; Holland, Jaymes; Miles, Dale; Engel, Caroline; Benrimoh, Natacha; O'Reilly, Terry; Lacy, Steven

    2015-09-01

    Cabozantinib is a small-molecule tyrosine kinase inhibitor that has been approved for the treatment of patients with progressive, metastatic medullary thyroid cancer. In vitro data indicate that (1) cytochrome P450 (CYP) 3A4 is the primary CYP isoenzyme involved in the metabolism of cabozantinib, and (2) CYP2C8 is the CYP isoenzyme most potently inhibited by cabozantinib with potential for in vivo inhibition at clinically relevant plasma exposures. Pharmacokinetic (PK) drug-drug interactions (DDIs) were evaluated clinically between cabozantinib and (1) a CYP3A inducer (rifampin) in healthy volunteers, (2) a CYP3A inhibitor (ketoconazole) in healthy volunteers, and (3) a CYP2C8 substrate (rosiglitazone) in patients with solid tumors. Compared with cabozantinib given alone, coadministration with rifampin resulted in a 4.3-fold higher plasma clearance (CL/F) of cabozantinib and a 77% decrease in cabozantinib plasma AUC0-inf , whereas coadministration with ketoconazole decreased cabozantinib CL/F by 29% and increased cabozantinib AUC0-inf by 38%. Chronic coadministration with cabozantinib resulted in no significant effect on rosiglitazone plasma Cmax , AUC0-24 , or AUC0-inf . In summary, chronic use of strong CYP3A inducers and inhibitors should be avoided when cabozantinib is administered, and cabozantinib at clinically relevant exposures is not anticipated to markedly affect the PK of concomitant medications via CYP enzyme inhibition. PMID:25854986

  19. Enantiomeric PLA-PEG block copolymers and their stereocomplex micelles used as rifampin delivery

    International Nuclear Information System (INIS)

    A novelty approach to self-assembling stereocomplex micelles by enantiomeric PLA-PEG block copolymers as a drug delivery carrier was described. The particles were encapsulated by enantiomeric PLA-PEG stereocomplex to form nanoscale micelles different from the microspheres or the single micelles by PLLA or PDLA in the reported literatures. First, the block copolymers of enantiomeric poly(l-lactide)-poly(ethylene-glycol) (PLLA-PEG) and poly(D-lactide)-poly(ethylene-glycol) (PDLA-PEG) were synthesized by the ring-opening polymerization of l-lactide and d-lactide in the presence of monomethoxy PEG, respectively. Second, the stereocomplex block copolymer micelles were obtained by the self-assembly of the equimolar mixtures of enantiomeric PLA-PEG copolymers in water. These micelles possessed partially the crystallized hydrophobic cores with the critical micelle concentrations (cmc) in the range of 0.8-4.8 mg/l and the mean hydrodynamic diameters ranging from 40 to 120 nm. The micelle sizes and cmc values obviously depended on the hydrophobic block PLA content in the copolymer. Compared with the single PLLA-PEG or PDLA-PEG micelles, the cmc values of the stereocomplex micelles became lower and the sizes of the stereocomplex micelles formed smaller. And lastly, the stereocomplex micelles encapsulated with rifampin were tested for the controlled release application. The rifampin loading capacity and encapsulation efficiency by the stereocomplex micelles were higher than those by the single polymer micelles, respectively. The drug release time in vitro was depending on the composites of the block copolymers and also could be controlled by the polymer molecular weight and the morphology of the polymer micelles

  20. Protective properties of rifampin-resistant rough mutants of Brucella melitensis.

    Science.gov (United States)

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

    2005-07-01

    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. PMID:15972510

  1. Successful treatment of multidrug-resistant tuberculosis following drug-induced hepatic necrosis requiring liver transplant.

    Science.gov (United States)

    Marra, F; Cox, V C; FitzGerald, J M; Moadebi, S; Elwood, R K

    2004-07-01

    A 28-year-old female developed multidrug-resistant (MDR) tuberculous lymphadenitis following a trip to India. She was initially treated with a four-drug regimen of first-line anti-tuberculosis medications, but when sensitivities indicated resistance to isoniazid and rifampin, her regimen was altered to ciprofloxacin (CFX), pyrazinamide (PZA) and ethambutol. She subsequently developed a rash, flu-like symptoms and fever, which progressed to acute hepatic necrosis despite discontinuation of medication. The clinical presentation and subsequent investigations suggested a hypersensitivity reaction, possibly related to the quinolone. The patient subsequently had an orthoptic liver transplant; second-line anti-tuberculosis medications were restarted to which she responded clinically and radiologically. Our findings raise the possibility that the CFX and PZA combination was responsible for the hepatic necrosis. The patient also illustrates that active, even MDR tuberculosis is not a contraindication to hepatic transplant. PMID:15260286

  2. 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

    2011-01-01

    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

  3. Modest but variable effect of rifampin on steady-state plasma pharmacokinetics of efavirenz in healthy African-American and Caucasian volunteers.

    Science.gov (United States)

    Kwara, Awewura; Tashima, Karen T; Dumond, Julie B; Poethke, Pamela; Kurpewski, Jaclyn; Kashuba, Angela D M; Court, Michael H; Greenblatt, David J

    2011-07-01

    Efavirenz-based antiretroviral regimen is preferred during rifampin-containing tuberculosis therapy. However, current pharmacokinetic data are insufficient to guide optimized concurrent dosing. This study aimed to better characterize the effects of rifampin on efavirenz pharmacokinetics. Subjects were randomized to receive 600 mg efavirenz/day or 600 mg efavirenz with 600 mg rifampin/day for 8 days, with plasma samples collected for pharmacokinetic analysis over 24 h on day 8. Treatments were then crossed over after at least a 2-week washout period, and procedures were repeated. Efavirenz concentrations were determined by high-performance liquid chromatography (HPLC), and pharmacokinetic parameters were estimated by noncompartmental analysis. Efavirenz pharmacokinetic differences between treatment periods were evaluated by paired t test. The coefficients of variation in efavirenz plasma AUC(0-24) (area under the concentration-time curve from 0 to 24 h) were 50% and 56% in the absence and presence of rifampin, respectively. Of the 11 evaluable subjects (6 white, 5 black; 6 women, 5 men), the geometric mean AUC(0-24) ratio on/off rifampin (90% confidence interval) was 0.82 (0.72, 0.92), with individual AUC(0-24) ratios varying from 0.55 to 1.18. Five subjects had a 24-hour efavirenz concentration (C(24)) of <1,000 ng/ml on rifampin. They were more likely to have received a lower dose in milligrams/kilogram of body weight and to have lower efavirenz AUC(0-24) values in the basal state. Although rifampin resulted in a modest reduction in efavirenz plasma exposure in subjects as a whole, there was high variability in responses between subjects, suggesting that efavirenz dose adjustment with rifampin may need to be individualized. Body weight and genetic factors will be important covariates in dosing algorithms. PMID:21518840

  4. A Case of Acquired Rifampin Resistance in Mycobacterium bovis Bacillus Calmette-Guérin-Induced Cystitis: Necessity for Treatment Guidelines

    Directory of Open Access Journals (Sweden)

    Joyce N Wolfe

    2006-01-01

    Full Text Available A case of presumed bacillus Calmette-Guérin (BCG cystitis in an elderly female patient following direct intravesical BCG instillation treatment for papillary transitional cell carcinoma is reported. The organism cultured from urine samples was eventually identified as a rifampin-resistant Mycobacterium bovis BCG isolate. Because the patient had received rifampin monotherapy during the course of treatment for presumed BCG disease, the clinical picture favoured acquired rifampin resistance. Sequencing of the target gene for rifampin (rpoB confirmed a known mutation responsible for conferring high levels of resistance to both rifampin and rifabutin (Ser531Tyr. To the authors' knowledge, this is the first reported case of M bovis BCG disease in a non-HIV patient where the organism had acquired drug resistance to rifampin, and the second reported case of M bovis BCG that had acquired drug resistance. The present case demonstrates the necessity to re-evaluate appropriate guidelines for the effective treatment of BCG disease.

  5. In vitro antibiotic susceptibility testing of Brucella isolates from Egypt between 1999 and 2007 and evidence of probable rifampin resistance

    Directory of Open Access Journals (Sweden)

    Abdel-Maksoud Mohamed

    2012-08-01

    Full Text Available Abstract Background Brucellosis poses a significant public health problem in Mediterranean countries, including Egypt. Treatment of this disease is often empirical due to limited information on the antibiotic susceptibility profiles of Brucella spp. in this region of the world. The aim of this study was to determine the antibiotic susceptibility profiles of Brucella blood isolates in Egypt, a country endemic for brucellosis. Methods Brucella spp. isolates were identified from the blood cultures of acute febrile illness (AFI patients presenting to a network of infectious disease hospitals from 1999–2007. Minimum inhibitory concentrations were determined for tetracycline, gentamicin, doxycycline, trimethoprim-sulfamethoxazole, streptomycin, ceftriaxone, ciprofloxacin and rifampin using the E-test. Interpretations were made according to Clinical and Laboratory Standards Institute (CLSI guidelines. Results A total of 355 Brucella spp. isolates were analyzed. All were susceptible to tetracycline, doxycycline, trimethoprim-sulfamethoxazole, streptomycin and ciprofloxacin; probable resistance to rifampin and ceftriaxone was observed among 277 (64% and 7 (2% of the isolates, respectively. Percentages of isolates showing probable resistance to rifampin were significantly lower before 2001 than in the following years (7% vs. >81%, p  Conclusions Despite the high burden of brucellosis in Egypt and frequent empirical treatment, isolates have remained susceptible to the majority of tested antibiotics. However, this is the first report of high rates of probable resistance to rifampin among Brucella isolates from Egypt. Patients should be closely monitored while following standard treatment regimens. Continued surveillance, drug susceptibility studies and updated CLSI interpretive criteria are needed to monitor and update antibiotic prescribing policies for brucellosis.

  6. Efficacy of Three-Week Oxytetracycline or Rifampin Monotherapy Compared with a Combination Regimen against the Filarial Nematode Onchocerca ochengi

    OpenAIRE

    Bah, G. S.; Ward, E. L.; A Srivastava; Trees, A. J.; Tanya, V. N.; B.L. Makepeace

    2014-01-01

    Onchocerciasis (river blindness), caused by the filarial nematode Onchocerca volvulus, is a major cause of visual impairment and dermatitis in sub-Saharan Africa. As O. volvulus contains an obligatory bacterial symbiont (Wolbachia), it is susceptible to antibiotic chemotherapy, although current regimens are considered too prolonged for community-level control programs. The aim of this study was to compare the efficacies of oxytetracycline and rifampin, administered separately or in combinatio...

  7. Contribution of N-Glucuronidation to Efavirenz Elimination In Vivo in the Basal and Rifampin-Induced Metabolism of Efavirenz▿

    OpenAIRE

    Cho, Doo-Yeoun; Ogburn, Evan T.; Jones, David; Desta, Zeruesenay

    2011-01-01

    In this study, the contribution of efavirenz N-glucuronidation to efavirenz elimination in vivo was assessed. In a two-period placebo-controlled crossover trial design, a single 600-mg oral dose of efavirenz was administered to healthy volunteers (n = 10) pretreated with placebo pills or 600 mg/day rifampin orally for 10 days. Urine and plasma concentrations of efavirenz and 8-hydroxyefavirenz were measured by the liquid chromatography-tandem mass spectrometry method after enzymatic hydrolysi...

  8. In Vitro and In Vivo Activities of Rifampin, Streptomycin, Amikacin, Moxifloxacin, R207910, Linezolid, and PA-824 against Mycobacterium ulcerans

    OpenAIRE

    Ji, Baohong; Lefrançois, Sébastien; Robert, Jerome; Chauffour, Aurélie; Truffot, Chantal; Jarlier, Vincent

    2006-01-01

    Seven antimicrobials were tested in vitro against 29 clinical isolates of Mycobacterium ulcerans. R207910 demonstrated the lowest MIC50 and MIC90, followed by moxifloxacin (MXF), streptomycin (STR), rifampin (RIF), amikacin (AMK), linezolid (LZD), and PA-824. All but PA-824 demonstrated an MIC90 significantly less than the clinically achievable peak serum level. Administered as monotherapy to mice, RIF, STR, AMK, MXF, R207910, and LZD demonstrated some degree of bactericidal activity, whereas...

  9. Effects of ketoconazole or rifampin on the pharmacokinetics of tivozanib hydrochloride, a vascular endothelial growth factor receptor tyrosine kinase inhibitor.

    Science.gov (United States)

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

    2015-03-01

    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. PMID:27128217

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

    DEFF Research Database (Denmark)

    Jeremiah, Kidola; Denti, Paolo; Chigutsa, Emmanuel;

    2014-01-01

    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......-coinfected patients 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...

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

    Indian Academy of Sciences (India)

    Palanichamy Jeyaraman; Balakrishnan Meenarathi; Ramasamy Anbarasan

    2016-02-01

    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.

  12. Enhanced Survival of Rifampin- and Streptomycin-Resistant Escherichia coli Inside Macrophages.

    Science.gov (United States)

    Durão, Paulo; Gülereşi, Daniela; Proença, João; Gordo, Isabel

    2016-07-01

    The evolution of multiple-antibiotic-resistant bacteria is an increasing global problem. Even though mutations causing resistance usually incur a fitness cost in the absence of antibiotics, the magnitude of such costs varies across environments and genomic backgrounds. We studied how the combination of mutations that confer resistance to rifampin (Rif(r)) and streptomycin (Str(r)) affects the fitness of Escherichia coli when it interacts with cells from the immune system, i.e., macrophages (Mϕs). We found that 13 Rif(r) Str(r) doubly resistant genotypes, of the 16 tested, show a survival advantage inside Mϕs, indicating that double resistance can be highly beneficial in this environment. Our results suggest that there are multiple paths to acquire multiple-drug resistance in this context, i.e., if a clone carrying Rif(r) allele H526 or S531 acquires a second mutation conferring Str(r), the resulting double mutant has a high probability of showing increased survival inside Mϕs. On the other hand, we found two cases of sign epistasis between mutations, leading to a significant decrease in bacterial survival. Remarkably, infection of Mϕs with one of these combinations, K88R+H526Y, resulted in an altered pattern of gene expression in the infected Mϕs. This indicates that the fitness effects of resistance may depend on the pattern of gene expression of infected host cells. Notwithstanding the benefits of resistance found inside Mϕs, the Rif(r) Str(r) mutants have massive fitness costs when the bacteria divide outside Mϕs, indicating that the maintenance of double resistance may depend on the time spent within and outside phagocytic cells. PMID:27161646

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

    OpenAIRE

    Daryoush Mohajeri; Yousef Doustar; Ali Rezaei

    2011-01-01

    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 cy...

  14. Suppression of thermosensitive initiation of DNA replication in a dnaR mutant of Escherichia coli by a rifampin resistance mutation in the rpoB gene.

    OpenAIRE

    Sakakibara, Y

    1995-01-01

    The thermosensitivity of the Escherichia coli dnaR130 mutant in initiation of DNA replication was suppressed by a spontaneous rifampin resistance mutation in rpoB, the gene for the beta subunit of RNA polymerase. Among the dnaR-suppressing rpoB alleles obtained was rpoB22, which was able to suppress the thermosensitivity of the dnaA46 or dnaA167 mutant, but not that of the dnaA5 mutant, in initiation of replication. Some dnaA-suppressing rpoB alleles obtained from rifampin-resistant derivativ...

  15. Evaluation of the pharmacokinetic interaction between repeated doses of rifapentine or rifampin and a single dose of bedaquiline in healthy adult subjects.

    Science.gov (United States)

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

    2015-02-01

    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 clinicaltrials.gov under identifier NCT02216331

  16. Evaluation of the Pharmacokinetic Interaction between Repeated Doses of Rifapentine or Rifampin and a Single Dose of Bedaquiline in Healthy Adult Subjects

    OpenAIRE

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

    2014-01-01

    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 bedaq...

  17. Multidrug-resistant tuberculosis: rapid detection of resistance to rifampin and high or low levels of isoniazid in clinical specimens and isolates

    DEFF Research Database (Denmark)

    Vijdea, R.; Stegger, M.; Sosnovskaja, A.;

    2008-01-01

    The aim of the present study was to evaluate a new improved multiplex polymerase chain reaction (PCR) hybridisation assay to detect multidrug-resistant tuberculosis. The assay, developed to detect rifampin (rpoB) and isoniazid (katG) gene mutations causing Mycobacterium tuberculosis resistance, w...... tool to combat and prevent new cases of multi- and extensively drug-resistant tuberculosis Udgivelsesdato: 2008/11......The aim of the present study was to evaluate a new improved multiplex polymerase chain reaction (PCR) hybridisation assay to detect multidrug-resistant tuberculosis. The assay, developed to detect rifampin (rpoB) and isoniazid (katG) gene mutations causing Mycobacterium tuberculosis resistance, was...

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

    Science.gov (United States)

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

    2016-08-01

    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. PMID:27105861

  19. Draft Genome Sequence of Highly Rifampin-Resistant Propionibacterium namnetense NTS 31307302T Isolated from a Patient with a Bone Infection.

    Science.gov (United States)

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

    2016-01-01

    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. PMID:27516511

  20. False-positive rifampin resistant results with Xpert MTB/RIF version 4 assay in clinical samples with a low bacterial load.

    Science.gov (United States)

    Ocheretina, Oksana; Byrt, Erin; Mabou, Marie-Marcelle; Royal-Mardi, Gertrude; Merveille, Yves-Mary; Rouzier, Vanessa; Fitzgerald, Daniel W; Pape, Jean W

    2016-05-01

    We report investigation of 22 TB cases with positive Xpert MTB/RIF result for resistance to Rifampin and "Very Low" MTB detection level. Twelve cases were false positive without rpoB mutations, 2 were false-positives with a silent mutation in rpoB codon T508, and only 10 were true positives. PMID:26915638

  1. 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.

  2. 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

    Science.gov (United States)

    Wang, Xiumei; Cong, Yulong

    2016-01-01

    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. PMID:27315107

  3. Comparison of Three Commercial Molecular Assays for Detection of Rifampin and Isoniazid Resistance among Mycobacterium tuberculosis Isolates in a High-HIV-Prevalence Setting.

    Science.gov (United States)

    Strydom, K; Ismail, F; Matabane, M M Z; Onwuegbuna, O; Omar, S V; Ismail, N

    2015-09-01

    In a head-to-head comparison of the MTBDRplus version 2.0 (Hain Lifescience), the Xpert MTB/RIF (Cepheid), and the Anyplex MTB/NTM (Seegene) assays, we demonstrated equal sensitivity (59/61; 96.7%) and specificity (53/54; 98.1%) for detecting rifampin resistance with further analysis of discordances. The Xpert assay does not detect isoniazid resistance while the Anyplex assay showed high false positivity. PMID:26135869

  4. In-House Phage Amplification Assay Is a Sound Alternative for Detecting Rifampin-Resistant Mycobacterium tuberculosis in Low-Resource Settings

    OpenAIRE

    Símboli, Norberto; Takiff, Howard; McNerney, Ruth; López, Beatriz; Martin, Anandi; Palomino, Juan Carlos; Barrera, Lucía; Ritacco, Viviana

    2005-01-01

    An in-house mycobacteriophage amplification assay for detecting rifampin-resistant Mycobacterium tuberculosis showed 100% sensitivity, 97.7% specificity, and 95.2% predictive value for resistance in a test of 129 isolates from a hot spot area of multidrug-resistant M. tuberculosis. The applicability of the test was demonstrated in the routine work flow of a low-resource reference laboratory.

  5. Synergistic Activity of Colistin and Rifampin Combination against Multidrug-Resistant Acinetobacter baumannii in an In Vitro Pharmacokinetic/Pharmacodynamic Model

    OpenAIRE

    Lee, Hee Ji; Bergen, Phillip J.; Bulitta, Jurgen B.; Tsuji, Brian; Forrest, Alan; Nation, Roger L; Jian LI

    2013-01-01

    Combination therapy may be required for multidrug-resistant (MDR) Acinetobacter baumannii. This study systematically investigated bacterial killing and emergence of colistin resistance with colistin and rifampin combinations against MDR A. baumannii. Studies were conducted over 72 h in an in vitro pharmacokinetic (PK)/pharmacodynamic (PD) model at inocula of ∼106 and ∼108 CFU/ml using two MDR clinical isolates of A. baumannii, FADDI-AB030 (colistin susceptible) and FADDI-AB156 (colistin resis...

  6. Failure of time-kill synergy studies using subinhibitory antimicrobial concentrations to predict in vivo antagonism of cephalosporin-rifampin combinations against Staphylococcus aureus.

    OpenAIRE

    Brandt, C M; Rouse, M S; Tallan, B M; Wilson, W. R.; Steckelberg, J M

    1994-01-01

    Results of in vitro time-kill synergy studies using subinhibitory, inhibitory, or suprainhibitory concentrations of bactericidal agents were compared with treatment outcomes of experimental infective endocarditis due to a methicillin-susceptible strain of Staphylococcus aureus. For rifampin-cephalosporin combinations, in vitro synergy testing using recommended fractions of the MIC failed to predict antagonism in vivo while concentrations above the MIC corresponded with antagonism in vivo.

  7. Relationship of In Vitro Synergy and Treatment Outcome with Daptomycin plus Rifampin in Patients with Invasive Methicillin-Resistant Staphylococcus aureus Infections

    OpenAIRE

    Rose, Warren E.; Berti, Andrew D.; Hatch, Jacob B.; Maki, Dennis G.

    2013-01-01

    We report the findings of a study examining the relationship between in vitro daptomycin-rifampin synergy and the therapeutic outcome of 12 patients with complex deep methicillin-resistant Staphylococcus aureus (MRSA) infections treated for prolonged periods with this combination. Checkerboard synergy was found in nine cases and was 100% predictive of therapeutic success; absence of synergy was found in three cases, two of which were therapeutic failures (P = 0.045). No relationship was obser...

  8. Mutations in the rpoB Gene of Rifampin-Resistant Mycobacterium tuberculosis Isolates in Spain and Their Rapid Detection by PCR–Enzyme-Linked Immunosorbent Assay

    Science.gov (United States)

    Garcia, Lucia; Alonso-Sanz, Mercedes; Rebollo, Maria J.; Tercero, Juan C.; Chaves, Fernando

    2001-01-01

    Genetic alterations in the rpoB gene were characterized in 50 rifampin-resistant (Rifr) clinical isolates of Mycobacterium tuberculosis complex from Spain. A rapid PCR–enzyme-linked immunosorbent assay (ELISA) technique for the identification of rpoB mutations was evaluated with isolates of the M. tuberculosis complex and clinical specimens from tuberculosis patients that were positive for acid-fast bacilli (AFB). Sequence analysis demonstrated 11 different rpoB mutations among the Rifr isolates in the study. The most frequent mutations were those associated with codon 531 (24 of 50; 48%) and codon 526 (11 of 50; 22%). Although the PCR-ELISA does not permit characterization of the specific Rifr allele within each strain, 10 of the 11 Rifr genotypes were correctly identified by this method. We used the PCR-ELISA to predict the rifampin susceptibility of M. tuberculosis complex organisms from 30 AFB-positive sputum specimens. For 28 samples, of which 9 contained Rifr organisms and 19 contained susceptible strains, results were concordant with those based on culture-based drug susceptibility testing and sequencing. Results from the remaining two samples could not be interpreted because of low bacillary load (microscopy score of 1+ for 1 to 9 microorganisms/100 fields). Our results suggest that the PCR-ELISA is an easy technique to implement and could be used as a rapid procedure for detecting rifampin resistance to complement conventional culture-based methods. PMID:11325996

  9. Direct Detection of Rifampin- and Isoniazid-Resistant Mycobacterium tuberculosis in Auramine-Rhodamine-Positive Sputum Specimens by Real-Time PCR

    Science.gov (United States)

    Ruiz, Maite; Torres, Maria J.; Llanos, Ana C.; Arroyo, Aurelio; Palomares, Jose C.; Aznar, Javier

    2004-01-01

    Our objective was to evaluate the feasibility of a molecular assay based on a real-time PCR technique, carried out with a LightCycler instrument (Roche Biochemicals), to identify Mycobacterium tuberculosis bacilli and to detect rifampin and isoniazid resistance in DNA extracts from sputum samples. We studied three genes: rpoB, which is associated with rifampin resistance, and katG and inhA, which are associated with isoniazid resistance. A total of 205 sputum samples collected from 108 patients diagnosed with pulmonary tuberculosis with positive auramine-rhodamine-staining (AR) sputum samples, were tested. The sensitivities of the LightCycler PCR assay for the positive AR specimens was 97.5% (200 of 205) for rpoB and inhA genes and 96.5% (198 of 205) for the katG gene. For the total number of patients tested, the sensitivity was 100% (108 of 108 patients) for rifampin, whereas the sensitivity was 98.1% (106 of 108 patients) for isoniazid. Full agreement was found with the Bactec MGIT 960 method and the genotype inferred from the LightCycler data for rifampin. The phenotypic method for isoniazid reported 13 resistant strains (≥0.1 μg/ml). In seven (53.8%) strains there was a concordance between both methods, but we found that six (46.2%) strains reported as resistant by the phenotypic method were determined to be susceptible by real-time PCR. For the 75 strains reported as susceptible by the phenotypic method, the concordance with the LightCycler data was 100%. Our results demonstrate that rifampin-resistant M. tuberculosis could be detected in DNA extracted from auramine-rhodamine-positive sputum samples in a single-tube assay that took less than 3 h to perform for a collection of auramine-rhodamine-positive specimens obtained from patients with culture-documented pulmonary tuberculosis. Similarly, this occurs in half of the isoniazid-resistant M. tuberculosis DNA extracted from auramine-rhodamine-positive specimens. PMID:15071008

  10. Compensatory Mutations of Rifampin Resistance Are Associated with Transmission of Multidrug-Resistant Mycobacterium tuberculosis Beijing Genotype Strains in China.

    Science.gov (United States)

    Li, Qin-Jing; Jiao, Wei-Wei; Yin, Qing-Qin; Xu, Fang; Li, Jie-Qiong; Sun, Lin; Xiao, Jing; Li, Ying-Jia; Mokrousov, Igor; Huang, Hai-Rong; Shen, A-Dong

    2016-05-01

    Mycobacterium tuberculosis can acquire resistance to rifampin (RIF) through mutations in the rpoB gene. This is usually accompanied by a fitness cost, which, however, can be mitigated by secondary mutations in the rpoA or rpoC gene. This study aimed to identify rpoA and rpoC mutations in clinical M. tuberculosis isolates in northern China in order to clarify their role in the transmission of drug-resistant tuberculosis (TB). The study collection included 332 RIF-resistant and 178 RIF-susceptible isolates. The majority of isolates belonged to the Beijing genotype (95.3%, 486/510 isolates), and no mutation was found in rpoA or rpoC of the non-Beijing genotype strains. Among the Beijing genotype strains, 27.8% (89/320) of RIF-resistant isolates harbored nonsynonymous mutations in the rpoA (n = 6) or rpoC (n = 83) gene. The proportion of rpoC mutations was significantly higher in new cases (P = 0.023) and in strains with the rpoB S531L mutation (P variable-number tandem-repeat clustering (P = 0.016). In summary, we believe that these findings indirectly suggest an epistatic interaction of particular mutations related to RIF resistance and strain fitness and, consequently, the role of such mutations in the spread of MDR M. tuberculosis strains. PMID:26902762

  11. Rifabutin and rifampin resistance levels and associated rpoB mutations in clinical isolates of Mycobacterium tuberculosis complex.

    Science.gov (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

    2016-06-01

    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. PMID:27036978

  12. The use of minocycline-rifampin coated central venous catheters for exchange of catheters in the setting of staphylococcus aureus central line associated bloodstream infections

    OpenAIRE

    Chaftari, Anne-Marie; El Zakhem, Aline; Jamal, Mohamed A.; Jiang, Ying; Hachem, Ray; Raad, Issam

    2014-01-01

    Background Central venous catheters (CVC) removal and reinsertion of a new CVC in the setting of central line associated bloodstream infections (CLABSI) is not always possible in septic patients. The purpose of this study was to evaluate the outcome of patients with Staphylococcus aureus-CLABSI (SA-CLABSI) who had their CVCs exchanged over guidewire for minocycline/rifampin-coated (M/R)-CVC within seven days of bacteremia. Methods Each case was matched with two control patients who had SA-CLA...

  13. Correlation between Genotypic and Phenotypic Testing for Resistance to Rifampin in Mycobacterium tuberculosis Clinical Isolates in Haiti: Investigation of Cases with Discrepant Susceptibility Results

    OpenAIRE

    Ocheretina, Oksana; Escuyer, Vincent E.; Mabou, Marie-Marcelle; Royal-Mardi, Gertrude; Collins, Sean; Vilbrun, Stalz C.; Pape, Jean W.; Fitzgerald, Daniel W.

    2014-01-01

    The World Health Organization has recommended use of molecular-based tests MTBDRplus and GeneXpert MTB/RIF to diagnose multidrug-resistant tuberculosis in developing and high-burden countries. Both tests are based on detection of mutations in the Rifampin (RIF) Resistance-Determining Region of DNA-dependent RNA Polymerase gene (rpoB). Such mutations are found in 95–98% of Mycobacterium tuberculosis strains determined to be RIF-resistant by the “gold standard” culture-based drug susceptibility...

  14. Activities of the Combination of Quinupristin-Dalfopristin with Rifampin In Vitro and in Experimental Endocarditis Due to Staphylococcus aureus Strains with Various Phenotypes of Resistance to Macrolide-Lincosamide-Streptogramin Antibiotics

    OpenAIRE

    Zarrouk, Virginie; Bozdogan, Bülent; Leclercq, Roland; Garry, Louis; Feger, Celine; Carbon, Claude; Fantin, Bruno

    2001-01-01

    We evaluated the activities of quinupristin-dalfopristin (Q-D), alone or in combination with rifampin, against three strains of Staphylococcus aureus susceptible to rifampin (MIC, 0.06 μg/ml) and to Q-D (MICs, 0.5 to 1 μg/ml) but displaying various phenotypes of resistance to macrolide-lincosamide-streptogramin antibiotics: S. aureus HM1054 was susceptible to quinupristin and dalfopristin (MICs of 8 and 4 μg/ml, respectively); for S. aureus RP13, the MIC of dalfopristin was high (MICs of quin...

  15. [Medical economics in tuberculosis management: what will come after the TB ward?].

    Science.gov (United States)

    Yotsumoto, Hideki

    2009-11-01

    Current unprofitability of medical services in tuberculosis (TB) ward in Japan has been induced by low medical fee and long-term hospital stays, aggravated by unoccupied beds due to the decrease in the number of patients. For the solution of this issue, the increase of medical fee, shortening of the length of hospital stay and drastic reduction of oversupplied beds are essential. An increment of medical fee by the change in the system would be appreciated, but even under the current system, the balance between revenue and expenditure could be obtained by reducing the length of hospital stay toward 4 weeks, and the elimination of deficit in TB ward could be accomplished by these efforts; shortening of length of hospital stay and reduction of TB beds. Although the latter might result in the difficulty of sustaining TB wards, these patients could be treated in the infectious disease ward. The integration of TB Control Law to Infectious Disease Control Law suggests that TB is not a special disease in Japan. If a true "short course therapy" era would be realized by novel anti-tuberculosis drugs, a dramatic change in TB management would occur in the near future. PMID:19999596

  16. Optimizing the clinical pharmacology of tuberculosis medications.

    Science.gov (United States)

    Egelund, E F; Alsultan, A; Peloquin, C A

    2015-10-01

    Tuberculosis (TB) treatment has changed little in the past 40 years. The current standard therapy requires four drugs for 2 months followed by two drugs for 4 months. This "short-course" regimen is not based on optimized pharmacokinetic and pharmacodynamic properties, but empiric evidence. A review of existing data suggests that pharmacokinetic variability with isoniazid and rifampin is greater than previously thought, and that efficacy is not as good as traditionally reported. Adding new drugs to the current regimen will be costly and time-consuming. Maximizing the efficacy of the current medications is a less expensive and more feasible option. This article reviews the current potential of the first-line TB drugs (rifamycins, isoniazid, pyrazinamide, and ethambutol) as well as the fluoroquinolones to introduce a true short-course TB regimen. PMID:26138226

  17. 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

    2006-09-01

    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.

  18. Abortion - medical

    Science.gov (United States)

    ... womb (uterus). There are different types of medical abortions: Therapeutic medical abortion is done because the woman has ... Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion

  19. Chalcones and flavonoids as anti-tuberculosis agents.

    Science.gov (United States)

    Lin, Yuh-Meei; Zhou, Yasheen; Flavin, Michael T; Zhou, Li-Ming; Nie, Weiguo; Chen, Fa-Ching

    2002-08-01

    A series of flavonoids, chalcones and chalcone-like compounds were evaluated for inhibitory activity against Mycobacterium tuberculosis H37Rv. Among them, eight compounds exhibited >90% inhibition on the growth of the bacteria at a concentration of 12.5 microg/mL. Chalcones 1-(2-hydroxyphenyl)-3-(3-chlorophenyl)-2-propen-1-one (22) and 1-(2-hydroxyphenyl)-3-(3-iodophenyl)-2-propen-1-one (37) demonstrated 90 and 92% inhibition, respectively. Chalcone-like compounds (heterocyclic ring-substituted 2-propen-1-one) 1-(4-fluorophenyl)-3-(pyridin-3-yl)-2-propen-1-one (48), 1-(3-hydroxyphenyl)-3-(phenanthren-9-yl)-2-propen-1-one (49), 1-(pyridin-3-yl)-3-(phenanthen-9-yl)-2-propen-1-one (50) and 1-(furan-2-yl)-3-phenyl-2-propen-1-one (51) exhibited 98, 97, 96 and 96% inhibition, respectively. The actual minimum inhibitory concentrations (MIC), defined as the lowest concentration inhibiting 99% of the inoculum, for 22, 37, 48, 49, 50 and 51 were 20.3, 31.5, 48.3, >35.7, 6.8 and 19.2, respectively. A hydrophobic substituent on one aromatic ring, and a hydrogen-bonding group on the other aromatic ring resulted in increased anti-TB activity of the chalcones and chalcone-like compounds. Flavones and flavanones are more geometrically constrained than the corresponding chalcone analogues. The decreased activity of the flavones with respect to the chalcones may be due to the confinement of the terminal aromatic rings to the same plane. PMID:12057669

  20. Antimicrobial peptides as novel anti-tuberculosis therapeutics.

    Science.gov (United States)

    Silva, João P; Appelberg, Rui; Gama, Francisco Miguel

    2016-01-01

    Tuberculosis (TB), a disease caused by the human pathogen Mycobacterium tuberculosis, has recently joined HIV/AIDS as the world's deadliest infectious disease, affecting around 9.6 million people worldwide in 2014. Of those, about 1.2 million died from the disease. Resistance acquisition to existing antibiotics, with the subsequent emergence of Multi-Drug Resistant mycobacteria strains, together with an increasing economic burden, has urged the development of new anti-TB drugs. In this scope, antimicrobial peptides (AMPs), which are small, cationic and amphipathic peptides that make part of the innate immune system, now arise as promising candidates for TB treatment. In this review, we analyze the potential of AMPs for this application. We address the mechanisms of action, advantages and disadvantages over conventional antibiotics and how problems associated with its use may be overcome to boost their therapeutic potential. Additionally, we address the challenges of translational development from benchside to bedside, evaluate the current development pipeline and analyze the expected global impact from a socio-economic standpoint. The quest for more efficient and more compliant anti-TB drugs, associated with the great therapeutic potential of emerging AMPs and the rising peptide market, provide an optimal environment for the emergence of AMPs as promising therapies. Still, their pharmacological properties need to be enhanced and manufacturing-associated issues need to be addressed. PMID:27235189

  1. New anti-tuberculosis drugs and regimens: 2015 update

    Directory of Open Access Journals (Sweden)

    Lia D'Ambrosio

    2015-05-01

    Full Text Available Over 480 000 cases of multidrug-resistant (MDR tuberculosis (TB occur every year globally, 9% of them being affected by extensively drug-resistant (XDR strains of Mycobacterium tuberculosis. The treatment of MDR/XDR-TB is unfortunately long, toxic and expensive, and the success rate largely unsatisfactory (<20% among cases with resistance patterns beyond XDR. The aim of this review is to summarise the available evidence-based updated international recommendations to manage MDR/XDR-TB, and to update the reader on the role of newly developed drugs (delamanid, bedaquiline and pretomanid as well as repurposed drugs (linezolid and meropenem clavulanate, among others used to treat these conditions within new regimens. A nonsystematic review based on historical trials results as well as on recent literature and World Health Organization (WHO guidelines has been performed, with special focus on the approach to managing MDR/XDR-TB. The new, innovative global public health interventions, recently approved by WHO and known as the “End TB Strategy”, support the vision of a TB-free world with zero death, disease and suffering due to TB. Adequate, universally accessed treatment is a pre-requisite to reach TB elimination. New shorter, cheap, safe and effective anti-TB regimens are necessary to boost TB elimination.

  2. Combined antiretroviral and anti-tuberculosis drug resistance following incarceration

    OpenAIRE

    Stott, K E; de Oliviera, T; Lessells, R.J.

    2013-01-01

    We describe a case of HIV/tuberculosis (TB) co-infection from KwaZulu-Natal, South Africa, characterised by drug resistance in both pathogens. The development of drug resistance was linked temporally to two periods of incarceration. This highlights the urgent need for improved integration of HIV/TB control strategies within prison health systems and within the broader public health framework.

  3. New anti-tuberculosis drugs and regimens: 2015 update

    OpenAIRE

    Lia D'Ambrosio; Rosella Centis; Giovanni Sotgiu; Emanuele Pontali; Antonio Spanevello; Giovanni Battista Migliori

    2015-01-01

    Over 480 000 cases of multidrug-resistant (MDR) tuberculosis (TB) occur every year globally, 9% of them being affected by extensively drug-resistant (XDR) strains of Mycobacterium tuberculosis. The treatment of MDR/XDR-TB is unfortunately long, toxic and expensive, and the success rate largely unsatisfactory (

  4. Evaluation of the Fully Automated BACTEC MGIT 960 System for Testing Susceptibility of Mycobacterium tuberculosis to Pyrazinamide, Streptomycin, Isoniazid, Rifampin, and Ethambutol and Comparison with the Radiometric BACTEC 460TB Method

    OpenAIRE

    Scarparo, Claudio; Ricordi, Paolo; Ruggiero, Giuliana; Piccoli, Paola

    2004-01-01

    The performance of the fully automated BACTEC MGIT 960 (M960) system for the testing of Mycobacterium tuberculosis susceptibility to streptomycin (SM), isoniazid (INH), rifampin (RMP), ethambutol (EMB), and pyrazinamide (PZA) was evaluated with 100 clinical isolates and compared to that of the radiometric BACTEC 460TB (B460) system. The agar proportion method and the B460 system were used as reference methods to resolve the discordant results for SM, INH, RMP, and EMB (a combination known as ...

  5. Evaluation of a High-Intensity Green Fluorescent Protein Fluorophage Method for Drug- Resistance Diagnosis in Tuberculosis for Isoniazid, Rifampin, and Streptomycin

    Science.gov (United States)

    Yu, Xia; Gu, Yunting; Jiang, Guanglu; Ma, Yifeng; Zhao, Liping; Sun, Zhaogang; Jain, Paras; O'Donnell, Max; Larsen, Michelle; Jacobs, William R.; Huang, Hairong

    2016-01-01

    A novel method for detecting drug resistance in Mycobacterium tuberculosis using mycobacteriophage Φ2GFP10 was evaluated with clinical isolates. The phage facilitates microscopic fluorescence detection due to the high expression of green fluorescence protein which also simplifies the operative protocol as well. A total of 128 clinical isolates were tested by the phage assay for isoniazid (INH), rifampin (RIF), and streptomycin (STR) resistance while conventional drug susceptibility test, by MGIT960, was used as reference. The sensitivities of Φ2GFP10 assay for INH, RIF, and STR resistance detection were 100, 98.2, and 89.3%, respectively while their specificities were 85.1, 98.6, and 95.8%, respectively. The agreement between phage and conventional assay for detecting INH, RIF, and STR resistance was 92.2, 98.4, and 93.0%, respectively. The Φ2GFP10-phage results could be available in 2 days for RIF and STR, while it takes 3 days for INH, with an estimated cost of less than $2 to test all the three antibiotics. The Φ2GFP10-phage method has the potential to be a valuable, rapid and economical screening method for detecting drug-resistant tuberculosis. PMID:27379052

  6. Lower cytotoxicity, high stability, and long-term antibacterial activity of a poly(methacrylic acid)/isoniazid/rifampin nanogel against multidrug-resistant intestinal Mycobacterium tuberculosis.

    Science.gov (United States)

    Chen, Tao; Li, Qiang; Guo, Lina; Yu, Li; Li, Zhenyan; Guo, Huixin; Li, Haicheng; Zhao, Meigui; Chen, Liang; Chen, Xunxun; Zhong, Qiu; Zhou, Lin; Wu, Ting

    2016-01-01

    To overcome the undesirable side effects and reduce the cytotoxicity of isoniazid (INH) and rifampin (RMP) in the digestive tract, a poly(methacrylic acid) (PMAA) nanogel was developed as a carrier of INH and RMP. This PMAA/INH/RMP nanogel was prepared as a treatment for intestinal tuberculosis caused by multidrug-resistant Mycobacterium tuberculosis (MTB). The morphology, size, and in vitro release properties were evaluated in a simulated gastrointestinal medium, and long-term antibacterial performance, cytotoxicity, stability, and activity of this novel PMAA/INH/RMP nanogel against multidrug-resistant MTB in the intestine were investigated. Our results indicate that the PMAA/INH/RMP nanogel exhibited extended antibacterial activity by virtue of its long-term release of INH and RMP in the simulated gastrointestinal medium. Further, this PMAA/INH/RMP nanogel exhibited lower cytotoxicity than did INH or RMP alone, suggesting that this PMAA/INH/RMP nanogel could be a more useful dosage form than separate doses of INH and RMP for intestinal MTB. The novel aspects of this study include the cytotoxicity study and the three-phase release profile study, which might be useful for other researchers in this field. PMID:26478357

  7. Medical marijuana

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000899.htm Medical marijuana To use the sharing features on this ... have legalized marijuana for medical use. How Does Medical Marijuana Work? Medical marijuana may be: Smoked Vaporized ...

  8. Use of Real-Time PCR and Fluorimetry for Rapid Detection of Rifampin and Isoniazid Resistance-Associated Mutations in Mycobacterium tuberculosis

    Science.gov (United States)

    Torres, Maria J.; Criado, Antonio; Palomares, Jose C.; Aznar, Javier

    2000-01-01

    Very fast amplification of DNA in small volumes can be continuously monitored with a rapid cycler that incorporates fluorimetric detection. Primers were designed to amplify a 157-bp fragment of the rpoB gene spanning codons 526 and 531 and a 209-bp fragment of the katG gene spanning codon 315 of Mycobacterium tuberculosis. Most mutations associated with resistance to rifampin (RMP) and isoniazid (INH) in clinical isolates occur in these codons. Two pairs of hybridization probes were synthesized; one in each pair was 3′ labeled with fluorescein and hybridized upstream of the codon with the mutation; the other two probes were 5′ labeled with LightCycler-Red 640. Each pair of probes recognized adjacent sequences in the amplicon. After DNA amplification was finished by using a LightCycler, the temperature at which the Red 640 probe melted from the product was determined in a 3-min melt program. Twenty M. tuberculosis clinical isolates susceptible to streptomycin, INH, RMP, and ethambutol and 36 antibiotic-resistant clinical M. tuberculosis isolates (16 resistant to RMP, 16 to INH, and 4 to both antimicrobial agents) were amplified, and the presence of mutations was determined using single-strand conformation polymorphism analysis, the LiQor automated sequencer, and the LightCycler system. Concordant results were obtained in all cases. Within 30 min, the LightCycler method correctly genotyped all the strains without the need of any post-PCR sample manipulation. Overall, this pilot study demonstrated that real-time PCR coupled to fluorescence detection is the fastest available method for the detection of RMP and INH resistance-associated mutations in M. tuberculosis clinical isolates. PMID:10970356

  9. Availability of an assay for detecting Mycobacterium tuberculosis, including rifampin-resistant strains, and considerations for its use - United States, 2013.

    Science.gov (United States)

    2013-10-18

    In August 2013, the Food and Drug Administration (FDA) permitted marketing of the Xpert MTB/RIF assay (Cepheid, Sunnyvale, California) to detect DNA of the Mycobacterium tuberculosis complex (MTBC) and genetic mutations associated with resistance to rifampin (RMP) in unprocessed sputum and concentrated sputum sediments. Along with clinical, radiographic, and other laboratory findings, results of the assay aid in the diagnosis of pulmonary tuberculosis (TB). The assay is a nucleic acid amplification-based (NAA)* test using a disposable cartridge in conjunction with the GeneXpert Instrument System. Sensitivity and specificity of the Xpert MTB/RIF assay for detection of MTBC appear to be comparable with other FDA-approved NAA assays for this use, although direct comparison studies have not been performed. Sensitivity of detection of RMP resistance was 95% and specificity 99% in a multicenter study using archived and prospective specimens from subjects aged ≥18 years suspected of having TB who had 0-3 days of antituberculous treatment. CDC continues to recommend following published U.S. guidelines for TB diagnosis and infection control practice, including the use and interpretation of NAA test results. Providers and laboratories need to ensure that specimens are available for other recommended mycobacteriological testing. The Xpert MTB/RIF assay aids in the prompt diagnosis of TB and RMP-resistant disease. RMP resistance most often coexists with isoniazid (INH) resistance; TB that is resistant to both drugs is multidrug-resistant (MDR)† TB. Because the prevalence of RMP resistance is low in the United States (about 1.8% of TB cases), a positive result indicating a mutation in the rpoB gene of MTBC should be confirmed by rapid DNA sequencing for prompt reassessment of the treatment regimen and followed by growth-based drug susceptibility testing (DST). CDC offers these services free of charge.§ PMID:24141407

  10. Ototoxic Medications (Medication Effects)

    Science.gov (United States)

    ... effects of the medications on your hearing and balance systems. The team will discuss with you how these side effects will affect your quality of life. What are the effects I may notice from ... speech is affected. Balance problems can also occur as a result of ...

  11. Use of Molecular Methods To Identify the Mycobacterium tuberculosis Complex (MTBC) and Other Mycobacterial Species and To Detect Rifampin Resistance in MTBC Isolates following Growth Detection with the BACTEC MGIT 960 System

    OpenAIRE

    Somoskovi, Akos; Song, Qunfeng; Mester, Judit; Tanner, Charise; Hale, Yvonne M.; Linda M. Parsons; Salfinger, Max

    2003-01-01

    A prospective study was organized by using a total of 1,585 consecutive clinical specimens to determine whether biomass obtained from positive growth in the MGIT 960 system could be used directly in AccuProbe DNA hybridization tests, the PCR-based Inno-LiPA Rif.TB (LiPA) assay, and a PCR-based DNA sequencing of the rpoB gene for the rapid identification of the Mycobacterium tuberculosis complex (MTBC) and other mycobacterial species and for the determination of rifampin (RIF) resistance in MT...

  12. Abortion - medical

    Science.gov (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 ...

  13. Ag85A DNA疫苗加强免疫显著提高卡介苗初免小鼠的抗结核T细胞免疫应答%Ag85A DNA vaccination boosting enhances BCG primed-mice anti-tuberculosis T cell responses

    Institute of Scientific and Technical Information of China (English)

    康涵; 范小勇; 袁琴; 吴福明; 沈芳

    2013-01-01

    Objective To construct DNA vaccine expressing Mycobacterium tuberculosis(Mtb) immunodominant antigen Ag85A and analyze its anti-tuberculosis T cell responses in BCG primed-mice after DNA vaccination boosting.Methods The coding gene of Ag85A mature fragment was amplified by PCR with H37Rv genomic DNA as template,and then cloned into the eukaryotic expression vector pVAX1 to construct Ag85A DNA vaccine.After purification,Ag85A DNA vaccine was injected intramuscularly twice in BCG primed-mice with BCG vaccination and DNA vaccination alone as control.Eight weeks post-vaccination,spleen lymphocytes were separated and were then used to analyze Mtb antigen specific effector T cell response and polyfuntional IFN-γ/TNF-α/IL-2 secreting CD4+ T cell frequencies and intensities,and CD8+T cell responses by IFN-γ ELISPOT assay and intracellular staining,respectively.Results Compared to BCG vaccinated-and DNA vaccinated-mice,Ag85A DNA boosting not only enhanced significantly BCG primed-mice IFN-γ+TNF-α+IL-2+,IFN-γ+ IL-2+,TNF-α+IL-2+ and IL-2+ CD4+ T cell frequencies and IL-2 secretion,but also improved significantly IFN-γ-secreting and IL-2-secreting CD8+ T cell frequencies.Condusion Ag85A DNA vaccine was constructed successfully and was demonstrated to enhance significantly BCG primed-mice Mtb antigen specific CD4+ and CD8+ T cell responses when boosting,which is beneficial to improve BCG immunogenicity and its waning immune protection against Mtb.%目的 构建表达结核分枝杆菌(Mycobacterium tuberculosis,Mtb)免疫优势抗原Ag85A的DNA疫苗,分析其加强免疫后提高卡介苗(BCG)初免小鼠的抗结核T细胞免疫应答.方法 以Mtb毒株H37Rv基因组DNA为模板,PCR扩增Ag85A抗原编码的结构基因并克隆至真核表达载体pVAX1中构建其DNA疫苗;接着,将纯化后的该DNA疫苗加强免疫BCG初免小鼠2针,以BCG和DNA单独免疫小鼠为对照,免疫8周后无菌分离脾淋巴细胞,分别应用IFN-γ ELISPOT和多

  14. 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

    2014-01-01

    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

  15. Multicenter Noninferiority Evaluation of Hain GenoType MTBDRplus Version 2 and Nipro NTM+MDRTB Line Probe Assays for Detection of Rifampin and Isoniazid Resistance.

    Science.gov (United States)

    Nathavitharana, Ruvandhi R; Hillemann, Doris; Schumacher, Samuel G; Schlueter, Birte; Ismail, Nazir; Omar, Shaheed Vally; Sikhondze, Welile; Havumaki, Joshua; Valli, Eloise; Boehme, Catharina; Denkinger, Claudia M

    2016-06-01

    Less than 30% of multidrug-resistant tuberculosis (MDR-TB) patients are currently diagnosed, due to laboratory constraints. Molecular diagnostics enable rapid and simplified diagnosis. Newer-version line probe assays have not been evaluated against the WHO-endorsed Hain GenoType MTBDRplus (referred to as Hain version 1 [V1]) for the rapid detection of rifampin (RIF) and isoniazid (INH) resistance. A two-phase noninferiority study was conducted in two supranational reference laboratories to allow head-to-head comparisons of two new tests, Hain Genotype MTBDRplus version 2 (referred to as Hain version 2 [V2]) and Nipro NTM+MDRTB detection kit 2 (referred to as Nipro), to Hain V1. In phase 1, the results for 379 test strains were compared to a composite reference standard that used phenotypic drug susceptibility testing (DST) and targeted sequencing. In phase 2, the results for 644 sputum samples were compared to a phenotypic DST reference standard alone. Using a challenging set of strains in phase 1, the values for sensitivity and specificity for Hain V1, Hain V2, and Nipro, respectively, were 90.3%/98.5%, 90.3%/98.5%, and 92.0%/98.5% for RIF resistance detection and 89.1%/99.4%, 89.1%/99.4%, and 89.6%/100.0% for INH resistance detection. Testing of sputa in phase 2 yielded values for sensitivity and specificity of 97.1%/97.1%, 98.2%/97.8%, and 96.5%/97.5% for RIF and 94.4%/96.4%, 95.4%/98.8%, and 94.9%/97.6% for INH. Overall, the rates of indeterminate results were low, but there was a higher rate of indeterminate results with Nipro than with Hain V1 and V2 in samples with low smear grades. Noninferiority of Hain V2 and Nipro to Hain V1 was demonstrated for RIF and INH resistance detection in isolates and sputum specimens. These results serve as evidence for WHO policy recommendations on the use of line probe assays, including the Hain V2 and Nipro assays, for MDR-TB detection. PMID:27076658

  16. Medical Illustration

    Science.gov (United States)

    ... and authentic illustrations used in the publication of medical books, journals, films, videotapes, exhibits, posters, wall charts, and computer programs. A medical illustrator may also work as a member of ...

  17. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

    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 is the...... 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...

  18. Medical Management

    Science.gov (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 ...

  19. Medical marijuana.

    OpenAIRE

    Marmor, J B

    1998-01-01

    Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several...

  20. Medical Complex

    OpenAIRE

    Kumaraswamy, Mohan

    2002-01-01

    One element of the CIVCAL project Web-based resources containing images, tables, texts and associated data on the construction of the Medical Complex. This project covers the construction of a new Hong Kong University Medical Complex on Sassoon Road, Pokfulam. The complex will comprise two buildings, one will house laboratories and a car park, while the other will contain lecture halls

  1. Cardiac Medications

    Science.gov (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. Medication Treatment

    Science.gov (United States)

    ... behavior, such as to reduce self-injury or aggression. Once a symptom is no longer a problem, ... of repetitive behaviors; decrease anxiety, irritability, tantrums, and aggressive behavior; and improve eye contact. Tricyclics These medications are ...

  3. Taking Medication

    Medline Plus

    Full Text Available ... Tip Sheets and Handouts AADE7 Self-Care Behaviors Healthy Eating Being Active Monitoring Taking Medication Problem Solving Reducing Risks Healthy Coping Education & Career Webinars Upcoming Webinars Recorded Webinars ...

  4. Medication Guide

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Help the Cause Glaucoma affects ...

  5. Taking Medication

    Medline Plus

    Full Text Available ... App Tip Sheets and Handouts AADE7 Self-Care Behaviors Healthy Eating Being Active Monitoring Taking Medication Problem Solving Reducing Risks Healthy Coping Education & Career Webinars ...

  6. Medical imaging

    International Nuclear Information System (INIS)

    This didactical book presents the medical imaging techniques: radiography, scanner, nuclear magnetic resonance (NMR). Examples are given for the most common pathologies in all domains of medicine. (J.S.)

  7. Taking Medication

    Medline Plus

    Full Text Available ... Sheets and Handouts AADE7 Self-Care Behaviors Healthy Eating Being Active Monitoring Taking Medication Problem Solving Reducing ... Media Policy | Contact AADE | Sitemap Copyright 2016 AADE Facebook Twitter LinkedIn Pinterest Google Plus Instagram

  8. Taking Medication

    Medline Plus

    Full Text Available ... Tracker App Tip Sheets and Handouts AADE7 Self-Care Behaviors Healthy Eating Being Active Monitoring Taking Medication ... Legislation State Legislation AADE Policy Positions & Statements Affordable Care Act Information Advocacy Tools and Resources Cart Search ...

  9. Medical radiation

    International Nuclear Information System (INIS)

    This leaflet in the At-a-Glance Series describes the medical use of X-rays, how X-rays help in diagnosis, radiation protection of the patient, staff protection, how radioactive materials in nuclear medicine examinations help in diagnosis and the use of radiation in radiotherapy. Magnetic resonance imaging, a diagnostic technique involving no ionizing radiation, is also briefly examined. The role of the NRPB in the medical use of radiation is outlined. (UK)

  10. Medical tourism

    OpenAIRE

    Abbas Ghanbari; Khadijeh Zirak Moradlu; Morteza Ramazani

    2014-01-01

    Medical tourism is considered as one of the tourism dimensions and it can contribute to the stabilized and dynamic development of a country's economy. Since it is cost-effective industry, most developing countries have focused on this industry and they are planning to develop this industry. Not only does Zanjan province, as the central region in medicine services, enjoy different kinds of variety and acceptable medical specialties but also it has historical, natural, and religious tourism pot...

  11. Hidradenitis suppurativa: A practical review of possible medical treatments based on over 350 hidradenitis patients.

    Science.gov (United States)

    Scheinfeld, Noah

    2013-01-01

    Hidradenitis suppurativa (HS), a pathological follicular disease, impacts patients' lives profoundly. HS most commonly involves cutaneous intertriginous areas, such as the axilla, inner thighs, groin and buttocks, and pendulous breasts, but can appear on any follicular skin. Protean, HS manifests with variations of abscesses, folliculitis, pyogenic granulomas, scars (oval honeycombed), comedones, tracts, fistulas, and keloids. The pathophysiology might involve both defects of the innate follicular immunity and overreaction to coagulase negative Staphylococcus. Treatment depends on the morphology, extent, severity, and duration. Topical clindamycin and dapsone are often adequate for treating mild HS. For Stage 1 and 2 HS, first line treatment combines rifampin with either oral clindamycin or minocycline. Other HS treatments include: fluoroquinolones with metronidazole and rifampin, oral dapsone, zinc, acitretin, hormone blockers (oral contraceptive pills, spironolactone, finasteride, and dutasteride), and oral prednisone. For severe HS, cyclosporine, adalimumab, or infliximab (used at double psoriatic doses) and intravenous carbapenems or cephalosporins are often required. Isotretinoin, etanercept, isoniazid, lymecycline, sulfasalazine, methotrexate, metformin, colchicine, clarithromycin, IVIG, and thalidomide are less favored treatments. The role of botulinum toxin is uncertain. The most important life style modification is weight loss. De-roofing fluctuant nodules and injection of intralesional corticosteroids ameliorates the disease and perhaps, if done at regular intervals, improves HS more permanently. Surgical excision and CO2 laser ablation are more definitive treatments. The 1064 nm laser for hair removal aids in the treatment of HS. This article centers on medical therapies and will only passingly mention surgical and laser treatments. This article summarizes my treatment experience with over 350 HS patients. PMID:24021361

  12. Medical migration.

    Science.gov (United States)

    Loefler, I J

    2001-10-01

    The issue of professional migration, however emotional it may have become, ought not to be regarded in moralizing terms. The history of western medicine is the history of migrating physicians. A doctor who moves from a locality to another to take up a new assignment there cannot be said to have "abandoned his patients". This emotional bond has become the victim of specialization and of depersonalization of medical services and not of medical migration, brain drain or otherwise. The primary reason for medical migration is not financial; the desire to migrate usually begins with the desire to learn. Professionals crave in the first line for professional satisfaction. The migration of medical manpower cannot be stopped with administrative measures and will not be stopped by exhortations and appeals, moralization and condemnations. Brain drain is a global phenomenon and has always been so. A country which loses its professionals, its doctors, should examine the social relationships within the profession and should investigate whether the opportunities for deriving professional satisfaction from everyday work exist or whether these have been thwarted by the hierarchy, conservatism, cronyism and the general lack of comprehension of what good medical care is about. PMID:11593497

  13. Medical leasing.

    Science.gov (United States)

    Holden, Elizabeth A

    2012-01-01

    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. PMID:22594070

  14. Medical Applications

    CERN Document Server

    Biscari, C

    2014-01-01

    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.

  15. Glaucoma medications.

    Science.gov (United States)

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

    2013-01-01

    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. PMID:23505792

  16. Medication Errors

    Science.gov (United States)

    ... Proprietary Names (PDF - 146KB) Draft Guidance for Industry: Best Practices in Developing Proprietary Names for Drugs (PDF - 279KB) ... or (301) 796-3400 druginfo@fda.hhs.gov Human Drug ... in Medication Errors Resources for You Agency for Healthcare Research and Quality: ...

  17. Medical imaging

    CERN Document Server

    Townsend, David W

    1996-01-01

    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 ...

  18. Medical tourism.

    Science.gov (United States)

    Reed, Christie M

    2008-11-01

    Searches of the literature or Internet using the term "medical tourism" produce two sets of articles: travel for the purpose of delivering health care or travel for the purpose of seeking health care. The first usage primarily appears in the medical literature and is beyond the scope of this article, which focuses on travel to seek health care. Still, there are some aspects these two topics have in common: both are affected by ease and speed of international travel and communication associated with globalization, and both raise questions about continuity of care as well as issues related to cultural, language, and legal differences; both also raise questions about ethics. This article describes some of the motivating factors, contributing elements, and challenges in elucidating trends, as well as implications for clinicians who provide pretravel advice and those who care for ill returning travelers. PMID:19061760

  19. Medical Malpractice

    DEFF Research Database (Denmark)

    Grembi, Veronica

    2014-01-01

    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....../or its affordability, the withdrawal from the MM insurance of commercial insurers, the growth of MM public insurance or self-insurance solutions, the choice of no-fault rather than negligence liability, the adoption of enterprise liability for hospitals, the concerns for defensive medicine, and the...... in the last decades also among European countries (Hospitals of the European Union (HOPE) (2004) Insurance and malpractice, final report. Brussels, www.hope.be; OECD (2006) Medical malpractice, insurance and coverage options, policy issues in insurance n.11; EC (European Commission, D.G. Sanco) (2006...

  20. Medical imaging.

    OpenAIRE

    Kreel, L.

    1991-01-01

    There is now a wide choice of medical imaging to show both focal and diffuse pathologies in various organs. Conventional radiology with plain films, fluoroscopy and contrast medium have many advantages, being readily available with low-cost apparatus and a familiarity that almost leads to contempt. The use of plain films in chest disease and in trauma does not need emphasizing, yet there are still too many occasions when the answer obtainable from a plain radiograph has not been available. Th...

  1. Medical Department

    International Nuclear Information System (INIS)

    Within Brookhaven National Laboratory, the life sciences program is carried out under two departments, the Medical Department and the Biological Department. The Medical Research Center contains three major divisions: the Hospital, the Research Laboratories, and the Occupational Medicine Clinic. The hospital, which is devoted entirely to research patients, supports clinical studies in: pulmonary diseases; neuropsychiatric disorders; hematological diseases (e.g., chronic lymphocytic leukemia); cardiopulmonary disorders; hepatobiliary dysfunction; cancer of various types; toxicological problems; bone and mineral metabolism; and dietary and nutritional disorders. Research efforts are also made to improve therapeutic measures for disease: brain tumor therapy through boron capture of epithermal neutrons, and proton beam irradiation; extracorporeal irradiation of blood in leukemia; iron chelator efficacy in thalassemia; and nonsurgical treatment of ocular melanoma. Early diagnoses and studies of the mechanism of disease are approached through medical applications of nuclear technology, including positron emission tomography. Work carried out within the Biological Department includes: biological structure determination, molecular genetics, DNA repair and plant sciences. A large part of the research is devoted to understanding how biological systems work. Central to this aim is the study of DNA. This includes effects of damage by physical and chemical agents, gene cloning of bacteria and plants and effects of low doses of radiation and other energy derived hazards

  2. Medical Applications

    Science.gov (United States)

    Boccara, A. Claude; Mordon, Serge

    2015-10-01

    In re-listening to the lectures of Charles Townes shortly after the invention of the laser (e.g., in the Boston Science Museum), one can already have a realistic vision of the potentialities of this new tool in the field of medical therapy, as evidenced by the use of the laser in ophthalmology to cure retinal detachment in the 1960's. Since then, applications have flourished in the domain of therapy. We will thus illustrate here only some of the main fields of application of medical lasers. On the opposite, the use of lasers in medical imaging is, with one exception in ophthalmology, still at the development level. It is becoming a diagnostic tool in addition to high performance imaging facilities that are often very expensive (such as CT scan, Magnetic Resonance Imaging (MRI) and nuclear imaging). Even if progress is sometimes slow, one can now image with light inside the human body, in spite of the strong scattering of light by tissues, in the same way as a pathologist sees surgical specimens.

  3. Pneumonectomy for chronic inflammatory lung disease: indications and complications

    Institute of Scientific and Technical Information of China (English)

    NIE Gang; LIU Guo-jun; Jean Deslauriers; FAN Zhi-min

    2010-01-01

    @@ Chronic inflammatory lung disease is a common health problem and often treated with potent antibiotics, anti-tuberculosis drugs, and antifungal agents. However, in case of medical therapy failure, surgical treatment has been often considered as an effective procedure.

  4. Medical electromechatronics

    Science.gov (United States)

    Osipov, Y. M.; Syryamkin, V. I.; Osipov, O. Y.

    2015-11-01

    The first part of the article presentsdevices of rehabilitation electromechatronics.As a research work, the author's team has performed sketch and technical developments on this subject, which are protected by patents of the Russian Federation. The second part providesan overview of medical robotic surgery, which is ideal for imperfections removing.It also describes capabilities of the author's team in development of active driveline based "iron" hands.Scalpels never tremble in the iron hands, which are not afraid of the aftershocks and never get tired.They can perform operations during not less than 48 consecutive hours.

  5. Medical robotics

    CERN Document Server

    Troccaz, Jocelyne

    2013-01-01

    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

  6. [Medical nanodevices].

    Science.gov (United States)

    Sugimachi, Masaru; Sunagawa, Kenji

    2006-02-01

    Development of implantable medical nanodevices enables us continuous automatic treatment of patients from inside of their body. Bionic devices, interfacing with neural systems and substituting native functions, such as bionic pacemaker, bionic pressure controller are candidates to miniaturize. For such miniaturization, efforts to reduce size of power supply (e.g., biological fuel cell) and to establish reliable high-throughput, low power telecommunication (e.g., spread spectrum telecommunication) are required. Simple devices such as pacemakers would benefit from miniaturization by lowering invasion and by developing a new usage such as ventricular resynchronization. PMID:16454192

  7. Smoking cessation medications

    Science.gov (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 ...

  8. The Medical Home

    Science.gov (United States)

    ... Melon Smoothie Pregnant? Your Baby's Growth The Medical Home KidsHealth > For Parents > The Medical Home Print A ... for your child. What Does the Term "Medical Home" Mean? A medical home isn't a place ...

  9. Medical alert bracelet (image)

    Science.gov (United States)

    People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will ... People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will ...

  10. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications ... Psychological Treatments Understanding Stress Cognitive Behavioral ...

  11. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Take Part in Online ...

  12. Medical radiation

    International Nuclear Information System (INIS)

    Three slide sets which can be used in lectures about radiation protection have been published by NRPB. The slide sets are based on publications in the NRPB ''At-a-Glance'' series of broadsheets, which use illustrations as the main source of information, supported by captions; the series generally avoids the jargon of radiation protection, although each leaflet is based on scientific studies. Slide Set Number 3, ''Medical Radiation'', outlines the production and use of x-rays in diagnosis, the protection of staff and patients, and the use of radioactive materials in diagnosis and radiotherapy. It summarises the use of magnetic resonance imaging. Radiation doses received during various x-ray examinations are compared with radiation doses from nature. (Author)

  13. 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......IT is central for the development of modern healthcare. Until now, researchers and designers have given great attention to how IT can render clinical data accessible and support collaborative and coordinative work. By focusing on how physicians make sense of patients’ illness trajectories and by...... conceptualizing this as narrative reasoning, this PhD dissertation offers novel perspectives on design of health IT. The dissertation consists of five research articles and an extended synopsis that presents findings from three years of research within the project ‘Co-Constructing IT and Healthcare...

  14. [MEDICAL CANNABIS].

    Science.gov (United States)

    Naftali, Timna

    2016-02-01

    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. PMID:27215115

  15. Matching Medical Websites to Medical Guidelines

    OpenAIRE

    Dusan Rak; Vojtech Svatek

    2016-01-01

    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 we...

  16. Medical muddle.

    Science.gov (United States)

    Gartrell, Nanette

    2014-01-01

    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. PMID:24400630

  17. Medical marketplace

    Science.gov (United States)

    Moretti, Michael

    1991-08-01

    Solid state lasers are the real highlight of my talk today, and were really the star of the year. In every application area I can think of, people have tried with some success to introduce corturiercial solid state products. I'll go into more detail, but aside from solid state, a very significant event happened in Deceniber when one of the laser angioplasty companies (Advanced Interventional Systens) received FDA clearance to begin marketing the excimer for coronary applications (Figure 1) . This is the first time to my knowledge that an excimer has ever been cleared for a medical application in the United States. It's an event that we didn't really expect to happen so soon. It's extremely significant and we'll see where it goes from here. The system needs to be road-tested a bit but to get past the FDA is the major obstacle. Looking back to solid state laser the importance of solid state lasers is as researchers become more involved with the excimer and conduct more clinical studies in ophthalmology, they realize that it's not going to be a panacea for all refractive surgery or other ophthalmolic applications. In many cases it looks like the solid state laser may be the laser of choice in certain types of surgery; most notably perhaps in refractive surgery. We've all read about the success of the excimer at least in capturing the press's attention for corneal sculpting and vision correction. Well, it could be that actually the next generation will be a solid state laser, so let's keep an open mind here.

  18. 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

    2015-01-01

    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

  19. Factors Associated with Fatality during the Intensive Phase of Anti-Tuberculosis Treatment

    Science.gov (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.

    2016-01-01

    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

  20. BACTERIAL DNA GYRASE IS NOT THE TARGET OF QUINOLINE-BASED ANTI-TUBERCULOSIS COMPOUNDS

    Directory of Open Access Journals (Sweden)

    Verma Rahul

    2013-01-01

    Full Text Available Few quinoline-based synthetic compounds (2, 8 Dicyclopentyl-4-methyl quinoline and 2, 8 Dicyclohexyl-4-methyl quinoline, the synthesis of which have been already shown by our medicinal chemistry group, were found to be potent inhibitor of mycobacterial growth. Based on the results of cell culture-based cell killing assays using DNA gyrase positive E. coli strains, we presumed that bacterial DNA gyrase might be a probable target of quinolines. The resemblance of the basic skeletal structural moiety of quinolone and quinoline inspired us to hypothesize that these quinolines might inhibit DNA gyrase. While the non-gyrase inhibitors like ethambutol and isoniazid did not inhibit the growth of these strains. The genesis of the notion of using E. coli DNA gyrase as an alternative to DNA gyrase from the pathogenic Mycobacterium, stems from the fact that E. coli DNA gyrase is found to be about eighty times more sensitive to the action of quinolones than the Mycobacterium DNA gyrase. Therefore, we had used E. coli DNA gyrase as a model enzyme for studying the action of some synthetic quinoline compounds synthesized by us. In the present work, we have used cell killing assay, gel electrophoresis assay (for DNA supercoiling and UV spectroscopy-based coupled assay (for ATP hydrolysis for characterizing the activity of DNA gyrase. Quinolones exhibited low IC50 values as compared to the studied quinolines on DNA gyrase positive E. coli strains We found that although quinolones are the potent inhibitors of supercoiling activity of E. coli DNA gyrase, quinolines are not. We further found that ATPase activity of E. coli DNA gyrase (Non-specific inhibitor was inhibited to a very minor extent in the presence of very high concentration of these synthetic quinolines. DNA gyrase is not the primary target of these synthetic quinolines (2, 8 Dicyclopentyl-4-methyl quinoline and 2, 8 Dicyclohexyl-4-methyl quinoline.

  1. Novel adjuvant formulations for delivery of anti-tuberculosis vaccine candidates.

    Science.gov (United States)

    Agger, Else Marie

    2016-07-01

    There is an urgent need for a new and improved vaccine against tuberculosis for controlling this disease that continues to pose a global health threat. The current research strategy is to replace the present BCG vaccine or boost BCG-immunity with subunit vaccines such as viral vectored- or protein-based vaccines. The use of recombinant proteins holds a number of production advantages including ease of scalability, but requires an adjuvant inducing cell-mediated immune responses. A number of promising novel adjuvant formulations have recently been designed and show evidence of induction of cellular immune responses in humans. A common trait of effective TB adjuvants including those already in current clinical testing is a two-component approach combining a delivery system with an appropriate immunomodulator. This review summarizes the status of current TB adjuvant research with a focus on the division of labor between delivery systems and immunomodulators. PMID:26596558

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

    Directory of Open Access Journals (Sweden)

    Cristina I. Canché Chay

    2014-03-01

    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.

  3. Recent patents and advances on anti - tuberculosis drug delivery and formulations.

    Science.gov (United States)

    Vora, Chintan; Patadia, Riddhish; Mittal, Karan; Mashru, Rajashree

    2013-08-01

    Tuberculosis has remained, unambiguously, a significant health care problem since long times, particularly in developing countries. The endeavoring battle against multi drug resistant TB, multiple dosing, their prominent side effects and bioavailability hiccups related to fixed dose combinations has undeniably become a Herculean task indicating rigorous research requirement in anti TB drug therapy. In view of the fact that patenting a drug molecule, a drug delivery system or a formulation has been very fruitful for the growth and sustainment of pharmaceutical industry, a meticulous review of recent developments, providing a balanced view on merits/demerits, will facilitate researchers to update themselves, thereby focusing their research in more relevant areas to furnish desired quality traits. This article reviews the present scenario in terms of drug delivery approaches for TB chemotherapy. The review encompasses and summarizes recent patents and advances on variegated facets of dosage forms, together with from conventional solid oral to novel controlled release oral formulations and additionally alternative weapons for anti TB drug delivery. A critical review of multidisciplinary approaches to boost anti TB therapy may facilitate the scientists to resolve existing technological gaps. PMID:23244680

  4. Encapsulation of Anti-Tuberculosis Drugs within Mesoporous Silica and Intracellular Antibacterial Activities

    Directory of Open Access Journals (Sweden)

    Xin Xia

    2014-09-01

    Full Text Available Tuberculosis is a major problem in public health. While new effective treatments to combat the disease are currently under development, they tend suffer from poor solubility often resulting in low and/or inconsistent oral bioavailability. Mesoporous materials are here investigated in an in vitro intracellular assay, for the effective delivery of compound PA-824; a poorly soluble bactericidal agent being developed against Tuberculosis (TB. Mesoporous materials enhance the solubility of PA-824; however, this is not translated into a higher antibacterial activity in TB-infected macrophages after 5 days of incubation, where similar values are obtained. The lack of improved activity may be due to insufficient release of the drug from the mesopores in the context of the cellular environment. However, these results show promising data for the use of mesoporous particles in the context of oral delivery with expected improvements in bioavailability.

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

    OpenAIRE

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

    2006-01-01

    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 o...

  6. Molecular epidemiology study of Mycobacterium tuberculosis and its susceptibility to anti-tuberculosis drugs in Indonesia

    OpenAIRE

    Lisdawati, Vivi; Puspandari, Nelly; Rif’ati, Lutfah; Soekarno, Triyani; M, Melatiwati; K, Syamsidar; Ratnasari, Lies; Izzatun, Nur; Parwati, Ida

    2015-01-01

    Background Genotyping of Mycobacterium tuberculosis helps to understand the molecular epidemiology of tuberculosis and to address evolutionary questions about the disease spread. Certain genotypes also have implications for the spread of infection and treatment. Indonesia is a very diverse country with a population with multiple ethnicities and cultures and a history of many trade and tourism routes. This study describes the first attempt to map the molecular epidemiology of TB in the Indones...

  7. Determinants of poor adherence to anti-tuberculosis treatment in Mumbai, India

    Directory of Open Access Journals (Sweden)

    Suparna Bagchi

    2010-01-01

    Conclusions: An approach, targeting easier access to drugs, an ensured drug supply, effective solutions for travel-related concerns and modification of smoking and alcohol related behaviors are essential for treatment adherence.

  8. Anti-Tuberculosis Therapy-Induced Hepatotoxicity among Ethiopian HIV-Positive and Negative Patients

    OpenAIRE

    Yimer, Getnet; Aderaye, Getachew; Amogne, Wondwossen; Makonnen, Eyasu; Aklillu, Eleni; Lindquist, Lars; Yamuah, Lawrence; Feleke, Beniyam; Aseffa, Abraham

    2008-01-01

    Background To assess and compare the prevalence, severity and prognosis of anti-TB drug induced hepatotoxicity (DIH) in HIV positive and HIV negative tuberculosis (TB) patients in Ethiopia. Methodology/Principal Findings In this study, 103 HIV positive and 94 HIV negative TB patients were enrolled. All patients were evaluated for different risk factors and monitored biochemically and clinically for development of DIH. Sub-clinical hepatotoxicity was observed in 17.3% of the patients and 8 out...

  9. The anti-tuberculosis agents under development and the challenges ahead.

    Science.gov (United States)

    Kumar, Deepak; Negi, Beena; Rawat, Diwan S

    2015-01-01

    Tuberculosis (TB) is a serious health problem causing 1.5 million deaths worldwide. After the discovery of first-line anti-TB drugs, the mortality rate declined sharply, however, the emergence of drug-resistant strains and HIV co-infection have led to increased incidence of this disease. A number of new potential antitubercular drug candidates with novel modes of action have entered clinical trials in recent years. Compounds such as gatifloxacin, moxifloxacin and linezolid, the already known antibiotics are currently being evaluated for their anti-TB activity. OPC-67683 and TMC207 have been approved for the treatment of MDR-TB patients recently, while PA-824, SQ109, PNU-100480, AZD5847, LL3858, SQ609, SQ641, BTZ043, DC-159a, CPZEN-45, Q-203, DNB1, TBA-354 are in various phases of clinical and preclinical developments. This review evaluates the current status of TB drug development and future aspects. PMID:26505682

  10. Sublineages of Mycobacterium tuberculosis Beijing genotype strains and unfavorable outcomes of anti-tuberculosis treatment.

    Science.gov (United States)

    Hang, Nguyen T L; Maeda, Shinji; Keicho, Naoto; Thuong, Pham H; Endo, Hiroyoshi

    2015-05-01

    The influence of Mycobacterium tuberculosis (MTB) lineages/sublineages on unfavorable tuberculosis (TB) treatment outcomes is poorly understood. We investigated the effects of Beijing genotype sublineages and other factors contributing to treatment outcome. Patients newly diagnosed with sputum smear-positive and culture-positive TB in Hanoi, Vietnam, participated in the study. After receiving anti-TB treatment, they were intensively followed up for the next 16 months. MTB isolates collected before treatment were subjected to drug susceptibility testing, and further analyzed to determine MTB (sub) lineages and their clonal similarities. Of 430 patients, 17 had treatment failure and 30 had TB recurrence. Rifampicin resistance was associated with treatment failure {adjusted odds ratio = 6.64 [95% confidence interval (CI), 1.48-29.73]}. The modern Beijing genotype was significantly associated with recurrent TB within 16 months [adjusted hazard ratio = 3.29 (95% CI, 1.17-9.27)], particularly after adjustment for the relevant antibiotic resistance. Human immunodeficiency virus coinfection and severity on chest radiographs were not significantly associated with unfavorable outcomes. Our findings provide further understanding of the influence of MTB strains on unfavorable treatment outcomes. Multiple risk factors should be considered for the optimal management of TB. PMID:25732626

  11. QTF-Gold assay for monitoring of anti-tuberculosis therapy in subjects with active TB

    Directory of Open Access Journals (Sweden)

    Ilaria Sauzullo

    2008-09-01

    Full Text Available Introduction: The identification and characterization of two M. tuberculosis-specific antigens (ESAT-6 and CFP- 10 has led to the development of a whole blood new generation of M. tuberculosis specific diagnostic tests, that have several advantages over tuberculin skin test (TST, in terms of higher specificity, better correlation with surrogate measures of exposure to M. tuberculosis in low-incidence setting, and less cross-reactivity with M. bovis (BCG vaccine and environmental mycobacteria.The role of these new tests in evaluating post-therapy tuberculosis eradication has not been investigated yet. Aim of this longitudinal study was to determinate changes of response to M. tuberculosis-specific antigens in patients during the standard tuberculosis treatment and to investigate the in vitro effects of tuberculosis drugs on the IFN-γ release. Methods: 23 individuals with active tuberculosis were enrolled and followed over time.They were tested with QuantiFERON TB-Gold (QFT-Gold at four time points: at diagnosis (t0, after 3 and 6 months of treatment (t1- t2 and at the end of the specific treatment (t3. Results: At baseline all patients were positive by QFT-Gold.At second time-point 17 out of 23 (74% were positive, at third time-point 11 of 23 (47% were positive, at treatment completion 3/23 (13% were positive.The conversion to negative response to M. tuberculosis-specific antigens was found in 87% patients analyzed after successful therapy. Longitudinal QFT-Gold testing shown a significant decrease (p<0.001 of IFN-γ response during the therapy. No inhibitory effect on IFN-γ release was noted in vitro for chemotherapy using at concentrations compatible with those achieved in serum of treated patients.We have revealed an inhibitory effect only at concentrations 2-3 times greater than those previously tested. Conclusion: A successful therapy for tuberculosis causes a significant decrease of the ESAT-6 and CFP-10 response and this data suggest that the QTF-Gold assay may have a role as a tool for evaluating tuberculosis eradication after standard tuberculosis treatment.

  12. 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;

    2014-01-01

    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...... patients. Therapy 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...

  13. Bioactivation of Anti-Tuberculosis Thioamide and Thiourea Prodrugs by Bacterial and Mammalian Flavin Monooxygenases

    OpenAIRE

    Nishida, Clinton R.; Ortiz de Montellano, Paul R.

    2010-01-01

    The thioamide and thiourea class of antituberculosis agents encompasses prodrugs that are oxidatively converted to their active forms by the flavin monooxygenase EtaA of Mycobacterium tuberculosis. Reactive intermediates produced in the EtaA-catalyzed transformations of ethionamide and prothionamide result in NAD+/NADH adducts that inhibit the enoyl CoA reductase InhA, the ultimate target of these drugs. In the case of thiacetazone and isoxyl, EtaA produces electrophilic metabolites that medi...

  14. HEPATOPROTECTIVE ACTIVITY OF SILYMARIN FLOATING DRUG DELIVERY SYSTEM AGAINST ANTI TUBERCULOSIS DRUG

    Directory of Open Access Journals (Sweden)

    Vinay kumar D*

    2010-06-01

    Full Text Available A Gastroretentive floating controlled drug delivery system containing Silymarin was prepared in the form of tablets and evaluated for its processing parameters, in vitro release in 0.1 N HCl. Eightformulations were prepared by using rate controlling polymers such as HPMC K4M and Eudragit RS100, alkalizing agent sodium bicarbonate and solubilizing agent poly vinyl Pyrrolidone (PVP K30.Floating tablets were prepared by direct compression method. The preformulation studies and tablet evaluation tests were performed and results were within the limits. Tablets remained buoyant over 20 hours in the release medium and the amount of sodium bicarbonate found to be significant for not only to remaining buoyant without causing disintegration of the tablet. The different ratios of polymers 15%and 20% showed the significant difference in the drug release with increasing in the concentration of solubilizing agent PVP K30. All the formulations exhibited diffusion dominant drug release. Stabilitystudies for all formulations were conducted for a period of 60 days at 4º±2ºC, 27º±2ºC and 45º±2ºC respectively and the formulations showed no significant changes in physical appearance, drug contentand in-vitro drug release even after 60 days. The control release of the drug from the dosage form shows the hepatoprotective activity against Isoniazid (INH + Rifampcin (RIF induced hepatotoxicity in rats.

  15. Impact of medical informatics on medical education.

    Science.gov (United States)

    Hou, S M

    1999-11-01

    In recent years, medical informatics has become a well-recognized branch of medicine. It is a multidisciplinary science that combines information technology and various specialties of medicine. The impact of medical informatics on medical education is advancing along with the rapid developments in computer science. Departments of medical informatics or similar divisions have appeared in schools of medicine in Taiwan in the past 5 years. At National Taiwan University College of Medicine, we offer curricula in basic computer concepts, network concepts, operating systems, word processing, database and data processing, computer media resources, multimedia computer statistics, intelligent health information systems, medical diagnostic support systems, and electronic medical record systems. Distance learning has also been favorably accepted on this campus. Recently, we proposed the concept of a virtual medical campus, which will break the physical barriers of time and space. We expect this revolution to influence every aspect of medicine, especially medical education. PMID:10705693

  16. Medication/Drug Allergy

    Science.gov (United States)

    ... Information > Allergy: Allergens > Medication/Drug Allergy Medication/Drug Allergy Allergies to medications/drugs are complicated because they ... Calendar Read the News View Daily Pollen Count Allergy Treatment Programs, Adult At National Jewish Health, some ...

  17. Medications (for IBS)

    Medline Plus

    Full Text Available ... of pain. This may involve a low-dose antidepressant, which acts as a pain reliever. Seeking referral ... Yoga Medications Laxatives Anticholinergic/Antispasmodic Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological ...

  18. Medications: Myths Versus Facts

    Science.gov (United States)

    ... High Blood Pressure Tools & Resources Stroke More Medications: Myths Versus Facts Updated:Aug 30,2016 Taking medication ... Association volunteer. Here are some of the top myths about taking cardiovascular medication: I feel OK, so ...

  19. Medications After the NICU

    Science.gov (United States)

    ... NICU) > Medications after the NICU Medications after the NICU E-mail to a friend Please fill in ... go home from the neonatal intensive care unit (NICU) on medication for apnea, reflux or respiratory problems. ...

  20. Asthma Medications and Pregnancy

    Science.gov (United States)

    ... MD Medical Director, Health Initiatives View full profile Asthma and Pregnancy: Asthma Medications We would like to avoid all medicine ... make sure you are using it correctly. Other Asthma Related Medication Treatment Annual influenza vaccine (flu shot) ...

  1. Cognitive Medical Multiagent Systems

    Directory of Open Access Journals (Sweden)

    Barna Iantovics

    2010-01-01

    Full Text Available The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System was proposed. CMDS system can solve flexibly a large variety of medical diagnosis problems. This paper analyses the increased intelligence of the CMDS system, which motivates its use for different medical problem’s solving.

  2. MEDICAL ETHICS COURSE IMPROVES MEDICAL PROFESSIONALISM: MEDICAL STUDENTS´ OPINIONS

    Directory of Open Access Journals (Sweden)

    Abdolreza Sotoodeh Jahromi

    2014-01-01

    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.

  3. Medical Informatics For Medical Students And Medical Practitioners

    Directory of Open Access Journals (Sweden)

    Jai MOHAN

    2010-06-01

    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.

  4. STS-3 medical report

    Science.gov (United States)

    Pool, S. L. (Editor); Johnson, P. C., Jr. (Editor); Mason, J. A. (Editor)

    1982-01-01

    The medical operations report for STS-3, which includes a review of the health of the crew before, during, and immediately after the third Shuttle orbital flight is presented. Areas reviewed include: health evaluation, medical debriefing of crewmembers, health stabilization program, medical training, medical 'kit' carried in flight, tests and countermeasures for space motion sickness, cardiovascular profile, biochemistry and endocrinology results, hematology and immunology analyses, medical microbiology, food and nutrition, potable water, shuttle toxicology, radiological health, and cabin acoustic noise. Environmental effects of shuttle launch and landing medical information management, and management, planning, and implementation of the medical program are also dicussed.

  5. Machine medical ethics

    CERN Document Server

    Pontier, Matthijs

    2015-01-01

    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...

  6. Medical Virtual Public Services

    OpenAIRE

    Iulia SURUGIU; Manole VELICANU

    2008-01-01

    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. Requireme...

  7. Rethinking the medical in the medical humanities.

    Science.gov (United States)

    O'Neill, Desmond; Jenkins, Elinor; Mawhinney, Rebecca; Cosgrave, Ellen; O'Mahony, Sarah; Guest, Clare; Moss, Hilary

    2016-06-01

    To clinicians there are a number of striking features of the ever-evolving field of the medical humanities. The first is a perception of a predominantly unidirectional relationship between medicine and the humanities, generally in terms of what the arts and humanities have to offer medicine. The second is the portrayal of medical practice in terms of problems and negativities for which the medical humanities are seen to pose the solution rather than viewing medicine as an active and positive contributor to an interdisciplinary project. Paradigms that fail to recognise the contributions of medicine and its practitioners (including students) to the medical humanities, this paper argues, will continue to struggle with definition and acceptance. This paper explores the possibilities for advancing the medical humanities through recognition of the contribution of medicine to the humanities and the importance of engaging with the arts, culture and leisure pursuits of doctors and medical students. Our research shows the richness of cultural engagement of medical students, their broad range of cultural interests and their ability to contribute to research and scholarship in the medical humanities. Mutual recognition of strengths, weaknesses and differences of scholarly approach is critical to successful development of the enterprise. Recognising and building on the interests, sympathies and contributions of medicine and its practitioners to the medical humanities is a fundamental component of this task. Future directions might include introductory courses for humanities scholars in aspects of healthcare and medicine. PMID:26944516

  8. Tracking medication information across medical records

    OpenAIRE

    Iglesias, Juan Eugenio; Rocks, Krupa; Jahanshad, Neda; Frias-Martinez, Enrique; Andrada, Lewellyn P.; Bui, Alex A. T.

    2009-01-01

    A patient’s electronic medical record can consist of a large number of reports, especially for an elderly patient or for one affected by a chronic disease. It can thus be cumbersome for a physician to go through all of the reports to understand the patient’s complete medical history. This paper describes work in progress towards tracking medications and their dosages through the course of a patient’s medical history. 923 reports associated with 11 patients were obtained from a university hosp...

  9. Medical narratives in electronic medical records.

    Science.gov (United States)

    Tange, H J; Hasman, A; de Vries Robbé, P F; Schouten, H C

    1997-08-01

    In this article, we describe the state of the art and directions of current development and research with respect to the inclusion of medical narratives in electronic medical-record systems. We used information about 20 electronic medical-record systems as presented in the literature. We divided these systems into 'classical' systems that matured before 1990 and are now used in a broad range of medical domains, and 'experimental' systems, more recently developed and, in general, more innovative. In the literature, three major challenges were addressed: facilitation of direct data entry, achieving unambiguous understandability of data, and improvement of data presentation. Promising approaches to tackle the first and second challenge are the use of dynamic data-entry forms that anticipate sensible input, and free-text data entry followed by natural-language interpretation. Both these approaches require a highly expressive medical terminology. How to facilitate the access to medical narratives has not been studied much. We found facilitating examples of presenting this information as fluent prose, of optimising the screen design with fixed position cues, and of imposing medical narratives with a structure of indexable paragraphs that can be used in flowsheets. We conclude that further study is needed to develop an optimal searching structure for medical narratives. PMID:9476152

  10. Characterization of rpoB gene mutation in rifampin mycobacterium tuberculosis isolated from tuberculosis patients in Suzhou City%苏州市耐利福平结核分枝杆菌rpoB基因突变特点的研究

    Institute of Scientific and Technical Information of China (English)

    张建平; 沈兴华; 王霞芳; 唐佩军; 虞忻; 曹丽娟; 王雪峰; 吴妹英

    2012-01-01

    目的 了解苏州市利福平( rifampin,RFP)耐药结核分枝杆菌rpoB基因突变特点,以期为苏州市RFP耐药结核分枝杆菌(mycobacterium tuberculosis,MTB)临床快速诊断提供有价值的分子标记靶点.方法 通过裂解MTB抽提基因组DNA,采用PCR扩增和DNA测序方法,分析苏州市结核病患者痰培养阳性并经药敏试验诊断为RFP耐药MTB的rpoB基因RFP耐药决定区(rifampin resistance-determining region,RRDR)和CⅡ区变异谱与变异率.将主要突变形式RRDR-531 (TCG→TTG)与传统药敏实验进行诊断学试验,评价此类型突变作为RFP耐药菌株分子标记靶点的临床应用价值.结果 42株RFP耐药MTB的rpoB基因总突变率为90.5% (38/42),在所检测到的突变中,以RRDR-531 (TCG→TTG)为主要形式(61.9%).以此类型的位点突变作为RFP耐药菌株诊断的分子标记,与传统药敏试验比较进行配对x2检验,结果表明,与敏感菌株相比,RRDR-531(TCG→TTG)突变在RFP耐药菌株中差异有统计学意义(x2=12.51,P<0.01).结论 rpoB基因RRDR-531(TCG→TTG)突变是苏州市MTB产生RFP耐药性的主要分子机制,其作为RFP耐药MTB诊断的分子标记靶点具有较好的临床应用价值.%Objective To understand the characteristics of rpoB gene mutation of rifampin ( RFP) resistant Myco-bacterium tuberculosis ( MTB) isolated from tuberculosis patients in Suzhou City and the significance of potential typical mutation as a molecular marker to diagnose RFP-resistant MTB strains. Methods After dissolving MTB and amplifying rpoB gene fragment by PCR, direct sequencing was used to analyze the mutation spectrum occurred in rifampin resistance-determining region ( RRDR) and C II region of rpoB gene from 42 RFP-resistant and sensitive MTB strains. Diagnostic tes-ting was used to evaluate the significance of typical mutation occurred in rpoB gene as a molecular marker of RFP-resistant MTB strains compared with the traditional sensitivity test. Results 38 0f

  11. STS-1 medical report

    Science.gov (United States)

    Pool, S. L. (Editor); Johnson, P. C., Jr. (Editor); Mason, J. A. (Editor)

    1981-01-01

    The report includes a review of the health of the crew before, during and immediately after the first Shuttle orbital flight (April 12-14, 1981). Areas reviewed include: health evaluation, medical debriefing of crewmembers, health stabilization program, medical training, medical kit carried inflight; tests and countermeasures for space motion sickness, cardiovascular profile, biochemistry and endocrinology results; hematology and immunology analyses; medical microbiology; food and nutrition; potable water; shuttle toxicology; radiological health; cabin acoustical noise. Also included is information on: environmental effects of Shuttle launch and landing, medical information management; and management, planning and implementation of the medical program.

  12. 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 ...

  13. HIV Medication Adherence

    Science.gov (United States)

    HIV Treatment HIV Medication Adherence (Last updated 3/1/2016; last reviewed 3/1/2016) Key Points Medication adherence means sticking ... exactly as prescribed. Why is adherence to an HIV regimen important? Adherence to an HIV regimen gives ...

  14. Medications (for IBS)

    Medline Plus

    Full Text Available ... Diet Complimentary or Alt Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS ... Diet Complimentary or Alt Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS ...

  15. Development of medical scintillator

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    This review presents the scintillators requirements for the medical imaging modalities. The history and the development in recent years of the medical scintillators (mainly for GSO:Ce, LSO:Ce, LuAP:Ce) are expatiated in detail.

  16. Medical design anthropology

    DEFF Research Database (Denmark)

    Ventura, Jonathan; Gunn, Wendy

    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...... medical products influence the various participants in the hospital environment (medical staff, patients, families etc.). We will demonstrate our approach through several projects dealing with medical design. In this preliminary research, we will present various issues regarding the understanding of......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...

  17. Medical Device Safety

    Science.gov (United States)

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

  18. Medications (for IBS)

    Medline Plus

    Full Text Available ... Complimentary or Alt Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS Relationships ... Complimentary or Alt Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS Relationships ...

  19. Medications (for IBS)

    Medline Plus

    Full Text Available ... atropine (Lomotil) Read more about antidiarrheal agents. Anti-anxiety medications – can be helpful for some people with ... who specializes in motility or stress-related gastrointestinal disorders. More complex medication regimens, and specialized motility and/ ...

  20. Medications (for IBS)

    Medline Plus

    Full Text Available ... of constipation. Laxatives should be used under the supervision of a physician. Read more about laxatives. Bulking ... medications intended for specific use under a doctor’s supervision. Read more about newer IBS medications. Summary The ...

  1. Medications (for IBS)

    Medline Plus

    Full Text Available ... by a physician who specializes in motility or stress-related gastrointestinal disorders. More complex medication regimens, and ... IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for IBS Take ...

  2. Medications (for IBS)

    Medline Plus

    Full Text Available ... atropine (Lomotil) Read more about antidiarrheal agents. Anti-anxiety medications – can be helpful for some people with ... by a physician who specializes in motility or stress-related gastrointestinal disorders. More complex medication regimens, and ...

  3. 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 Home Medications ...

  4. Medical Treatments for Fibroids

    Science.gov (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 ...

  5. Emergency Medical Services

    Science.gov (United States)

    ... need help right away, you should use emergency medical services. These services use specially trained people and ... emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They ...

  6. Medical SAS File (MDP)

    Data.gov (United States)

    Department of Veterans Affairs — The Medical SAS system provides a variety of SAS-formatted files containing medical data for use by VA staff. These files, and the ability to create user files, are...

  7. Ending pregnancy with medications

    Science.gov (United States)

    ... to the medicines that are used to end pregnancy. Take any medicines that should not be used with a medical abortion. Do not have access to a doctor or an emergency room. Getting Ready for a Medical Abortion The ...

  8. Medications (for IBS)

    Medline Plus

    Full Text Available ... IBS Global Treatments IBS Diet Low FODMAP Diet Complimentary or Alt Treatments Medications Psychological Treatments Online Studies ... IBS Global Treatments IBS Diet Low FODMAP Diet Complimentary or Alt Treatments Medications Psychological Treatments Online Studies ...

  9. Avoiding Medical Identity Theft

    Science.gov (United States)

    ... reports of medical debts Awareness is critical for timely detection of and thorough response to a medical ... appears to have occurred Request an accounting of disclosures from the relevant healthcare providers or health plans ...

  10. Medications for Arrhythmia

    Science.gov (United States)

    ... a one-stop, easy-to-use set of online tracking tools for medications, blood pressure, cholesterol, blood glucose, ... a one-stop, easy-to-use set of online tracking tools for medications, blood pressure, cholesterol, blood glucose, ...

  11. Heart Failure Medications

    Science.gov (United States)

    ... a one-stop, easy-to-use set of online tracking tools for medications, blood pressure, cholesterol, blood glucose, ... a one-stop, easy-to-use set of online tracking tools for medications, blood pressure, cholesterol, blood glucose, ...

  12. Advanced Medication Dispenser

    OpenAIRE

    A. I. Alexan; A. R. Osan; Oniga, S.

    2013-01-01

    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” ...

  13. Development of Medical Devices

    OpenAIRE

    Limaye, Dnyanesh

    2016-01-01

    The medical devices sector helps save lives by providing innovative health care solutions regarding diagnosis, prevention, monitoring, treatment, and alleviation. Medical devices are classified into 1 of 3 categories in the order of increasing risk: Class I, Class II, and Class III.1 Medical devices are distinguished from drugs for regulatory purposes based on mechanism of action. Unlike drugs, medical devices operate via physical or mechanical means and are not dependent on metabolism to acc...

  14. Implantable electronic medical devices

    CERN Document Server

    Fitzpatrick, Dennis

    2014-01-01

    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

  15. Research in medical education

    OpenAIRE

    Vassallo, Josanne

    2009-01-01

    The year 2009 saw a number of developments in Medical Education in Malta that were initiated as a result of a commitment to revising the medical curriculum in order to meet the challenges in medical education. A record number of students were admitted to the medical course in 2009. There is concern that eventually this exponential increase in admissions is not sustainable due to infrastructural, financial and human resource restraints. Meanwhile there has been a simultane...

  16. Medical education and society.

    OpenAIRE

    Murray, T.J.

    1995-01-01

    As health care changes under the pressures of restraint and constraint our vision of the future of medical education should be based on the medical school's responsibility to the community. The medical school is "an academy in the community": as an academy, it fosters the highest standards in education and research; as an institution in the community, it seeks to improve public health and alleviate suffering. The author argues that to better achieve these goals medical schools need to become ...

  17. Law and Medical Ethics

    OpenAIRE

    Frenkel, D A

    1984-01-01

    Summarising the interrelationship between law and medical ethics, I would say that in cases which do not touch the patient's body or integrity, such as professional secrecy, statutory law may take precedence over rules of medical ethics. But in cases where the human subject becomes a victim because of domestic statutory laws which are in contradiction with medical ethics, the medical practitioners should insist on adhering to their professional standards in such a way that the legislators wil...

  18. Growth of medical knowledge

    NARCIS (Netherlands)

    Verhoeven, BH; Verwijnen, GM; Scherpbier, AJJA; van der Vleuten, CPM

    2002-01-01

    Background Knowledge is an essential component of medical competence and a major objective of medical education. Thus, the degree of acquisition of knowledge by students is one of the measures of the effectiveness of a medical curriculum. We studied the growth in student knowledge over the course of

  19. Medical leadership compensation framework

    OpenAIRE

    Uhlíř, Tomáš

    2009-01-01

    This master thesis deals with outlining the rationale of redesigning medical leadership compensation framework within Interior Health Authority (IH). In particular, reviews IH's organizational structure, analyses job descriptions for medical leaders, recommends improvements of communication flow across the authority and designs medical leader's compensation model.

  20. Medications (for IBS)

    Medline Plus

    Full Text Available ... Home Medications Details Medications Last Updated: 17 August 2016 Print Tweet Jump to Topic Medications for IBS ... problem arises requiring an expert’s care. © Copyright 1998-2016 International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). ...

  1. Marijuana: Modern Medical Chimaera

    Science.gov (United States)

    Lamarine, Roland J.

    2012-01-01

    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…

  2. Medications (for IBS)

    Medline Plus

    Full Text Available ... Home Medications Details Medications Last Updated: 15 May 2016 Print Tweet Jump to Topic Medications for IBS ... problem arises requiring an expert’s care. © Copyright 1998-2016 International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). ...

  3. Conducting the Medical History

    Science.gov (United States)

    Finkel, Martin A.; Alexander, Randell A.

    2011-01-01

    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,…

  4. Your Medical Records

    Science.gov (United States)

    ... Can I Help a Friend Who Cuts? Your Medical Records KidsHealth > For Teens > Your Medical Records Print ... Records? en español Tus historias clínicas What Are Medical Records? Each time you climb up on a ...

  5. Mission Medical Information System

    Science.gov (United States)

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

    2008-01-01

    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).

  6. SELF-MEDICATION IN MEDICAL STUDENTS

    OpenAIRE

    Anuj Jain; Chandni Gupta

    2014-01-01

    Self-medication is consumption of medicinal products for treating diseases without a prescription resulting in wastage of resources, increased drug resistance and causes health hazards. Selfmedication, often without adult guidance, has been reported to be a common practice during adolescence. Similar to other preventable health-risk behaviors initiated in early adolescence, it has become a cause for concern universally. The main problem with self medication with antimicrobials is ...

  7. Medical marijuana: Medical necessity versus political agenda

    OpenAIRE

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

    2011-01-01

    Summary 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 ...

  8. [Research in medical education

    DEFF Research Database (Denmark)

    Ringsted, Charlotte Vibeke

    2008-01-01

    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...

  9. Advanced Medication Dispenser

    Directory of Open Access Journals (Sweden)

    A.I. Alexan

    2013-12-01

    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.

  10. Technologies for Medical Sciences

    CERN Document Server

    Tavares, João; Barbosa, Marcos; Slade, AP

    2012-01-01

    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.

  11. Effects of Medications on Voice

    Science.gov (United States)

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

  12. The medical alumni story.

    Science.gov (United States)

    Lim, K H

    2005-07-01

    The Medical Alumni is unique in being the oldest alumni association with medical, dental and pharmacy graduates from our seminal medical school, that has now evolved into the faculties of medicine in 2 countries, namely Malaysia and Singapore. Founded in 1923, the medical alumni association has undergone several name changes with its evolution and activism. After the Japanese Occupation, it was given its present name in 1947, comprising 3 branches working under a common Constitution operating in 2 separate countries. It is also unique in being the only association recognised by the Registrar of Societies with membership in 2 countries. Following the development of medical professional and academic bodies, the medical alumni wound down its medico-political activities to concentrate on providing social and mutual support for its members and its alma mater. PMID:16010406

  13. Evaluation of medical audit.

    OpenAIRE

    Robinson, M. B.

    1994-01-01

    OBJECTIVE--To review current knowledge of the effectiveness of medical audit programmes as a whole and of specific interventions within these programmes, as a means of changing clinical behaviour. CRITERIA FOR INCLUSION AND EXCLUSION OF PUBLISHED REPORTS--Articles listed on Medline from 1985-92 with key words "quality assurance" or "medical audit", and "evaluation" and relevant references from these articles, and from recently published reviews and reports on medical audit, were included. Exc...

  14. Catastrophic Medical Expenditure Risk

    OpenAIRE

    O'Donnell, Owen; Flores, Gabriela

    2012-01-01

    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 data containing information on the means of financing health payments. We estimate medical expenditure risk in seven Asian countries and find it is highest in Laos and China, and is lowest in Mala...

  15. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2002-01-01

    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.Medical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  16. Reminder from Medical Service

    CERN Multimedia

    Medical Service

    2004-01-01

    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.Medical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  17. Fundamentals of Medical Ultrasonics

    CERN Document Server

    Postema, Michiel

    2011-01-01

    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.

  18. Medical waste management plan.

    Energy Technology Data Exchange (ETDEWEB)

    Lane, Todd W.; VanderNoot, Victoria A.

    2004-12-01

    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.

  19. Medicalization of Society

    OpenAIRE

    Lundø, Emma-Sophie; Larsen, Astrid; Sørensen, Camilla; Ettrup, Lærke; Winther, Kamma; Yndgaard, Sif; Jensen, Cecilie

    2014-01-01

    This study investigates how medicalization in the United States of America affects the invention and discovering of new diseases, with point of origin in Female Sexual Dysfunction (FSD). We will discuss the concepts of mental health, mental illness and disorder using Thomas Szasz, George Graham and Lawrie Reznek in order to try to classify FSD. In this context, we will ac-count for and discuss medicalization by using the sociologist Peter Conrad. An increased medi-calization would mean an inc...

  20. Medical errors in neurosurgery

    Directory of Open Access Journals (Sweden)

    John D Rolston

    2014-01-01

    23.7-27.8% were technical, related to the execution of the surgery itself, highlighting the importance of systems-level approaches to protecting patients and reducing errors. Conclusions: Overall, the magnitude of medical errors in neurosurgery and the lack of focused research emphasize the need for prospective categorization of morbidity with judicious attribution. Ultimately, we must raise awareness of the impact of medical errors in neurosurgery, reduce the occurrence of medical errors, and mitigate their detrimental effects.

  1. [Perspectives in medical liability].

    Science.gov (United States)

    Pizarro W, Carlos

    2008-04-01

    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. PMID:18769798

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

    CERN Document Server

    Organization, World Health

    2011-01-01

    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

  3. Commercial Crew Medical Ops

    Science.gov (United States)

    Heinbaugh, Randall; Cole, Richard

    2016-01-01

    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.

  4. Medical Virtual Public Services

    Directory of Open Access Journals (Sweden)

    Iulia SURUGIU

    2008-01-01

    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.

  5. Medical Practice Makes Perfect

    Science.gov (United States)

    1998-01-01

    Cedaron Medical Inc., was founded in 1990 as a result of a NASA SBIR (Small Business Innovative Research) grant from Johnson Space Center to develop a Hand Testing and Exercise Unit for use in space. From that research came Dexter, a comprehensive workstation that creates a paperless environment for medical data management.

  6. Medications (for IBS)

    Medline Plus

    Full Text Available ... IBS Diet Low FODMAP Diet Complimentary or Alt Treatments Medications Psychological Treatments Online Studies News You Can Use Living ... IBS Diet Low FODMAP Diet Complimentary or Alt Treatments Medications Psychological Treatments Online Studies News You Can Use Living ...

  7. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Service Médical

    2000-01-01

    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

  8. Medication and Reading Disability.

    Science.gov (United States)

    Humphries, Laurie L.

    1981-01-01

    The clinical syndrome which relates most frequently to the reading-disabled child is the attention deficity disorder. The child psychiatrist will generally resort to medication only when behavioral management techniques have failed. The two most frequently used medications are Ritalin and Dexedrine, central nervous system stimulants. (JN)

  9. [Medical education and professionalism].

    Science.gov (United States)

    Martins e Silva, João

    2013-01-01

    Is briefly analyzed the evolution that the objectives, strategies and models of medical education have had since their presentation and subsequent implementation of the famous model of Abraham Flexner, is now 103 years. Although globally accepted in their original pedagogical principles and instruments, that model does not have avoided the continuing dissatisfaction by the medical community and students and, most markedly in recent decades, the demanding of a most efficient health care by society, in general, and by patients in particular. In response to these ambitions, the medical community felt that it was essential to review the traditional criteria of medical professionalism, adapting them to a new paradigm of society and an appropriate and more efficient model of medical education. In this respect, are analyzed strategies and methodologies, apparently more suitable proposals for the inclusion of the principles and responsibilities of medical professionalism since the early period of pre-graduated medical education. It is assumed that the emphasis in teaching and practice of reflection throughout the course will have positive and lasting repercussions during active working life. However, the author believes that the success of the measures to be introduced in medical education programs to a new model of professionalism continues to depend, above all, of the humanistic and cognitive attributes of the students to be chosen, and the pedagogical quality, professional and academic of their teachers. PMID:24016652

  10. Workshop of medical physics

    International Nuclear Information System (INIS)

    This event was held in San Carlos de Bariloche, Argentine Republic from 14 th. through 18 th. November, 1988. A great part of the physicians in the area of medical physics participated in this workshop. This volume includes the papers presented at this Workshop of Medical Physics

  11. Medical cyclotron facilities

    International Nuclear Information System (INIS)

    This report examines the separate proposals from the Austin Hospital and the Australian Atomic Energy Commission for a medical cyclotron facility. The proponents have argued that a cyclotron facility would benefit Australia in areas of patient care, availability and export of radioisotopes, and medical research. Positron emission tomography (PET) and neutron beam therapy are also examined

  12. Medical Humanities Introduction

    OpenAIRE

    Shapiro, Johanna

    2009-01-01

    As editor the Medical Humanities section, Shapiro provides an introduction and discusses how the articles in this section of the journal use reflective writing in medical education contexts to explore the perspectives and priorities of a range of others - patients, family members, other health care professionals - involved in the clinical encounter.

  13. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    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...

  14. Catastrophic Medical Expenditure Risk

    NARCIS (Netherlands)

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

    2012-01-01

    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

  15. Maintaining medical competence

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2012-11-01

    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 …

  16. SIMULATION IN MEDICAL EDUCATION

    Directory of Open Access Journals (Sweden)

    Jorge L. Palés Argullós

    2010-07-01

    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. Restoring medical professionalism.

    Science.gov (United States)

    Bernat, James L

    2012-08-21

    The essence of medical professionalism is placing dedication to the welfare of patients above physicians' personal or proprietary interests. Medicine has become deprofessionalized as a consequence of socioeconomic factors leading to increasing commercialization and perverse financial incentives converting it into a business, the presence of unmanaged conflicts of interest, challenges to medical authority by insurance companies and the consumerism movement, and by gradual changes in the attitudes of physicians. Organized medicine has responded by making explicit its standards of professionalism and its dedication to preserving them. Medical educators have studied the means to develop professional attitudes and behaviors among medical students and residents. Modeling the characteristics of professional behavior by virtuous physicians remains the most effective method to instill professional behaviors in trainees. Restoring professionalism may be abetted by changes in physicians' financial incentives through innovative models of health care delivery, by physicians reducing their conflicts of interest, and by medical societies rejecting a guild identity. PMID:22915177

  18. Medical education in Greece.

    Science.gov (United States)

    Georgantopoulou, Catherine

    2009-01-01

    This paper aims to present an overview of current medical education in Greece. Greece has a centuries-long tradition in practising and teaching medicine. Medical training, although rigorous, is particularly humane. All Medical Schools in Modern Greece are currently, undergoing a series of changes in an effort to modernize training. The medical education system is also getting harmonized to European Standards for Higher Education, relating to Undergraduate, Postgraduate and Continuous Medical Education of doctors. A specific strength of the Greek educational system is its ethos that emphasises good working conditions and excellent support and supervision at all levels. The current overhauls in Higher Education occupy students, academics and the society at large. Political issues, such as accountability, regulation and autonomy of academia are generating debate. The two-cycle, Bachelor-Master, Undergraduate Model, as described in the Bologna Declaration is still to be implemented. Quality control measures are currently introduced in all academic sectors. PMID:19253151

  19. 76 FR 8637 - Medical Devices; Medical Device Data Systems

    Science.gov (United States)

    2011-02-15

    ... Devices; Medical Device Data Systems AGENCY: Food and Drug Administration, HHS. ACTION: Final rule... device are not medical devices. (Response) FDA agrees that the term ``medical device data'' could be... medical devices. (Response) An MDDS is intended to be a communication conduit for medical device data.......

  20. New Medical Device Evaluation.

    Science.gov (United States)

    Ikeda, Koji

    2016-01-01

    In this presentation, as a member of the Harmonization by Doing (HBD) project, I discuss the significance of regulatory science in global medical device development and our experience in the international collaboration process for medical devices. In Japan, most innovative medical therapeutic devices were previously developed and exported by foreign-based companies. Due to this device lag, Japanese had minimal opportunities for receiving treatment with innovative medical devices. To address this issue, the Japanese government has actively accepted foreign clinical trial results and promoted global clinical trials in projects such as HBD. HBD is a project with stakeholders from academia, regulatory authorities, and industry in the US and Japan to promote global clinical trials and reduce device lags. When the project started, medical device clinical trials were not actively conducted in Japan at not just hospitals but also at medical device companies. We started to identify issues under the concept of HBD. After 10 years, we have now become key members in global clinical trials and able to obtain approvals without delay. Recently, HBD has started promoting international convergence. Physicians and regulatory authorities play central roles in compiling guidelines for the clinical evaluation of medical device development, which will be a more active field in the near future. The guidelines compiled will be confirmed with members of academia and regulatory authorities in the United Sates. PMID:27040333

  1. Medical Information Security

    Directory of Open Access Journals (Sweden)

    William C. Figg, Ph.D.

    2011-05-01

    Full Text Available 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 and application security and transmission protocols are not consistently maintained. Health insurance needs and general financial opportunity has created an emerging market in medical identity theft. Medical offices have the perfect storm of information collection, personal, credit, banking, health, and insurance. Thieves have realized that medical facilities have as much economic value as banks and the security is much easier to crack. Mostly committed by insiders, medical identity theft is a well-hidden information crime. In spite of its covert nature, the catastrophic ramification to the victims is overt. This information crime involves stealing patients’ records to impersonate the patients in an effort of obtaining health care services or claiming Medicare on the patients’ behalf. Unlike financial identity theft, there is a lack of recourse for the victims to recover from damages. Medical identity theft undermines the quality of health care information systems and enervates the information security of electronic patient record.

  2. Exploration Medical Capability

    Science.gov (United States)

    Watkins, Sharmila; Baumann, David; Wu, Jimmy; Barsten, Kristina

    2010-01-01

    Exploration Medical Capability (ExMC) is an element of NASA's Human Research Program (HRP). ExMC's goal is to address the risk of the Inability to Adequately Recognize or Treat an Ill or Injured Crewmember. This poster highlights the approach ExMC has taken to address this goal and our current areas of interest. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to identify medical conditions of concern during exploration missions. The list was derived from space flight medical incidents, the shuttle medical checklist, the International Space Station medical checklist, and expert opinion. The conditions on the list were prioritized according to mission type by a panel comprised of flight surgeons, physician astronauts, engineers, and scientists. From the prioritized list, the ExMC element determined the capabilities needed to address the medical conditions of concern. Where such capabilities were not currently available, a gap was identified. The element s research plan outlines these gaps and the tasks identified to achieve the desired capabilities for exploration missions. This poster is being presented to inform the audience of the gaps and tasks being investigated by ExMC and to encourage discussions of shared interests and possible future collaborations.

  3. Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal

    OpenAIRE

    Banerjee, I.; Bhadury, T

    2012-01-01

    Background: Self-medication is a widely prevalent practice in India. It assumes a special significance among medical students as they are the future medical practitioners. Aim: To assess the pattern of self-medication practice among undergraduate medical students. Settings and Design: Tertiary care medical college in West Bengal, India. Material and Methods: A cross-sectional questionnaire-based study was conducted among the undergraduate medical students. Results: Out of 500 students of the ...

  4. Medication safety in hospitals : medication errors and interventions to improve the medication use process

    OpenAIRE

    Samaranayake, Nithushi Rajitha

    2013-01-01

    Medication errors are an unnecessary threat to patient safety. The aim of this study was to assess the epidemiology of medication errors and to assess the effectiveness of interventions intended to avoid medication errors in a tertiary-care hospital in Hong Kong. The epidemiology of medication errors included the study of the pattern of interception of medication errors and the study of technology-related medication errors using medication incidents reported during years 2006–2010. 34.1% ...

  5. Medical Virology in Malaysia

    Institute of Scientific and Technical Information of China (English)

    Kaw Bing Chua

    2009-01-01

    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

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

    Institute of Scientific and Technical Information of China (English)

    ZHAORI Getu

    2011-01-01

    @@ 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.

  7. Kennedy Space Center Medical Operations and Medical Kit

    Science.gov (United States)

    Scarpa, Philip

    2011-01-01

    This slide presentation reviews the emergency medical operations at Kennedy Space center, the KSC launch and landing contingency modes, the triage site, the medical kit, and the medications available.

  8. Medical instruments in museums

    DEFF Research Database (Denmark)

    Söderqvist, Thomas; Arnold, Ken

    2011-01-01

    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....

  9. Medical Therapy of Acromegaly

    Directory of Open Access Journals (Sweden)

    U. Plöckinger

    2012-01-01

    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.

  10. Exploration Medical System Demonstration

    Science.gov (United States)

    Rubin, D. A.; Watkins, S. D.

    2014-01-01

    BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that

  11. Medical Service Information

    CERN Document Server

    GS Department

    2010-01-01

    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 psychologist-me@cern.ch.

  12. Cannabinoids: Medical implications.

    Science.gov (United States)

    Schrot, Richard J; Hubbard, John R

    2016-05-01

    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. Key messages The medical disorders with the current best evidence that supports a benefit for cannabinoid use are the following: multiple sclerosis patient-reported symptoms of spasticity (nabiximols, nabilone, dronabinol, and oral cannabis extract), multiple sclerosis central pain or painful spasms (nabiximols, nabilone, dronabinol, and oral cannabis extract), multiple sclerosis bladder frequency (nabiximols), and chronic cancer pain/neuropathic pain (nabiximols and smoked THC). Herbal cannabis has not met rigorous US FDA

  13. Medications (for IBS)

    Medline Plus

    Full Text Available ... 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 Home ...

  14. Medications (for IBS)

    Medline Plus

    Full Text Available ... Updated: 06 July 2016 Print Tweet Jump to Topic Medications for IBS Laxatives Anticholinergic/Antispasmodic Agents Antidiarrheal ... Help You? IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and ...

  15. The coming medical apocalypse.

    Science.gov (United States)

    Washburn, E R

    1999-01-01

    Is there a medical apocalypse in our future? Will it happen soon? No one can say for sure, but five ominous trends suggest that a medical meltdown could occur at any time. These trends are: (1) The practice of providing medical care becoming too complex from both a business and a legal perspective; (2) Less money being spent on medical care without any corresponding reduction in services provided, creating long-term operating deficits; (3) Investor-owned, for-profit corporations changing the focus of medicine by putting shareholder concerns ahead of patient care; (4) Employment-linked health care insurance creating a growing uninsured population, adding extra financial stress to our hospitals; and, (5) Providers losing faith in their future and becoming increasingly demoralized about practicing the healing arts. These dangerous trends are considered, along with some suggestions that physician executives and organizations might take to protect themselves. PMID:10387269

  16. Medications (for IBS)

    Medline Plus

    Full Text Available ... Take Part in Online Studies News You Can Use Living With IBS Relationships and IBS Pregnancy and ... agents or the relatively newer medications. Antidepressants –The use of the antidepressant drug class in low doses ...

  17. Medications (for IBS)

    Medline Plus

    Full Text Available ... for some people with IBS, mainly those with emotional distress. There are also effective medications available that ... This Article Help You? IFFGD is a nonprofit education and research organization. Our mission is to inform, ...

  18. Atrial Fibrillation Medications

    Science.gov (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. German Medical Science ausgezeichnet

    OpenAIRE

    Müller, W.

    2011-01-01

    German Medical Science - das medizinische Publikationsportal von AWMF, DIMDI und ZB MED - wird am 21. Oktober 2011 von der Initiative "Deutschland - Land der Ideen" als "Ausgewählter Ort im Land der Ideen 2011" ausgezeichnet.

  20. Alzheimer's Disease Medications

    Science.gov (United States)

    ... Referral Center Alzheimer's Disease Education and Referral Center Alzheimer's Disease Education and Referral Center Home About Alzheimer’s ... Plan National Alzheimer's Project Act (NAPA) About ADEAR Alzheimer's Disease Medications Fact Sheet Treatment for Mild to ...

  1. [Medical Equipment Maintenance Methods].

    Science.gov (United States)

    Liu, Hongbin

    2015-09-01

    Due to the high technology and the complexity of medical equipment, as well as to the safety and effectiveness, it determines the high requirements of the medical equipment maintenance work. This paper introduces some basic methods of medical instrument maintenance, including fault tree analysis, node method and exclusive method which are the three important methods in the medical equipment maintenance, through using these three methods for the instruments that have circuit drawings, hardware breakdown maintenance can be done easily. And this paper introduces the processing methods of some special fault conditions, in order to reduce little detours in meeting the same problems. Learning is very important for stuff just engaged in this area. PMID:26904890

  2. Medical Issues: Equipment

    Science.gov (United States)

    ... strollers also have trays to carry medical equipment. Bath Chairs Specialized bath chairs provide comfortable and secure bathing for children and small adults with special needs. Bath chairs are adjustable, with multiple seat and back angles. ...

  3. Medications (for IBS)

    Medline Plus

    Full Text Available ... about antidiarrheal agents. Anti-anxiety medications – can be helpful for some people with IBS, mainly those with ... questions and concerns. If you found this article helpful, please consider supporting IFFGD with a small tax- ...

  4. Medications for back pain

    Science.gov (United States)

    ... narcotics, do not drink alcohol, drive, or operate heavy machinery. MUSCLE RELAXANTS Your provider may prescribe a medicine ... medical conditions worse. Do not drive or operate heavy machinery while taking muscle relaxants. Do not drink alcohol ...

  5. Medications (for IBS)

    Medline Plus

    Full Text Available ... it. He or she can help you monitor quality, effectiveness, possible interactions with other medicines you may ... effective in treating IBS in multi-center, high quality clinical trials. These are prescription medications intended for ...

  6. Medications (for IBS)

    Medline Plus

    Full Text Available ... have potential side effects . Medications for IBS First line treatment has traditionally been aimed at treating the ... This Article Help You? IFFGD is a nonprofit education and research organization. Our mission is to inform, ...

  7. Managing Your COPD Medications

    Science.gov (United States)

    ... Lookup > COPD > Diagnosing and Treating COPD Managing Your COPD Medications There are a variety of medicines available ... are the types of medicines usually prescribed for COPD: Bronchodilators Bronchodilators relax the muscles around your airways, ...

  8. Medications (for IBS)

    Medline Plus

    Full Text Available ... IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for IBS Take Part in Online Studies News You Can Use Working with Doctor Successful ...

  9. Medical dosimetry in Hungary

    Science.gov (United States)

    Turák, O.; Osvay, M.; Ballay, L.

    2012-09-01

    Radiation exposure of medical staff during cardiological and radiological procedures was investigated. The exposure of medical staff is directly connected to patient exposure. The aim of this study was to determine the distribution of doses on uncovered part of body of medical staff using LiF thermoluminescent (TL) dosimeters in seven locations. Individual Kodak film dosimeters (as authorized dosimetry system) were used for the assessment of medical staff's effective dose. Results achieved on dose distribution measurements confirm that wearing only one film badge under the lead apron does not provide enough information on the personal dose. The value of estimated annual doses on eye lens and extremities (fingers) were in good correlation with international publications.

  10. Surgery, Hospitals, and Medications

    Science.gov (United States)

    ... OTC products that are not commonly stocked in hospital pharmacies. Examples include: Salagen ® , Evoxac ® , and Restasis ® Eye drops, ... of your medication will be sent to the hospital pharmacy for verification. Depending on hospital policy, you may ...

  11. Medical Library Association

    Science.gov (United States)

    ... 11th, 2016 Patricia Flatley Brennan, registered nurse, informatician, industrial engineer, and renowned researcher is appointed as Director of the National Library of Medicine Tweets Copyright © 2016 Medical Library Association. ...

  12. 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 ...

  13. Understanding Medical Research

    Science.gov (United States)

    ... hear about the results of a new medical research study. Sometimes the results of one study seem ... a randomized controlled clinical trial? Where was the research done? If a new treatment was being tested, ...

  14. Medical Device Safety

    Science.gov (United States)

    ... Communication Date Mycobacterium chimaera Infections Associated with Sorin Group Deutschland GmbH Stӧckert 3T Heater-Cooler System: FDA Safety Communication 06/01/16 More Medical Device Safety Communications ...

  15. MDR (Medical Device Reporting)

    Data.gov (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...

  16. Emergency Medical Services

    Science.gov (United States)

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

  17. Medications (for IBS)

    Medline Plus

    Full Text Available ... Bacteria and IBS IBS in Men: A Different Disease? Other Disorders Signs & Symptoms Overview Recognizing Symptoms Diagnosis Pain in ... who specializes in motility or stress-related gastrointestinal disorders. More complex medication regimens, and specialized motility and/ ...

  18. Color Medical Image Analysis

    CERN Document Server

    Schaefer, Gerald

    2013-01-01

    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.

  19. Medications (for IBS)

    Medline Plus

    Full Text Available ... discomfort, usually if the symptoms occur soon after eating. Examples include dicyclomine (Bentyl), and hyoscyamine (Levsin). Read ... who specializes in motility or stress-related gastrointestinal disorders. More complex medication regimens, and specialized motility and/ ...

  20. Medical leech therapy (Hirudotherapy

    Directory of Open Access Journals (Sweden)

    Uwe Wollina

    2016-01-01

    Full Text Available Leeches have been used in medicine long time before BC. In recent years medical leech therapy has gained increasing interest in reconstructive surgery and pain management and other medical fields. The possible indications and success rates of this treatment are discussed. There is a special interest in salvage of flaps and grafts by the use of medical leeches. Retrospective analysis indicates a success rate of >80%. Randomized controlled trials have been performed in osteoarthritis. Case reports and smaller series are available for the treatment of chronic wounds, post-phlebitic syndrome and inflammatory skin diseases. The most common adverse effects are prolonged bleeding and infection by saprophytic intestinal bacteria of leeches. Medical leech therapy is a useful adjunct to other measures wound management.

  1. 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 ( ... take for a therapeutic effect counts as a medicine. It can be readily available over-the-counter, ...

  2. Recognizing medical emergencies

    Science.gov (United States)

    ... there in an emergency. Wear a medical identification tag if you have a chronic condition or look ... to the principles of the Health on the Net Foundation (www.hon.ch). The information provided herein ...

  3. American Veterinary Medical Association

    Science.gov (United States)

    ... Board of Directors has approved revisions to the Principles of Veterinary Medical Ethics that include a broad-based statement on diversity, including gender identity. Wellness & economics take center stage for Board of Directors April ...

  4. Catastrophic medical expenditure risk.

    Science.gov (United States)

    Flores, Gabriela; O'Donnell, Owen

    2016-03-01

    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. PMID:26812650

  5. Medications (for IBS)

    Medline Plus

    Full Text Available ... of the lack of effective treatment for the overall improvement of multiple symptoms in IBS patients. However, ... effective in treating IBS in multi-center, high quality clinical trials. These are prescription medications intended for ...

  6. Medications (for IBS)

    Medline Plus

    Full Text Available ... What's a medication? Anything you take for a therapeutic effect counts as a medicine. It can be ... When you take something for a long-term therapeutic effect, tell your doctor about it. He or ...

  7. Medications for Memory Loss

    Science.gov (United States)

    ... Find your chapter: search by state Home > Alzheimer's Disease > Treatments > Medications for Memory Overview What Is Dementia? What Is Alzheimer's? Younger/Early Onset Facts and Figures Know the 10 Signs Stages Inside the Brain: ...

  8. PROPERTIES OF ANTIBACTERIAL MEDICATIONS

    Directory of Open Access Journals (Sweden)

    Boyko N. N.

    2014-01-01

    Full Text Available The possibility to use vector algebra theory for quantitative description of antibacterial medications and comparison of their properties has been shown. Mathematic formulas for description of medications’ antibacterial action basing on data of simple to use well method have been presented. This method allows evaluation of medications’ antibacterial activity and opportunity to choose the most active ones, as well as compare them with each other. It is noted that medications of natural origin are inferior to those of synthetic origin as for their antibacterial activity, and new galenic medications possess the most antimicrobial properties. The prospects of this method for pharmacoeconomic analysis of medications conducted in order to chose optimal cost/quality ratio has been demonstrated.

  9. Medical and Radiological Economy

    OpenAIRE

    Jalal Jalal Shokouhi

    2009-01-01

    Economy ride ahead of the world. "nAll human activities lead to financial problems. "nEconomy has two dimensions in usual daily commercial problems but medical and radiological economy is a tridimensional phenomenon. "nIn the two-dimensional economy, both sides, see their own benefits and fair "gains" but in the  medical and radiologic economy, the patient gives us money and gets health. We protect the patient’s benefits by controlling the complications and c...

  10. Origins of Medical Informatics

    OpenAIRE

    Collen, Morris F.

    1986-01-01

    Medical informatics is a new knowledge domain of computer and information science, engineering and technology in all fields of health and medicine, including research, education and practice. Medical informatics has evolved over the past 30 years as medicine learned to exploit the extraordinary capabilities of the electronic digital computer to better meet its complex information needs. The first articles on this subject appeared in the 1950s, the number of publications rapidly increased in t...

  11. Anorexia nervosa medical issues.

    Science.gov (United States)

    Mehler, Philip S; Krantz, Mori

    2003-05-01

    Anorexia nervosa is an increasingly common chronic psychiatric disorder with a multitude of medical complications. Most of these complications are reversible if there is timely restoration of body weight. A few of them, particularly osteoporosis, refeeding complications, and cardiac arrhythmia, are potentially much more serious. In the end, a multidisciplinary team approach with input from a primary care provider who is familiar with these medical sequelae, together with psychiatric and dietary expertise, can effectuate a successful outcome. PMID:12804340

  12. Medical Art Therapy

    OpenAIRE

    Aydın, Birgül

    2012-01-01

    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...

  13. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    2003-01-01

    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.Médical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  14. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    2003-01-01

    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.Médical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  15. Reminder from Medical Service

    CERN Multimedia

    2003-01-01

    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.Médical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  16. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Service Médical

    2000-01-01

    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: Infirmary.Service@cern.chMarion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch Medical Service

  17. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Service médical

    2000-01-01

    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: 73802.by electronic mail to:Infirmary.Service@cern.chMarion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.chMedicalService

  18. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2000-01-01

    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 mail:Infirmary.Service@cern.chMarion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.chMedicalService

  19. Compliance with Antihypertensive Medication

    OpenAIRE

    Evans, C. Edward

    1985-01-01

    Although we have efficacious treatment for hypertension many patients do not take their medication or even follow through with their physician visits, thereby negating potential benefits. Detecting patients who do not take their medications is as important as diagnosing and treating the hypertension itself. This paper outlines methods of detecting and ‘treating’ non-compliance and discusses the role of the physician/patient relationship in compliance.

  20. Medical physics 2013. Abstracts

    International Nuclear Information System (INIS)

    The proceedings of the medical physics conference 2013 include abstract of lectures and poster sessions concerning the following issues: Tele-therapy - application systems, nuclear medicine and molecular imaging, neuromodulation, hearing and technical support, basic dosimetry, NMR imaging -CEST (chemical exchange saturation transfer), medical robotics, magnetic particle imaging, audiology, radiation protection, phase contrast - innovative concepts, particle therapy, brachytherapy, computerized tomography, quantity assurance, hybrid imaging techniques, diffusion and lung NMR imaging, image processing - visualization, cardiac and abdominal NMR imaging.

  1. Motivation in medical students

    OpenAIRE

    Kusurkar, R.A.

    2012-01-01

    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 were to gather insights and investigate medical students’ motivation, particularly the importance of quality of motivation, factors influencing and outcomes and to explore how these can be applied to ...

  2. Use of Medications in Pregnancy

    Science.gov (United States)

    ... Summary” links to learn more about each study. Use of Medication in Pregnancy A 2011 study using ... medication. Over the last 30 years, First trimester use of prescription medications has increased more than 60% ...

  3. Medical and Health Services Managers

    Science.gov (United States)

    ... SITE MAP | EN ESPAÑOL Management > Medical and Health Services Managers PRINTER-FRIENDLY EN ESPAÑOL Summary What They ... occupations. What They Do -> What Medical and Health Services Managers Do About this section In group medical ...

  4. Medical Ethics in Radiology

    International Nuclear Information System (INIS)

    According to the recent developments in radiological techniques, the role of radiology in the clinical management of patients is ever increasing and in turn, so is the importance of radiology in patient management. Thus far, there have been few open discussions about medical ethics related to radiology in Korea. Hence, concern about medical ethics as an essential field of radiology should be part of an improved resident training program and patient management. The categories of medical ethics related with radiology are ethics in the radiological management of patient, the relationship of radiologists with other medical professionals or companies, the hazard level of radiation for patients and radiologists, quality assurance of image products and modalities, research ethics, and other ethics issues related to teleradiology and fusion imaging. In order to achieve the goal of respectful progress in radiology as well as minimizing any adverse reaction from other medical professions or society, we should establish a strong basis of medical ethics through the continuous concern and self education

  5. Medical x-ray

    International Nuclear Information System (INIS)

    This book describes the fundamental subject about medical radiography. It is a multidisciplinary field that requires cross professional input from scientists, engineers and medical doctors. However, it is presented in simple language to suit different levels of readers from x-ray operators and radiographers to physists, general practitioners and radiology specialists.The book is written in accordance to the requirements of the standard syllabus approved by the Ministry of Health Malaysia for the training of medical x-ray operator and general practitioners. In general, the content is not only designed to provide relevant and essential subject for related professionals in medical radiological services such as x-ray operator, radiographer and radiologists, but also to address those in associated radiological services including nurses, medical technologists and physicists.The book is organized and arranged sequentially into 3 parts for easy reference: Radiation safety; X-ray equipment and associated facilities; Radiography practices. With proper grasping of all these parts, the radiological services could be provided with confident and the highest professional standard. Thus, medical imaging with highest quality that can provide useful diagnostic information at minimum doses and at cost effective could be assured

  6. Medical Information Security

    Directory of Open Access Journals (Sweden)

    William C. Figg, Ph.D.

    2011-05-01

    Full Text Available Modern medicine is facing a complex environment, not from medical technology but rather governmentregulations and information vulnerability. HIPPA is the government’s attempt to protect patient’sinformation yet this only addresses traditional record handling. The main threat is from the evolvingsecurity 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 and applicationsecurity and transmission protocols are not consistently maintained.Health insurance needs and general financial opportunity has created an emerging market in medicalidentity theft. Medical offices have the perfect storm of information collection, personal, credit, banking,health, and insurance. Thieves have realized that medical facilities have as much economic value asbanks and the security is much easier to crack. Mostly committed by insiders, medical identity theft is awell-hidden information crime. In spite of its covert nature, the catastrophic ramification to the victims isovert. This information crime involves stealing patients’ records to impersonate the patients in an effort ofobtaining health care services or claiming Medicare on the patients’ behalf. Unlike financial identity theft,there is a lack of recourse for the victims to recover from damages. Medical identity theft undermines thequality of health care information systems and enervates the information security of electronic patientrecord.

  7. Rationing medical education.

    Science.gov (United States)

    Walsh, Kieran

    2016-03-01

    The purpose of this paper is to discuss the role of rationing in medical education. Medical education is expensive and there is a limit to that which governments, funders or individuals can spend on it. Rationing involves the allocation of resources that are limited. This paper discussed the pros and cons of the application of rationing to medical education and the different forms of rationing that could be applied. Even though some stakeholders in medical education might be taken aback at the prospect of rationing, the truth is that rationing has always occurred in one form or another in medical education and in healthcare more broadly. Different types of rationing exist in healthcare professional education. For example rationing may be implicit or explicit or may be based on macro-allocation or micro-allocation decisions. Funding can be distributed equally among learners, or according to the needs of individual learners, or to ensure that overall usefulness is maximised. One final option is to allow the market to operate freely and to decide in that way. These principles of rationing can apply to individual learners or to institutions or departments or learning modes. Rationing is occurring in medical education, even though it might be implicit. It is worth giving consideration to methods of rationing and to make thinking about rationing more explicit. PMID:27358649

  8. Optimization of Medical Teaching Methods

    OpenAIRE

    Wang Fei

    2015-01-01

    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 teac...

  9. Polymeric materials in medication

    CERN Document Server

    Carraher, Charles

    1985-01-01

    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...

  10. Transportation of medical isotopes

    International Nuclear Information System (INIS)

    A Draft Technical Information Document (HNF-1855) is being prepared to evaluate proposed interim tritium and medical isotope production at the Fast Flux Test Facility (FFTF). This assessment examines the potential health and safety impacts of transportation operations associated with the production of medical isotopes. Incident-free and accidental impacts are assessed using bounding source terms for the shipment of nonradiological target materials to the Hanford Site, the shipment of irradiated targets from the FFTF to the 325 Building, and the shipment of medical isotope products from the 325 Building to medical distributors. The health and safety consequences to workers and the public from the incident-free transportation of targets and isotope products would be within acceptable levels. For transportation accidents, risks to works and the public also would be within acceptable levels. This assessment is based on best information available at this time. As the medical isotope program matures, this analysis will be revised, if necessary, to support development of a final revision to the Technical Information Document

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...

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

    LENUS (Irish Health Repository)

    Byrne, D

    2010-03-01

    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.

  13. The medicalization of love.

    Science.gov (United States)

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

    2015-07-01

    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.' PMID:24937632

  14. Adolf Hitler's medical care.

    Science.gov (United States)

    Doyle, D

    2005-02-01

    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. PMID:15825245

  15. FUSION OF MEDICAL IMAGES

    Directory of Open Access Journals (Sweden)

    ALINE APARECIDA DE OLIVEIRA

    2013-08-01

    Full Text Available The use of image multiple modalities to achieve medical diagnosis has been commom practice lately. Nowadays the most used practice is medical image fusion, that is integrating information from several different methods within the same image. This paper aims at showing aplication and functionality of medical image fusion process such as Computed Tomography, Magnetic Resonance Imaging, Positron Emission Tomography and Doppler U.S. Image fusion process can be perfomed by pixel to pixel, region to region as well as based on decision taking. Free softwares can be found in the internet and images can be obtained either in separated or conneceted equipments. The choice of processes depends on several factors and the purpose of fusion as well as characteristics and conditions of each method should be taken into consideration. Currently equipment manufacturers are investing at improving the quality and detection capacity of images aiming at upgrading the fusion process which makes image interpretation more evident and trustworthy.

  16. Format( )MEDIC( )Input

    Science.gov (United States)

    Foster, K.

    1994-09-01

    This document is a description of a computer program called Format( )MEDIC( )Input. The purpose of this program is to allow the user to quickly reformat wind velocity data in the Model Evaluation Database (MEDb) into a reasonable 'first cut' set of MEDIC input files (MEDIC.nml, StnLoc.Met, and Observ.Met). The user is cautioned that these resulting input files must be reviewed for correctness and completeness. This program will not format MEDb data into a Problem Station Library or Problem Metdata File. A description of how the program reformats the data is provided, along with a description of the required and optional user input and a description of the resulting output files. A description of the MEDb is not provided here but can be found in the RAS Division Model Evaluation Database Description document.

  17. 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...

  18. Evaluation of moxifloxacin for the treatment of tuberculosis : 3 years of experience

    NARCIS (Netherlands)

    Pranger, A. D.; van Altena, R.; Aarnoutse, R. E.; van Soolingen, D.; Uges, D. R. A.; Kosterink, J. G. W.; van der Werf, T. S.; Alffenaar, J. W. C.

    2011-01-01

    Moxifloxacin (MFX) is a powerful second-line anti-tuberculosis (TB) agent, but the optimal dose has not yet been established and long-term safety data are scarce. We retrospectively reviewed the medical charts of TB patients treated at the Tuberculosis Centre Beatrixoord, University Medical Centre G

  19. Medical ultrasound imaging

    DEFF Research Database (Denmark)

    Jensen, Jørgen Arendt

    2007-01-01

    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...

  20. Readmissions of medical patients

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... discriminatory 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...

  1. Medical Emergencies in Goa

    OpenAIRE

    Saddichha Sahoo; Saxena Mukul

    2010-01-01

    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 o...

  2. Medication Overuse Headache

    DEFF Research Database (Denmark)

    Munksgaard, Signe B; Jensen, Rigmor H

    2014-01-01

    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 is...

  3. Instrumentation in medical systems

    International Nuclear Information System (INIS)

    The demand for clinical use of accelerated heavy charged-particle (proton and light-ion) beams for cancer treatment is now burgeoning worldwide. Clinical trials are underway at more than a dozen accelerators. Several hospital-based accelerator facilities dedicated to radiation treatment of human cancer have been constructed, and their number is growing. Many instruments in medical systems have been developed for modifying extracted particle beams for clinical application, monitoring the delivery of the treatment beams, and controlling the treatment processes to ensure patient safety. These in turn demand new developments of instruments in controlling beam extraction, beam tuning, and beam transportation at the medical systems

  4. Instrumentation in medical systems

    Energy Technology Data Exchange (ETDEWEB)

    Chu, W.T. [Lawrence Berkeley Lab., CA (United States). Accelerator and Fusion Research Div.

    1995-05-01

    The demand for clinical use of accelerated heavy charged-particle (proton and light-ion) beams for cancer treatment is now burgeoning worldwide. Clinical trials are underway at more than a dozen accelerators. Several hospital-based accelerator facilities dedicated to radiation treatment of human cancer have been constructed, and their number is growing. Many instruments in medical systems have been developed for modifying extracted particle beams for clinical application, monitoring the delivery of the treatment beams, and controlling the treatment processes to ensure patient safety. These in turn demand new developments of instruments in controlling beam extraction, beam tuning, and beam transportation at the medical systems.

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

    Directory of Open Access Journals (Sweden)

    Nitasha Bhat

    2012-04-01

    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.

  6. Metabolism and pharmacokinetics of the anti-tuberculosis drug ethionamide in a flavin-containing monooxygenase null mouse.

    Science.gov (United States)

    Palmer, Amy L; Leykam, Virginia L; Larkin, Andrew; Krueger, Sharon K; Phillips, Ian R; Shephard, Elizabeth A; Williams, David E

    2012-01-01

    Multiple drug resistance (MDR) in Mycobacterium tuberculosis (mTB), the causative agent for tuberculosis (TB), has led to increased use of second-line drugs, including ethionamide (ETA). ETA is a prodrug bioactivated by mycobacterial and mammalian flavin-containing monooxygenases (FMOs). FMO2 is the major isoform in the lungs of most mammals, including primates. In humans a polymorphism exists in the expression of FMO2. FMO2.2 (truncated, inactive) protein is produced by the common allele, while the ancestral allele, encoding active FMO2.1, has been documented only in individuals of African and Hispanic origin, at an incidence of up to 50% and 7%, respectively. We hypothesized that FMO2 variability in TB-infected individuals would yield differences in concentrations and ratios of ETA prodrug and metabolites. In this study we assessed the impact of the FMO2 genetic polymorphism on the pharmacokinetics of ETA after administration of a single oral dose of ETA (125 mg/kg) to wild type and triple Fmo1/2/4-null mice, measuring levels of prodrug vs. metabolites in plasma collected from 0 to 3.5 h post-gavage. All mice metabolized ETA to ETA S-oxide (ETASO) and 2-ethyl-4-amidopyridine (ETAA). Wild type mice had higher plasma concentrations of metabolites than of parent compound (p = 0.001). In contrast, Fmo1/2/4-null mice had higher plasma concentrations of parent compound than of metabolites (p = 0.0001). Thus, the human FMO2 genotype could impact the therapeutic efficacy and/or toxicity of ETA. PMID:23580869

  7. Effect of scheduled monitoring of liver function during anti-Tuberculosis treatment in a retrospective cohort in China

    OpenAIRE

    Wu Shanshan; Xia Yinyin; Lv Xiaozhen; Zhang Yuan; Tang Shaowen; Yang Zhirong; Tu Dehua; Deng Peiyuan; Cheng Shiming; Wang Xiaomeng; Yuan Yanli; Liu Feiying; Hu Daiyu; Zhan Siyan

    2012-01-01

    Abstract Background Data on effect of regular liver function monitoring during anti-TB treatment is limited in China. This study aimed to evaluate the effects of scheduled liver function monitoring on identification of asymptomatic liver damage and anti-TB treatment outcomes during anti-TB treatment. Methods A retrospective analysis was performed based on a national-level cohort study. A total of 273 patients developing liver dysfunction were divided into two groups, 111 patients who were dia...

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

    Science.gov (United States)

    Kong, Ying; Yang, Dong; Cirillo, Suat L G; Li, Shaoji; Akin, Ali; Francis, Kevin P; Maloney, Taylor; Cirillo, Jeffrey D

    2016-01-01

    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. PMID:26934495

  9. 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.

  10. Design of the Anti-tuberculosis Drugs induced Adverse Reactions in China National Tuberculosis Prevention and Control Scheme Study (ADACS

    Directory of Open Access Journals (Sweden)

    He Ping

    2010-05-01

    Full Text Available Abstract Background More than 1 million tuberculosis (TB patients are receiving the standard anti-TB treatment provided by China National Tuberculosis Prevention and Control Scheme (CNTS in China every year. Adverse reactions (ADRs induced by anti-TB drugs could both do harm to patients and lead to anti-TB treatment failure. The ADACS aimed to explore ADRs' incidences, prognoses, economical and public health impacts for TB patients and TB control, and build a DNA bank of TB patients. Methods/Design Multiple study designs were adopted. Firstly, a prospective cohort with 4488 sputum smears positive pulmonary tuberculosis patients was established. Patients were followed up for 6-9 months in 52 counties of four regions. Those suspected ADRs should be checked and confirmed by Chinese State Food and Drug Administration (SFDA. Secondly, if the suspected ADR was anti-TB drug induced liver injury (ATLI, a nested case-control study would be performed which comprised choosing a matched control and doing a plus questionnaire inquiry. Thirdly, health economical data of ADRs would be collected to analyze financial burdens brought by ADRs and cost-effectiveness of ADRs' treatments. Fourthly, a drop of intravenous blood for each patient was taken and saved in FTA card for DNA banking and genotyping. Finally, the demographic, clinical, environmental, administrative and genetic data would be merged for the comprehensive analysis. Discussion ADACS will give an overview of anti-TB drugs induced ADRs' incidences, risk factors, treatments, prognoses, and clinical, economical and public health impacts for TB patients applying CNTS regimen in China, and provide suggestions for individualized health care and TB control policy.

  11. Experiences in anti-tuberculosis treatment in patients with multiple previous treatments and its impact on drug resistant tuberculosis epidemics

    OpenAIRE

    Xu, Biao; Zhao, Qi; Hu, Yi; SHI Ying; Wang, Weibing; Diwan, Vinod K.

    2014-01-01

    Background: Tuberculosis (TB) patients with a history of multiple anti-TB treatments are the ‘neglected’ group to the free anti-TB treatment policy in China.Objective: To understand the experiences of TB patients with multiple previous treatments with regard to bacteriological diagnosis and treatment regimens, especially for second-line anti-TB drugs, and how this might influence the risks of multidrug and extensively drug-resistant TB (M/XDR-TB).Design: A cross-sectional study was conducted ...

  12. Experiences in anti-tuberculosis treatment in patients with multiple previous treatments and its impact on drug resistant tuberculosis epidemics

    Directory of Open Access Journals (Sweden)

    Biao Xu

    2014-08-01

    Full Text Available Background: Tuberculosis (TB patients with a history of multiple anti-TB treatments are the ‘neglected’ group to the free anti-TB treatment policy in China. Objective: To understand the experiences of TB patients with multiple previous treatments with regard to bacteriological diagnosis and treatment regimens, especially for second-line anti-TB drugs, and how this might influence the risks of multidrug and extensively drug-resistant TB (M/XDR-TB. Design: A cross-sectional study was conducted in 10 county/district TB clinics in five provinces of China. The study participants were TB patients that had at least two previous treatment episodes that lasted longer than 1 month each. Face-to-face interviews and drug susceptibility testing (DST were conducted with the consenting participants. Results: A total of 328 TB patients were recruited. The proportion of multidrug-resistant tuberculosis (MDR-TB was 58.2% in the 287 DST-confirmed patients. Forty-two percent of the patients did not complete their first treatment course. About 23.8% of the participants had a history of taking second-line drugs, and more than 77.8% of them were treated in county TB dispensaries where only sputum microscopy was applied. Multivariate analysis found that the use of second-line drugs was significantly associated with frequency of previous treatments (p<0.01, but not with drug resistance profiles of patients. Conclusions: Patients with multiple previous treatments are at extremely high risk of MDR-TB in China. The unregulated use of second-line drugs bring about the threat of XDR-TB epidemic. DST-guided treatment and strict regulations of anti-TB treatment should be assured for the high-risk TB patients for the prevention and control of M/XDR-TB.

  13. Design of the Anti-tuberculosis Drugs induced Adverse Reactions in China National Tuberculosis Prevention and Control Scheme Study (ADACS)

    OpenAIRE

    He Ping; Yang Li; Chen Da; Wang Hong; Gao Wei; Zhu Li; Zhou Lin; Chen Yi; Tu,, Y.; Yuan Yan; Wang Xiao; Liu Fei; Hu Dai; Xia Yin; Li Xiao

    2010-01-01

    Abstract Background More than 1 million tuberculosis (TB) patients are receiving the standard anti-TB treatment provided by China National Tuberculosis Prevention and Control Scheme (CNTS) in China every year. Adverse reactions (ADRs) induced by anti-TB drugs could both do harm to patients and lead to anti-TB treatment failure. The ADACS aimed to explore ADRs' incidences, prognoses, economical and public health impacts for TB patients and TB control, and build a DNA bank of TB patients. Metho...

  14. Development of a prediction system for anti-tuberculosis drug-induced liver injury in Japanese patients

    Science.gov (United States)

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

    2016-01-01

    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

  15. Novel anti-tuberculosis drug designs by data mining for similarity in substituent substitution and structure modification

    Directory of Open Access Journals (Sweden)

    Ronald Lee Bartzatt

    2011-11-01

    Full Text Available Mycobacterium tuberculosis (TB is among the most common of infectious diseases that cause death, and as many as one-third of the world’s population may be infected. This work presents 17 novel hydrazide agents formed by focused in silico data mining utilizing search parameters restricted to substituent replacement only. Substituent substitution has been highly successful in design of novel antibacterial and antiviral drugs. This diverse set of hydrazide constructs possess molecular properties indicating favorable bioavailability with excellent intestinal absorption for oral administration. All agents have zero violations of the Rule of 5, indicating favorable druglikeness. Important pharmaceutical properties including polar surface area, Log P, and formula weight were determined and compared to that of the parent structure of isoniazid by hierarchical cluster analysis and discriminant analysis. The average Log P with range is -0.258 and -2.165 to 1.373, respectively. The average polar surface area (PSA with range is 75.19 A2 and 55.121 A2 to 94.036 A2, respectively. The diverse range of PSA and Log P, with other descriptors, portend a versatile group of hydrazide drugs having substantial potential to expand the application and effectiveness for clinical treatment of multi-organ infected TB patients. Analysis of similarity indicated that all 17 agents are significantly similar to isoniazid, however discriminant analysis and hierarchical cluster analysis are able to differentiate isoniazid based upon molecular properties. Molecular weight and number of atoms were highly correlated by Pearson r (r > 0.9000, with Log P moderately correlated (r > 0.5500 to number of atoms, molecular weight, and volume. Seventeen hydrazide compounds (success rate of approximately 38% having diverse pharmaceutical properties resulted from substituent data mining with potential for clinical application.

  16. 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

    2014-01-01

    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...... 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...

  17. Development of a prediction system for anti-tuberculosis drug-induced liver injury in Japanese patients.

    Science.gov (United States)

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

    2016-01-01

    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

  18. 2,3-Bifunctionalized Quinoxalines: Synthesis, DNA Interactions and Evaluation of Anticancer, Anti-tuberculosis and Antifungal Activity

    OpenAIRE

    Tom Ellis; Mohamed Bouakka; Abdelkader Hakkou; Sghir Elkadiri; Rachid Touzani; Abdelkrim Ramdani; Kotchevar, Ann T.; Taibi Ben-Hadda; Michael J Waring

    2002-01-01

    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 À-conjugated quinoxa...

  19. 2,3-Bifunctionalized Quinoxalines: Synthesis, DNA Interactions and Evaluation of Anticancer, Anti-tuberculosis and Antifungal Activity

    Directory of Open Access Journals (Sweden)

    Tom Ellis

    2002-08-01

    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.

  20. Rates of Anti-Tuberculosis Drug Resistance in Kampala-Uganda Are Low and Not Associated with HIV Infection

    NARCIS (Netherlands)

    D. Lukoye; F.G.J. Cobelens; N. Ezati; S. Kirimunda; F.E. Adatu; J.K. Lule; F. Nuwaha; M.L. Joloba

    2011-01-01

    Background: Drug resistance among tuberculosis patients in sub-Saharan Africa is increasing, possibly due to association with HIV infection. We studied drug resistance and HIV infection in a representative sample of 533 smear-positive tuberculosis patients diagnosed in Kampala, Uganda. Methods/Princ

  1. Is resistance to anti-tuberculosis drugs associated with type 2 diabetes mellitus? A register review in Beijing, China

    Directory of Open Access Journals (Sweden)

    Fengling Mi

    2014-05-01

    Full Text Available Background: China has a high burden of drug-resistant tuberculosis (TB and diabetes mellitus (DM. Objective: The objectives of this study were to determine the following in patients with culture-confirmed TB: 1 demographic characteristics and disease patterns in relation to the presence or absence of type 2 diabetes and 2 presence or absence of drug resistance to isoniazid (INH, rifampicin (RMP or both in relation to duration of diabetes and control of diabetes. Design: This is a cross-sectional and retrospective study involving record reviews. Results: There were 621 patients with culture-positive TB, of whom 187 (30% had previously known or new type 2 diabetes. In those with diabetes, there was a significantly higher proportion of males, persons aged ≥35 years and patients registered with new TB (p<0.05. Prevalence of multidrug-resistant TB (MDR-TB was 6.2% in new patients (N=422 and 62.3% in previously treated patients (N=199, with no significant differences between those with and without diabetes. In patients with diabetes, there was no association of drug resistance with diabetes duration or disease control [assessed by fasting blood glucose (FBG at 1 week]. Conclusion: A high proportion of patients with TB in a tertiary health facility, Beijing, China, had diabetes, but there was no association between type 2 diabetes and drug-resistant TB. Further prospective studies are needed to confirm these findings.

  2. Total Synthesis of Cyclomarin A, a Marine Cycloheptapeptide with Anti-Tuberculosis and Anti-Malaria Activity.

    Science.gov (United States)

    Barbie, Philipp; Kazmaier, Uli

    2016-01-15

    An efficient synthetic protocol for the stereoselective synthesis of cyclomarin A is reported. Key steps in the syntheses of the building blocks are an asymmetric chelate-enolate Claisen rearrangement, an asymmetric hydrogenation, and highly diastereoselective additions of organozinc and -titanium reagents. PMID:26699807

  3. Development of a New Indirect ELISA Method for Detection of Anti-Tuberculosis Antibodies in Human Serum

    Directory of Open Access Journals (Sweden)

    Mohammad Morad-Farajollahi

    2015-10-01

    Full Text Available Background: Tuberculosis is a crucial health problem. Establishing a rapid, reliable and still inexpensive diagnostic method for tuberculosis seems to be substantial in developing countries where TB has very high incidence rate. Methods:  An Indirect  Enzyme-linked  immunosorbent  Assay (ELISA  was established to detect serum antibodies against Mycobacterium  tuberculosis. Three kinds of antigens were used to prepare the solid phase for antibody as- say including: purified protein derivative (PPD, M. tuberculosis Bacilli, and Mycobacterium  bovis Bacillus  Calmette  Guerin  (BCG.  Sera  of two main following groups were investigated in this study: sera samples from smear- positive, culture-positive and Tuberculin Skin Test-positive TB patients and sera samples from smear-negative, culture negative and TST-negative healthy individuals.Results: Among the antigens used, BCG produced higher sensitivity and spe-cificity in the assay. With PPD as the solid phase, higher sensitivity, but low- er specificity was observed in comparison with BCG. Both, low response and noise (non-specific binding were observed with TB bacilli as the solid phase in the assay.Conclusion: Using BCG solid phase system in this method resulted in highersensitivity in comparison to single antigen solid phase systems. In addition, we were able to circumvent  the problem of non-specific  bindings in more popular multi-antigenic solid systems such as PPD. By using this new indi- rect ELISA, a rapid, reliable and still inexpensive diagnosis of tuberculosis might be possible. Although,  further investigations  are required to confirm our result.

  4. Availability of second-line drugs and anti-tuberculosis drug susceptibility testing in China: a situational analysis

    NARCIS (Netherlands)

    G.X. He; S. van den Hof; M.W. Borgdorff; M.J. van der Werf; S.M. Cheng; Y.L. Hu; L.X. Zhang; L.X. Wang

    2010-01-01

    OBJECTIVE: To assess the availability of second-line drugs (SLDs) and the use of drug susceptibility testing (DST) results for the treatment of tuberculosis (TB) in China. DESIGN: Cross-sectional survey in 4675 health care facilities, 1960 of which have a dedicated TB clinic, in 12 provinces in Chin

  5. Features of Medical English Vocabulary

    Institute of Scientific and Technical Information of China (English)

    刘翠萍

    2015-01-01

    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.

  6. Features of Medical English Vocabulary

    Institute of Scientific and Technical Information of China (English)

    刘翠萍

    2015-01-01

    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.

  7. Legal aspects of medical errors

    OpenAIRE

    Vučetić Čedomir S.; Vukašinović Zoran S.; Tulić Goran Dž.; Dulić Borivoje V.; Dimitrijević K.; Kalezić Nevena K.

    2011-01-01

    Healing people and medical care are together highly organized technological system with significant expert, ethical and legal regulative. Taking medical care is very sensitive area and it interfears deep into one’s integrity, so the law is necessary in this area as a regulator. The aim of work is to show medical errors from legal aspects and clinical practice. Errors, negligent conduct during the medical treatment and bad results of medical treatment are categories that can easily be sw...

  8. Burnout among Dutch medical residents

    OpenAIRE

    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.

    2007-01-01

    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 percentage of burnout cases among medical residents in Psychiatry. Significantly more male residents than female residents suffered from severe burnout. Medical residents reported significantly lower mea...

  9. Medical education: Changes and perspectives

    OpenAIRE

    Zhang, Qin; Lee, Liming; Gruppen, Larry D.; Ba, Denian

    2013-01-01

    As medical education undergoes significant internationalization, it is important for the medical education community to understand how different countries structure and provide medical education. This article highlights the current landscape of medical education in China, particularly the changes that have taken place in recent years. It also examines policies and offers suggestions about future strategies for medical education in China. Although many of these changes reflect international tr...

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

    CERN Document Server

    Ahamed, Syed V; 10.5121/ijcnc.2010.2602

    2011-01-01

    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...

  11. Medications and Blood Pressure

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More Medications and Blood Pressure Updated:Jul 6,2016 When your blood pressure ... was last reviewed on 08/04/2014. High Blood Pressure • Home • About High Blood Pressure (HBP) • Why HBP ...

  12. A Medical Delivery Device

    DEFF Research Database (Denmark)

    2010-01-01

    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 by...

  13. Medical Art Therapy

    Directory of Open Access Journals (Sweden)

    Birgul Aydin

    2012-03-01

    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.

  14. Electives during Medical Internship

    International Nuclear Information System (INIS)

    The purpose of study was to find out the reasons for selecting elective rotations during a rotating medical internship.One hundred and seventy-eight medical interns in the College of Medicine, King Faisal University,Dammam, Kingdom of Saudi Arabia during the period March 2001 to August 2002 completed a questionnaire for their selection reasons with responses on a scale of 1-5.The study comprised 60% males and 98.3% Saudis. The most frequently chosen elective is Dermatology 28.1% ,radiology 20.8%, anesthesia 9.6% and otorhinolaryngology (ear, nose and throat [ENT]) 9%. Significantly, more males (89.2%) chose radiology rotation and more females (75%) chose ENT rotation.The leading reasons to choose an elective rotations are;1, to gain broad medical training and education,2, to assist in choice of future speciality and,3, being relevant to future speciality .The mean score for ENT and dermatology is higher than radiology and anesthesia for the response to participate in medical practice in different institute , while dermatology is higher than anesthesia for response to help for getting aceptance for job in the same instituteand radiology is higher than ENT and anesthesia for the response it has infrequent or no night duties. The reason chosen reflect the educational value of electives and their important role in choosing future career. Dermatology and radiology rotations are most popular electives ,with additional and though different reasons. (author)

  15. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2001-01-01

    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: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch

  16. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2001-01-01

    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: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch

  17. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Service Médical

    2000-01-01

    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: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch

  18. A medical proton synchrotron

    International Nuclear Information System (INIS)

    A special medical weak-focusing synchrotron using only wedge focusing at dipole ends, is proposed to make a proton cancer therapy. A new method of the turn number calculation in a proton synchrotron allowing to calculate the energy gain per turn, is formulated. 13 refs.; 10 figs.; 1 tab

  19. Microfluidics for medical applications

    NARCIS (Netherlands)

    Berg, van den Albert; Segerink, Loes

    2015-01-01

    Lab-on-a-chip devices for point of care diagnostics have been present in clinics for several years now. Alongside their continual development, research is underway to bring the organs and tissue on-a-chip to the patient, amongst other medical applications of microfluidics. This book provides the re

  20. Medical Query Language

    OpenAIRE

    Morgan, Mary M.; Beaman, Peter D.; Shusman, Daniel J.; Hupp, Jon A.; Zielstorff, Rita D.; Barnett, G. Octo

    1981-01-01

    This paper describes the Medical Query Language (MQL), a “formal” language which enables unsophisticated users, having no background in programming or computer science, to express information retrieval and analysis questions of their data bases. MQL is designed to access any MUMPS data base. Most MQL applications to date have dealt with the COmputer STored Ambulatory Record (COSTAR) data base.

  1. Other Injectable Medications

    Science.gov (United States)

    ... by Mail Close www.diabetes.org > Living With Diabetes > Treatment and Care > Medication > Insulin & Other Injectables Share: Print Page Text ... Gestational Myths Statistics Common Terms Genetics Living With Diabetes Recently Diagnosed Treatment & Care Complications Health Insurance For Parents & Kids Know Your ...

  2. Denying Medical Students' Emotions.

    Science.gov (United States)

    USA Today, 1984

    1984-01-01

    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)

  3. Innovation of Medical Products

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...

  4. Medical imaging systems

    Science.gov (United States)

    Frangioni, John V

    2013-06-25

    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.

  5. Implantable Medical Devices

    Science.gov (United States)

    ... therapy’ in end-stage heart failure patients when heart transplantation is not an option. How does an LVAD work? A common type of LVAD has a tube that pulls blood from the left ... Procedures and Surgeries At-A-Glance Cardiac Medications ...

  6. Medications: Using Them Safely

    Science.gov (United States)

    ... the medicine should be taken with or without food how the medicine should be stored how long the medicine can be stored safely before it needs to be discarded common side effects or reactions interactions with other medications your child may be taking what happens if ...

  7. Medications and International Travel

    Centers for Disease Control (CDC) Podcasts

    2011-04-12

    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.

  8. Motivation in medical students

    NARCIS (Netherlands)

    Kusurkar, R.A.

    2012-01-01

    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

  9. Medications (for IBS)

    Medline Plus

    Full Text Available ... it. He or she can help you monitor quality, effectiveness, possible interactions with other medicines you may be taking, or possible side effects. Remember, all medicines have potential side effects . Medications for IBS First line treatment has traditionally been aimed at treating ...

  10. Slow medical education.

    Science.gov (United States)

    Wear, Delese; Zarconi, Joseph; Kumagai, Arno; Cole-Kelly, Kathy

    2015-03-01

    Slow medical education borrows from other "slow" movements by offering a complementary orientation to medical education that emphasizes the value of slow and thoughtful reflection and interaction in medical education and clinical care. Such slow experiences, when systematically structured throughout the curriculum, offer ways for learners to engage in thoughtful reflection, dialogue, appreciation, and human understanding, with the hope that they will incorporate these practices throughout their lives as physicians. This Perspective offers several spaces in the medical curriculum where slowing down is possible: while reading and writing at various times in the curriculum and while providing clinical care, focusing particularly on conducting the physical exam and other dimensions of patient care. Time taken to slow down in these ways offers emerging physicians opportunities to more fully incorporate their experiences into a professional identity that embodies reflection, critical awareness, cultural humility, and empathy. The authors argue that these curricular spaces must be created in a very deliberate manner, even on busy ward services, throughout the education of physicians. PMID:25426738

  11. Medications (for IBS)

    Medline Plus

    Full Text Available ... of IBS Gallery Contact Us About IBS Twitter Facebook YouTube Search Search ... About Us What is IBS? ... discomfort, usually if the symptoms occur soon after eating. Examples include ... disorders. More complex medication regimens, and specialized motility and/ ...

  12. Medical translation in arabic

    OpenAIRE

    Didouche - Zidi, Fayza

    2013-01-01

    The present thesis is based on the translation of International Union against Cancer’s report “Protection Against Cancer-causing Infections” in the framework of World Cancer Campaign 2010. It deals with the specificities of specialized language and difficulties of translation in specialized field of medical science from the Interpretative theory perspective.

  13. Automated Medical Literature Retrieval

    Directory of Open Access Journals (Sweden)

    David Hawking

    2012-09-01

    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.

  14. A STUDY ON SELF MEDICATION PATTERNS AMONG MEDICAL STUDENTS IN SANTHIRAM MEDICAL COLLEGE, NANDYAL

    Directory of Open Access Journals (Sweden)

    Venkateswarlu

    2014-11-01

    Full Text Available BACKGROUND: Self-medication can be defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. Self‐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. AIMS AND OBJECTIVES: To study the prevalence and pattern of use of self-medication among medical students from first year to final year. METHODS: This cross‐sectional descriptive study was conducted at the Santhiram Medical College, Nandyal, during the period of Dec 10th 2013 to Jan 10th 2014. Medical students were selected through convenience sampling. The data was collected using a pre‐tested semi‐structured questionnaire. RESULTS: A total of 150 students, 93 (62% male and 57 (38% female 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 timesaving in providing relief from minor ailments. The most common ailments for which self‐medication were used were: the common cold (73%, fever (68% and headache (62%. The students consulted their textbooks (45% and seniors or classmates (39% for the medications. Antipyretics (78%, analgesics (72%, antihistamines (42% and antibiotics (38% were the most common self-medicated drugs. Of the respondents, 29% were unaware of the adverse effects of the medication. CONCLUSION: Self‐medication is becoming an increasingly important area within healthcare. The prevalence of self‐medication among medical students is high, facilitated by the easy availability of drugs and information from textbooks or seniors, due to high level of education and professional

  15. Medical Rituals and Media Rituals

    Directory of Open Access Journals (Sweden)

    Zoltán Zsinkó-Szabó

    2013-01-01

    Full Text Available In the present article the author examines the ritual elements of theprofessionalization during medical studies, and its interference with media content of medical significance, comparing the role of medical and media rituals on the way of becoming a doctor. It is to be explored how these medical soap operas, medical dramas, medical thrillers or crime stories do exert influence on medical identity and role expectations. Do medical students and their relatives (withmedical expertise frequently identify themselves with these roles? Is their way of reception critical or naïve? How media rituals are organizing, modulating the students’ medical perception and expectations. Is there a mediated “shadow initiation” via media or it is excluded and denied? Does it perfuse the common social experience of becoming a doctor via peer communication and peer shapingof model behavior? We search the answers in the context of a theory of media rituals.

  16. 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

    2011-01-01

    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

  17. Social Risks of Medical Tourism

    Directory of Open Access Journals (Sweden)

    Gennady Yurievich Shchekin

    2015-03-01

    Full Text Available Modern medicine as a subject of international tourism. Conceptual approaches to the definition and descriptionof medical tourism were analyzed. International experience in rendering services of medical tourism, its rapidgrowth in such countries as the USA, Germany Israel and India was studied. A range of serviced rendered byforeign medical institutions was described. Prospects of medical tourism in today’s Russia was considered.Social role of travel agencies in development of medical tourism was described. Social risks were revealed anddescribed and recommendations to develop medical tourism were suggested.

  18. Optimization of Medical Teaching Methods

    Directory of Open Access Journals (Sweden)

    Wang Fei

    2015-12-01

    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.

  19. Medical education: Changes and perspectives

    Science.gov (United States)

    Zhang, Qin; Lee, Liming; Gruppen, Larry D.; Ba, Denian

    2013-01-01

    As medical education undergoes significant internationalization, it is important for the medical education community to understand how different countries structure and provide medical education. This article highlights the current landscape of medical education in China, particularly the changes that have taken place in recent years. It also examines policies and offers suggestions about future strategies for medical education in China. Although many of these changes reflect international trends, Chinese medical education has seen unique transformations that reflect its particular culture and history. PMID:23631405

  20. Self-medication among medical and pharmacy students in Bangladesh

    OpenAIRE

    Alam, Naznin; Saffoon, Nadia; Uddin, Riaz

    2015-01-01

    Background This cross-sectional survey examined the pattern of self-medication and factors associated with this practice among medical and pharmacy students in context to Bangladesh. Methods The study used a self-administered questionnaire. A total of 500; 250 medical and 250 pharmacy, students participated in the study. As it is a comparative analysis between the medical and pharmacy students, we used independent t test and Chi square test. Results The findings indicated that the impact of s...

  1. Knowledge of medical ethics among Nigerian medical doctors

    OpenAIRE

    Fadare, Joseph O.; Desalu, Olufemi O; Abiodun C Jemilohun; Oluwole A. Babatunde

    2012-01-01

    Background: The knowledge of medical ethics is essential for health care practitioners worldwide. The main objective of this study was to evaluate the knowledge of medical doctors in a tertiary care hospital in Nigeria in the area of medical ethics. Materials and Methods: A cross-sectional questionnaire-based study involving 250 medical doctors of different levels was carried out. The questionnaire, apart from the bio-data, also sought information on undergraduate and postgraduate training in...

  2. Bullying among medical students in a Saudi medical school

    OpenAIRE

    Alzahrani Hasan

    2012-01-01

    Abstract Background Bullying and sexual harassment of medical students by their teachers appears to be widespread phenomenon. However, nothing is published about its prevalence in conservative countries such as Saudi Arabia. This survey aims to ascertain the extent of these mistreatments among students in a Saudi medical school. Findings A cross-sectional questionnaire survey was conducted on a group of 542 clinical years’ medical students in a Saudi medical school to explore students' percep...

  3. Radiation education in medical and Co-medical schools

    International Nuclear Information System (INIS)

    In the medical field, ionizing radiation is very widely in diagnostic and therapeutic procedures, Around 60% of environmental radiation, including natural background and man-made sources of radiation, is caused from medical exposure in Japan. Education of radiation in medical ad co-medical schools are mainly aimed to how effectively use the radiation, and the time shared to fundamental physics, biology and safety or protection of radiation is not so much. (author)

  4. Medical therapy in acromegaly.

    LENUS (Irish Health Repository)

    Sherlock, Mark

    2011-05-01

    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.

  5. MEDICAL MANUFACTURING INNOVATIONS

    Directory of Open Access Journals (Sweden)

    Cosma Sorin Cosmin

    2015-02-01

    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.

  6. [Medical politics. Graffiti].

    Science.gov (United States)

    Fugelli, P

    1991-03-20

    If doctors want to play a role in future health promotion, they have to leave their citadel, and come closer to life and society. Modern preventive medicine cannot be dissociated from basic political, cultural and religious values and processes. Genetic counseling and engineering, influencing lifestyle, community intervention and changing the health culture among patients and doctors all require ethical and political competence rather than traditional medical skills. The author advocates the development of a new discipline, medical politics, with two major commitments: -To define basic health rights -To study the public health consequences of political systems and decisions. In a polemic and provocative style the article enlightens the potentials and dangers associated with an expanded concept of preventive medicine. PMID:2042221

  7. Medical Images Remote Consultation

    Science.gov (United States)

    Ferraris, Maurizio; Frixione, Paolo; Squarcia, Sandro

    Teleconsultation of digital images among different medical centers is now a reality. The problem to be solved is how to interconnect all the clinical diagnostic devices in a hospital in order to allow physicians and health physicists, working in different places, to discuss on interesting clinical cases visualizing the same diagnostic images at the same time. Applying World Wide Web technologies, the proposed system can be easily used by people with no specific computer knowledge providing a verbose help to guide the user through the right steps of execution. Diagnostic images are retrieved from a relational database or from a standard DICOM-PACS through the DICOM-WWW gateway allowing connection of the usual Web browsers to DICOM applications via the HTTP protocol. The system, which is proposed for radiotherapy implementation, where radiographies play a fundamental role, can be easily converted to different field of medical applications where a remote access to secure data are compulsory.

  8. Nonsecular Medical Anthropology.

    Science.gov (United States)

    Whitmarsh, Ian; Roberts, Elizabeth F S

    2016-01-01

    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. PMID:26652795

  9. Psychotropic medications and leukopenia.

    Science.gov (United States)

    Sedky, Karim; Lippmann, Steven

    2006-09-01

    Neutropenia and/or agranulocytosis are among the medicinal side-effects induced by many psychotropic drugs. Clozapine and carbamazepine cause the highest incidence of this side-effect and require long-term blood cell monitoring. Bone marrow suppression can have an allergic, hypersensitivity etiology (e.g., clozapine), which mandates the causative drug discontinuation. It can also be a direct, toxic effect (e.g., carbamazepine), which calls for dosage reduction or a medication change. Other treatment options may include filgrastim, sargramostim, or lithium. Blood cell count monitoring is encouraged on patients receiving clozapine as long as the drug is continued. Such evaluation is also advised on those medicated with other psychotropics, especially carbamazepine. PMID:17017894

  10. [Medical emergency teams

    DEFF Research Database (Denmark)

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

    2008-01-01

    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...... show conflicting results. Despite the lack of evidence, METs are gaining popularity and are being implemented in Danish hospitals as part of Operation Life Udgivelsesdato: 2008/8/25...

  11. Medical emergencies in Goa

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo

    2010-01-01

    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.

  12. The Medicalization of Love

    OpenAIRE

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

    2015-01-01

    Abstract: 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 necessari...

  13. Neurophobia among medical students

    OpenAIRE

    Abulaban, Ahmad A.; Obeid, Tahir H.; Algahtani, Hussein A.; Kojan, Suleiman M.; Al-Khathaami, Ali M.; Abulaban, Abdulrhman A; Bokhari, Maryam F.; Merdad, Anas A; Radi, Suhaib A.

    2015-01-01

    Objective: To assess the attitude of medical students and junior physicians toward neurology. Methods: A self-administered, previously validated, questionnaire was distributed among 422 students and junior physicians at King Abdulaziz University, Jeddah, Saudi Arabia from September to December 2012. In this cross-sectional study, the questionnaire included demographic data and 12 statements to examine attitudes toward neurology using a Likert scale. Results: The response rate among participan...

  14. Adherence to Antidepressant Medication

    OpenAIRE

    Åkerblad, Ann-Charlotte

    2007-01-01

    Non-adherence to medication is a major obstacle in the treatment of depression. The objectives of the present study were to explore the effect of two interventions aiming to increase antidepressant treatment adherence, and to examine long-term consequences and costs of depression in adherent and non-adherent primary care patients. A randomised controlled design was used to assess the respective effects of a written educational adherence enhancing programme and therapeutic drug monitoring in ...

  15. Transsexualism: a medical perspective.

    OpenAIRE

    Armstrong, C. N.

    1980-01-01

    Transsexualism, a condition in which from earliest recollection the individual is unshakeably convinced he or she has been endowed with the wrong physical sexual body presents one of the most difficult problems as regards management and treatment in clinical medicine. The aetiology and treatment is discussed and the problems with which the medical practitioner may be faced in advising his transsexual patient which include change in social role and marriage and the difference between sex and g...

  16. The medicalization of cannabis

    OpenAIRE

    2010-01-01

    Cannabis has been considered as both an illicit drug and a medicine throughout its history. Introduced to the UK as a medicine in the nineteenth century, its medical utility was limited and it was not until tetrahydrocannabinol (THC), one of the principal active components in cannabis, was isolated in 1964 by Raphael Mechoulam and his team in Israel that scientific research on the drug expanded. Further major developments came in the 1980s, when the cannabinoid receptors in the brain were dis...

  17. [Medically unexplained symptoms].

    Science.gov (United States)

    Sayar, Kemal

    2002-01-01

    Patients with physical symptoms for which no medical explanation can be found are relatively common in general practice. Patients with medically unexplained symptoms are frequently frustrating to physicians both in primary and secondary care and utilize health sources disproportionately. They frequently attend both primary care units and hospitals and are usually not satisfied with the care they receive. Medically unexplained symptoms in patient populations are strongly associated with psychiatric pathology and with anxiety and depression in particular. They are also linked to personality pathology, childhood adversity, adult trauma or medically unexplained symptoms in childhood. The predictive value of alexithymia in determining these symptoms is controversial. Patients who have high negative affectivity or neuroticism tend to score high on measures of physical symptoms. These symptoms have a high degree of co-occurrence. The same person may meet the diagnostic criteria for several functional somatic syndromes simultaneously. The clinician should be aware of the cultural and social shaping of the bodily experience of these patients and hence acknowledge the somatic nature and reality of the symptoms. The clinician should make the person feel understood and establish a positive collaborative relationship. This would enable him/her to correct misconceptions about the disease and give a positive explanation of symptoms. Antidepressant therapy and cognitive-behavioural psychotherapy have been proved to be moderately effective in this group of patients. Because of the high disability that might be caused by these symptoms, psychiatrists and primary and secondary care physicians should pay careful attention to this clinical condition. These symptoms may also aid us in challenging the long-held idea of mind-body dualism which is inherent in Western biomedicine. PMID:12794657

  18. Justice and medical ethics.

    Science.gov (United States)

    Gillon, R

    1985-07-20

    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. PMID:3926121

  19. Medical consequences of cocaine.

    Science.gov (United States)

    Gray, J. D.

    1993-01-01

    Cocaine use among middle-class North Americans increased dramatically during the 1980s. Medical complications involve almost every organ system and are produced by intense vasoconstriction. Managing cocaine-induced disease requires careful identification and the use of alpha-adrenergic blocking agents, in addition to standard therapy and referral to specialists to manage cocaine withdrawal. Images p1976-a p1980-a PMID:8106032

  20. The medicalization of beauty

    OpenAIRE

    Paulo Poli Neto; Sandra N.C. Caponi; Silvana Polchlopek

    2007-01-01

    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 o...

  1. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2001-01-01

    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: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch  

  2. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Service Médical

    2000-01-01

    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: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch

  3. Medical-chiropractic correspondence *

    OpenAIRE

    Cassidy, J David; Mierau, Dale R; Nykoliation, Jim W.; Arthur, Brian

    1985-01-01

    The authors are engaged in a multidisciplinary practice setting and have accumulated years of experience in medical-chiropractic co-operation. This paper outlines the importance of effective communication between disciplines in day-to-day clinical practice. It is important to know when and how to write letters of referral and chart notes. The proper development of these skills will foster greater interdisciplinary co-operation, better practice management skills, and an increased number of pat...

  4. Maltese medical Pauline traditions

    OpenAIRE

    Savona-Ventura, Charles

    2010-01-01

    The advent of the apostle Paul and evangelist Luke to the Maltese Islands in 60 AD led to the development of a number of pseudo-historic and medical beliefs that apparently saw their rise around the 12th century and reached a climax during the 17-18th centuries when an indigenous materia medica known as terra sigillata melitensis was being prepared and exported overseas. This eventually fell into disrepute by the latter half of the 19th century.

  5. Canada's medical isotope strategy

    International Nuclear Information System (INIS)

    This paper details Canada's medical isotope strategy and the role of the Canadian Government in the security of the isotope supply chain. The government's role is to promote health and safety of Canadians, establish appropriate regulatory framework, allow the markets to work, facilitate international collaboration, fund high-risk early stage research and development, encourage private sector investment in innovation and support and respect environmental and non-proliferation goals.

  6. STS-2 medical report

    Science.gov (United States)

    Pool, S. L. (Editor); Johnson, P. C., Jr. (Editor); Mason, J. A. (Editor)

    1982-01-01

    All medially related activities of the Space Transportation System 2 flight are described, ranging from preflight to postflight. Several medical problems occured during the flight. Their was marginal operation on-board potable water system caused by a malfunctioning fuel cell. Work and rest cycles by the crew were altered to maximize the scientific data acquisition. Inadequate time was allocated for food preparation and consumption. There was low water intake by the crew because of the water shortage.

  7. Designing sustainable medical devices

    OpenAIRE

    Marshall, J-L; Hinton, M; Wrobel, L; Troisi, G

    2009-01-01

    Stakeholders in the medical device manufacturing industry are becoming more concerned about the environmental impact of their products and processes. The consumers are also becoming more aware of the negative impact that manufacturers can have on the environment. Government initiatives continue to increase environmental awareness through the development of new policy and legislation, encouraging industry to become more accountable for the environmental impact of their products and operations....

  8. Medical nutrition therapy planning

    OpenAIRE

    Torović Ljilja; Grujičić Maja; Pavlović-Trajković Ljiljana; Jovičić Jelena; Novaković Budimka; Balać Dragana

    2010-01-01

    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 diet...

  9. Commercializing medical technology

    OpenAIRE

    Scanlon, Kevin J.; Lieberman, Mark A.

    2007-01-01

    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...

  10. Medical physics in Europe

    International Nuclear Information System (INIS)

    Radiotherapy was in the early days empirically developed and thought to be applicable only in dermatology. The x-ray equipment was rather primitive and dosimetry very rudimentary. Radium, radon and mesothorium was introduced for brachytherapy and dosage could be expressed in mgh Ra or in mCd. Radiation protection became of great concern in view of the injuries noted among staff members. The need for physical support became apparent and in certain places physicists were appointed. Their main duties were in the planning of new departments, basic and clinical dosimetry, design, maintenance and performance checking of equipment and instruments, development of new treatment techniques, physical treatment planning, radiation protection e.t.c. ICRU and ICRP were set up in London in 1925 and in Stockholm in 1928 respectively by the first and second International Congress of Radiology. Physicists have throughout the years been leading scientists in these well reputed commissions. With increasing responsibilities and the growth of the profession separate departments have been established in hospitals, medical schools and at universities. Education and training programs have been introduced with the aim of ensuring competence for all categories engaged in the realization of the procedures. Quality Assurance (QA) is the modern term for procedures which have always been the main aim with medical radiation physics. National and international organizations for hospital- or medical physics have been very influential. Handbooks, codes of practice and journals published by leading associations are widely accepted and through workshops, conferences and regional meetings the knowledge is conveyed. In this respect the cooperation with such organizations as the IAEA and WHO is very important. Through work in IEC committees setting standards for medical equipment valuable contributions can be made by physicists

  11. Teratogenicity of Antiepileptic Medications

    OpenAIRE

    Benzi M Kluger; Meador, Kimford J.

    2008-01-01

    Antiepileptic drugs (AEDs) are frequently used to treat several conditions that are common in women of childbearing age, including epilepsy, headaches, and mood disorders. Moreover, as in the case of epilepsy and severe psychiatric disease, clinicians frequently do not have the option of stopping these medications or switching to another class of drugs. Overall, AEDs have been associated with an increased risk of major congenital malformations, minor anomalies, specific congenital syndromes, ...

  12. More New Medication Approvals.

    Science.gov (United States)

    Turkoski, Beatrice B

    2016-01-01

    In the past year, the Federal Drug Administration (FDA) approved many new drugs for treating a wide variety of patient health problems. In a previous article, examples of approvals for the early part of last year were addressed. In this article, selected new FDA approvals through January 2016 are discussed. Nurses who are knowledgeable and informed about these new drugs will be able to answer patients' questions, clarify misunderstandings, and reduce the potential for medication misadventures. PMID:27441881

  13. Medical Student Utilization of the Medical Specialty Preference Inventory

    Science.gov (United States)

    Zimny, George H.; Senturia, Audrey G.

    1973-01-01

    This study was aimed specifically at determining the number of medical students who would, on a voluntary basis, utilize a source of information about their medical specialty preferences. The information was that provided by the Medical Specialty Preference Inventory (MSPI) developed by the authors. (Author)

  14. Initiatives for Medical Education Research at the International Medical University

    OpenAIRE

    Ramesh Chandra Jutti; Vishna Devi Nadarajah; Victor Lim

    2008-01-01

    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.

  15. International Conference Medical Radiations

    International Nuclear Information System (INIS)

    Full text : The second edition of the international conference Medical radiation : research and applications which took place in Marrakech (Morocco) from 7 to 9 April 2010, was designed to bring together researchers and physicians from different countries who dedicated their talents and time to this endeavour. The conference's program defined goals were is to identify the most reliable techniques among the several tested so far and to establish the most practical standardized methodologies, taking into account such recent technological development in radiation medical research. The scientific objectives of this conference are as follows : present the state of the art of the various topics of the congress, give a progress report on the impact of the interaction of the various scientific and technical disciplinary fields (Medicine, Biology, Mathematics, Physics,..) on the applications of radiations in medicine, promote the interdisciplinary efforts of research among researchers, present new technologies and research and development tasks prepared in the field of medical radiations, contribute to the emergence of new ideas of research and development of new collaborations

  16. Radioisotopes for medical applications

    International Nuclear Information System (INIS)

    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

  17. Stress in medical students.

    Science.gov (United States)

    Nechita, Florina; Nechita, Dan; Pîrlog, Mihail Cristian; Rogoveanu, Ion

    2014-01-01

    Stress has been defined as the state of a body threatened by imbalance under the influence of agents or conditions endangering its homeostatic mechanisms but the concept have multiple meanings in correlation with the origin and biological support of its effects. Also, stressors are multiple, recording one of the highest levels during the academic studies. For the medical students, stress represents an important challenge, especially during the first year of medical school, caused by the absence of a learning strategy, the sleepless night before the exam and also an unhealthy food intake during the exams. The coping strategies are important, their background being represented by the social support, especially within the family, and emotional, the passions of the medicine students being the most important stress-combating factor. Gender represents also an important factor for the stress vulnerability, manifested through medical and psychiatric symptoms. In order to train good doctors, fair and above all healthy, it is important to consider not only the information we want to transmit, but also the context in which we educate. PMID:25607418

  18. Multimedia medical archiving system

    Science.gov (United States)

    Sood, Arun K.; Atallah, George C.; Rao, Amar; Perez-Lopez, Kathleen G.; Freedman, Matthew T.

    1995-11-01

    The demand for digital radiological imaging and archiving applications has been increasingly rapidly. These digital applications offer significant advantages to the physician over the traditional film-based technique. They result in faster and better quality services, support remote access and conferencing capabilities, provide on demand service availability, eliminate film processing costs, and most significantly, they are suitable services for the evolving global information super highway. Several existing medical multimedia systems incorporate and utilize those advanced technical features. However, radiologists are seeking an order of magnitude improvement in the overall current system design and performance indices (such as transactions response times, system utilization and throughput). One of the main technical concern radiologists are raising is the miss-filing occurrence. This even will decrease the radiologist productivity; introduce unnecessarily workload; and will result in total customer dissatisfaction. This paper presents Multimedia Medical Archiving System, which can be used in hospitals and medical centers for storing and retrieving radiological images. Furthermore, this paper emphasizes a viable solution for the miss-filing problem. The results obtained demonstrate and quantify the improvement in the overall radiological operations. Specifically this paper demonstrates an order of 80% improvement in the response time for retrieving images. This enhancement in system performance directly translates to a tremendous improvement in the radiologist's productivity.

  19. Medical error and disclosure.

    Science.gov (United States)

    White, Andrew A; Gallagher, Thomas H

    2013-01-01

    Errors occur commonly in healthcare and can cause significant harm to patients. Most errors arise from a combination of individual, system, and communication failures. Neurologists may be involved in harmful errors in any practice setting and should familiarize themselves with tools to prevent, report, and examine errors. Although physicians, patients, and ethicists endorse candid disclosure of harmful medical errors to patients, many physicians express uncertainty about how to approach these conversations. A growing body of research indicates physicians often fail to meet patient expectations for timely and open disclosure. Patients desire information about the error, an apology, and a plan for preventing recurrence of the error. To meet these expectations, physicians should participate in event investigations and plan thoroughly for each disclosure conversation, preferably with a disclosure coach. Physicians should also anticipate and attend to the ongoing medical and emotional needs of the patient. A cultural change towards greater transparency following medical errors is in motion. Substantial progress is still required, but neurologists can further this movement by promoting policies and environments conducive to open reporting, respectful disclosure to patients, and support for the healthcare workers involved. PMID:24182370

  20. Radioisotopes for medical applications

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-03-01

    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.

  1. Medical and Dental Patient Issues

    Science.gov (United States)

    ... properly performed clinically indicated diagnostic imaging procedures, including CT scans, far outweigh any hypothetical cancer risk. Diagnostic medical imaging procedures provide a medical benefit to you even if they do not appear ...

  2. Medical Consequences of Drug Abuse

    Science.gov (United States)

    ... Home » Related Topics » Medical Consequences Medical Consequences of Drug Abuse Email Facebook Twitter Drug addiction is a brain ... and lung disease can all be affected by drug abuse. Some of these effects occur when drugs are ...

  3. Medical complications of anorexia nervosa.

    Science.gov (United States)

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

    2016-05-01

    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. PMID:27166107

  4. Medical Specialty Counseling: A Survey

    Science.gov (United States)

    Zimny, George H.; Senturia, Audrey G.

    1973-01-01

    The survey asked the following questions: describe what you do to assist students in resolving their problem of selecting a medical specialty, and what is your reaction to the proposed medical counseling service. (Author)

  5. Medical Encyclopedia: MedlinePlus

    Science.gov (United States)

    ... of this page: https://medlineplus.gov/encyclopedia.html 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, ...

  6. American College of Medical Toxicology

    Science.gov (United States)

    ... Club ACMT Grand Rounds Medical Toxicology LLSA JMT Peer Reviewer Webinar Resident-Medical Student Webinars 2015 Fellows-in-Training Research Webinar Other Enduring Education PEHSU National Classroom Chemical Agents of Opportunity Webinars Podcasts Public Health ...

  7. Mobile medical image retrieval

    Science.gov (United States)

    Duc, Samuel; Depeursinge, Adrien; Eggel, Ivan; Müller, Henning

    2011-03-01

    Images are an integral part of medical practice for diagnosis, treatment planning and teaching. Image retrieval has gained in importance mainly as a research domain over the past 20 years. Both textual and visual retrieval of images are essential. In the process of mobile devices becoming reliable and having a functionality equaling that of formerly desktop clients, mobile computing has gained ground and many applications have been explored. This creates a new field of mobile information search & access and in this context images can play an important role as they often allow understanding complex scenarios much quicker and easier than free text. Mobile information retrieval in general has skyrocketed over the past year with many new applications and tools being developed and all sorts of interfaces being adapted to mobile clients. This article describes constraints of an information retrieval system including visual and textual information retrieval from the medical literature of BioMedCentral and of the RSNA journals Radiology and Radiographics. Solutions for mobile data access with an example on an iPhone in a web-based environment are presented as iPhones are frequently used and the operating system is bound to become the most frequent smartphone operating system in 2011. A web-based scenario was chosen to allow for a use by other smart phone platforms such as Android as well. Constraints of small screens and navigation with touch screens are taken into account in the development of the application. A hybrid choice had to be taken to allow for taking pictures with the cell phone camera and upload them for visual similarity search as most producers of smart phones block this functionality to web applications. Mobile information access and in particular access to images can be surprisingly efficient and effective on smaller screens. Images can be read on screen much faster and relevance of documents can be identified quickly through the use of images contained in

  8. Commercializing medical technology.

    Science.gov (United States)

    Scanlon, Kevin J; Lieberman, Mark A

    2007-04-01

    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

  9. ‘Gezonde buitenlucht’ en ‘krachtige voeding’: kinderen en de anti-tuberculosecampagne in Nederland (ca. 1910–1940)

    OpenAIRE

    Nelleke Bakker

    2013-01-01

    ‘Healthy air’ and ‘powerful nutrition’: children and the anti-tuberculosis campaign in the Netherlands (c. 1910–1940)As elsewhere in the Western world, between 1910 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 author discusses from a comparative perspect...

  10. Learning Resources for Medical Computing

    OpenAIRE

    Jelovsek, Frederick R.

    1986-01-01

    For medical professionals to acquire computer literacy can be an arduous task. Resources for learning medical computing fall into four major categories: learning technical microcomputer use, computerizing an office practice, tracking patient care experience and integrating medical information systems. Both microcomputer use and tracking patient care experience are technical skills similar to learning any medical procedure with which physicians are already familiar. These skills can be acquire...

  11. Medical photography: principles for orthopedics

    OpenAIRE

    Uzun, Metin; Bülbül, Murat; Toker, Serdar; Beksaç, Burak; Kara, Adnan

    2014-01-01

    Background Medical photography is used clinically for patient evaluation, treatment decisions, and scientific documentation. Although standards for medical photography exist in many branches of medicine, we have not encountered such criteria in publications in the area of orthopedics. Purpose This study aims to (1) assess the quality of medical images used in an orthopedic publication and (2) to propose standards for medical photography in this area. Methods Clinical photographs were reviewed...

  12. Medication adherence in the elderly

    OpenAIRE

    Angela Frances Yap, BSc (Pharm) (Hons); Thiru Thirumoorthy, MBBS, FRCP (London), FAMS; Yu Heng Kwan, BSc (Pharm) (Hons)

    2016-01-01

    Medication adherence is a crucial component in the treatment of chronic diseases. In the elderly, clinicians are faced with a unique set of problems associated with adherence that they may not have been adequately trained for. In this paper, we demonstrate the importance of medication adherence in the elderly through a case study. The different factors affecting medication adherence in the elderly are highlighted: patient, medication, health care providers, health care system, and socioeconom...

  13. Regression methods for medical research

    CERN Document Server

    Tai, Bee Choo

    2013-01-01

    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

  14. Evidence on global medical travel

    OpenAIRE

    Ruggeri, Kai; Záliš, Ladislav; Meurice, Christopher R; Hilton, Ian; Ly, Terry-Lisa; Zupan, Zorana; Hinrichs, Saba

    2015-01-01

    Abstract The potential benefits of travelling across national borders to obtain medical treatment include improved care, decreased costs and reduced waiting times. However, medical travel involves additional risks, compared to obtaining treatment domestically. We review the publicly-available evidence on medical travel. We suggest that medical travel needs to be understood in terms of its potential risks and benefits so that it can be evaluated against alternatives by patients who are seeking...

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

    Directory of Open Access Journals (Sweden)

    Turner Leigh

    2012-06-01

    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

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

    Science.gov (United States)

    2012-01-01

    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 companies. Seven other

  17. Medical writing, revising and editing

    DEFF Research Database (Denmark)

    Pilegaard, Morten

    2006-01-01

    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...

  18. Blended Learning in Medical Education

    Science.gov (United States)

    Zayapragassarazan, Z.; Kumar, Santosh

    2012-01-01

    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…

  19. Optimizing Medical Kits for Spaceflight

    Science.gov (United States)

    Keenan, A. B,; Foy, Millennia; Myers, G.

    2014-01-01

    The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulation outcomes describing the impact of medical events on the mission may be used to optimize the allocation of resources in medical kits. Efficient allocation of medical resources, subject to certain mass and volume constraints, is crucial to ensuring the best outcomes of in-flight medical events. We implement a new approach to this medical kit optimization problem. METHODS We frame medical kit optimization as a modified knapsack problem and implement an algorithm utilizing a dynamic programming technique. Using this algorithm, optimized medical kits were generated for 3 different mission scenarios with the goal of minimizing the probability of evacuation and maximizing the Crew Health Index (CHI) for each mission subject to mass and volume constraints. Simulation outcomes using these kits were also compared to outcomes using kits optimized..RESULTS The optimized medical kits generated by the algorithm described here resulted in predicted mission outcomes more closely approached the unlimited-resource scenario for Crew Health Index (CHI) than the implementation in under all optimization priorities. Furthermore, the approach described here improves upon in reducing evacuation when the optimization priority is minimizing the probability of evacuation. CONCLUSIONS This algorithm provides an efficient, effective means to objectively allocate medical resources for spaceflight missions using the Integrated Medical Model.

  20. [Involvement of medical representatives in team medical care].

    Science.gov (United States)

    Hirotsu, Misaki; Sohma, Michiro; Takagi, Hidehiko

    2009-04-01

    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. PMID:19381051