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Sample records for atypical skeletal tuberculosis

  1. Diagnostic role of whole body bone scintigraphy in atypical skeletal tuberculosis resembling multiple metastases: a case report

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    Assadi Majid

    2009-11-01

    Full Text Available Abstract Introduction Osseous tuberculosis can be present with unifocal or multifocal bony involvement. Although multifocal involvement of the skeletal system in areas where tuberculosis is endemic is not a rare presentation, its exact prevalence is not well known. A case of atypical skeletal tuberculosis mimicking multiple secondary metastases on radiologic and scintigraphic imaging is presented to emphasize the contribution of bone scintigraphy in the assessment of osseous tuberculosis in typical and atypical presentations. Case presentation A 73-year-old cachectic Asian man (Iranian presented with a general feeling of being unwell and an acute loss of vision in his left eye accompanied by a severe headache. A Tc-99 m-methylene diphosphonate bone scan demonstrated multiple regions of intense activity in the appendicular and axial skeleton, suggesting metastatic involvement. Tumor markers (PSA, CA125, CA 19-9 and AFP were within normal ranges. Based on clinical presentation and laboratory, radiological and scintigraphic findings, a presumptive diagnosis of tuberculosis was made. Quadruple antituberculous chemotherapy was consequently started and the patient later showed marked improvement. Conclusion Scintigraphic bone scanning should be kept in mind when assessing bone pain in patients at a high risk of tuberculosis infection or reactivation. We present this unusual case of multifocal skeletal tuberculosis, and stress the related clinical and diagnostic points with the aim of stimulating a high index of suspicion that could facilitate early diagnosis and appropriate treatment.

  2. Skeletal tuberculosis

    International Nuclear Information System (INIS)

    Tuberculosis remains a major cause of bone and joint infection, and its frequency has been increasing during recent years. Recent imaging methods, especially MR, are necessary for the early diagnosis of the disease, because conventional radiography may fail to reveal the initial osseous lesions. Spine is the most common site of infection, with relatively characteristic features; MR is the most suitable method for evaluation of bone involvement, paravertebral and epidural abscesses. Radiographic presentation of tuberculous osteitis and osteo-arthritis is less characteristic. The final diagnosis frequently needs histological studies and cultures of bone, synovial tissue or synovial fluid. (authors)., 13 figs., 35 refs

  3. Multifocal skeletal tuberculosis: A case report

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    Zhang, Liang; Wang, Jingcheng; Feng, Xinmin; Tao, Yuping; Yang, Jiandong; ZHANG, SHENFEI; Cai, Jun

    2016-01-01

    Tuberculosis (TB) of the musculoskeletal system is a rare clinical condition. Multifocal bone involvement is extremely rare and difficult to recognize. Thus, due to the diverse and atypical clinical manifestations of multifocal skeletal TB, the disease is easy to misdiagnose. In the present study, a rare case of atypical disseminated multifocal skeletal TB was reported, which exhibited uncommon findings in radiological images that were more suggestive of a hematological malignancy or metastat...

  4. Multifocal skeletal tuberculosis: A case report

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    ZHANG, LIANG; WANG, JINGCHENG; FENG, XINMIN; TAO, YUPING; YANG, JIANDONG; ZHANG, SHENFEI; CAI, JUN

    2016-01-01

    Tuberculosis (TB) of the musculoskeletal system is a rare clinical condition. Multifocal bone involvement is extremely rare and difficult to recognize. Thus, due to the diverse and atypical clinical manifestations of multifocal skeletal TB, the disease is easy to misdiagnose. In the present study, a rare case of atypical disseminated multifocal skeletal TB was reported, which exhibited uncommon findings in radiological images that were more suggestive of a hematological malignancy or metastatic disease. In conclusion, the diagnosis of this condition by conventional diagnostic methods is challenging. The importance of CT-guided needle biopsy and open biopsy in the diagnosis of skeletal TB was emphasized. PMID:27073438

  5. Atypical extraspinal musculoskeletal tuberculosis in immunocompetent patients, a reivew. Part I: atypical osteoarticular tuberculosis and tuberculous osteomyelitis

    International Nuclear Information System (INIS)

    With the resurgence of pulmonary tuberculosis and musculoskeletal tuberculosis in North America and Europe over the last 20 years, the typical pattern of extraspinal musculoskeletal tuberculosis has been changing; presentation of the disease often mimics that of neoplasia. However, certain radiographic features may offer some clues to the more benign nature of the process and its inflammatory and infectious nature. Although the diagnosis of extraspinal musculoskeletal tuberculosis depends largely on clinical context, it is the radiologist's role to guide the imaging workup to initiate the specific treatment as early as possible. As in classic extraspinal tuberculosis, delayed diagnosis may lead to deformity of the involved joint and permanent disability. This review considers atypical osteoarticular tuberculosis and tuberculous osteomyelitis. We discuss examples of these atypical presentations. All patients were permanent residents in Europe and North America, and all were immunocompetent. (author)

  6. Multifocal skeletal tuberculosis in children.

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    Rahman, M A; Mutanabbi, M; Rahman, M H; Arefin, K E; Helal, M A

    2009-01-01

    Multifocal bone involvement is though rare but is reported from some countries where tuberculosis is endemic. Here we report a case of three years old boy was admitted in Bangabandhu Sheikh Mujib Medical University, Dhaka with the complaints of difficulty in walking ,low grade fever for six months, swelling over the back, elbow joint, knee joint and upper part of forearm and legs for two months. Family history of tuberculosis was positive. Mantoux test was 18 mm, ESR 85 mm in first hour, chest X-ray reveals right hilar lymphadenopathy, X-ray dorsolumber spine shows wedge shaped deformity in T11, L4 and with paravertebral collection from L2-L4. X-ray of legs, knee joint and forearms show multiple lytic lesions in shaft with periosteal reaction and cortical thickening. Ultrasonograph of whole abdomen shows psoas abscess. Culture of bone marrow aspirate reveals Mycobacterium tuberculosis. Patient was given an anti tubercular regimen with Rifampicin, Isoniazid, Pyrazinamide and Streptomycin for initial two months which to be followed by Rifampicin and Isoniazid for another 10 months. PMID:19182762

  7. Hypercalcaemia: atypical presentation of miliary tuberculosis

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    So, Edison; Bolger, Dennis Thomas

    2014-01-01

    We report an unusual case of miliary tuberculosis in a 77-year-old Filipino man with hypertension, diabetes mellitus, nephrolithiasis status-post left nephrectomy, presenting with 1 month of fever, generalised weakness and weight loss. Laboratory data were significant for anaemia, hypercalcaemia and acute kidney injury. Chest radiograph showed ground glass opacities and interstitial infiltrates. Extensive workup was performed to evaluate fever and hypercalcaemia. Malignancy, hormonal and sept...

  8. Atypical extraspinal musculoskeletal tuberculosis in immunocompetent patients: Part II, tuberculous myositis, tuberculous bursitis, and tuberculous tenosynovites

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    Abdelwahab, I.F. [Coney Island Hospital, Brooklyn, New York (United States); Bianchi, S. [Clinique et Fondation des Grangettes, Geneva (Switzerland)]. E-mail: stefanobianchi@bluewin.ch; Martinoli, C. [Universita di Genova, Cattedra di Radiologia, DICMI, Genoa (Italy); Klein, M. [Univ. of Alabama School of Medicine, Dept. of Pathology, Birmingham, Alabama (United States); Hermann, G. [Mount Sinai Medical Center, Dept. of Radiology, New York, New York (United States)

    2006-12-15

    Tuberculosis involving the soft tissue from adjacent bone or joint is well recognized. However, primary tuberculous pyomyositis, tuberculous bursitis, and tuberculous tenosynovitis are rare entities constituting 1% of skeletal tuberculosis. Tuberculosis tenosynovitis involves most commonly the tendon sheaths of the hand and wrist, and tuberculous bursitis occurs most commonly around the hip. The greater trochanteric bursa and the greater trochanter are the most frequent sites of tuberculous bursitis. Cases of primary tuberculous pyomyositis and tenosynovitis of the tendons of the ankle and foot are seldom reported in the radiology literature. All imaging modalities - plain radiography, bone scan, computed tomography, and magnetic resonance imaging (MRI) - provide information that is helpful in determining therapy. MRI in particular, with its multiplanar capabilities and superb contrast of soft tissue, can demonstrate the extent of the soft tissue mass and access the adjacent bones and joints. However, MRI has no diagnostic specificity in regard to tuberculosis, and in nonendemic areas, biopsy is strongly recommended. All patients in this review were permanent residents of North America or Western Europe and were immunocompetent. Examples of atypical presentations of the above entities are demonstrated. (author)

  9. Concomitant cutaneous metastatic tuberculous abscesses and multifocal skeletal tuberculosis

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    Sezgin Betul

    2008-01-01

    Full Text Available Tuberculosis, one of the oldest diseases known to affect humans is caused by the bacteria mycobacterium tuberculosis. The disease usually affects the lungs, although, in up to one third of cases, other organs are involved. Metastatic tuberculosis abscess is a rare form of skin tuberculosis. It is characterized by nodule and abscess formation throughout the body after hematogenous spread of mycobacterium tuberculosis from a primary focus during a period of impaired immunity. Tuberculosis osteomyelitis is also a rare form of extrapulmonary tuberculosis in pediatric age group. Skeletal tuberculosis pathogenesis is related to reactivation of hematogenous foci or spread from adjacent paravertebral lymph nodes. Weight-bearing joints are affected most commonly. Bilateral hand and foot bone involvement is rarely reported. We present a five-year-old girl with two very rare presentations of the disease such as osteomyelitis and metastatic skin abscess.

  10. Primary skeletal muscle tuberculosis at an unusual site

    International Nuclear Information System (INIS)

    Tuberculosis can involve virtually any organ and it manifests itself in various forms. The selective involvement of muscles by a tuberculous process without coexisting active skeletal or extra skeletal tuberculosis is very rarely seen. A case of isolated tuberculosis of the biceps brachii muscle without any evident primary focus revealed as an intramuscular mass in a 37 years old immunocompetent female is presented. Diagnosis was established by histology and acid fast stain culture. The patient showed marked improvement with a standard four drug regimen with no evidence of disease activity at the four year follow up. This rare case is presented with review of literature. (author)

  11. Research on the significance of TSPOT.TB test in diagnosing the atypical pulmonary tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Jin Li; Qi-Huang Chen; Yan-Yu Pan; Wei-Zheng Chen; Wen-Feng Lin; Sai-Li Zeng

    2015-01-01

    Objective:To investigate the sensitivity and specificity of the TSPOT.TB test in diagnosing the atypical pulmonary tuberculosis.Methods:A total of 100 patients with suspected pulmonary tuberculosis were diagnosed by TSPOT.TB test and TST, and the difference between the two detection methods was compared.Results:The positive detection rate in the atypical pulmonary tuberculosis was significantly higher than that in the pulmonary tuberculosis group. The sensitivity (94.21), specificity (94.50), PPV (74.20), NPV (94.17), and LR+ (6.14) in the atypical pulmonary tuberculosis group by TSPOT.TB test were significantly higher than those by TST, while LR-(0.13) was significantly lower than that by TST.Conclusions:When compared with TST, TSPOT. TB test has a higher clinical application value, possesses advantages of rapidness and sensitivity, and plays a vital role in diagnosing atypical pulmonary tuberculosis.

  12. Usefulness of bone scintigraphy with HMDP 99mTc in one case of atypical tuberculosis

    International Nuclear Information System (INIS)

    We present a case of atypical osseous tuberculosis mimicking multiple secondary metastases on radiological and nuclear imaging. A multi-bacterial spondylitis of Ti was first diagnosed on a 56 year-old patient presenting with dorsal pain and neurological deficit of the left arm (fine needle aspiration was negative for Mycobacterium tuberculosis). Whole-body bone scintigraphy identified additional sites, including an asymptomatic sacroiliac lesion, which was accessible to biopsy that gave the final diagnosis of osseous tuberculosis. We propose, in the discussion, a practical review of imaging patterns in cases of typical or atypical osseous tuberculosis. (author)

  13. Skeletal tuberculosis; Tuberculose osteo-articulaire

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    Miquel, A.; Frouge, C.; Antoun, A.; Le Guen, O.; Blery, M. [Centre Hospitalier Universitaire de Bicetre, 94 - Le Kremlin-Bicetre (France)

    1995-12-31

    Tuberculosis remains a major cause of bone and joint infection, and its frequency has been increasing during recent years. Recent imaging methods, especially MR, are necessary for the early diagnosis of the disease, because conventional radiography may fail to reveal the initial osseous lesions. Spine is the most common site of infection, with relatively characteristic features; MR is the most suitable method for evaluation of bone involvement, paravertebral and epidural abscesses. Radiographic presentation of tuberculous osteitis and osteo-arthritis is less characteristic. The final diagnosis frequently needs histological studies and cultures of bone, synovial tissue or synovial fluid. (authors)., 13 figs., 35 refs.

  14. IDENTIFICATION OF NON-MYCOBACTERIA, ATYPICAL MYCOBACTERIA AND MYCOBACTERIUM TUBERCULOSIS BY A NEW MICROBIOLOGICAL PROTOCOL

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    Rojas, Jesús

    2011-01-01

    Full Text Available Tuberculosis is a major pandemic disease caused by Mycobacterium tuberculosis. There are also other bacteria that cause clinically similar patterns leading to a misinterpretation in the identification in the laboratory. Therefore it is necessary to introduce a new protocol to correctly identify pathogens in samples in the microbiology laboratory. ATP1084, TCD007 and LS (M. tuberculosis samples were used. Staining was performed with Ziehl-Neelsen (ZN and auramine. Cultures used were MOD (Middle Microscopic Observation for Tuberculosis, LJ (Lowenstein-Jensen and 7H11 solid medium. ATP1084 and TCD007 samples showed similar patterns on auramine staining, cultivation 7H11 and MOD in early growth, but showed different characteristics in ZN staining and culture of LJ. TCD007, ATP1084 and LS were compared with growth time discriminating between MOD but with a shape similar to the colonies. Although culture in liquid media like MOD has a high sensitivity and specificity, the presence of cord formation is considered a feature for LS. In some cases, different bacteria have a similar morphology LS medium even MOD. However, a key point is to use the culture time, ZN staining and the LJ culture to discriminate whether they are atypical mycobacteria or not, tuberculosis by LS. ATP1084, TCD007 and LS were identified as a non-alcohol acid resistant mycobacteria, atypical mycobacteria and M. tuberculosis, respectively.

  15. CONCOMITANT CUTANEOUS METASTATIC TUBERCULOUS ABSCESSES AND MULTIFOCAL SKELETAL TUBERCULOSIS

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    Sezgin Betul; Atilganoglu Ulviye; Yigit Ozgul; Ergun Selma; Cambaz Nevin; Demirkesen Cuyan

    2008-01-01

    Tuberculosis, one of the oldest diseases known to affect humans is caused by the bacteria mycobacterium tuberculosis. The disease usually affects the lungs, although, in up to one third of cases, other organs are involved. Metastatic tuberculosis abscess is a rare form of skin tuberculosis. It is characterized by nodule and abscess formation throughout the body after hematogenous spread of mycobacterium tuberculosis from a primary focus during a period of impaired immunity. Tuberculosis osteo...

  16. The antiquity of tuberculosis in Hungary: the skeletal evidence

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    Antónia Marcsik

    2006-12-01

    Full Text Available The analysis of the skeletons of past human populations provides some of the best biological data regarding the history of significant diseases such as tuberculosis. The purpose of this study is to present the pathological alterations of the bones in this disease deriving from the ancient time of the territory of the Hungarian Great Plain on the basis of the earlier references and new cases. The bone changes in tuberculosis were mainly manifested in the vertebrae and less frequently in the hip, however, further alterations were observed on the surface of the endocranium and the ribs.

  17. Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient

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    Juanarita Jaafar; Wan Hazabbah Wan Hitam; Raja Azmi Mohd Noor

    2012-01-01

    A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye and 6/120 (pinhole 3/60) in the left eye. Anterior segment in both eyes was unremarkable. Funduscopy showed bilateral optic disc swelling with presence of multiple foci of choroiditis in the peripheral retina. The vitreous and retinal vessels were normal. Chest radiography was normal. CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis. This patient was managed with infectious disease team. She was started on HAART and anti-TB treatment was continued. She completed anti-TB treatment after 9 months without any serious side effects. During follow up the visual acuity in both eyes was not improved. However, funduscopy showed resolving of disc swelling and choroiditis following treatment.

  18. Tuberculosis the great mimicker: 18F-fludeoxyglucose positron emission tomography/computed tomography in a case of atypical spinal tuberculosis

    International Nuclear Information System (INIS)

    Tuberculosis (TB) has aptly been called the great mimicker. A 14-year-old boy, who had been treated for Hodgkin's Lymphoma 2 years back and had been in remission, underwent a whole body 18F-fludeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan, owing to a recent onset of backache and difficulty in walking. The study showed an FDG avid destructive lesion of the posterior elements of the sixth, seventh and eighth dorsal vertebrae along with a hypermetabolic collection in the adjacent paraspinal muscles with extension into the spinal canal, causing encasement of the thecal sac as well. Based on this constellation of findings, a diagnosis of atypical spinal TB was made, which was subsequently proven on histopathology. The present case illustrates that spinal TB, including the atypical form can be diagnosed on PET/CT even in clinically unsuspected cases

  19. Skeletal Tuberculosis Presenting as a Small Cystic Lesion in the Medial Femoral Condyle

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    Asghar Elmi

    2013-12-01

    Full Text Available   Skeletal tuberculosis is an unusual disease involving bone and joints and it may have different manifestations. This report introduces a 25-year-old woman suffering from chronic knee pain without any response to conservative treatments for one year. X-ray was normal but CT-scan and MRI indicated a small lesion in medial condyle of the femur. The patient underwent percutaneous CT-guided biopsy. Following an evaluation of the obtained sample, tuberculous osteomyelitis was detected. After resection of the femoral mass and starting anti TB medical treatment, symptoms dramatically eliminated.

  20. Small atypically redistributed pleural effusion in upper lobe collapse: an auxiliary differential feature of bronchogenic carcinoma and pulmonary tuberculosis

    International Nuclear Information System (INIS)

    We reviewed the computed tomography (CT) of 32 patients with upper lobe collapse to assess the significance of small atypically redistributed pleural effusion (ARPE) in distinguishing the bronchogenic carcinoma (BC) from tuberculosis (TB). Lobar collapse is frequently encontered in patients with both malignant and benign diseases Upper lobe collapse was caused by BC in 21 and by TB in 11 of the 32 patients. Small ARPE was present in 14 of 21 patients with BC and two of the 11 patients with TB. Among 16 patients with small ARPE, CT showed mediastinal invasion in 11 (69%) patients and mediastinal lymphadenopathyn 6 (38%). Our results suggest that small ARPE associated with upper lobe collapse can be used a an auxiliary sign in the differential diagnosis between BC and TB

  1. Usefulness of bone scintigraphy with HMDP {sup 99m}Tc in one case of atypical tuberculosis; Utilise de la scintigraphie osseuse a l'HMDP-{sup 99m}Tc dans un cas de tuberculose atypique

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    Evangelista, E.; Itti, E.; Maaloul, M.; Azah, T.; Maignan, M. [Hopital Henri-Mondor, AP-HP, Universite Paris-12, Service de Medecine Nucleaire, 94 - Creteil (France); Bertocchi, M. [Hopital Henri-Mondor, AP-HP, Universite Paris-12, Service d' immunologie, 94 - Creteil (France); Oniankitan, O.; Chevalier, X. [Hopital Henri-Mondor, AP-HP, Universite Paris-12, Service de Rhumatologie, 94 - Creteil (France)

    2004-07-01

    We present a case of atypical osseous tuberculosis mimicking multiple secondary metastases on radiological and nuclear imaging. A multi-bacterial spondylitis of Ti was first diagnosed on a 56 year-old patient presenting with dorsal pain and neurological deficit of the left arm (fine needle aspiration was negative for Mycobacterium tuberculosis). Whole-body bone scintigraphy identified additional sites, including an asymptomatic sacroiliac lesion, which was accessible to biopsy that gave the final diagnosis of osseous tuberculosis. We propose, in the discussion, a practical review of imaging patterns in cases of typical or atypical osseous tuberculosis. (author)

  2. Treatment paradox in musculo-skeletal tuberculosis in an immunocompetent adult male; a case report from a tertiary care hospital.

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    Chaskar, Priyanka; Rana, Geetika; Anuradha; Duggal, Nandini; Arora, Jyoti

    2015-04-01

    Paradoxical reactions like immune reconstitution inflammatory syndrome (IRIS) as seen with patients on retroviral treatment in HIV infection, have also been identified in HIV sero-negative patients with extra pulmonary tuberculosis especially lymph-node tuberculosis. Musculo-skeletal tuberculosis presenting as a cold abscess of the anterior chest wall is a rare entity which poses diagnostic and therapeutic challenge. A 35-year-old immunocompetent male came with complains of painless lump on right side of his chest over 9th and 10th intercostal space which gradually increased and extended upto 11th rib area. Clinically, diagnosis of cold abscess was made and anti-tubercular therapy (ATT) was started. Despite of being on ATT for 3 weeks, patient developed pain and signs of inflammation. Fluid was aspirated and sent for biochemical and microbiological investigations. The aspirated fluid was positive for acid fast bacilli by ZN stain and grew Mycobacterium tuberculosis in culture, sensitive to first line ATT. Pyogenic and fungal culture was negative. This case presented as an anterior chest wall cold abscess which deteriorated on initiation of first line ATT, thus creating a suspicion of resistance to ATT which was cleared on ATT susceptibility testing. Hence, this case underlines the possibility of treatment paradoxes seen in immunocompetent musculo-skeletal tuberculosis. PMID:26046019

  3. Methyltransferase Erm(37) Slips on rRNA to Confer Atypical Resistance in Mycobacterium tuberculosis

    Czech Academy of Sciences Publication Activity Database

    Madsen, Ch. T.; Jakobsen, L.; Buriánková, Karolína; Doucet-Populaire, F.; Perdonet, J. L.; Douthwaite, S.

    2005-01-01

    Roč. 280, č. 47 (2005), s. 38942-38947. ISSN 0021-9258 R&D Projects: GA ČR GA310/03/0292 Institutional research plan: CEZ:AV0Z50200510 Keywords : methyltransferase erm * mycobacterium tuberculosis * rRNA Subject RIV: EE - Microbiology, Virology Impact factor: 5.854, year: 2005

  4. Infectivity in skeletal muscle of cattle with atypical bovine spongiform encephalopathy.

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    Suardi, Silvia; Vimercati, Chiara; Casalone, Cristina; Gelmetti, Daniela; Corona, Cristiano; Iulini, Barbara; Mazza, Maria; Lombardi, Guerino; Moda, Fabio; Ruggerone, Margherita; Campagnani, Ilaria; Piccoli, Elena; Catania, Marcella; Groschup, Martin H; Balkema-Buschmann, Anne; Caramelli, Maria; Monaco, Salvatore; Zanusso, Gianluigi; Tagliavini, Fabrizio

    2012-01-01

    The amyloidotic form of bovine spongiform encephalopathy (BSE) termed BASE is caused by a prion strain whose biological properties differ from those of typical BSE, resulting in a clinically and pathologically distinct phenotype. Whether peripheral tissues of BASE-affected cattle contain infectivity is unknown. This is a critical issue since the BASE prion is readily transmissible to a variety of hosts including primates, suggesting that humans may be susceptible. We carried out bioassays in transgenic mice overexpressing bovine PrP (Tgbov XV) and found infectivity in a variety of skeletal muscles from cattle with natural and experimental BASE. Noteworthy, all BASE muscles used for inoculation transmitted disease, although the attack rate differed between experimental and natural cases (∼70% versus ∼10%, respectively). This difference was likely related to different prion titers, possibly due to different stages of disease in the two conditions, i.e. terminal stage in experimental BASE and pre-symptomatic stage in natural BASE. The neuropathological phenotype and PrP(res) type were consistent in all affected mice and matched those of Tgbov XV mice infected with brain homogenate from natural BASE. The immunohistochemical analysis of skeletal muscles from cattle with natural and experimental BASE showed the presence of abnormal prion protein deposits within muscle fibers. Conversely, Tgbov XV mice challenged with lymphoid tissue and kidney from natural and experimental BASE did not develop disease. The novel information on the neuromuscular tropism of the BASE strain, efficiently overcoming species barriers, underlines the relevance of maintaining an active surveillance. PMID:22363650

  5. Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient

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    Jaafar, Juanarita; Hitam, Wan Hazabbah Wan; Noor, Raja Azmi Mohd

    2012-01-01

    A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye a...

  6. Multifocal Tubercular Osteomyelitis with Tubercular Breast Abscess: An Atypical Presentation of Tuberculosis

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    Mita Bar

    2015-01-01

    Full Text Available Tuberculosis of spine is common in a developing country like India. However, involvement of spine at multiple levels along with involvement of rib and tubercular breast abscess in an immunocompetent patient without any pulmonary involvement is extremely rare. Here we report a case of 53-year-old immunocompetent lady who presented with quadriparesis and MRI (magnetic resonance imaging of spine revealed multiple lesions involving cervical, thoracic, lumbar, and sacral region without any involvement of intervertebral disc. On detailed examination she was found to have a lump in right breast. Fine needle aspiration cytology of both paravertebral collection and breast lump revealed presence of acid fast bacilli. She was put on antitubercular drug for one year and she responded well to therapy.

  7. On the trail of pulmonary tuberculosis based on rib lesions: Results from the human identified skeletal collection from the Museu Bocage (Lisbon, Portugal)

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    Matos, Vítor; Santos, Ana Luísa

    2006-01-01

    In the last 20 years, studies on human identified skeletal collections have revealed a significant relationship between new bone formation on the visceral surface of ribs and pulmonary tuberculosis (TB). To improve methods of differential diagnosis of respiratory diseases in archaeological skeletons, an investigation was conducted on 197 individuals from the Human Identified Skeletal Collection of the Museu Bocage (Lisbon, Portugal). This sample included 109 males and 88 females who lived dur...

  8. Tuberculosis

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    C. Robert Horsburgh, Jr

    2014-03-01

    Full Text Available This article reviews the published literature on tuberculosis from September 2012 to August 2013 and describes important advances in tuberculosis epidemiology, microbiology, pathology, clinical pharmacology, genetics, treatment and prevention.

  9. Tuberculosis.

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    Dheda, Keertan; Barry, Clifton E; Maartens, Gary

    2016-03-19

    Although the worldwide incidence of tuberculosis has been slowly decreasing, the global disease burden remains substantial (∼9 million cases and ∼1·5 million deaths in 2013), and tuberculosis incidence and drug resistance are rising in some parts of the world such as Africa. The modest gains achieved thus far are threatened by high prevalence of HIV, persisting global poverty, and emergence of highly drug-resistant forms of tuberculosis. Tuberculosis is also a major problem in health-care workers in both low-burden and high-burden settings. Although the ideal preventive agent, an effective vaccine, is still some time away, several new diagnostic technologies have emerged, and two new tuberculosis drugs have been licensed after almost 50 years of no tuberculosis drugs being registered. Efforts towards an effective vaccine have been thwarted by poor understanding of what constitutes protective immunity. Although new interventions and investment in control programmes will enable control, eradication will only be possible through substantial reductions in poverty and overcrowding, political will and stability, and containing co-drivers of tuberculosis, such as HIV, smoking, and diabetes. PMID:26377143

  10. A case of skeletal tuberculosis and psoas abscess: disease activity evaluated using 18 F-fluorodeoxyglucose positron emission tomography-computed tomography

    International Nuclear Information System (INIS)

    Psoas abscess complicating tuberculous spondylitis is a rare morbidity in extrapulmonary tuberculosis. There are no established guidelines for evaluating the clinical response of psoas abscess. Although several studies have shown that positron emission tomography-computed tomography with 18 F-fluorodeoxyglucose can play a potential role in diagnosing multifocal tuberculosis and monitoring the clinical response of pulmonary tuberculosis, to our knowledge, this is the first report demonstrating that positron emission tomography-computed tomography is useful for evaluating local inflammation and disease activity of a tuberculous psoas abscess. We report a case of multifocal bone and lymph node tuberculosis with concomitant lumbar psoas abscess in a 77-year-old man, along with a literature review. An initial positron emission tomography-computed tomography scan showed intense 18 F-fluorodeoxyglucose accumulation in the sternum, ribs, vertebrae, and lymph nodes. The patient was successfully treated with antitubercular agents and computed tomography-guided drainage therapy. A follow-up positron emission tomography-computed tomography after abscess drainage and 9 months of antitubercular drug treatment revealed that the majority of lesions improved; however, protracted inflammation surrounding the psoas abscess was still observed. These results indicate that disease activity of psoas abscess can remain, even after successful drainage and antitubercular medication regime of appropriate duration. We have successfully followed up the extent of skeletal tuberculosis complicated with psoas abscess by positron emission tomography-computed tomography. In this patient, positron emission tomography-computed tomography is useful for evaluating the disease activity of tuberculous psoas abscess and for assessing the appropriate duration of antitubercular drug therapy in psoas abscess

  11. Osteo-articular tuberculosis

    International Nuclear Information System (INIS)

    Various authors have reported differences in the radiological features of skeletal tuberculosis in the coloured patient. We studied retrospectively the radiographs of 71 patients with proven skeletal tuberculosis seen in our hospital, over a 6 year period. Sclerotic bone reactions and periosteal new bone formations were unusual findings but multiple bone involvement occurred about 15% of our patients. There was also a high in incidence of tuberculosis of the ankle and foot compared to that reported in white Caucasian patients. (orig.)

  12. Delay in diagnosis of generalized miliary tuberculosis with osseo-articular involvement: a case report

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    Atukorala Inoshi

    2011-10-01

    Full Text Available Abstract Introduction Diagnosis of atypical tuberculosis is difficult. Therefore, it is important that physicians are aware of rare presentations of tuberculosis to avoid diagnostic delays. Case presentation We present the case of a 17-year-old Sri Lankan man who presented to our facility with an ill-defined large induration over the skin of his left buttock and thigh. A cause could not be found despite extensive investigations. He also complained of chronic knee pain, but this was not investigated further at the time due to spontaneous resolution. Three years later his knee disease flared up again, with pain, swelling and restriction of movement. A synovial biopsy was suggestive of tuberculosis. He was started on antituberculosis therapy, to which he responded well. Our patient was asymptomatic two months after completion of therapy without any subsequent flare-ups. A chest roentgenogram taken on his second presentation showed evidence of tuberculosis sequelae in his lungs. The most likely diagnosis for the buttock and thigh swelling, when considering the entire clinical picture, is a tuberculous abscess. The constellation of skin and skeletal symptoms and pulmonary tuberculosis is a rare occurrence in an immunocompetent individual, but cases have been reported. Conclusions This case demonstrates the different presentations and the diagnostic difficulties posed by atypical manifestations of tuberculosis. It also demonstrates the value of maintaining a high degree of suspicion in endemic areas, even in the absence of microbiological evidence.

  13. Atypical Depression

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    Erhan Ertekin

    2013-09-01

    Full Text Available Atypical depression is defined as a specifier of major depressive disorder. Columbia criteria for atypical depression are commonly used to make a diagnosis. Female sex, onset at early age, chronic course, and higher rate of comorbidity (especially anxiety disorder and bipolar disorder is noteworthy in atypical depression. Although, the atypical depression seems to support the familial genetic transition, there is not any specific study supporting these data. In the treatment of atypical depression, monoamine oxidase inhibitors are reported to be more effective than tricyclic antidepressants. In recent studies, selective serotonin reuptake inhibitors have also proven to be efficient.

  14. Imaging of pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Tuberculosis, more than any other infectious disease, has always been a challenge, since it has been responsible for a great amount of morbidity and mortality in humans. After a steady decline in the number of new cases during the twentieth century, due to improved social and environmental conditions, early diagnosis, and the development of antituberculous medication, a stagnation and even an increase in the number of new cases was noted in the mid-1980s. The epidemiological alteration is multifactorial: global increase in developing countries; minority groups (HIV and other immunocompromised patients); and elderly patients due to an altered immune status. Other factors that may be responsible are a delayed diagnosis, especially in elderly patients, incomplete or inadequate therapy, and the emergence of multidrug-resistant tuberculosis. The course of the disease and its corresponding clinicoradiological pattern depends on the interaction between the organism and the host response. Classically, pulmonary tuberculosis has been classified in primary tuberculosis, which occurred previously in children, and postprimary tuberculosis, occurring in adult patients. In industrialized countries, however, there seems to be a shift of primary tuberculosis towards adults. Furthermore, due to an altered immunological response in certain groups, such as immunocompromised and elderly patients, an atypical radioclinical pattern may occur. The changing landscape, in which tuberculosis occurs, as well as the global resurgence, and the changed spectrum of the clinical and radiological presentation, justify a renewed interest of radiologists for the imaging features of pulmonary tuberculosis. This article deals with the usual imaging features of pulmonary tuberculosis as well as the atypical patterns encountered in immunodepressed and elderly patients. (orig.)

  15. Imaging of musculoskeletal tuberculosis

    International Nuclear Information System (INIS)

    Purpose and methods. To perform an illustrated and educational review of musculoskeletal tuberculosis. Results. As the incidence of musculoskeletal tuberculosis still increases, a review appears justified. The following four main presentations are detailed and illustrated, by emphasizing the value of both CT and MR imaging: a) spine tuberculosis (∼ 50 %/) commonly involves two adjacent vertebral bodies with usual large paravertebral abscesses. The following lesions are highly suggestive of tuberculosis: solitary vertebral involvement, solitary epidural abscess with or without erosive spondylitis; b) osteo-arthritis: peripherally located erosions at synovial insertions with gradual narrowing of the joint space are highly suggestive; c) osteomyelitis: unusual, may involve any bones; d) tenosynovitis and bursitis. Conclusion. Imaging studies are essential for diagnosis and to assess the extent of musculo-skeletal tuberculosis. (author)

  16. Laparoscopy can be used to diagnose peritoneal tuberculosis

    DEFF Research Database (Denmark)

    Ferløv Schwensen, Jakob; Bulut, Mustafa; Nordholm-Carstensen, Andreas

    2014-01-01

    and widespread pale nodules were found throughout the peritoneum. Consequently, the patient was diagnosed with peritoneal tuberculosis. This case demonstrates that atypical manifestations of tuberculosis exist in Denmark and that laparoscopy with biopsy can be performed to obtain the diagnosis when...... suspecting peritoneal tuberculosis....

  17. Tuberculosis in Older Adults.

    Science.gov (United States)

    Rajagopalan, Shobita

    2016-08-01

    Tuberculosis (TB) remains one of the world's most lethal infectious diseases. Preventive and control strategies among other high-risk groups, such as the elderly population, continues to be a challenge. Clinical features of TB in older adults may be atypical and confused with age-related diseases. Diagnosis and management of TB in the elderly person can be difficult; treatment can be associated with adverse drug reactions. This article reviews the current global epidemiology, pathogenesis, clinical characteristics, diagnosis, management, and prevention of Mycobacterium tuberculosis infection in community-dwelling and institutionalized aging adults. PMID:27394018

  18. Cerebellar medulloblastoma presenting with skeletal metastasis

    OpenAIRE

    Barai Sukanta; Bandopadhayaya G; Julka P; Dhanapathi H; Haloi A; Seith A

    2004-01-01

    Medulloblastomas are highly malignant brain tumours, but only rarely produce skeletal metastases. No case of medulloblastoma has been documented to have produced skeletal metastases prior to craniotomy or shunt surgery. A 21-year-old male presented with pain in the hip and lower back with difficulty in walking of 3 months′ duration. Signs of cerebellar dysfunction were present hence a diagnosis of cerebellar neoplasm or skeletal tuberculosis with cerebellar abscess formation was consid...

  19. Tuberculosis latente Latent tuberculosis

    OpenAIRE

    Juan C Rodríguez D

    2012-01-01

    La tuberculosis continúa siendo un problema enorme en salud pública. Se ha estimado que anualmente en todo el mundo 9 millones de personas contraen esta enfermedad y que 2 millones de muertes se deben a la tuberculosis. La exposición al M. tuberculosis causa la enfermedad en cerca del 10% de la población expuesta. En el 90% restante de los expuestos la respuesta inmune inhibe la multiplicación del M. tuberculosis. En una parte de las personas expuestas (~40%) algunos bacilos no son muertos pe...

  20. Imaging and differential diagnosis of pediatric spinal tuberculosis

    Directory of Open Access Journals (Sweden)

    Xiao-ying Xing

    2015-03-01

    Conclusion: Pediatric spinal tuberculosis often occurs in the cervical and thoracic vertebrae with typical imaging findings. The cases with atypical manifestations should be differentiated from other diseases such as Langerhans cell histiocytosis and metastatic neoplasm.

  1. Chest wall tuberculosis - A clinical and imaging experience

    International Nuclear Information System (INIS)

    Tuberculous infection of the thoracic cage is rare and is difficult to discern clinically or on radiographs. This study aims to describe the common sites and the imaging appearances of chest wall tuberculosis. A retrospective review of the clinical and imaging records of 12 confirmed cases of thoracic cage tuberculosis (excluding that of the spine), seen over the last 7 years, was performed. Imaging studies available included radiographs, ultrasonographies (USGs), and computed tomography (CT) scans. Pathological confirmation was obtained in all cases. All patients had clinical signs and symptoms localized to the site of involvement, whether it was the sternum, sternoclavicular joints, or ribs. CT scan revealed sternal destruction in three patients and osteolytic lesions with sclerosis of the articular surfaces of the sternoclavicular joints in two patients. In five patients with rib lesions, USG elegantly demonstrated the bone destruction underlying the cold abscess. All cases were confirmed to be of tuberculous origin by pathology studies of the aspirated/curetted material, obtained by CT / USG guidance. Tuberculous etiology should be considered for patients presenting with atypical sites of skeletal inflammation. CT scan plays an important role in the evaluation of these patients. However, the use of USG for demonstrating rib destruction in a chest wall cold abscess has so far been under-emphasized, as has been the role of CT and USG guided aspiration in confirming the aetiology

  2. Tuberculosis latente Latent tuberculosis

    Directory of Open Access Journals (Sweden)

    Juan C Rodríguez D

    2012-03-01

    Full Text Available La tuberculosis continúa siendo un problema enorme en salud pública. Se ha estimado que anualmente en todo el mundo 9 millones de personas contraen esta enfermedad y que 2 millones de muertes se deben a la tuberculosis. La exposición al M. tuberculosis causa la enfermedad en cerca del 10% de la población expuesta. En el 90% restante de los expuestos la respuesta inmune inhibe la multiplicación del M. tuberculosis. En una parte de las personas expuestas (~40% algunos bacilos no son muertos permaneciendo en una condición que no les permite replicarse, generándose así la infección denominada tuberculosis latente. Los bacilos inactivos pueden recuperar su vitalidad (capacidad de replicación y causar una tuberculosis activa, si la respuesta inmune está alterada. La detección y el tratamiento de la infección tuberculosa latente han sido reconocidos como objetivos estratégicos efectivos en el control de la tuberculosis. En el pasado reciente, el único test disponible para la detección de infección tuberculosa latente era el test cutáneo con tuberculina (PPD. Recientemente se ha desarrollado un ensayo basado en la liberación "in vitro" de interferón-gama (IGRApor células T. Este ensayo usa antígenos específicos del M. tuberculosis y no es interferido por la vacunación previa con BCG, lo que lo convierte en un test de tamizaje útil en poblaciones vacunadas con BCG. La FDA ha aprobado dos IGRAs comerciales: a QuantiFERON-TB Gold (QFT, Cellestis cuya variación simplificada se denomina Quantiferon T in Tube (QFT-G-IT y b el T-SPOT TB test (Oxford, Immunotec. Según el Programa Nacional de Control de la Tuberculosis el tratamiento para la infección tuberculosa latente es la administración diaria de isoniacida por 9 meses; este tratamiento proporciona una protección superior al 90% si es administrado regularmente. Otra opción, usada en EE.UU. y Europa es prescribir rifampicina por 4 meses. La identificación y el tratamiento de

  3. Tuberculosis of the chest

    International Nuclear Information System (INIS)

    The relationship between tuberculosis and mankind has been known for many centuries, with the disease being one of the major causes of illness and death. During the early 1980s, there was a widespread belief that the disease was being controlled, but by the mid-1980s, the number of cases increased. This change in the epidemiological picture has several causes, of which the AIDS epidemic, the progression of poverty in developing countries, the increase in the number of elderly people with an altered immune status and the emergence of multidrug-resistant tuberculosis are the most important. Mainly due to this epidemiological change, the radiological patterns of the disease are also being altered, with the classical distinction between primary and postprimary disease fading and atypical presentations in groups with an altered immune response being increasingly reported. Therefore, the radiologist must be able not only to recognize the classical features of primary and postprimary tuberculosis but also to be familiar with the atypical patterns found in immuno-compromised and elderly patients, since an early diagnosis is generally associated with a greater therapeutic efficacy. Radiologists are, in this way, presented with a new challenge at the beginning of this millennium

  4. Tuberculosis of Calcaneum: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Bhat Sandhya K

    2012-08-01

    Full Text Available Tuberculosis is a leading cause of morbidity and mortality in developing countries including India. Skeletal tuberculosis accounts for 1-3%. Tuberculosis of bone may evade the diagnosis for a long time, as it usually remains silent till either involvement of a neighbouring joint or development of a soft tissue swelling due to cold abscess formation. Tuberculosis of bone mimics clinical conditions like Chronic Osteomyelitis, Madura mycosis and Actinomycosis. There have been few case reports of unusual sites being affected and with unusual presentation by this disease.

  5. Tuberculosis extrapulmonar Extrapulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    P. Fanlo

    2007-01-01

    Full Text Available A pesar de que el pulmón es el órgano diana por excelencia de la tuberculosis, cualquier otro órgano y sistema puede verse afectado. En este trabajo se revisan las formas de tuberculosis extrapulmonar a excepción de la pleural que requieren del facultativo, en ocasiones, su más valiosa pericia diagnóstica. Desde la temida meningitis tuberculosa, pasando por la afectación insidiosa de la espondilodiscitis, la llamativa afectación ganglionar, la afectación genitourinaria, la pericarditis, para terminar las formas menos frecuentes como la ocular o la cutánea. En cada apartado indicaremos lo más característico con la finalidad de que pueda servir de orientación diagnóstica y terapéutica.In spite of the lung being the target organ par excellence of tuberculosis, any other organ and system can be affected. In this article we review the forms of extrapulmonary tuberculosis, with the exception of the pleural form that requires the use of good diagnostic skills. From the dreaded tuberculous meningitis, by way of the insidious affectation of the spondylodiscitis, the so-called ganglionary affectation , the genitourinary affectation, pericarditis, and ending with less frequent forms such as ocular and cutaneous tuberculosis. In each section we will indicate what is most characteristic with the aim of providing a diagnostic and therapeutic orientation.

  6. Cutaneous tuberculosis overview and current treatment regimens.

    Science.gov (United States)

    van Zyl, Lindi; du Plessis, Jeanetta; Viljoen, Joe

    2015-12-01

    Tuberculosis is one of the oldest diseases known to humankind and it is currently a worldwide threat with 8-9 million new active disease being reported every year. Among patients with co-infection of the human immunodeficiency virus (HIV), tuberculosis is ultimately responsible for the most deaths. Cutaneous tuberculosis (CTB) is uncommon, comprising 1-1.5% of all extra-pulmonary tuberculosis manifestations, which manifests only in 8.4-13.7% of all tuberculosis cases. A more accurate classification of CTB includes inoculation tuberculosis, tuberculosis from an endogenous source and haematogenous tuberculosis. There is furthermore a definite distinction between true CTB caused by Mycobacterium tuberculosis and CTB caused by atypical mycobacterium species. The lesions caused by mycobacterium species vary from small papules (e.g. primary inoculation tuberculosis) and warty lesions (e.g. tuberculosis verrucosa cutis) to massive ulcers (e.g. Buruli ulcer) and plaques (e.g. lupus vulgaris) that can be highly deformative. Treatment options for CTB are currently limited to conventional oral therapy and occasional surgical intervention in cases that require it. True CTB is treated with a combination of rifampicin, ethambutol, pyrazinamide, isoniazid and streptomycin that is tailored to individual needs. Atypical mycobacterium infections are mostly resistant to anti-tuberculous drugs and only respond to certain antibiotics. As in the case of pulmonary TB, various and relatively wide-ranging treatment regimens are available, although patient compliance is poor. The development of multi-drug and extremely drug-resistant strains has also threatened treatment outcomes. To date, no topical therapy for CTB has been identified and although conventional therapy has mostly shown positive results, there is a lack of other treatment regimens. PMID:26616847

  7. Tuberculosis de oído medio. Descripción de dos casos

    OpenAIRE

    Novoa Juiz, Vania; Piqueras Pérez, Francisco M.

    2016-01-01

    Introduction and objective : The increasing incidence of tuberculosis in developed countries leads to an increase in the percentage of patients with atypical presentations and locations, including tuberculosis of the middle ear, a condition that is usually not considered before an ear pathology. Objective: Raising awareness among professionals about the possibility of an otic tuberculosis and facilitate its clinical management. Description: The literature on tuberculosis of the middle ear was...

  8. Multifocal Tubercular Osteomyelitis: A Case with Atypical Manifestations

    Directory of Open Access Journals (Sweden)

    Mukesh Thawani

    2011-01-01

    Full Text Available Skeletal tuberculosis (TB accounts for about 1–2% of all TB cases and 10% of extrapulmonary TB cases. We present a 19-year-old male with multifocal tubercular osteomyelitis, who presented with progressively worsening back pain, weight loss, fatigue, anorexia, decreased mobility, low-grade fever, and night sweats—but without pulmonary involvement.

  9. Tuberculose pancreática Pancreatic tuberculosis

    Directory of Open Access Journals (Sweden)

    Fernando Antônio Bhorer Pitrez

    2002-10-01

    Full Text Available Tuberculosis is an extremely common chronic disease in developing countries, caused by Mycobacterium tuberculosis. The principal target organ is the lung, causing focal necrosis and destruction. In about 12% of cases, extrapulmonary dissemination involving the gastrointestinal system occurs. The pancreas is involved in about 0,25% of all cases of disseminated tuberculosis, but its isolated involvement is a medical curiosity. In the last years, with the advent of AIDS, extrapulmonary dissemination and atypical abdominal presentation has increased. We report a case of pancreatic tuberculosis in a 66-year-old patient, with no previous history of pulmonary tuberculosis or immunocompromised state in whom the diagnosis was made by CT-guided skin needle biopsy. After clinical treatment with current antibiotic therapy, the patient recovered well.

  10. Tuberculosis (TB)

    Science.gov (United States)

    ... infectious, immunologic, and allergic diseases NIAID Home Health & Research Topics Labs & Scientific Resources Funding About NIAID News & Events Volunteer NIAID > Health & Research Topics > Tuberculosis > Research Tuberculosis Understanding TB Research Research Goals ...

  11. Tuberculosis (TB)

    Science.gov (United States)

    ... Skip Content Marketing Share this: Main Content Area Tuberculosis (TB) Overview In developed countries, such as the ... thought to be infected with TB bacteria, Mycobacterium tuberculosis ( Mtb ). TB is a chronic bacterial infection. It ...

  12. Tuberculosis Prevention

    Science.gov (United States)

    ... Skip Content Marketing Share this: Main Content Area Tuberculosis (TB) Prevention TB is an airborne disease and ... patients. Many people who are infected with Mycobacterium tuberculosis ( Mtb ) do not get sick or spread the ...

  13. Osteo-articular tuberculosis. A radiological study in a Malaysian hospital

    Energy Technology Data Exchange (ETDEWEB)

    Rathakrishnan, V.; Mohd, T.H. (Malaya Univ., Kuala Lumpur (Malaysia). Dept. of Radiology)

    1989-07-01

    Various authors have reported differences in the radiological features of skeletal tuberculosis in the coloured patient. We studied retrospectively the radiographs of 71 patients with proven skeletal tuberculosis seen in our hospital, over a 6 year period. Sclerotic bone reactions and periosteal new bone formations were unusual findings but multiple bone involvement occurred about 15% of our patients. There was also a high in incidence of tuberculosis of the ankle and foot compared to that reported in white Caucasian patients. (orig.).

  14. Rv2969c, essential for optimal growth in Mycobacterium tuberculosis, is a DsbA-like enzyme that interacts with VKOR-derived peptides and has atypical features of DsbA-like disulfide oxidases

    OpenAIRE

    Premkumar, Lakshmanane; Heras, Begoña; Duprez, Wilko; Walden, Patricia; Halili, Maria; Kurth, Fabian; Fairlie, David P.; Martin, Jennifer L.

    2013-01-01

    The bacterial disulfide machinery is an attractive molecular target for developing new antibacterials because it is required for the production of multiple virulence factors. The archetypal disulfide oxidase proteins in Escherichia coli (Ec) are DsbA and DsbB, which together form a functional unit: DsbA introduces disulfides into folding proteins and DsbB re­oxidizes DsbA to maintain it in the active form. In Mycobacterium tuberculosis (Mtb), no DsbB homologue is encoded but a functionally si...

  15. Radiological analysis of image on geriatric pulmonary tuberculosis

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To evaluate the radiological features in the cases with geriatric pulmonary tuberculosis(GPTB). Methods: One hundred and two elderly patients with tuberculosis were studied in this paper. All patients had an examination on chest X-ray, and 63 of them had a chest scan of CT. Results: The pulmonary tuberculosis infiltration, caseous pneumonia and cavitary lesions were found in 85, 11 and 19 cases with GPTB respectively. Acute miliary tuberculosis was diagnosed in 2 cases. Pleural effusion was in 26 cases. In addition, Hilar and mediastinal lymphadenopathy was presented in the other 13 cases. Conclusion: Radiological findings of GPTB were atypical in general.

  16. Colorectal tuberculosis

    International Nuclear Information System (INIS)

    Our objective was to evaluate the incidence of colorectal tuberculosis in our series and to study its radiological spectrum. A total of 684 cases of proven gastrointestinal tuberculosis with positive barium contrast findings seen over a period of more than one decade were evaluated. The study did not include cases where colon was involved in direct contiguity with ileo-caecal tuberculosis. Seventy-four patients (10.8%) had colorectal tuberculosis. Commonest site involved was transverse colon, closely followed by rectum and ascending colon. Radiological findings observed were in the form of strictures (54%), colitis (39%) and polypoid lesions (7%). Complications noted were in the form of perforations and fistulae in 18.9% of cases. Colorectal tuberculosis is a very common site for gastrointestinal tuberculosis. Typical findings of colorectal tuberculosis are strictures, signs of colitis and polypoid lesions. Common complications are perforation and fistulae. (orig.)

  17. The imaging manifestations of caseous pulmonary tuberculosis with type-II diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mingyue Wang

    2015-11-01

    Conclusion: Type-II diabetic patients with caseous tuberculosis mainly showed consolidation and atypical lung field lesions on chest radiographs. Becoming familiar with these features will be helpful to imaging diagnosis of DMTB.

  18. Rv2969c, essential for optimal growth in Mycobacterium tuberculosis, is a DsbA-like enzyme that interacts with VKOR-derived peptides and has atypical features of DsbA-like disulfide oxidases

    International Nuclear Information System (INIS)

    The gene product of M. tuberculosis Rv2969c is shown to be a disulfide oxidase enzyme that has a canonical DsbA-like fold with novel structural and functional characteristics. The bacterial disulfide machinery is an attractive molecular target for developing new antibacterials because it is required for the production of multiple virulence factors. The archetypal disulfide oxidase proteins in Escherichia coli (Ec) are DsbA and DsbB, which together form a functional unit: DsbA introduces disulfides into folding proteins and DsbB reoxidizes DsbA to maintain it in the active form. In Mycobacterium tuberculosis (Mtb), no DsbB homologue is encoded but a functionally similar but structurally divergent protein, MtbVKOR, has been identified. Here, the Mtb protein Rv2969c is investigated and it is shown that it is the DsbA-like partner protein of MtbVKOR. It is found that it has the characteristic redox features of a DsbA-like protein: a highly acidic catalytic cysteine, a highly oxidizing potential and a destabilizing active-site disulfide bond. Rv2969c also has peptide-oxidizing activity and recognizes peptide segments derived from the periplasmic loops of MtbVKOR. Unlike the archetypal EcDsbA enzyme, Rv2969c has little or no activity in disulfide-reducing and disulfide-isomerase assays. The crystal structure of Rv2969c reveals a canonical DsbA fold comprising a thioredoxin domain with an embedded helical domain. However, Rv2969c diverges considerably from other DsbAs, including having an additional C-terminal helix (H8) that may restrain the mobility of the catalytic helix H1. The enzyme is also characterized by a very shallow hydrophobic binding surface and a negative electrostatic surface potential surrounding the catalytic cysteine. The structure of Rv2969c was also used to model the structure of a paralogous DsbA-like domain of the Ser/Thr protein kinase PknE. Together, these results show that Rv2969c is a DsbA-like protein with unique properties and a limited

  19. Rv2969c, essential for optimal growth in Mycobacterium tuberculosis, is a DsbA-like enzyme that interacts with VKOR-derived peptides and has atypical features of DsbA-like disulfide oxidases

    Energy Technology Data Exchange (ETDEWEB)

    Premkumar, Lakshmanane, E-mail: p.lakshmanane@imb.uq.edu.au; Heras, Begoña; Duprez, Wilko; Walden, Patricia; Halili, Maria; Kurth, Fabian; Fairlie, David P.; Martin, Jennifer L., E-mail: p.lakshmanane@imb.uq.edu.au [University of Queensland, St Lucia, QLD 4067 (Australia)

    2013-10-01

    The gene product of M. tuberculosis Rv2969c is shown to be a disulfide oxidase enzyme that has a canonical DsbA-like fold with novel structural and functional characteristics. The bacterial disulfide machinery is an attractive molecular target for developing new antibacterials because it is required for the production of multiple virulence factors. The archetypal disulfide oxidase proteins in Escherichia coli (Ec) are DsbA and DsbB, which together form a functional unit: DsbA introduces disulfides into folding proteins and DsbB reoxidizes DsbA to maintain it in the active form. In Mycobacterium tuberculosis (Mtb), no DsbB homologue is encoded but a functionally similar but structurally divergent protein, MtbVKOR, has been identified. Here, the Mtb protein Rv2969c is investigated and it is shown that it is the DsbA-like partner protein of MtbVKOR. It is found that it has the characteristic redox features of a DsbA-like protein: a highly acidic catalytic cysteine, a highly oxidizing potential and a destabilizing active-site disulfide bond. Rv2969c also has peptide-oxidizing activity and recognizes peptide segments derived from the periplasmic loops of MtbVKOR. Unlike the archetypal EcDsbA enzyme, Rv2969c has little or no activity in disulfide-reducing and disulfide-isomerase assays. The crystal structure of Rv2969c reveals a canonical DsbA fold comprising a thioredoxin domain with an embedded helical domain. However, Rv2969c diverges considerably from other DsbAs, including having an additional C-terminal helix (H8) that may restrain the mobility of the catalytic helix H1. The enzyme is also characterized by a very shallow hydrophobic binding surface and a negative electrostatic surface potential surrounding the catalytic cysteine. The structure of Rv2969c was also used to model the structure of a paralogous DsbA-like domain of the Ser/Thr protein kinase PknE. Together, these results show that Rv2969c is a DsbA-like protein with unique properties and a limited

  20. Atypical idiopathic inflammatory demyelinating lesions

    DEFF Research Database (Denmark)

    Wallner-Blazek, Mirja; Rovira, Alex; Fillipp, Massimo; Rocca, Mara A; Miller, Andrew David; Schmierer, Klaus; Frederiksen, Jette; Gass, Achim; Gama, Hugo; Tilbery, Charles P; Rocha, Antonio J; Flores, José; Barkhof, Frederik; Seewann, Alexandra; Palace, Jacqueline; Yousry, Tarek; Montalban, Xavier; Enzinger, Christian; Fazekas, Franz

    2013-01-01

    Atypical lesions of a presumably idiopathic inflammatory demyelinating origin present quite variably and may pose diagnostic problems. The subsequent clinical course is also uncertain. We, therefore, wanted to clarify if atypical idiopathic inflammatory demyelinating lesions (AIIDLs) can be class...

  1. Pancreatic Tuberculosis.

    Science.gov (United States)

    Chaudhary, Poras; Bhadana, Utsav; Arora, Mohinder P

    2015-12-01

    Tuberculosis of the pancreas is extremely rare and in most of the cases mimics pancreatic carcinoma. There are a number of case reports on pancreatic tuberculosis with various different presentations, but only a few case series have been published, and most of our knowledge about this disease comes from individual case reports. Patients of pancreatic tuberculosis may remain asymptomatic initially and manifest as an abscess or a mass involving local lymph nodes and usually present with non-specific features. Pancreatic tuberculosis may present with a wide range of imaging findings. It is difficult to diagnose tuberculosis of pancreas on imaging studies as they may present with masses, cystic lesions or abscesses and mass lesions in most of the cases mimic pancreatic carcinoma. As it is a rare entity, it cannot be recommended but suggested that pancreatic tuberculosis should be considered in cases with a large space occupying lesions associated with necrotic peripancreatic lymph nodes and constitutional symptoms. Ultrasonography/computed tomography/endosonography-guided biopsy is the recommended diagnostic technique. Most patients achieve complete cure with standard antituberculous therapy. The aims of this study are to review clinical presentation, diagnostic studies, and management of pancreatic tuberculosis and to present our experience of 5 cases of pancreatic tuberculosis. PMID:26884661

  2. Tuberculosis neonatal

    OpenAIRE

    Pastor Durán, Xavier

    1986-01-01

    PROTOCOLOS TERAPEUTICOS. TUBERCULOSIS NEONATAL 1. CONCEPTO La tuberculosis neonatal es la infección del recién nacido producida por el bacilo de Koch. Es una situación rara pero grave que requiere un diagnóstico precoz y un tratamiento enérgico..

  3. Imaging features of musculoskeletal tuberculosis

    International Nuclear Information System (INIS)

    The purpose of this article is to review the imaging characteristics of musculoskeletal tuberculosis. Skeletal tuberculosis represents one-third of all cases of tuberculosis occurring in extrapulmonary sites. Hematogenous spread from a distant focus elsewhere in the body is the cornerstone in the understanding of imaging features of musculoskeletal tuberculosis. The most common presentations are tuberculous spondylitis, arthritis, osteomyelitis, and soft tissue involvement. The diagnostic value of the different imaging techniques, which include conventional radiography, CT, and MR imaging, are emphasized. Whereas conventional radiography is the mainstay in the diagnosis of tuberculous arthritis and osteomyelitis, MR imaging may detect associated bone marrow and soft tissue abnormalities. MR imaging is generally accepted as the imaging modality of choice for diagnosis, demonstration of the extent of the disease of tuberculous spondylitis, and soft tissue tuberculosis. Moreover, it may be very helpful in the differential diagnosis with pyogenic spondylodiscitis, as it may easily demonstrate anterior corner destruction, the relative preservation of the intervertebral disk, multilevel involvement with or without skip lesions, and a large soft tissue abscess, as these are all arguments in favor of a tuberculous spondylitis. On the other hand, CT is still superior in the demonstration of calcifications, which are found in chronic tuberculous abscesses. (orig.)

  4. Living with Tuberculosis

    Science.gov (United States)

    ... and Diseases > Lung Disease Lookup > Tuberculosis Living With Tuberculosis What to Expect You will need regular checkups ... Blank Section Header Lung Disease Lookup Learn About Tuberculosis Tuberculosis Symptoms, Causes & Risk Factors Diagnosing and Treating ...

  5. Rv2969c, essential for optimal growth in Mycobacterium tuberculosis, is a DsbA-like enzyme that interacts with VKOR-derived peptides and has atypical features of DsbA-like disulfide oxidases.

    Science.gov (United States)

    Premkumar, Lakshmanane; Heras, Begoña; Duprez, Wilko; Walden, Patricia; Halili, Maria; Kurth, Fabian; Fairlie, David P; Martin, Jennifer L

    2013-10-01

    The bacterial disulfide machinery is an attractive molecular target for developing new antibacterials because it is required for the production of multiple virulence factors. The archetypal disulfide oxidase proteins in Escherichia coli (Ec) are DsbA and DsbB, which together form a functional unit: DsbA introduces disulfides into folding proteins and DsbB reoxidizes DsbA to maintain it in the active form. In Mycobacterium tuberculosis (Mtb), no DsbB homologue is encoded but a functionally similar but structurally divergent protein, MtbVKOR, has been identified. Here, the Mtb protein Rv2969c is investigated and it is shown that it is the DsbA-like partner protein of MtbVKOR. It is found that it has the characteristic redox features of a DsbA-like protein: a highly acidic catalytic cysteine, a highly oxidizing potential and a destabilizing active-site disulfide bond. Rv2969c also has peptide-oxidizing activity and recognizes peptide segments derived from the periplasmic loops of MtbVKOR. Unlike the archetypal EcDsbA enzyme, Rv2969c has little or no activity in disulfide-reducing and disulfide-isomerase assays. The crystal structure of Rv2969c reveals a canonical DsbA fold comprising a thioredoxin domain with an embedded helical domain. However, Rv2969c diverges considerably from other DsbAs, including having an additional C-terminal helix (H8) that may restrain the mobility of the catalytic helix H1. The enzyme is also characterized by a very shallow hydrophobic binding surface and a negative electrostatic surface potential surrounding the catalytic cysteine. The structure of Rv2969c was also used to model the structure of a paralogous DsbA-like domain of the Ser/Thr protein kinase PknE. Together, these results show that Rv2969c is a DsbA-like protein with unique properties and a limited substrate-binding specificity. PMID:24100317

  6. Multicentric Spinal Tuberculosis with Sternoclavicular Joint Involvement: A Rare Presentation

    Directory of Open Access Journals (Sweden)

    Balaji Saibaba

    2014-01-01

    Full Text Available Background. Tuberculosis is a chronic disease which may have varied presentations. Though pulmonary tuberculosis is the commonest, extrapulmonary tuberculosis involving skeletal system is often seen. Individuals with poor nourishment and immunological status are especially susceptible for disseminated and multicentric tuberculosis. Case Report. We here present a case of tuberculosis involving multiple anatomical locations in an immune-competent patient which was diagnosed with radiological studies and confirmed with histological examination. Patient was put on multidrug antitubercular therapy and responded well to the treatment with improvement in clinical and radiological picture. Clinical Relevance. This report of a rare case makes us aware of the varied presentations which tuberculosis can present with. It should be kept as a differential diagnosis in patients with cough and fever but not responding to conventional treatment. This is even more important in countries with poor socioeconomic conditions.

  7. Dengue fever: atypical manifestation

    Directory of Open Access Journals (Sweden)

    Nataraj Gangasiddaiah

    2014-08-01

    Full Text Available Dengue fever is affecting millions of population globally. For the past one decade, we have seen several outbreaks and even causing significant mortality of affected population. We witnessed numerous pattern and multisystem presentation of dengue in this period. The CNS manifestation like encephalitis, polyneuropathy (GB like syndrome and paresthesias were uncommonly reported priorly. Pancreatitis, polyserositis, carditis of varying severity and hepatic failure are the, some of atypical manifestations observed in recent out breaks. So dengue illness can presents with multi system involvement and can account to significant mortality. Here an attempt was done to present varying, uncommon and atypical manifestation of dengue illness. [Int J Res Med Sci 2014; 2(4.000: 1804-1806

  8. Endocervical Atypical Polypoid Adenomyoma.

    Science.gov (United States)

    Protopapas, Athanasios; Sotiropoulou, Maria; Athanasiou, Stavros; Loutradis, Dimitrios

    2016-01-01

    Atypical polypoid adenomyomas (APAMs) are rare uterine tumors that occur predominantly in premenopausal women, with less than 250 cases reported so far, worldwide. They may recur after treatment, and they may coexist with, or precede development of an endometrial adenocarcinoma. For this reason cases managed with conservative surgery or medical therapies require long-term follow-up. We report the case of a 41 years old nulliparous patient who during a diagnostic hysteroscopy was found with an endocervical atypical polypoid adenomyoma (APAM). The patient was desirous of a pregnancy, reported menometrorrhagia, and had a coexistent 5 cm, grade 2, submucous myoma, 3 endometrial polyps, and diffuse adenomyosis. She was treated with hysteroscopic resection of the APAM and polyps, plus laparoscopic myomectomy and wedge resection of adenomyosis. She is on an IVF list and after 4 months she is symptoms-free. PMID:26304721

  9. Atypical femoral fractures

    OpenAIRE

    Giannini, Sandro; Chiarello, Eugenio; Tedesco, Giuseppe; Cadossi, Matteo; Luciani, Deianira; Mazzotti, Antonio; Donati, Davide Maria

    2013-01-01

    Bisphosphonates (BPs) represent the most widely used therapy for osteoporosis. Recently, a relationship between long-term treatment with BPs and a subset of atypical femoral fractures (AFFs) from below the lesser trochanter to the sovracondilar line has been described. Many etiopathogenetic theories have been invoked to explain AFFs: reduced bone turnover and increased osteoblast bone apposition with accumulation of microdamage and decreased bone toughness with subsequent increased risk of mi...

  10. Conns' syndrome - atypical presentations

    International Nuclear Information System (INIS)

    Primary hyperaldosteronism (Conns' syndrome) commonly presents with a combination of clinical features of hypokalemia and hypertension. Atypical presentations like normotension, normokalemia and neurological ailments are described in few cases. We encountered two such cases, the first presenting with acute neurological complaint and second case having insignificant hypertension. Both the patients had a characteristic biochemical and imaging profile consistent with primary hyperaldosteronism and responded to surgical resection of adrenal adenoma. (author)

  11. Tuberculosis in patients with end-stage renal disease

    International Nuclear Information System (INIS)

    The purpose of our study was to describe the clinical and radiological manifestations of tuberculosis in patients with end-stage renal disease. The medical records, chest radiographs, and CT scans of 42 patients with tuberculosis among 871 consecutive patients with end-stage renal disease were reviewed. Patterns of initial chest radiographs were categorized as primary, postprimary, miliary, or atypical, according to the predominant radiologic findings. Chest radiographs and CT scans revealed pulmonary tuberculosis in 28 patients and extrapulmonary tuberculosis in 15. The pattern of chest radiographs indicative of pulmonary tuberculosis was primary in 12 cases, postprimary in 11, miliary in one, demonstrated atypical infiltrates in three, and was normal in one. Tuberculosis involved the extrathoracic lymph nodes in six cases, the peritoneum in four, the spine in three, and the bone marrow in two. The primary pattern, seen in 12 patients, manifested as pleural effusion or segmental consolidation, and in ten of the twelve the former was dominant. The radiological pattern of pulmonary tuberculosis in end-stage renal disease is often primary, and extrapulmonary involvement is frequent

  12. Skeletal mastocytosis.

    OpenAIRE

    Andrew, S M; Freemont, A J

    1993-01-01

    AIMS--To characterise the condition of skeletal mastocytosis, an uncommon cause of apparently "idiopathic" osteoporosis. METHODS--Transiliac crest biopsy specimens submitted over a period of five years were examined for nodular accumulation of mast cells. The cases were reviewed histologically and clinical follow up was obtained from hospital notes. RESULTS--Six cases of mastocytosis occurring in bone biopsy specimens submitted to our department were identified. Four patients presented initia...

  13. Cavitary pulmonary tuberculosis HIV-related

    International Nuclear Information System (INIS)

    Introduction: It was usually assumed that pulmonary tuberculosis (TB) in HIV-seropositive patients represents reactivation TB, despite the radiographic appearance frequently consistent rather with a recent disease. Hence, these radiographic features were considered 'atypical'. We have hypothesised that the so called 'atypical' radiographic features could be due to a greater proportion of primary TB among these patients, representing the typical appearance of primary radiological pattern. Material and methods: We reviewed chest imaging of 219 HIV+ patients with microbiological proven pulmonary tuberculosis, who were assessed for the presence, number, distribution of cavitations and for associated pulmonary parenchymal abnormalities, adenopathies and pleural effusion, and were classified as a primary or post-primary pattern. Results: The patients with post-primary pattern were 50%, and the rate of cavitation was 63%, not wandering off the general population. Cavities still occurred with similar proportion in groups with CD4 200 cells/mm3. Conclusion: We suggest that HIV-related pulmonary tuberculosis is typical in its radiological appearances, consistent with those of the general population, and this could be confirmed by the most recent molecular epidemiological techniques that allow to definitely classify the tuberculosis episodes as either primary or post-primary disease

  14. ISOLATED TUBERCULOSIS OF NAVICULAR BONE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Indudhara

    2015-05-01

    Full Text Available Skeletal tuberculosis rare in foot. Bones generally involved are the spine ( D orso - lumbar, skull, shoulder girdle and hip bones. Involvement of the foot is infrequent. Very rare in navicular bone. A female of 23 years presented with swelling and pain in of right foot. X - ray showed lytic lesion with sclerotic margins. Biopsy was done and histopathological diagnosis of tuberculosis was made.

  15. Childhood tuberculosis.

    Science.gov (United States)

    Jacobs, R F; Eisenach, K D

    1993-01-01

    The dramatic resurgence and increase in the total number of cases of tuberculous infection and disease in children is alarming in the United States. With poverty, poor access to health care, overcrowding (predominantly in inner-city areas), and an increase in immigration from areas with high endemic rates of tuberculosis, the problem in children will continue to increase. If the impact of coinfection with HIV and M. tuberculosis becomes significant, as it has in adults in the United States, this increase in the total number of cases of tuberculous disease could be staggering. The impact of multiple drug-resistant strains of M. tuberculosis and the current crises in availability of effective antituberculous drugs will need to undergo basic and clinical research. Although the possibility for eradication of M. tuberculosis as a human pathogen in the United States still exists, clinicians must reeducate themselves regarding the epidemiology, pathophysiology, diagnostic work-up, and effective treatment of children with tuberculosis in the current situation of increasing tuberculous disease and resistant organisms in children. PMID:8217004

  16. Tuberculosis of the Gallbladder

    OpenAIRE

    2000-01-01

    Analysis of 5 patients with gallbladder tuberculosis who had open cholecystectomy and review of literature have shown that, although still rare it presents as a part of systemic miliary tuberculosis, abdominal tuberculosis, isolated gallbladder tuberculosis and as acalculus cholecystitis in anergic patients. There are no pathognomonic signs, the diagnosis depends on suspicion of tuberculosis, peroperative findings and histological examination.

  17. Tuberculosis (TB): Treatment

    Science.gov (United States)

    ... 2/13 By Dr. Iseman Michael Iseman, MD Tuberculosis (TB): Treatment Given the many effective medications available ... is treated longer. NEXT: Preventive Treatment More Treating Tuberculosis Information Active TB Disease Drug-Resistant Tuberculosis Latent ...

  18. Tuberculosis: General Information

    Science.gov (United States)

    TB Elimination Tuberculosis: General Information What is TB? Tuberculosis (TB) is a disease caused by germs that are spread from person ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination CS227840_A What Does a Positive Test ...

  19. Pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Dissemination of the tubercle bacillus is of three types: bronchogenic, hematogenous, and lymphangitic. Bronchogenic dissemination occurs when exudate from a cavity or small area of caseation drains into a bronchus and is aspirated into previously uninfected areas either on the same or on the opposite side. This type of spreading occurs frequently after bleeding and when there is a cavity emptying into a bronchus. Hematogenous dissemination leads to miliary tuberculosis and to extrapulmonary lesions throughout the body. Acute massive hematogenous spread causes miliary tuberculosis, while chronic spread in smaller amounts usually results in the chronic extrapulmonary foci. Lymphangitic dissemination is common in primary infection. It is responsible for involvement with subsequent enlargement of hilar and mediastinal nodes that is often seen in children and in young black adults. The reaction to M. tuberculosis depends on the presence or absence of immunity to tuberculoprotein. In individuals having no tissue hypersensitivity or immunity, primary tuberculosis results. In those with immunity produced by previous infection or BCG vaccination, the reactivation (reinfection) disease may develop

  20. Dermatofibroma: Atypical presentations

    Directory of Open Access Journals (Sweden)

    Mousumi Roy Bandyopadhyay

    2016-01-01

    Full Text Available Dermatofibroma is a common benign fibrohistiocytic tumor and its diagnosis is easy when it presents classical clinicopathological features. However, a dermatofibroma may show a wide variety of clinicopathological variants and, therefore, the diagnosis may be difficult. The typical dermatofibroma generally occurs as a single or multiple firm reddish-brown nodules. We report here two atypical presentations of dermatofibroma - Atrophic dermatofibroma and keloidal presentation of dermatofibroma. Clinical dermal atrophy is a common phenomenon in dermatofibromas as demonstrated by the dimpling on lateral pressure. However, this feature is exaggerated in the atrophic variant of dermatofibroma. Atrophic dermatofibroma is defined by dermal atrophy of more than 50% of the lesion apart from the usual features of common dermatofibroma. The keloidal variant of dermatofibroma should not be overlooked as a simple keloid. The findings of keloidal change in dermatofibromas may support that trauma is a possible cause of dermatofibroma.

  1. Dermatofibroma: Atypical Presentations.

    Science.gov (United States)

    Bandyopadhyay, Mousumi Roy; Besra, Mrinal; Dutta, Somasree; Sarkar, Somnath

    2016-01-01

    Dermatofibroma is a common benign fibrohistiocytic tumor and its diagnosis is easy when it presents classical clinicopathological features. However, a dermatofibroma may show a wide variety of clinicopathological variants and, therefore, the diagnosis may be difficult. The typical dermatofibroma generally occurs as a single or multiple firm reddish-brown nodules. We report here two atypical presentations of dermatofibroma - Atrophic dermatofibroma and keloidal presentation of dermatofibroma. Clinical dermal atrophy is a common phenomenon in dermatofibromas as demonstrated by the dimpling on lateral pressure. However, this feature is exaggerated in the atrophic variant of dermatofibroma. Atrophic dermatofibroma is defined by dermal atrophy of more than 50% of the lesion apart from the usual features of common dermatofibroma. The keloidal variant of dermatofibroma should not be overlooked as a simple keloid. The findings of keloidal change in dermatofibromas may support that trauma is a possible cause of dermatofibroma. PMID:26955137

  2. Postmenopausal Tuberculosis Endometritis

    Directory of Open Access Journals (Sweden)

    Kemal Güngördük

    2007-05-01

    Full Text Available Tuberculosis remains a global health problem, primarily in developing countries with inadequate health services. A significant portion of tuberculosis in these settings is extrapulmonary, including tuberculosis of the genitourinary tract. Patients with genital tuberculosis are usually young women detected during work up for infertility. After menopause, tuberculosis of the endometrium is a rare possibility probably because of the decreased vascularity of the tissues. We present a case of endometrial tuberculosis with postmenopausal vaginal bleeding.

  3. Skeletal scintigraphy

    International Nuclear Information System (INIS)

    Skeletal scintigraphy, using phosphates or diphosphonates labeled with technetium 99m, is a sensitive method of detecting bone abnormalities. The most important and most frequent role of bone scanning is evaluating the skeletal areas in patients who have a primary cancer, especially a malignant condition that has a tendency to spread to bone areas. The bone scan is superior to bone radiographs in diagnosing these abnormalities; 15 percent to 25 percent of patients with breast, prostate or lung cancer, who have normal roentgenograms, also have abnormal scintigrams due to metastases. The majority of bone metastases appear as hot spots on the scan and are easily recognized. The incidence of abnormal bone scans in patients with early stages (I and II) of breast cancer varies from 6 percent to 26 percent, but almost invariably those patients with scan abnormalities have a poor prognosis and should be considered for additional therapies. Progression or regression of bony lesions can be defined through scanning, and abnormal areas can be identified for biopsy. The incidence of metastases in solitary scan lesions in patients with known primary tumors varies from 20 percent to 64 percent. Bone scintigraphy shows positive uptake in 95 percent of cases with acute osteomyelitis. Stress fractures and trauma suspected in battered babies can be diagnosed by scanning before there is radiological evidence. The procedure is free from acute or long-term side effects and, except in cases of very young patients, sedation is seldom necessary. Although the test is sensitive, it is not specific and therefore it is difficult to overemphasize the importance of clinical, radiographic, biochemical and scanning correlation in each patient

  4. A Rare Case: Atypical Measles

    Directory of Open Access Journals (Sweden)

    Ümmü Sena Sarı

    2016-03-01

    Full Text Available Atypical measles has been described in persons who were exposed to wild measles virus several years after they were immunized with killed measles vaccine. Occasionally, it can be caused by live measles vaccines also. It is a clinical picture different from typical measles. In this report, an adult patient with a history of immunization, who presented with high fever, maculopapular rash starting at the palms and soles, and pneumonia, is presented. Atypical measles that was first reported in the 1970s in mostly kids should be considered for differential diagnosis in adult cases presenting with high fever, atypical rash and pneumonia even if patients have a history of immunization

  5. ISOLATED TUBERCULOSIS OF NAVICULAR BONE: A CASE REPORT

    OpenAIRE

    Indudhara; Harish; Yenni

    2015-01-01

    Skeletal tuberculosis rare in foot. Bones generally involved are the spine ( D orso - lumbar), skull, shoulder girdle and hip bones. Involvement of the foot is infrequent. Very rare in navicular bone. A female of 23 years presented with swelling and pain in of right foot. X - ray showed lytic lesion with sclerotic margins. Biop...

  6. A Rare Case: Atypical Measles

    OpenAIRE

    Ümmü Sena Sarı; Figen Kaptan

    2016-01-01

    Atypical measles has been described in persons who were exposed to wild measles virus several years after they were immunized with killed measles vaccine. Occasionally, it can be caused by live measles vaccines also. It is a clinical picture different from typical measles. In this report, an adult patient with a history of immunization, who presented with high fever, maculopapular rash starting at the palms and soles, and pneumonia, is presented. Atypical measles that was ...

  7. Integration of PET/CT in Current Diagnostic and Response Evaluation Methods in Patients with Tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Oezmen, Oelem; Goekcek, Atila; Tatci, Ebru; Biner, Inci; Akkalyoncu, Behiye [Atatuerk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara (Turkmenistan)

    2014-03-15

    Tuberculosis is a systemic disease that still affects many people. While pleural involvement is frequently observed in extrapulmonary tuberculosis, multiple skeletal system and articular involvements are quite rare. FDG PET imaging could be a promising diagnostic and treatment monitoring method, especially in complicated cases and if the other methods are inadequate. In this case study, we report a patient who was admitted with suspected malignancy and then diagnosed with tuberculosis pleuritis, lymphadenitis, spondylodiscitis, and sacroiliitis with specific symptoms; the response to anti-tuberculosis therapy was shown using FDG PET/CT.

  8. Gallbladder tuberculosis: case report

    Institute of Scientific and Technical Information of China (English)

    余日胜; 刘奕青

    2002-01-01

    @@ Abdominal tuberculosis is common in developing countries, but gallbladder involvement is extremely rare. The diagnosis of gallbladder tuberculosis is often not suspected prior to surgery or biopsy.This paper describes the CT and ultrasonographic features of gallbladder tuberculosis in a 35-year-old patient and reviews the literature of gallbladder tuberculosis.

  9. Tuberculosis (For Parents)

    Science.gov (United States)

    ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth Tuberculosis KidsHealth > For Parents > Tuberculosis Print A A A Text Size What's in ... When to You Call the Doctor en español Tuberculosis Tuberculosis (popularly known as "TB") is a disease ...

  10. Imaging in Tuberculosis abdominal

    International Nuclear Information System (INIS)

    In this article we illustrate and discuss imaging features resulting from Tuberculosis abdominal affectation. We present patients evaluated with several imaging modalities who had abdominal symptoms and findings suggestive of granulomatous disease. Diagnosis was confirm including hystopatology and clinical outgoing. Cases involved presented many affected organs such as lymphatic system, peritoneum, liver, spleen, pancreas, kidneys, ureters, adrenal glands and pelvic organs Tuberculosis, Tuberculosis renal, Tuberculosis hepatic, Tuberculosis splenic Tomography, x-ray, computed

  11. Postmenopausal Tuberculosis Endometritis

    OpenAIRE

    Kemal Güngördük; Volkan Ulker; Ahmet Sahbaz; Cemal Ark; Alı Ismet Tekırdag

    2007-01-01

    Tuberculosis remains a global health problem, primarily in developing countries with inadequate health services. A significant portion of tuberculosis in these settings is extrapulmonary, including tuberculosis of the genitourinary tract. Patients with genital tuberculosis are usually young women detected during work up for infertility. After menopause, tuberculosis of the endometrium is a rare possibility probably because of the decreased vascularity of the tissues. We present a case of endo...

  12. Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis

    International Nuclear Information System (INIS)

    Objectives: Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk of pulmonary tuberculosis. However, detecting pulmonary tuberculosis may be difficult due to the underlying fibrosis. The aim of this report is to describe the radiological and clinical findings of pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis. Materials and methods: We reviewed 143 consecutive patients in whom IPF was diagnosed by either the histological or radio-clinical criteria. Among them, nine patients were histologically (n=2) or bacteriologically (n=7) confirmed to have active pulmonary tuberculosis. The location and patterns of pulmonary tuberculosis were examined on a thin section CT scan. Results: The most common thin section CT findings were subpleural nodules (n=6; mean diameter, 3.2 cm) and a lobar or segmental consolidation (n=3). The lesions were located most commonly in the right lower lobe (n=4). The incidence of tuberculosis in patients with idiopathic pulmonary fibrosis was more than five times higher than that of the general population. Conclusion: The atypical manifestation of pulmonary tuberculosis is common in patients with idiopathic pulmonary fibrosis, which may mimic lung cancer or bacterial pneumonia

  13. Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Myung Jin; Goo, Jin Mo E-mail: jmgoo@plaza.snu.ac.kr; Im, Jung-Gi

    2004-11-01

    Objectives: Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk of pulmonary tuberculosis. However, detecting pulmonary tuberculosis may be difficult due to the underlying fibrosis. The aim of this report is to describe the radiological and clinical findings of pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis. Materials and methods: We reviewed 143 consecutive patients in whom IPF was diagnosed by either the histological or radio-clinical criteria. Among them, nine patients were histologically (n=2) or bacteriologically (n=7) confirmed to have active pulmonary tuberculosis. The location and patterns of pulmonary tuberculosis were examined on a thin section CT scan. Results: The most common thin section CT findings were subpleural nodules (n=6; mean diameter, 3.2 cm) and a lobar or segmental consolidation (n=3). The lesions were located most commonly in the right lower lobe (n=4). The incidence of tuberculosis in patients with idiopathic pulmonary fibrosis was more than five times higher than that of the general population. Conclusion: The atypical manifestation of pulmonary tuberculosis is common in patients with idiopathic pulmonary fibrosis, which may mimic lung cancer or bacterial pneumonia.

  14. Atypical presentation of mucopolysaccharidosis type IVA.

    Science.gov (United States)

    Rush, Eric T

    2016-09-01

    A 14 year old patient with short stature, type I diabetes, and cataracts was referred for evaluation of avascular necrosis of the femoral head. Radiography was suggestive of spondyloepiphyseal dysplasia with decreased bone mineral density for age. Targeted molecular and biochemical testing were normal in this patient. Whole exome sequencing was performed and showed compound heterozygosity for previously reported pathogenic GALNS variants which were diagnostic of mucopolysaccharidosis, type IVA (Morquio A). While this case describes neither a novel condition nor a new mutation, it does illustrate three important points in the diagnosis of patients with atypical forms of MPS IVA. First, that in many instances urine glycosaminoglycan analysis is not sufficient to rule out MPS IVA as a potential diagnosis. Patients in whom biochemical screening is advised should have measurement of leukocyte enzymatic activity. Second, that in patients with radiographic evidence of spondyloepiphyseal dysplasia with additional features or with normal targeted testing, MPS IVA should remain in the differential diagnosis. Third, that whole exome sequencing represents a viable diagnostic platform for evaluation of patients with unknown skeletal or metabolic disease. PMID:27331011

  15. Drug therapy in spinal tuberculosis

    OpenAIRE

    Rajasekaran, S.; Khandelwal, Gaurav

    2012-01-01

    Although the discovery of effective anti-tuberculosis drugs has made uncomplicated spinal tuberculosis a medical disease, the advent of multi-drug-resistant Mycobacterium tuberculosis and the co-infection of HIV with tuberculosis have led to a resurgence of the disease recently. The principles of drug treatment of spinal tuberculosis are derived from our experience in treating pulmonary tuberculosis. Spinal tuberculosis is classified to be a severe form of extrapulmonary tuberculosis and henc...

  16. Induced skeletal mutations

    International Nuclear Information System (INIS)

    This paper describes a large-scale experiment that, by means of breeding tests, confirmed that many dominant skeletal mutations are induced by large-dose radiation exposure. The author also discusses: (1) the major advantages and disadvantages of the skeletal method in improving estimates of genetic hazard to man; (2) future uses of the skeletal method; (3) direct estimation of risk beyond the first generation using the skeletal method; and (4) the possibility of using the skeletal method as a quick and easy screen for chemical mutagens

  17. Familial benign pemphigus atypical localization

    OpenAIRE

    Reyes, Maria Veronica; Halac, Sabina; Mainardi, Claudio; Kurpis, Maria; Ruiz Lascano, Alejandro

    2016-01-01

    We present an atypical case of familial benign pemphigus (Hailey-Hailey disease), which presented as crusted, annular plaques limited to the back without intertriginous involvement. We could not find in the literature another patient with plaques located solely on the back without a prior history of classical disease.

  18. Recognition and diagnosis of atypical depression.

    Science.gov (United States)

    Thase, Michael E

    2007-01-01

    The term atypical depression dates to the first wave of reports describing differential response to monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs). In contrast to more TCA-responsive depressions, patients with so-called atypical symptoms (e.g., hypersomnia, interpersonal sensitivity, leaden paralysis, increased appetite and/or weight, and phobic anxiety) were observed to be more responsive to MAOIs. After several decades of controversy and debate, the phrase "with atypical features" was added as an episode specifier in the DSM-IV in 1994. The 1-year prevalence of the defined atypical depression subtype is approximately 1% to 4%; around 15% to 29% of patients with major depressive disorder have atypical depression. Hardly "atypical" in contemporary contexts, atypical depression also is common in dysthymic bipolar II disorders and is notable for its early age at onset, more chronic course, and high rates of comorbidity with social phobia and panic disorder with agoraphobia. The requirement of preserved mood reactivity is arguably the most controversial of the DSM-IV criteria for atypical depression. When compared with melancholia, the neurobiological profiles of patients with atypical depression are relatively normal. The utility of the atypical depression subtype for differential therapeutics diminished substantially when the TCAs were supplanted as first-line antidepressants by the selective serotonin reuptake inhibitors. Although introduction of safer MAOIs has fostered renewed interest in atypical depression, the validity and importance of the DSM-IV definition of atypical depression for the nosology of affective illness remains an open question. PMID:17640153

  19. Role of GeneXpert MTB/Rif Assay in Diagnosing Tuberculosis in Pregnancy and Puerperium

    OpenAIRE

    Habib, Zaiyad G.; Dayyab, Farouq M.; Abdallah Sanda; Tambuwal, Sirajo H.; Mahmood M. Dalhat; Hamza Muhammad; Garba Iliyasu; Ibrahim Nashabaru; Habib, Abdulrazaq G.

    2015-01-01

    Presentation of tuberculosis (TB) in pregnancy may be atypical with diagnostic challenges. Two patients with complicated pregnancy outcomes, foetal loss and live premature delivery at 5 and 7 months of gestation, respectively, and maternal loss, were diagnosed with pulmonary TB. Chest radiography and computed tomography showed widespread reticuloalveolar infiltrates and consolidation with cavitations, respectively. Both patients were Human Immunodeficiency Virus (HIV) seronegative and sputum ...

  20. The patellar tuberculosis

    OpenAIRE

    Taser, Omer; Cakmak, Mehmet; Karamehmetoglu, Mahmut; Durmaz, Hayati; Cubuk, Mustafa Kemal

    2004-01-01

    A case has been reported herein with isolated patellar tuberculosis, which is very rarely enconsitered. Attempts have been made to review under the light of literature the significance of early diagnosis and treatment of choice in patellar tuberculosis.

  1. Hepatobiliary and pancreatic tuberculosis: A two decade experience

    Directory of Open Access Journals (Sweden)

    Sahni Peush

    2007-06-01

    Full Text Available Abstract Background Isolated hepatobiliary or pancreatic tuberculosis (TB is rare and preoperative diagnosis is difficult. We reviewed our experience over a period two decades with this rare site of abdominal tuberculosis. Methods The records of 18 patients with proven histological diagnosis of hepatobiliary and pancreatic tuberculosis were reviewed retrospectively. The demographic features, sign and symptoms, imaging, cytology/histopathology, procedures performed, outcome and follow up data were obtained from the departmental records. The diagnosis of tuberculosis was based on granuloma with caseation necrosis on histopathology or presence of acid fast bacilli. Results Of 18 patients (11 men, 11 had hepatobiliary TB while 7 had pancreatic TB. Two-thirds of the patients were 1 intraabdominal abscess 1 and 3 developed ATT induced hepatotoxicity. No patient died. The median follow up period was 12 months (9 – 96 months. Conclusion Tuberculosis should be considered as a differential diagnosis, particularly in young patients, with atypical signs and symptoms coming from areas where tuberculosis is endemic and preoperative tissue and/or cytological diagnosis should be attempted before labeling them as hepatobiliary and pancreatic malignancy.

  2. Mycolic Acids as Markers of Osseous Tuberculosis in the Neolithic Skeleton from Kujawy Region (Central Poland)

    OpenAIRE

    Borowska-Strugiń Beata; Druszczyńska Magdalena; Lorkiewicz Wiesław; Szewczyk Rafał; Ządzińska Elzbieta

    2014-01-01

    The subject of analysis is the male skeleton from a double burial of the Globular Amphora Culture, derived from the Neolithic site at Brześć Kujawski in Kujawy region (central Poland). Within the spine of the individual advanced lesions are observed (destruction of the vertebral bodies, symptoms of the periostitis in the thoracic region) which are characteristic of skeletal tuberculosis. To check whether the observed morphological changes resulted from infection with Mycobacterium tuberculosi...

  3. Tuberculosis verrucosa cutis (TBVC)--foot with miliary tuberculosis.

    Science.gov (United States)

    Padmavathy, L; Lakshmana Rao, L; Ethirajan, N; Ramakrishna Rao, M; Subrahmanyan, E N; Manohar, U

    2007-07-01

    Tuberculosis Verrucosa Cutis (TBVC) or warty tuberculosis is a variant of cutaneous tuberculosis in patients with good cell mediated immunity (CMI) to Mycobacterium Tuberculosis, while Miliary Tuberculosis is associated with very poor CMI. Two widely different clinical presentations in the same patient are very rare and being reported. PMID:17886704

  4. Tuberculosis and nutrition

    Directory of Open Access Journals (Sweden)

    Gupta Krishna

    2009-01-01

    Full Text Available Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world. These two problems tend to interact with each other. Tuberculosis mortality rates in different economic groups in a community tend to vary inversely with their economic levels. Similarly, nutritional status is significantly lower in patients with active tuberculosis compared with healthy controls. Malnutrition can lead to secondary immunodeficiency that increases the host′s susceptibility to infection. In patients with tuberculosis, it leads to reduction in appetite, nutrient malabsorption, micronutrient malabsorption, and altered metabolism leading to wasting. Both, protein-energy malnutrition and micronutrients deficiencies increase the risk of tuberculosis. It has been found that malnourished tuberculosis patients have delayed recovery and higher mortality rates than well-nourished patients. Nutritional status of patients improves during tuberculosis chemotherapy. High prevalence of human immunodeficiency (HIV infection in the underdeveloped countries further aggravates the problem of malnutrition and tuberculosis. Effect of malnutrition on childhood tuberculosis and tuberculin skin test are other important considerations. Nutritional supplementation may represent a novel approach for fast recovery in tuberculosis patients. In addition, raising nutritional status of population may prove to be an effective measure to control tuberculosis in underdeveloped areas of world.

  5. Atypical fractures, a biased perspective.

    Science.gov (United States)

    Aspenberg, Per

    2016-01-01

    When stress fractures started to show up in the femurs of elderly ladies, it was soon evident that bisphosphonate use lay behind, and the absolute risk increase due to bisphosphonate use was reasonably well estimated already in 2008. Thereafter followed a period of confusion: the term atypical fracture was introduced, with a definition so vague that the true stress fractures tended to disappear in a cloud of ambiguity. This cast doubt on the association with bisphosphonates. The association was then re-established by large epidemiological studies based on radiographic adjudication. Atypical fractures are largely caused by bisphosphonates. With a correct indication, bisphosphonates prevent many more fractures than they cause, at least during the first years of use. With an incorrect indication they are likely to cause more harm than good. PMID:26768286

  6. Atypical manifestations of early syphilis

    Directory of Open Access Journals (Sweden)

    Koranne R

    1990-01-01

    Full Text Available A study of 36 untreated patients with early syphilis revealed atypical variations namely; long incubation period of 101 days in I patient, more than 3 chancres in 1, undermined margin of the chancre along with tenderness in 1 and moderate to severe tenderness of the ulcers in 2 cases. In 3 patients there was no indurations of the ulcers. Three patients with primary syphilis had unilateral lymphadenitis, and in I case the lymph nodes were not only tender but showed tendency towardsmatingawell. Insecondarysyphilis, 11 out of 16 patients having condylomata lata had no other muco-cutaneous lesions. Concomitant presence of other venereal disease to account for the atypical manifestations was discounted- by appropriate laboratory tests, response to therapeutic agents and follow up.

  7. Atypical eating disorders: a review

    OpenAIRE

    Garcia, Frederico

    2011-01-01

    Frederico Duarte Garcia1, Héloïse Délavenne2, Pierre Déchelotte11Nutrition and Digestive System Research Group (EA 4311) and Nutrition Unit, Rouen Institute of Medical Research and Innovation, Federative Institute for Peptide Research (IFRMP 23), Rouen University and University Hospital, Rouen, France; 2Department of Addictology of the Rouen University Hospital, Rouen University, Rouen, FranceIntroduction: Atypical eating disorders (AEDs), also known ...

  8. Imaging of musculoskeletal tuberculosis; Imagerie de la tuberculose osteo-articulaire

    Energy Technology Data Exchange (ETDEWEB)

    Boussel, L.; Marchand, B.; Blineau, N.; Picaud, G.; Emn, M.; Coulon, A.; Pagnon, P.; Rode, A.; Pin-Leveugle, J.; Berthezene, Y.; Pariset, C.; Boibieux, A. [Hopital de la Croix-Rousse, 69 - Lyon (France); Hermier, M. [Hopital de la Croix-Rousse, Serv. de Neuroradiologie, 69 - Lyon (France)

    2002-09-01

    Purpose and methods. To perform an illustrated and educational review of musculoskeletal tuberculosis. Results. As the incidence of musculoskeletal tuberculosis still increases, a review appears justified. The following four main presentations are detailed and illustrated, by emphasizing the value of both CT and MR imaging: a) spine tuberculosis ({approx} 50 %/) commonly involves two adjacent vertebral bodies with usual large paravertebral abscesses. The following lesions are highly suggestive of tuberculosis: solitary vertebral involvement, solitary epidural abscess with or without erosive spondylitis; b) osteo-arthritis: peripherally located erosions at synovial insertions with gradual narrowing of the joint space are highly suggestive; c) osteomyelitis: unusual, may involve any bones; d) tenosynovitis and bursitis. Conclusion. Imaging studies are essential for diagnosis and to assess the extent of musculo-skeletal tuberculosis. (author)

  9. Tuberculosis Facts - Testing for TB

    Science.gov (United States)

    Tuberculosis (TB) Facts Testing for TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination

  10. Tuberculosis Facts - Exposure to TB

    Science.gov (United States)

    Tuberculosis (TB) Facts Exposure to TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination

  11. Tuberculosis in the lung (image)

    Science.gov (United States)

    Tuberculosis is caused by a group of organisms Mycobacterium tuberculosis, M bovis , M africanum and a few other rarer subtypes. Tuberculosis usually appears as a lung (pulmonary) infection. However, ...

  12. Evolving A-Type Artificial Neural Networks

    CERN Document Server

    Orr, Ewan

    2011-01-01

    We investigate Turing's notion of an A-type artificial neural network. We study a refinement of Turing's original idea, motivated by work of Teuscher, Bull, Preen and Copeland. Our A-types can process binary data by accepting and outputting sequences of binary vectors; hence we can associate a function to an A-type, and we say the A-type {\\em represents} the function. There are two modes of data processing: clamped and sequential. We describe an evolutionary algorithm, involving graph-theoretic manipulations of A-types, which searches for A-types representing a given function. The algorithm uses both mutation and crossover operators. We implemented the algorithm and applied it to three benchmark tasks. We found that the algorithm performed much better than a random search. For two out of the three tasks, the algorithm with crossover performed better than a mutation-only version.

  13. Five Cases of Atypical Rickettsial Infections

    OpenAIRE

    Salva, I; Gouveia, C.; De Sousa, R.; Brito, MJ

    2011-01-01

    Background: Rickettsia conorii is the most frequent species of RickettsiaI causing disease in Portugal. In general the disease manifests itself by fever, exanthema, headaches and the presence of an eschar. However atypical forms can be present and physicians should be aware. Aims: Analyse the atypical presentation of rickettsiosis. Material and Methods: Children admitted at the CHLC Hospital from 2000 to 2010 with atypical presentation of rickettsiosis. Clinical diagnosis wa...

  14. Atypical disease phenotypes in pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Levine, Arie; de Bie, Charlotte I; Turner, Dan; Cucchiara, Salvatore; Sladek, Malgorzata; Murphy, M Stephen; Escher, Johanna C; Pærregaard, Anders

    2013-01-01

    Definitive diagnosis of pediatric ulcerative colitis (UC) may be particularly challenging since isolated colitis with overlapping features is common in pediatric Crohn's disease (CD), while atypical phenotypes of UC are not uncommon. The Paris classification allows more accurate phenotyping of...... atypical inflammatory bowel disease (IBD) patients. Our aim was to identify the prevalence of atypical disease patterns in new-onset pediatric UC using the Paris classification....

  15. Tuberculosis among older adults – time to take notice

    Directory of Open Access Journals (Sweden)

    Joel Negin

    2015-03-01

    Full Text Available Knowledge that older people are vulnerable to develop tuberculosis is rarely considered in developing country settings. According to 2010 Global Burden of Disease estimates, the majority of tuberculosis-related deaths occurred among people older than 50; most in those aged 65 and above. Older people also contribute a large proportion of Disability-Adjusted Life Years (DALYs; 51% of tuberculosis DALYs occurred in patients aged 50 years and older in East Asia. Tuberculosis age distributions in Africa have been severely skewed by the human immunodeficiency virus (HIV epidemic, but emerging data suggest increasing disease burdens among older people. Older adults are more likely to develop extra-pulmonary and atypical forms of disease that are often harder to diagnose than conventional sputum smear-positive pulmonary tuberculosis. Their care is complicated by more frequent drug-related adverse events and increased co-morbidity, which may prove difficult to manage in regions where health resources are already constrained. Health systems will have to confront the challenge of an ageing global population and the integrated services required to address their health needs.

  16. Problems in distinguishing spinal tuberculosis from neoplasia on MRI

    International Nuclear Information System (INIS)

    We reviewed MRI studies of 60 patients presenting with extradural compressive myeloradiculopathy secondary to vertebral disease to assess the imaging features which may help in differentiating tuberculous from neoplastic disease. Spin-echo T1-, proton density- and T2-weighted images were available for all patients and fast low-angle shot images with a low flip angle for 21 patients. Contrast-enhanced images were available for 28 patients. There were 41 patients with tuberculosis and 19 patients with neoplastic disease (metastases 11, lymphoma 6, plasmacytoma 1, and giant cell tumour 1). Discovertebral disease with or without involvement of the posterior arch was a feature not only of tuberculous spondylitis (30 patients) but also of metastases (6). The remaining 11 patients with tuberculosis had ''atypical'' involvement (vertebral body with or without posterior arch in 8 and posterior arch alone in 3) described as typical of neoplasms. This ''typical'' involvement was seen in metastases (5), lymphoma (6) and the 2 primary bone tumours. The presence of an abscess helped in differentiating tuberculosis from neoplasia in 22 of the 41 patients with tuberculosis and was absent in all with neoplasms. The presence of bone fragments in 16 patients (8 with and 8 without an abscess) was found to be specific for tuberculosis. In the absence of an abscess or bone fragments, image-guided biopsy is essential to establish the diagnosis. (orig.). With 9 figs., 2 tabs

  17. [Pharyngeal tuberculosis: Case report].

    Science.gov (United States)

    Spini, Roxana Gabriela; Bordino, Lucas; Cohen, Daniela; Martins, Andrea; Ramírez, Zaida; González, Norma E

    2015-08-01

    Pharyngeal tuberculosis is a rare extrapulmonary manifestation. In Argentina, the number of cases of tuberculosis reported in children under 19 years in 2012 was 1752. Only 12.15% had extrapulmonary manifestation. A case of a 17 year old girl with pharyngeal tuberculosis is reported. The patient presented intermittent fever and swallowing pain for 6 months, without response to conventional antibiotic treatment. Chest X-ray showedbilateral micronodular infiltrate, so hospitalization was decided to study and treat. The sputum examination for acid-fast resistant bacilli was positive and treatment with four antituberculous drugs was started, with good evolution and disappearance of symptoms. Diagnostic confirmation with the isolation of Mycobacterium tuberculosis in sputum culture was obtained. The main symptoms of pharyngeal tuberculosis are sore throat and difficulty in swallowing of long evolution. It is important to consider tuberculosis as differential diagnosis in patients with chronic pharyngitis unresponsive to conventional treatment. PMID:26172025

  18. Pictorial essay: Orbital tuberculosis

    International Nuclear Information System (INIS)

    Tuberculosis of the orbit is rare, even in places where tuberculosis is endemic. The disease may involve soft tissue, the lacrimal gland, or the periosteum or bones of the orbital wall. Intracranial extension, in the form of extradural abscess, and infratemporal fossa extension has been described. This pictorial essay illustrates the imaging findings of nine histopathologically confirmed cases of orbital tuberculosis. All these patients responded to antituberculous treatment

  19. Atypical parkinsonism: diagnosis and treatment.

    Science.gov (United States)

    Stamelou, Maria; Bhatia, Kailash P

    2015-02-01

    Atypical parkinsonism comprises typically progressive supranuclear palsy, corticobasal degeneration, and mutilple system atrophy, which are distinct pathologic entities; despite ongoing research, their cause and pathophysiology are still unknown, and there are no biomarkers or effective treatments available. The expanding phenotypic spectrum of these disorders as well as the expanding pathologic spectrum of their classic phenotypes makes the early differential diagnosis challenging for the clinician. Here, clinical features and investigations that may help to diagnose these conditions and the existing limited treatment options are discussed. PMID:25432722

  20. Tuberculosis treatment among smear positive tuberculosis patients

    International Nuclear Information System (INIS)

    Tuberculosis is a major health problem in many parts of the world. Delay in initiation of the treatment may result in prolonged infectious state, drug resistance, relapse and death. Objectives: To determine the factors responsible for not starting tuberculosis treatment among smear positive tuberculosis patients. Study type, settings and duration: This cross sectional study was done at Pakistan Medical Research Council TB Research Center, King Edward Medical University, Lahore, from fifth March 2010 to fifth December 2010. Patients and Methods: Fifty sputum smear positive patients of tuberculosis who did not register themselves in treatment register and presumably did not initiate anti tuberculosis treatment were contacted using telephone or traced by their home addresses. Once contact was established, they were inquired about the reasons for not starting tuberculosis treatment. Results: Of 50 patients 38(76%)belonged to the lower socio economic class and 12(24%) to the lower middle class. Fourteen patients (28%) were illiterate and 23(46%) had only 8 years of education. Of the 50 cases 41(82%) were taking treatment from traditional healers and 4% did not go back to the DOTS program. Physical condition of the patient, social, domestic and religious issues also played some role in default. Conclusions: Lack of health education and poverty were the main factors responsible for non compliance from treatment. Policy message: Sputum testing sites should have a paramedic who should educate the patients about the benefits of treatment and the dangers of default or partial treatment. (author)

  1. Primary isolated hepatic tuberculosis

    International Nuclear Information System (INIS)

    Isolated hepatic tuberculosis without pulmonary or bowel involvement is a diagnostic challenge and can cause considerable morbidity. A young lady from Lahore presented with fever, pain in right hypochondria, nausea and weight loss. CT scan of abdomen showed multiple small hypodense non-enhancing lesions and a heterogeneous texture of liver. Biopsy confirmed the diagnosis of hepatic tuberculosis. It was concluded a case of isolated hepatic tuberculosis without evidence of other primary sites involvement. It is important to consider tuberculosis in the differential diagnosis when suspecting lymphoproliferative or metastatic diseases in a patient with vague symptoms and abnormal hepatic texture on CT. (author)

  2. TUBERCULOSIS COMO ENFERMEDAD OCUPACIONAL

    Science.gov (United States)

    Mendoza-Ticona, Alberto

    2014-01-01

    Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto. PMID:22858771

  3. Characteristics of pulmonary tuberculosis in HIV seropositive and seronegative patients in a Northeastern region of Brazil.

    Science.gov (United States)

    Liberato, Isabella Ramos de Oliveira; de Albuquerque, Maria de Fatima P Militão; Campelo, Antônio Roberto Leite; de Melo, Heloísa Ramos Lacerda

    2004-01-01

    The aim of this study was to analyse the clinical, epidemiological and bacteriological features present in 60 pulmonary tuberculosis patients who were also infected with human immunodeficiency virus (HIV) and to compare these with 120 TB patients who were not infected with HIV. The patients with pulmonary tuberculosis and HIV coinfection were mostly male (p = 0.001), showed a higher frequency of weight loss >10 kilos (p tuberculosis (p = 0.001). Treatment failure was more common in those who were HIV positive (p extrapulmonary and pulmonary tuberculosis was more frequent in those seropositive to HIV than those without HIV virus, 30% and 1.6% respectively. These findings showed a predominance of atypical clinical laboratory features in co-infected patients, and suggest that health care personnel should consider the possibility this diagnosis. PMID:15042183

  4. Radiological profile of pulmonary tuberculosis in HIV: concerning 171 observations in Kinshasa

    International Nuclear Information System (INIS)

    This prospective descriptive study was conducted in Depistage center of the Tuberculosis treatment of Kabinda during a period of three months, had as objectives to study the radiological profile of pulmonary tuberculosis in HIV and HIV- patients, then to compare the frequency of different radiological abnormalities between the two groups to determine some characteristics of co-infection HIV/TP+. Among 171 patients with contagious pulmonary tuberculosis, 50 patients had positive serology for HIV, a prevalence of 29,2%. The intrathoracic lymph nodes, localized lesions only in the lower field were more observed in HIV, as well as pleurisy and the absence of radiological abnormality. The only one case of miliary was HIV positive. By contrast, excavations and localized lesions in the upper field were predominant in HIV-. Atypical radiological manifestations of pulmonary tuberculosis were more common in patients with HIV infection.

  5. Atypical Manifestation of Vestibular Schwannoma

    Directory of Open Access Journals (Sweden)

    Webster, Guilherme

    2013-09-01

    Full Text Available Introduction: Vestibular schwannoma (also known as acoustic neuroma is a benign tumor whose cells are derived from Schwann sheaths, which commonly occurs from the vestibular portion of the eighth cranial nerve. Furthermore, vestibular schwannomas account for ∼8% of intracranial tumors in adults and 80 to 90% of tumors of the cerebellopontine angle. Its symptoms are varied, but what stands out most is a unilateral sensorineural hearing loss, with a low index of speech recognition. Objective: Describe an atypical manifestation of vestibular schwannoma. Case Report: The 46-year-old woman had vertigo and binaural hearing loss and fullness, with ear, nose, and throat examination suggestive of cochlear injury. After 6 months, the patient developed worsening of symptoms and onset of right unilateral tinnitus. In further exams the signs of cochlear damage remained, except for the vestibular test (hyporeflexia. Magnetic resonance imaging showed an expansive lesion in the right cerebellopontine angle. Discussion: This report warns about the atypical manifestations of vestibular schwannoma, which must always be remembered in investigating and diagnosing hearing loss.

  6. Atypical extragonadal germ cell tumors

    Directory of Open Access Journals (Sweden)

    Mainak Deb

    2012-01-01

    Full Text Available Aim: To review the experience with the diagnosis and management of extragonadal germ cell tumors (GCT with a subset analysis of those with atypical features. Materials and Methods: A retrospective chart review of patients of extragonadal germ cell tumors between 2000 and 2010 was carried out. Results: Fifteen children aged 7 days to 15 years (median, 1.5 years were included. Three had an antenatal diagnosis (one sacrococcygeal, one retrobulbar, one retroperitoneal tumor and were operated in the neonatal period. The locations were distributed between the retrobulbar area (1, anterior neck-thyroid gland (1, mediastinum (4, abdominothoracic extending through the esophageal hiatus (1, retroperitoneal (4 and sacrococcygeal (4. On histological examination, five harbored immature elements while two were malignant; the latter children received postexcision adjuvant chemotherapy. There was no mortality. At a median follow-up of 4.5 years (6 months to 8 years, 14/15 have had an event-free survival. One immature mediastinal teratoma that recurred locally 7.5 years after the initial operation was excised and adjuvant chemotherapy instituted. Conclusions: Extragonadal GCTs in children are uncommon and occasionally present with atypical clinical, radiological and histological features resulting in diagnostic and therapeutic dilemmas.

  7. Mycobacterium bovis (Bovine Tuberculosis) in Humans

    Science.gov (United States)

    Mycobacterium bovis (Bovine Tuberculosis) in Humans What is Mycobacterium bovis ? In the United States, the majority of tuberculosis (TB) cases in people are caused by Mycobacterium tuberculosis ( ...

  8. Structure of Skeletal Muscle

    Science.gov (United States)

    ... and in some they are oblique. Each skeletal muscle fiber is a single cylindrical muscle cell. An individual ... made up of hundreds, or even thousands, of muscle fibers bundled together and wrapped in a connective tissue ...

  9. Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part II.

    Science.gov (United States)

    Merchant, Suleman; Bharati, Alpa; Merchant, Neesha

    2013-01-01

    This article reviews the computed tomography and magnetic resonance imaging (MRI) features of renal tuberculosis (TB), including TB in transplant recipients and immunocompromised patients. Multi detector computed tomography (MDCT) forms the mainstay of cross-sectional imaging in renal TB. It can easily identify calcification, renal scars, mass lesions, and urothelial thickening. The combination of uneven caliectasis, with urothelial thickening and lack of pelvic dilatation, can also be demonstrated on MDCT. MRI is a sensitive modality for demonstration of features of renal TB, including tissue edema, asymmetric perinephric fat stranding, and thickening of Gerota's fascia, all of which may be clues to focal pyelonephritis of tuberculous origin. Diffusion-weighted MR imaging with apparent diffusion coefficient (ADC) values may help in differentiating hydronephrosis from pyonephrosis. ADC values also have the potential to serve as a sensitive non-invasive biomarker of renal fibrosis. Immunocompromised patients are at increased risk of renal TB. In transplant patients, renal TB, including tuberculous interstitial nephritis, is an important cause of graft dysfunction. Renal TB in patients with HIV more often shows greater parenchymal affection, with poorly formed granulomas and relatively less frequent findings of caseation and stenosis. Atypical mycobacterial infections are also more common in immunocompromised patients. PMID:23986619

  10. Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part II

    Directory of Open Access Journals (Sweden)

    Suleman Merchant

    2013-01-01

    Full Text Available This article reviews the computed tomography and magnetic resonance imaging (MRI features of renal tuberculosis (TB, including TB in transplant recipients and immunocompromised patients. Multi detector computed tomography (MDCT forms the mainstay of cross-sectional imaging in renal TB. It can easily identify calcification, renal scars, mass lesions, and urothelial thickening. The combination of uneven caliectasis, with urothelial thickening and lack of pelvic dilatation, can also be demonstrated on MDCT. MRI is a sensitive modality for demonstration of features of renal TB, including tissue edema, asymmetric perinephric fat stranding, and thickening of Gerota′s fascia, all of which may be clues to focal pyelonephritis of tuberculous origin. Diffusion-weighted MR imaging with apparent diffusion coefficient (ADC values may help in differentiating hydronephrosis from pyonephrosis. ADC values also have the potential to serve as a sensitive non-invasive biomarker of renal fibrosis. Immunocompromised patients are at increased risk of renal TB. In transplant patients, renal TB, including tuberculous interstitial nephritis, is an important cause of graft dysfunction. Renal TB in patients with HIV more often shows greater parenchymal affection, with poorly formed granulomas and relatively less frequent findings of caseation and stenosis. Atypical mycobacterial infections are also more common in immunocompromised patients.

  11. Seasonality of tuberculosis

    Directory of Open Access Journals (Sweden)

    Auda Fares

    2011-01-01

    Full Text Available Objectives: This study was designed to review previous studies and analyse the current knowledge and controversies related to seasonal variability of tuberculosis (TB to examine whether TB has an annual seasonal pattern. Study Design and Methods: Systematic review of peer reviewed studies identified through literature searches using online databases belonging to PubMed and the Cochrane library with key words "Tuberculosis, Seasonal influence" and " Tuberculosis, Seasonal variation". The search was restricted to articles published in English. The references of the identified papers for further relevant publications were also reviewed. Results: Twelve studies conducted between the period 1971 and 2006 from 11 countries/regions around the world (South Western Cameroon, South Africa, India, Hong Kong, Japan, Kuwait, Spain, UK, Ireland, Russia, and Mongolia were reviewed. A seasonal pattern of tuberculosis with a mostly predominant peak is seen during the spring and summer seasons in all of the countries (except South Western Cameroon and Russia. Conclusions: The observation of seasonality leads to assume that the risk of transmission of M. tuberculosis does appear to be the greatest during winter months. Vitamin D level variability, indoor activities, seasonal change in immune function, and delays in the diagnosis and treatment of tuberculosis are potential stimuli of seasonal tuberculosis disease. Additionally, seasonal variation in food availability and food intake, age, and sex are important factors which can play a role in the tuberculosis notification variability. Prospective studies regarding this topic and other related subjects are highly recommended.

  12. Abdominal tuberculosis: Imaging features

    International Nuclear Information System (INIS)

    Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis

  13. Typical and atypical AIS. Pathogenesis.

    Science.gov (United States)

    Dudin, M; Pinchuk, D

    2012-01-01

    AIS hypothesis has the right to recognition, if it explains the transition of "healthy" vertebra column into status of "scoliotic" one. AIS is the most investigated disease in the history of orthopedics, but up the present time there is no clear explanation of some its phenomena: vertebra column mono-form deformation along with its poly etiology character, interrelation of its origin and development and child's growth process etc. The key for authors' view at AIS was scoliosis with non-standard (concave side) rotation. On the bases of its' multifunctional instrumental investigation results (Rtg, EMG, EEG, optical topography, hormonal and neuropeptides trials, thermo-vision methods and other) in comparison with typical AIS was worked out the new hypothesis, part of it is suggested for discussion. In the work under observation is the sequence of appearance of typical and atypical scoliosis symptomatology beginning from the preclinical stage. PMID:22744477

  14. Osteogenesis imperfecta: an atypical association

    Directory of Open Access Journals (Sweden)

    Snehal Mallakmir

    2015-06-01

    Full Text Available Osteogenesis Imperfecta (OI also known as and lsquo;brittle bone disease', is a clinically heterogeneous connective tissue disorder with defect in type I collagen. The more prevalent autosomal dominant forms of OI are caused by primary defects in type I collagen, while autosomal recessive forms are caused by deficiency of proteins which interact with type I procollagen for post-translational modification and/or folding. Few cases of OI associated with atypical features have been reported. We report a case of 54 days male child of OI associated with pyloric stenosis. The case probably is a form of autosomal recessive OI with severe phenotype. [Int J Res Med Sci 2015; 3(3.000: 783-785

  15. Extra pulmonary tuberculosis in a tertiary teaching hospital:A five years review

    Institute of Scientific and Technical Information of China (English)

    Siti Suraiya Md Noor; Zaidah Abdul Rahman; Sarimah Abdullah; Zakuan Zainy Deris; Che Wan Aminuddin

    2009-01-01

    Objective:To investigate the prevalence,clinical and bacteriological features and outcome of extrapulmonary tuberculosis in patients attending a tertiary care hospital at Kota Bharu,Kelantan.Methods:All culture posi-tive tuberculosis cases recorded in Hospital Universiti Sains Malaysia at Kota Bharu during five years period from 2003-2007 were included in the study.Mycobacterium detected in samples originating from sites other than lungs was considered as a case of extrapulmonary tuberculosis.Age,site of infection,bacteriological find-ings and outcomes were analyzed.Results:Out of 437 tuberculosis cases recorded from 2002-2006,59 cases had culture positive extrapulmonary tuberculosis.Their mean age was 37 years and 44% were between the ages of 20-40 years.About 63% were negative for acid-fast bacilli by Z-N stain.Of the 59,97% was Mycobacteri-um tuberculosisc (M.tuberculosis)while two (3%)were atypical Mycobacterium Runyon Group-IV.Only 3 (5%)were isoniazid resistant.Extrapulmonary sites involved were lymph nodes 19 (31%),central nervous system 12 (20%),pleural 11(19%)spine 8 (14%),renal 3 (5.1%)and others 6 (10.2%).In this se-ries,11(18%)were positive for HIV.There was no significant association between extrapulmonary tuberculo-sis and HIV status.The outcome of CNS tuberculosis was the poorest with a mortality rate of 25%.Conclu-sion:M.tuberculosis is the predominant organism in extrapulmonary tuberculosis and culture is the most effec-tive method for its diagnosis.

  16. Multidrug-resistant tuberculosis

    Directory of Open Access Journals (Sweden)

    McNerney Ruth

    2008-01-01

    Full Text Available Abstract Background With almost 9 million new cases each year, tuberculosis remains one of the most feared diseases on the planet. Led by the STOP-TB Partnership and WHO, recent efforts to combat the disease have made considerable progress in a number of countries. However, the emergence of mutated strains of Mycobacterium tuberculosis that are resistant to the major anti-tuberculosis drugs poses a deadly threat to control efforts. Multidrug-resistant tuberculosis (MDR-TB has been reported in all regions of the world. More recently, extensively drug resistant-tuberculosis (XDR-TB that is also resistant to second line drugs has emerged in a number of countries. To ensure that adequate resources are allocated to prevent the emergence and spread of drug resistance it is important to understand the scale of the problem. In this article we propose that current methods of describing the epidemiology of drug resistant tuberculosis are not adequate for this purpose and argue for the inclusion of population based statistics in global surveillance data. Discussion Whereas the prevalence of tuberculosis is presented as the proportion of individuals within a defined population having disease, the prevalence of drug resistant tuberculosis is usually presented as the proportion of tuberculosis cases exhibiting resistance to anti-tuberculosis drugs. Global surveillance activities have identified countries in Eastern Europe, the former Soviet Union and regions of China as having a high proportion of MDR-TB cases and international commentary has focused primarily on the urgent need to improve control in these settings. Other regions, such as sub-Saharan Africa have been observed as having a low proportion of drug resistant cases. However, if one considers the incidence of new tuberculosis cases with drug resistant disease in terms of the population then countries of sub-Saharan Africa have amongst the highest rates of transmitted MDR-TB in the world. We propose

  17. Primary hepatic tuberculosis mimicking intrahepatic cholangiocarcinoma: report of two cases

    Science.gov (United States)

    2015-01-01

    Hepatic tuberculosis (TB) is usually associated with pulmonary or miliary TB, but primary hepatic TB is very uncommon even in countries with high prevalence of TB. The clinical manifestation of primary hepatic TB is atypical and imaging modalities are unhelpful for differential diagnosis of the liver mass. Image-guided needle biopsy is the best diagnostic method for primary hepatic TB. In the cases presented here, we did not perform liver biopsy because we believed the liver masses were cholangiocarcinoma, but primary hepatic TB was ultimately confirmed by postoperative pathology. Here we report two cases of patients who were diagnosed with primary hepatic TB mimicking mass-forming intrahepatic cholangiocarcinoma. PMID:26236700

  18. Peritoneal tuberculosis: radiographic diagnosis

    Directory of Open Access Journals (Sweden)

    Carolina Ospina-Moreno

    2014-12-01

    Full Text Available Peritoneal tuberculosis (TB is an extrapulmonary form of presentation of tuberculosis. HIV infection is a primary risk factor for this condition. Diagnosis requires microbiological or histopathological confirmation in addition to supporting radiological imaging studies. Abdominal ultrasonography and CT are useful to obtain a radiographic diagnosis, with typical findings including diffuse peritoneal thickening, presence of ascites in varying volumes, adenopathies, and caseating nodes. We report 2 cases of patients with ascites and nodular peritoneal thickening on diagnostic images, as well as high CA-125 levels in laboratory tests. In both patients, a diagnosis of peritoneal tuberculosis was reached following a US-guided peritoneal biopsy.

  19. Atypical imaging appearances of intracranial meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    O' Leary, S. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom); Adams, W.M. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom); Parrish, R.W. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom); Mukonoweshuro, W. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom)]. E-mail: William.mukonoweshuro@phnt.swest.nhs.uk

    2007-01-15

    Meningiomas are the commonest primary, non-glial intracranial tumours. The diagnosis is often correctly predicted from characteristic imaging appearances. This paper presents some examples of atypical imaging appearances that may cause diagnostic confusion.

  20. [Muscle-skeletal pain].

    Science.gov (United States)

    Vygonskaya, M V; Filatova, E G

    2016-01-01

    The paper is devoted to the most complicated aspects of low back pain. The differences between specific and nonspecific low back pain using the "red flags" system is highlighted. The authors consider the causes of pain chronification (the "yellow flags" system) and the necessity of using a biopsychosocial model. Main pathogenetic mechanisms of chronic muscle/skeletal pain are considered and the possible involvement of several mechanism in the pathogenesis of chronic pain as well as the use of complex therapy is discussed. The high efficacy and safety of ketorolac in treatment of nonspecific muscle/skeletal pain is demonstrated. PMID:27042717

  1. ATYPICAL ANTIPSYCHOTICS FROM SCRATCH TO THE PRESENT

    Directory of Open Access Journals (Sweden)

    Ashish Chauhan*, Amit Mittal, Pradeep Kumar Arora

    2013-01-01

    Full Text Available Mental illness constitutes the second-largest disease burden in the United States. Psychosis is one of the most common and severe mental illnesses. It is an extremely devastating condition characterised by delusions, hallucinations, distortion of thoughts and deteriorating social functioning experiences. Psychosis in all human societies has approximately same incidence of occurrence as in accordance to “anthropo-parity principle.” It has large economic impact on various aspects of cognition, health, and quality of life which has devastated effects on its sufferers and facing them large economic burden. Psychosis (Schizophrenia is associated with an imbalance of the dopaminergic system, entailing hyper-stimulation of dopamine function in the brain, particularly in the mesolimbic pathway. Consequences of antipsychotic treatment are far reaching and expensive. Detrimental extrapyramidal side effects associated with conventional antipsychotics and non-compliance among patients limits long term treatment with conventional antipsychotics. It gives rise to a new class, atypical antipsychotics owning low propensity to cause EPS, efficacy against refractory cases and better control over negative symptoms, better tolerance and compliance along with lower relapse rate and safer adverse effect profile. Atypical antipsychotics have revolutionized the treatment of psychosis, now being the treatment of choice for patients with psychosis. The positive therapeutic experience with the atypical antipsychotics in the treatment of psychosis and their favourable effects outweighs their unfavourable adverse effects. Though atypical antipsychotics are widely prescribed in the treatment of schizophrenia, however not a single atypical antipsychotic drug having any exceptional efficacy and safety profile. Thus, there is still a lot of research needed to be carried out in the development of novel atypical antipsychotics. This review is comprehensive appraisal about

  2. Surgical Options for Atypical Facial Pain Syndromes.

    Science.gov (United States)

    Rahimpour, Shervin; Lad, Shivanand P

    2016-07-01

    Atypical neuropathic facial pain is a syndrome of intractable and unremitting facial pain that is secondary to nociceptive signaling in the trigeminal system. These syndromes are often recalcitrant to pharmacotherapy and other common interventions, including microvascular decompression and percutaneous procedures. Herein, the authors present two other viable approaches (nucleus caudalis dorsal root entry zone lesioning and motor cortex stimulation), their indications, and finally a possible treatment algorithm to consider when assessing patients with atypical facial pain. PMID:27325003

  3. Interventional trials in atypical parkinsonism.

    Science.gov (United States)

    Eschlböck, S; Krismer, F; Wenning, G K

    2016-01-01

    Atypical parkinson disorders (APD) are rapidly progressive neurodegenerative diseases with a variable clinical presentation that may even mimic Parkinson's disease. Multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are commonly summarized under this umbrella term. Significant developments in research have expanded knowledge and have broadened available symptomatic treatments, particularly for the treatment of neurogenic orthostatic hypotension. Nonetheless, symptomatic support still remains limited in all of these disorders. Currently, there exists no effective treatment to delay disease progression and disease-modifying trials have failed to provide coherent and convincing results. Recent trials of rasagiline (in MSA), rifampicin (in MSA), tideglusib (in PSP) and davunetide (in PSP) reported negative results. Nevertheless, large cohorts of patients were recruited for interventional studies in the last few years which improved our understanding of trial methodology in APDs immensely. In addition, remarkable progress in basic research has been reported recently and will provide a solid foundation for future therapeutic trials. In this review, we will summarize published randomized, placebo-controlled clinical trials (RCTs) in APDs. Additionally, the design of ongoing and unpublished interventions will be presented. PMID:26421389

  4. Atypical presentations of neuromyelitis optica

    Directory of Open Access Journals (Sweden)

    Douglas Sato

    2011-10-01

    Full Text Available Neuromyelitis optica (NMO is an inflammatory disease of central nervous system classically characterized by acute, severe episodes of optic neuritis and longitudinally extensive transverse myelitis, usually with a relapsing course. The identification of an autoantibody exclusively detected in NMO patients against aquaporin-4 (AQP-4 has allowed identification of cases beyond the classical phenotype. Brain lesions, once thought as infrequent, can be observed in NMO patients, but lesions have different characteristics from the ones seen in multiple sclerosis. Additionally, some AQP-4 antibody positive patients may present with a variety of symptoms not being restricted to optic neuritis and acute myelitis during the first attack or in a relapse. Examples are not limited to, but may include patients only with brain and/or brainstem lesions, narcolepsy with hypothalamic lesions or patients with intractable hiccups, nausea and vomiting. The prompt identification of NMO patients with atypical presentations may benefit these patients with institution of early treatment to reduce disability and prevent further attacks.

  5. Tuberculosis Endometrial Polyp

    Directory of Open Access Journals (Sweden)

    Julien Seror

    2013-01-01

    Full Text Available Tuberculosis can cause infertility when it infects the genital tract (e.g., endometritis. A 31-year-old woman (origin: Algeria was referred to our academic gynecological institute for unexplained primary infertility. The patient presented with no complaint. Hysteroscopy showed a 10 mm sized endometrial polyp. The polyp was removed. Pathology showed lymphocytic and plasmacytic chronic inflammatory modification, granulomatous modification, and gigantocellular modification,which lead to the diagnosis of tuberculosis. No acid fast organism was seen on Ziehl-Neelsen staining. A chest thorax X-ray revealed no sign of pulmonary tuberculosis. The patient underwent antituberculosis therapy during one year. Posttreatment hysteroscopy revealed no abnormality. This is the first reported case of endometrial tuberculosis diagnosed following removal of a polyp with classical benign appearance.

  6. Update on cutaneous tuberculosis.

    Science.gov (United States)

    Dias, Maria Fernanda Reis Gavazzoni; Bernardes Filho, Fred; Quaresma, Maria Victória; Nascimento, Leninha Valério do; Nery, José Augusto da Costa; Azulay, David Rubem

    2014-01-01

    Tuberculosis continues to draw special attention from health care professionals and society in general. Cutaneous tuberculosis is an infection caused by M. tuberculosis complex, M. bovis and bacillus Calmette-Guérin. Depending on individual immunity, environmental factors and the type of inoculum, it may present varied clinical and evolutionary aspects. Patients with HIV and those using immunobiological drugs are more prone to infection, which is a great concern in centers where the disease is considered endemic. This paper aims to review the current situation of cutaneous tuberculosis in light of this new scenario, highlighting the emergence of new and more specific methods of diagnosis, and the molecular and cellular mechanisms that regulate the parasite-host interaction. PMID:25387498

  7. Update on cutaneous tuberculosis*

    Science.gov (United States)

    Dias, Maria Fernanda Reis Gavazzoni; Bernardes Filho, Fred; Quaresma, Maria Victória; do Nascimento, Leninha Valério; Nery, José Augusto da Costa; Azulay, David Rubem

    2014-01-01

    Tuberculosis continues to draw special attention from health care professionals and society in general. Cutaneous tuberculosis is an infection caused by M. tuberculosis complex, M. bovis and bacillus Calmette-Guérin. Depending on individual immunity, environmental factors and the type of inoculum, it may present varied clinical and evolutionary aspects. Patients with HIV and those using immunobiological drugs are more prone to infection, which is a great concern in centers where the disease is considered endemic. This paper aims to review the current situation of cutaneous tuberculosis in light of this new scenario, highlighting the emergence of new and more specific methods of diagnosis, and the molecular and cellular mechanisms that regulate the parasite-host interaction. PMID:25387498

  8. NNDSS - Table IV. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table IV. Tuberculosis - 2016.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  9. NNDSS - Table IV. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table IV. Tuberculosis - 2015.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  10. NNDSS - Table IV. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table IV. Tuberculosis - 2014.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  11. Multidrug-resistant tuberculosis

    Directory of Open Access Journals (Sweden)

    Álvarez-Gaviria Manuel

    2013-06-01

    Full Text Available Introduction: tuberculosis is an increasing problem of global health and the microbialdrug resistance a generating element of worry.Clinical case: 19 year-old patient, who admitted to the emergency room for presentinghemoptysis and who had history of pulmonary tuberculosis with irregular treatment.Multidrug-resistant tuberculosis was documented and different strategies of availablemedical treatment were considered. Due to the increased epidemiological risk and thehistory of poor adherence to the treatment, an in-hospital treatment was carried outwith a satisfactory response.Conclusion: multidrug-resistant tuberculosis is a social risk, keeping the route oftransmission of the disease. Rev.cienc.biomed. 2013;4(1:159-164RESUMEN:Introducción: la tuberculosis (TB pulmonar es un problema creciente de saludmundial y la resistencia a los antibióticos un elemento de preocupación.Caso clínico: paciente de 19 años, quien ingresó al servicio de urgencias por presentarhemoptisis. Antecedente de TB con tratamiento irregular. Se documentó resistenciaa varios medicamentos. Se consideraron las diferentes estrategias de tratamientodisponible. Debido al elevado riesgo epidemiológico y la historia de pobre adherencia altratamiento, se realizó manejo intrahospitalario con respuesta satisfactoria.Conclusiones: la tuberculosis multirresistente (MDR-TB representa un riesgo parala comunidad, teniendo en cuenta la vía de transmisión de la entidad. Rev.cienc.biomed. 2013;4(1:159-164

  12. Correlation of immunologic status with high-resolution CT and distributions of pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Purpose: To investigate the correlation of cluster of differentiation (CD)4 lymphocyte counts with high-resolution CT (HRCT) findings and distribution of pulmonary tuberculosis. Material and Methods: Thirty-seven bacteriologically proven pulmonary tuberculosis, clinically non-AIDS, patients underwent HRCT and CD4 lymphocyte counts in peripheral blood cells were obtained within 3 days after the CT examinations. Patients were categorized into four groups according to CD4 lymphocyte counts (A >800; B 800-500; C 500-200; D <200). HRCT findings analyzed were as follows: typical, atypical, and mixed findings of post-primary tuberculosis, common, uncommon, and mixed distribution, and number of lobes involved. Results: CD4 lymphocyte counts correlated with the degree of the mixture of atypical CT findings (=0.565, p<0.001) and the degree of the mixture of uncommon distribution (=0.431, p<0.01). Number of involved lobes showed no statistically significant correlation (=0.209, p=0.21). Conclusion: In patients with low CD4 levels, atypical HRCT findings co-exist with typical findings, and uncommon sites are involved in addition to common sites

  13. The skeletal system

    NARCIS (Netherlands)

    Nikkels, PGJ

    2015-01-01

    Skeletal dysplasias are a group of disorders with a disturbance in development and/or growth of cartilage and/or bone. Epiphysis, metaphysis, and diaphysis of long bones are affected in a generalized manner with or without involvement of membranous bone of the skull. A dysostosis affects one or some

  14. Update on Veterinary Tuberculosis Vaccines

    Science.gov (United States)

    Educational Objective: At the conclusion of this presentation, the participant will know the current status of veterinary tuberculosis vaccine research and development, and understand the challenges which remain for the future introduction of tuberculosis vaccines intended for wildlife and livestock...

  15. Tuberculosis: Getting Healthy, Staying Healthy

    Science.gov (United States)

    Tuberculosis Getting Healthy, Staying Healthy U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Allergy and Infectious Diseases Tuberculosis Getting Healthy, Staying Healthy U.S. DEPARTMENT OF HEALTH ...

  16. Growth of Mycobacterium tuberculosis Biofilms

    OpenAIRE

    Kulka, Kathleen; Hatfull, Graham; Ojha, Anil K.

    2012-01-01

    Mycobacterium tuberculosis, the etiologic agent of human tuberculosis, has an extraordinary ability to survive against environmental stresses including antibiotics. Although stress tolerance of M. tuberculosis is one of the likely contributors to the 6-month long chemotherapy of tuberculosis 1, the molecular mechanisms underlying this characteristic phenotype of the pathogen remain unclear. Many microbial species have evolved to survive in stressful environments by self-assembling in highly o...

  17. Perinatal tuberculosis: a diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Edna Lúcia S. de Souza

    2006-06-01

    Full Text Available Despite the high prevalence of tuberculosis in adults and children, the congenital and perinatal forms of tuberculosis are rare. In Brazil, there has been only one published case of congenital tuberculosis and two cases of the perinatal form of this disease. We report a case of perinatal tuberculosis presenting with pneumonia. Alcohol-acid-resistant bacilli were found in the gastric lavage. Diagnosis of this disease presentation requires a high index of suspicion.

  18. Imaging of Esophageal Tuberculosis

    International Nuclear Information System (INIS)

    Purpose: To evaluate the various radiological abnormalities in patients with proven esophageal tuberculosis. Material and Methods: The case records of 23 patients with proven esophageal tuberculosis were evaluated retrospectively for various radiological abnormalities. Twenty-two patients had secondary involvement of esophagus in the form of direct extension of mediastinal and pulmonary tuberculosis or spinal tuberculosis. Only 1 patient had primary involvement of the esophagus with no evidence of disease elsewhere. The diagnosis was confirmed by endoscopic and CT-guided biopsy/aspiration cytology in 7 and 6 cases, respectively. Diagnosis was made on the basis of surgical biopsy of lymph node and autopsy in 1 patient each. In the remaining 8 patients the diagnosis was based on radiological and endoscopic findings and the response to antituberculous treatment. Results: Chest radiography (CXR) was abnormal in 65% patients. While the findings were non-conclusive for esophageal tuberculosis, characteristic lesions of tuberculosis in lungs or spine were suggestive of tuberculous etiology. In 15 patients, CT of the chest confirmed the corresponding CXR findings and also showed additional findings of mediastinal lymphadenopathy when CXR was normal. Fourteen patients showed mediastinal lymphadenopathy on CT of the chest. In all these patients, more than one group of lymph nodes was involved. The characteristic hypodense center of lymph nodes suggestive of tuberculosis was seen in 12 patients. Radiological abnormalities seen in barium swallow examination were extrinsic compression, traction diverticula, strictures, sinus/fistulous tracts, kinking and pseudotumor mass of esophagus in decreasing order of frequency. The middle third of the esophagus was found to be the most frequent site of involvement

  19. [Tuberculosis in compromised hosts].

    Science.gov (United States)

    2003-11-01

    Recent development of tuberculosis in Japan tends to converge on a specific high risk group. The proportion of tuberculosis developing particularly from the compromised hosts in the high risk group is especially high. At this symposium, therefore, we took up diabetes mellitus, gastrectomy, dialysis, AIDS and the elderly for discussion. Many new findings and useful reports for practical medical treatment are submitted; why these compromised hosts are predisposed to tuberculosis, tuberculosis diagnostic and remedial notes of those compromised hosts etc. It is an important question for the future to study how to prevent tuberculosis from these compromised hosts. 1. Tuberculosis in diabetes mellitus: aggravation and its immunological mechanism: Kazuyoshi KAWAKAMI (Department of Internal Medicine, Division of Infectious Diseases, Graduate School and Faculty of Medicine, University of the Ryukyus). It has been well documented that diabetes mellitus (DM) is a major aggravating factor in tuberculosis. The onset of this disease is more frequent in DM patients than in individuals with any underlying diseases. However, the precise mechanism of this finding remains to be fully understood. Earlier studies reported that the migration, phagocytosis and bactericidal activity of neutrophils are all impaired in DM patients, which is related to their reduced host defense to infection with extracellular bacteria, such as S. aureus and E. colli. Host defense to mycobacterial infection is largely mediated by cellular immunity, and Th1-related cytokines, such as IFN-gamma and IL-12, play a central role in this response. It is reported that serum level of these cytokines and their production by peripheral blood mononuclear cells (PBMC) are reduced in tuberculosis patients with DM, and this is supposed to be involved in the high incidence of tuberculosis in DM. Our study observed similar findings and furthermore indicated that IFN-gamma and IL-12 production by BCG-stimulated PBMC was lower

  20. Tobacco smoking and pulmonary tuberculosis

    OpenAIRE

    Kolappan, C.; Gopi, P

    2002-01-01

    Background: The prevalence of tuberculosis in adult men in India is 2–4 times higher than in women. Tobacco smoking is prevalent almost exclusively among men, so it is possible that tobacco smoking may be a risk factor for developing pulmonary tuberculosis. A nested case control study was carried out to study the association between tobacco smoking and pulmonary tuberculosis.

  1. Imaging features of extraaxial musculoskeletal tuberculosis

    International Nuclear Information System (INIS)

    Tuberculosis (TB) continues to be a public health problem in both developing and industrialized countries. TB can involve pulmonary as well as extrapulmonary sites. The musculoskeletal system is involved in 1–3% of patients with tuberculosis. Although musculoskeletal TB has become uncommon in the Western world, it remains a huge problem in Asia, Africa, and many developing countries. Tuberculous spondylitis is the most common form of musculoskeletal TB and accounts for approximately 50% of cases. Extraspinal musculoskeletal TB shows a predilection for large joints (hip and knee) and para-articular areas; isolated soft tissue TB is extremely rare. Early diagnosis and prompt treatment are mandatory to prevent serious destruction of joints and skeletal deformity. However, due to the nonspecific and often indolent clinical presentation, the diagnosis may be delayed. Radiological assessment is often the first step in the diagnostic workup of patients with musculoskeletal TB and further investigations are decided by the findings on radiography. Both the radiologist and the clinician should be aware of the possibility of this diagnosis. In this manuscript we review the imaging features of extraspinal bone, joint, and soft tissue TB

  2. Tuberculosis of the spine radiological imaging. Case report

    International Nuclear Information System (INIS)

    Skeletal tuberculosis constitutes 1-3% of all cases of tuberculosis and involves the spine in up to 50% of cases, most commonly the thoracolumbar spine. The purpose of this article is to review the case of a 47-year-old man who complained of back pain, weakness of muscles and weight loss. He was examined with conventional anteriorposterior and lateral X-rays of thoracic spine, computed tomography (CT) and magnetic resonance imaging. Radiological imaging suggested tubercolosis of the spine. The authors present the imaging procedures applied to diagnose this case. Conventional radiography was used as the first basic examination. Computed tomography (CT) and magnetic resonance imaging (MR) were used as complementary methods. The final diagnosis was based on a biopsy of the bone. The definite diagnosis is required to adequate treatment. In some cases surgical treatment is used. (author)

  3. Mycolic Acids as Markers of Osseous Tuberculosis in the Neolithic Skeleton from Kujawy Region (Central Poland

    Directory of Open Access Journals (Sweden)

    Borowska-Strugiń Beata

    2014-07-01

    Full Text Available The subject of analysis is the male skeleton from a double burial of the Globular Amphora Culture, derived from the Neolithic site at Brześć Kujawski in Kujawy region (central Poland. Within the spine of the individual advanced lesions are observed (destruction of the vertebral bodies, symptoms of the periostitis in the thoracic region which are characteristic of skeletal tuberculosis. To check whether the observed morphological changes resulted from infection with Mycobacterium tuberculosis (M.tb, the bone material was tested positively for the presence of mycolic acids, the specific components of the cell wall of pathogenic M.tb bacilli, by mass spectrometry.

  4. Clinical Presentation of Atypical Genital Herpes

    Institute of Scientific and Technical Information of China (English)

    李俊杰; 梁沛杨; 罗北京

    2002-01-01

    Objective: To make a clinical analysis on the basis of 36cases of atypical genital herpes (GH) patients. Methods: Thirty-six cases of atypical GH were diagnosedclinically, and their case histories, symptoms and signs wererecorded in detail and followed up. Polymerase chain reaction(PCR) was adopted for testing HSV2-DNA with cotton-tippedswabs. Enzyme-linked immuno sorbent assay (ELISA) forserum anti-HSV2-IgM was done to establish a definfiivediagnosis. Other diagnoses were excluded at the same time bytesting for related pathogens including fungi, Chlamydia,Mycoplasma, Treponema pallidum, gonococci, Trichomonas,etc. Results: The main clinical manifestations of atypical GHwere: (1) small genital ulcers; (2) inflammation of urethralmeatus; (3) nonspecific genital erythema; (4) papuloid noduleson the glands; (5) nonspecific vaginitis. Twenty-three cases(64%) tested by PCR were HSV2-DNA sera-positive, and 36cases (100 %) anti-HSV2-IgM sera-positive by ELISA. Conclusion: atypical HSV is difficult to be diagnosed. Butthe combination of PCR and ELIAS will be helpful to thediagnosis of atypical HSV.

  5. Tuberculosis in ancient times

    Directory of Open Access Journals (Sweden)

    Louise Cilliers

    2008-09-01

    Full Text Available In spite of an array of effective antibiotics, tuberculosis is still very common in developing countries where overcrowding, malnutrition and poor hygienic conditions prevail. Over the past 30 years associated HIV infection has worsened the situation by increasing the infection rate and mortality of tuberculosis. Of those diseases caused by a single organism only HIV causes more deaths internationally than tuberculosis. The tubercle bacillus probably first infected man in Neolithic times, and then via infected cattle, but the causative Mycobacteriacea have been in existence for 300 million years. Droplet infection is the most common way of acquiring tuberculosis, although ingestion (e.g. of infected cows’ milk may occur. Tuberculosis probably originated in Africa. The earliest path gnomonic evidence of human tuberculosis in man was found in osteo-archaeological findings of bone tuberculosis (Pott’s disease of the spine in the skeleton of anEgyptian priest from the 21st Dynasty (approximately 1 000 BC. Suggestive but not conclusiveevidence of tuberculotic lesions had been found in even earlier skeletons from Egypt and Europe. Medical hieroglyphics from ancient Egypt are silent on the disease, which could be tuberculosis,as do early Indian and Chinese writings. The Old Testament refers to the disease schachapeth, translated as phthisis in the Greek Septuagint. Although the Bible is not specific about this condition, tuberculosis is still called schachapeth in modern Hebrew. In pre-Hippocratic Greece Homer did not mention phthisis, a word meaning non-specific wasting of the body. However. Alexander of Tralles (6th century BC seemed to narrow the concept down to a specific disease, and in the Hippocratic Corpus (5th-4th centuries BC phthisis can be recognised as tuberculosis. It was predominantly a respiratory disease commonly seen and considered to be caused by an imbalance of bodily humours. It was commonest in autumn, winter and spring

  6. Multifocal tuberculosis of long bones in an immunocompetent child.

    Science.gov (United States)

    Baghdadi, Taghi; Shirazi, Mehdi Ramezan; Daneshjoo, Khadijeh

    2016-05-01

    Although tuberculosis (TB) is prevalent in many parts of the world, multifocal TB involvement of bones is rare. It is believed that less than 5% of skeletal TB is multifocal. We report a case of multifocal TB of long bones in an immunocompetent child. We describe the radiological and diagnostic features of TB osteomyelitis and outline its therapy and prognosis. To the best of the authors' knowledge, such a case with multiple long bone involvement without articular sequel and visceral involvement/constitutional symptoms has not been reported previously in the literature. PMID:26600081

  7. CT appearances of abdominal tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, W.-K., E-mail: leewk33@hotmail.com [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Van Tonder, F.; Tartaglia, C.J.; Dagia, C. [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Cazzato, R.L. [Department of Radiology, Universita Campus Bio-Medico di Roma, Rome (Italy); Duddalwar, V.A. [Department of Radiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California (United States); Chang, S.D. [Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia (Canada)

    2012-06-15

    The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

  8. CT appearances of abdominal tuberculosis

    International Nuclear Information System (INIS)

    The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

  9. Skeletal parallel programming

    OpenAIRE

    Saez, Fernando; Printista, Alicia Marcela; Piccoli, María Fabiana

    2007-01-01

    In the last time the high-performance programming community has worked to look for new templates or skeletons for several parallel programming paradigms. This new form of programming allows to programmer to reduce the time of development, since it saves time in the phase of design, testing and codification. We are concerned in some issues of skeletons that are fundamental to the definition of any skeletal parallel programming system. This paper present commentaries about these issues in the c...

  10. Reversibility of skeletal fluorosis.

    OpenAIRE

    Grandjean, P; Thomsen, G

    1983-01-01

    At two x ray examinations in 1957 and 1967, 17 cases of skeletal fluorosis were identified among long term cryolite workers in Copenhagen. In 1982 four of these patients were alive, eight to 15 years after exposure had ended. Radiographs were obtained, and the urinary fluoride excretion was measured. A similar picture emerged in all four cases: extensive fading of the sclerosis of trabecular bone in ribs, vertebral bodies, and pelvis, whereas cortical bone thickening and calcification of musc...

  11. Skeletal (stromal) stem cells

    DEFF Research Database (Denmark)

    Abdallah, Basem M; Kermani, Abbas Jafari; Zaher, Walid;

    2015-01-01

    Skeletal (marrow stromal) stem cells (BMSCs) are a group of multipotent cells that reside in the bone marrow stroma and can differentiate into osteoblasts, chondrocytes and adipocytes. Studying signaling pathways that regulate BMSC differentiation into osteoblastic cells is a strategy for....../preadipocyte factor 1 (Dlk1/Pref-1), the Wnt co-receptor Lrp5 and intracellular kinases. This article is part of a Special Issue entitled: Stem Cells and Bone....

  12. HIV-Tuberculosis: A Study of Chest X-Ray Patterns in Relation to CD4 Count

    Directory of Open Access Journals (Sweden)

    Mahesha Padyana

    2012-01-01

    Full Text Available Background : Fight against human immunodeficiency virus (HIV is incomplete without addressing problems associated with difficult diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients. Chest X-ray is a primary tool to evaluate tuberculosis in HIV. Aim: To assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients and compare these patterns in relation to CD4 counts. Materials and Methods : Prospective cohort study was conducted in a tertiary hospital in South India from September 2009 to July 2011 with 200 HIV positive patients. WHO guidelines were used for diagnosis of HIV and tuberculosis. Results : 27% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (33% among CD4 less than 200 as compared to CD4 more than 200 (14%. Infiltration (39% followed by consolidation (30%, cavity (11%, and lymphadenopathy (9% seen with CD4 less than 200. Infiltration (37.5% followed by cavity (25% and miliary (25% with CD4 above 200. Bilateral (68.5% and mid and lower zones or all zone involvement more commonly seen. Conclusion : In patients with CD4 lower than 200 noncavitory infiltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIV positive patients.

  13. [Tuberculosis and immigration].

    Science.gov (United States)

    Salas-Coronas, Joaquín; Rogado-González, M Cruz; Lozano-Serrano, Ana Belén; Cabezas-Fernández, M Teresa

    2016-04-01

    The incidence of tuberculosis worldwide is declining. However, in Western countries this decline is slower due to the impact of immigration. Tuberculosis in the immigrant population is related to health status in the country of origin and with overcrowding and poverty conditions in the host country. Immigrants with tuberculosis are younger, have a higher prevalence of extrapulmonary forms, greater proportion of drug resistance and higher treatment default rates than those of natives. New molecular techniques not only reduce diagnostic delay time but also allow the rapid identification of resistances and improve knowledge of transmission patterns. It is necessary to implement measures to improve treatment compliance in this population group like facilitating access to health card, the use of fixed-dose combination drugs, the participation of cultural mediators and community health workers and gratuity of drugs. PMID:26851978

  14. Tuberculosis and HIV Coinfection.

    Science.gov (United States)

    Bruchfeld, Judith; Correia-Neves, Margarida; Källenius, Gunilla

    2015-07-01

    Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) constitute the main burden of infectious disease in resource-limited countries. In the individual host, the two pathogens, Mycobacterium tuberculosis and HIV, potentiate one another, accelerating the deterioration of immunological functions. In high-burden settings, HIV coinfection is the most important risk factor for developing active TB, which increases the susceptibility to primary infection or reinfection and also the risk of TB reactivation for patients with latent TB. M. tuberculosis infection also has a negative impact on the immune response to HIV, accelerating the progression from HIV infection to AIDS. The clinical management of HIV-associated TB includes the integration of effective anti-TB treatment, use of concurrent antiretroviral therapy (ART), prevention of HIV-related comorbidities, management of drug cytotoxicity, and prevention/treatment of immune reconstitution inflammatory syndrome (IRIS). PMID:25722472

  15. Skeletal surveys in multiple myeloma

    International Nuclear Information System (INIS)

    Thirty-three patients with multiple myeloma were studied with serial skeletal surveys, serum immunoglobulin levels, and postabsorptive urinary hydroxyproline (Spot-HYPRO) determinations. Twenty receiving chemotherapy were also followed with skeletal surveys in order to evaluate bone response to treatment. A close association was found between skeletal findings and changes in immunoglubulin levels with positive correlation in 71% of the patients. A similar association was found between skeletal disease and Spot-HYPRO level changes in 65%. Five of 12 patients (42%) with partial or complete clinical response to chemotherapy, demonstrated improvement in the appearance of skeletal lesions. Positive correlation between the roentgenographic changes and clinical markers of myeloma as well as therapeutic response, indicates that skeletal surveys are useful and effective in monitoring patients with multiple myeloma. (orig.)

  16. The Bandim tuberculosis score

    DEFF Research Database (Denmark)

    Rudolf, Frauke; Joaquim, Luis Carlos; Vieira, Cesaltina;

    2013-01-01

    Background: This study was carried out in Guinea-Bissau's capital Bissau among inpatients and outpatients attending for tuberculosis (TB) treatment within the study area of the Bandim Health Project, a Health and Demographic Surveillance Site. Our aim was to assess the variability between 2...... physicians in performing the Bandim tuberculosis score (TBscore), a clinical severity score for pulmonary TB (PTB), and to compare it to the Karnofsky performance score (KPS). Method: From December 2008 to July 2009 we assessed the TBscore and the KPS of 100 PTB patients at inclusion in the TB cohort and...

  17. Genetics Home Reference: atypical hemolytic-uremic syndrome

    Science.gov (United States)

    ... the genes associated with atypical hemolytic-uremic syndrome C3 CD46 CFB CFH CFHR5 CFI THBD Related Information ... Manual Consumer Version: Thrombocytopenia Merck Manual Professional Version: Complement System Orphanet: Atypical hemolytic-uremic syndrome Patient Support ...

  18. Atypical MRI appearance of desmoplastic infantile ganglioglioma

    International Nuclear Information System (INIS)

    We report the atypical MRI features and histopathological findings of a desmoplastic infantile ganglioglioma in an 8-year-old girl. The mass was predominantly solid with a large, solid, non-enhancing exophytic component. The adjacent brain showed cortical necrosis and white-matter gliosis, suggesting earlier hypoxia. (orig.)

  19. Atypical pyoderma gangrenosum mimicking an infectious process.

    Science.gov (United States)

    To, Derek; Wong, Aaron; Montessori, Valentina

    2014-01-01

    We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics. PMID:25024856

  20. Atypical Pyoderma Gangrenosum Mimicking an Infectious Process

    Directory of Open Access Journals (Sweden)

    Derek To

    2014-01-01

    Full Text Available We present a patient with atypical pyoderma gangrenosum (APG, which involved the patient’s arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics.

  1. Disentangling the Emerging Evidence around Atypical Fractures

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Clark, Emma M

    2012-01-01

    Atypical femur fractures are rare but a growing concern, as they are more common in patients who use bisphosphonates. The best radiology-based studies have had access to only short-term exposure data, while the studies using prescription databases with substantial long-term data did not have access...

  2. Atypical manifestation of dural arteriovenous fistula.

    Directory of Open Access Journals (Sweden)

    Tripathi R

    2002-01-01

    Full Text Available A case of secondary dural arteriovenous fistula presenting as infantile stroke, in a fifteen month old boy, is reported. The initial impression on CT scan in this case was misleading, due to the atypical appearance of the pathological periventricular blood vessels, interpreted as periventricular calcification.

  3. Observing Behavior and Atypically Restricted Stimulus Control

    Science.gov (United States)

    Dube, William V.; Dickson, Chata A.; Balsamo, Lyn M.; O'Donnell, Kristin Lombard; Tomanari, Gerson Y.; Farren, Kevin M.; Wheeler, Emily E.; McIlvane, William J.

    2010-01-01

    Restricted stimulus control refers to discrimination learning with atypical limitations in the range of controlling stimuli or stimulus features. In the study reported here, 4 normally capable individuals and 10 individuals with intellectual disabilities (ID) performed two-sample delayed matching to sample. Sample-stimulus observing was recorded…

  4. Infant Perception of Atypical Speech Signals

    Science.gov (United States)

    Vouloumanos, Athena; Gelfand, Hanna M.

    2013-01-01

    The ability to decode atypical and degraded speech signals as intelligible is a hallmark of speech perception. Human adults can perceive sounds as speech even when they are generated by a variety of nonhuman sources including computers and parrots. We examined how infants perceive the speech-like vocalizations of a parrot. Further, we examined how…

  5. Atypical Pyoderma Gangrenosum Mimicking an Infectious Process

    OpenAIRE

    Derek To; Aaron Wong; Valentina Montessori

    2014-01-01

    We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics.

  6. Atypical fractures on long term bisphosphonates therapy.

    LENUS (Irish Health Repository)

    Hussein, W

    2011-01-01

    Bisphosphonates reduce fractures risk in patients with osteoporosis. A new pattern of fractures is now being noted in patients on prolonged bisphosphonate therapy. We report a case of an atypical femoral fracture with preceding pain and highlight the characteristics of these fractures.

  7. Cohort study of atypical pressure ulcers development.

    Science.gov (United States)

    Jaul, Efraim

    2014-12-01

    Atypical pressure ulcers (APU) are distinguished from common pressure ulcers (PU) with both unusual location and different aetiology. The occurrence and attempts to characterise APU remain unrecognised. The purpose of this cohort study was to analyse the occurrence of atypical location and the circumstances of the causation, and draw attention to the prevention and treatment by a multidisciplinary team. The cohort study spanned three and a half years totalling 174 patients. The unit incorporates two weekly combined staff meetings. One concentrates on wound assessment with treatment decisions made by the physician and nurse, and the other, a multidisciplinary team reviewing all patients and coordinating treatment. The main finding of this study identified APU occurrence rate of 21% within acquired PU over a three and a half year period. Severe spasticity constituted the largest group in this study and the most difficult to cure wounds, located in medial aspects of knees, elbows and palms. Medical devices caused the second largest occurrence of atypical wounds, located in the nape of the neck, penis and nostrils. Bony deformities were the third recognisable atypical wound group located in shoulder blades and upper spine. These three categories are definable and time observable. APU are important to be recognisable, and can be healed as well as being prevented. The prominent role of the multidisciplinary team is primary in identification, prevention and treatment. PMID:23374746

  8. Non-diabetic atypical necrobiosis lipoidica

    Directory of Open Access Journals (Sweden)

    Mittal R

    1994-01-01

    Full Text Available One 8 year female child had asymptomatic, anaesthetic, hypohidrotic, atrophic, yellowish, waxy plaque on the front of left thigh since 2 months. No nerve thickening was observed clinically or histopathologically. Hyperkeratosis, follicular keratosis, epidermal atrophy, degeneration of collagen, mononuclear granulomas and perivascular mononuclear infiltrate confirmed the clinical diagnosis of atypical necrobiosis lipoidica.

  9. Psychiatric syndromes associated with atypical chest pain

    Directory of Open Access Journals (Sweden)

    Nikolić Gordana

    2010-01-01

    Full Text Available Background/Aim. Chest pain often indicates coronary disease, but in 25% of patients there is no evidence of ischemic heart disease using standard diagnostic tests. Beside that, cardiologic examinations are repeated several times for months. If other medical causes could not be found, there is a possibility that chest pain is a symptom of psychiatric disorder. The aim of this study was to determine the presence of psychiatric syndromes, increased somatization, anxiety, stress life events exposure and characteristic of chest pain expression in persons with atypical chest pain and coronary patients, as well as to define predictive parameters for atypical chest pain. Method. We compared 30 patients with atypical chest pain (E group to 30 coronary patients (K group, after cardiological and psychiatric evaluation. We have applied: Mini International Neuropsychiatric Interview (MINI, The Symptom Checklist 90-R (SCL-90 R, Beck Anxiety Inventory (BAI, Holms-Rahe Scale of stress life events (H-R, Questionnaire for pain expression Pain-O-Meter (POM. Significant differences between groups and predictive value of the parameters for atypical chest pain were determined. Results. The E group participants compared to the group K were younger (33.4 ± 5.4 : 48.3 ± 6,4 years, p < 0.001, had a moderate anxiety level (20.4 ± 11.9 : 9.6 ± 3.8, p < 0.001, panic and somatiform disorders were present in the half of the E group, as well as eleveted somatization score (SOM ≥ 63 -50% : 10%, p < 0.01 and a higher H-R score level (102.0 ± 52.2 : 46.5 ± 55.0, p < 0.001. Pain was mild, accompanied with panic. The half of the E group subjects had somatoform and panic disorders. Conclusion. Somatoform and panic disorders are associated with atypical chest pain. Pain expression is mild, accompained with panic. Predictive factors for atypical chest pain are: age under 40, anxiety level > 20, somatization ≥ 63, presence of panic and somatoform disorders, H-R score > 102

  10. Diffuse infiltrative cardiac tuberculosis

    International Nuclear Information System (INIS)

    We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy

  11. Antigen smuggling in tuberculosis.

    Science.gov (United States)

    Hudrisier, Denis; Neyrolles, Olivier

    2014-06-11

    The importance of CD4 T lymphocytes in immunity to M. tuberculosis is well established; however, how dendritic cells activate T cells in vivo remains obscure. In this issue of Cell Host & Microbe, Srivastava and Ernst (2014) report a mechanism of antigen transfer for efficient activation of antimycobacterial T cells. PMID:24922567

  12. Basic Tuberculosis Facts

    Centers for Disease Control (CDC) Podcasts

    2012-03-12

    In this podcast, Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, discusses basic TB prevention, testing, and treatment information.  Created: 3/12/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/12/2012.

  13. Diagnostic Importance of 3D CT Images in Klippel-Feil Syndrome with Multiple Skeletal Anomalies: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yuksel, Murvet [Kahramanmaras Sutcu Imam University, Radiology Dept. (Turkey); Karabiber, Hamza [Kahramanmaras Sutcu Imam University Pediatrics Dept. (Turkey); Yuksel, K. Zafer [Kahramanmaras Sutcu Imam University Neuroradiology Dept (Turkey); Parmaksiz, Gonul [Kahramanmaras Sutcu Imam University Pediatrics Dept. (Turkey)

    2005-07-01

    We present here the case of a 12-year-old boy who had Klippel-Feil syndrome with renal, cardiac and multiple skeletal anomalies, and we show the relevent three-dimensional computed tomography images. Our patient had a triple renal pelvis, mitral valve prolapsus, multiple cervical vertebrae fusions, cervical ribs, hypoplasia of the right thumb, spina bifida of L5, lumbalization at the right side of S1 and a sacral curved defect. In this study, we discuss the atypical clinical features and the diagnostic value of three-dimensional CT for evaluating the skeletal anomalies of the Klippel-Feil syndrome cases.

  14. Diagnostic Importance of 3D CT Images in Klippel-Feil Syndrome with Multiple Skeletal Anomalies: A Case Report

    International Nuclear Information System (INIS)

    We present here the case of a 12-year-old boy who had Klippel-Feil syndrome with renal, cardiac and multiple skeletal anomalies, and we show the relevent three-dimensional computed tomography images. Our patient had a triple renal pelvis, mitral valve prolapsus, multiple cervical vertebrae fusions, cervical ribs, hypoplasia of the right thumb, spina bifida of L5, lumbalization at the right side of S1 and a sacral curved defect. In this study, we discuss the atypical clinical features and the diagnostic value of three-dimensional CT for evaluating the skeletal anomalies of the Klippel-Feil syndrome cases

  15. Atypical presentation of colon adenocarcinoma: a case report

    Directory of Open Access Journals (Sweden)

    Tumwine Lynnette K

    2012-02-01

    Full Text Available Abstract Introduction Adenocarcinoma of the colon is the most common histopathological type of colorectal cancer. In Western Europe and the United States, it is the third most common type and accounts for 98% of cancers of the large intestine. In Uganda, as elsewhere in Africa, the majority of patients are elderly (at least 60 years old. However, more recently, it has been observed that younger patients (less than 40 years of age are presenting with the disease. There is also an increase in its incidence and most patients present late, possibly because of the lack of a comprehensive national screening and preventive health-care program. We describe the clinicopathological features of colorectal carcinoma in the case of a young man in Kampala, Uganda. Case presentation A 27-year-old man from Kampala, Uganda, presented with gross abdominal distension, progressive loss of weight, and fever. He was initially screened for tuberculosis, hepatitis, and lymphoma, and human immunodeficiency virus/acquired immunodeficiency syndrome infection. After a battery of tests, a diagnosis of colorectal carcinoma was finally established with hematoxylin and eosin staining of a cell block made from the sediment of a liter of cytospun ascitic fluid, which showed atypical glands floating in abundant extracellular mucin, suggestive of adenocarcinoma. Ancillary tests with alcian blue/periodic acid Schiff and mucicarmine staining revealed that it was a mucinous adenocarcinoma. Immunohistochemistry showed strong positivity with CDX2, confirming that the origin of the tumor was the colon. Conclusions Colorectal carcinoma has been noted to occur with increasing frequency in young adults in Africa. Most patients have mucinous adenocarcinoma, present late, and have rapid disease progression and poor outcome. Therefore, colorectal malignancy should no longer be excluded from consideration only on the basis of a patient's age. A high index of suspicion is important in the

  16. Skeletal muscle connective tissue

    DEFF Research Database (Denmark)

    Brüggemann, Dagmar Adeline

      The connective tissue content of skeletal muscle is believed to be the major factor responsible for defining the eating quality of different meat cuts, although attempts to correlate quantifications based on traditional histological methods have not as yet been able to prove this relation...... systems of muscle have been visualized in their full complexity, including the ‘neglected' lymphatic capillaries at the level of the endomysium. These findings serve to remind us that muscle contraction is not only about force generation and transmission, but also about nutrient supply and waste removal...

  17. Moving Beyond Directly Observed Therapy for Tuberculosis

    OpenAIRE

    Xiaoqiu Liu; Lewis, James J.; Hui Zhang; Wei Lu; Shun Zhang; Guilan Zheng; Liqiong Bai; Jun Li; Xue Li; Hongguang Chen; Mingming Liu; Rong Chen; Junying Chi; Jian Lu; Shitong Huan

    2015-01-01

    Editors' Summary Background Tuberculosis—a contagious bacterial disease that usually infects the lungs—is a major global public health problem. Every year, about 9 million people develop tuberculosis and at least 1.3 million people die as a result. Mycobacterium tuberculosis, the organism that causes tuberculosis, is spread in airborne droplets when people with tuberculosis cough or sneeze. The symptoms of tuberculosis include cough, weight loss, and fever. Diagnostic tests for tuberculosis i...

  18. The skeletal system

    International Nuclear Information System (INIS)

    The joy of diagnostic radiology is derived in great measure in its neverending variety including the unveiling of new diagnostic entities and new information concerning known disease processes. This year is no exception in the fascinating documentation of skeletal disease. In the study of disorders of the joints, CT investigation of the temporomandibular joint and arthotomography of the shoulder are gaining in popularity. New observations concerning cyst-like osseous lesions in lupus erthematosis, destructive joint lesions in renal osteodystrophy, and intra- and periarticular calcifications secondary to steroid injections have come forward. Articles discussing interesting observations concerning chondrosarcoma are included as well as one that describes the demonstration of fluid levels in aneurysmal bone cysts by CT. Ossification in soft tissues following resection of giant cell tumors as evidence of residual neoplasm is an important new sign. Marrow transplantation for treatment of mucopolysaccharidosis represents a new therapeutic breakthrough. Some of the skeletal manifestions of hypomagnesemia, 13-cis-retinoic acid, and aluminum are elucidated in this year's articles on metabolic disease. Further studies of methods of measuring bone density are also included

  19. Bovine Tuberculosis, A Zoonotic Disease

    OpenAIRE

    Tarmudji; Supar

    2008-01-01

    Bovine tuberculosis is caused by the infection of Mycobacterium tuberculosis var. bovis (M. bovis). This species is one of Mycobacterium tuberculosis complex, can infect wide range of hosts: cattle and other domesticated animals, wild mammals and humans (zoonotic). M. bovis bacterium from infected hosts can be transmitted to other susceptible animals and humans through respiratory excretes and secretion materials. Humans can be infected with M. bovis by ingested M. bovis contaminated animal p...

  20. A Rare unusual case presentation of the Tuberculosis of the Shoulder Joint

    Directory of Open Access Journals (Sweden)

    Ashwin Deshmukh

    2013-10-01

    Full Text Available Introduction: Afflictions of shoulder by tuberculosis is rare and when it occurs its more commonly a dry lesion (caries sicca. Wet lesions in shoulder are rare and we report this case for the rarity of its occurrence. Case Report: A 55yrs old female patient presented with a painful swelling with restriction of movements of the right shoulder since six months. Patient had taken various treatments without any relief; there was no history of trauma, weight loss, recent infection in the past or any history of tuberculosis in family or contact with tubercular patient. Right shoulder revealed restricted movements with no local rise in temperature. Tenderness was present over anterior and posterior aspect of the right shoulder diffusely. External rotation and abduction movements were restricted while adduction and flexion were not restricted. Power of the muscles was unaffected with no neurological deficit. Antero-posterior and axial X-rays of the right shoulder showed no bony involvement however, ultrasonography showed lipoma. Serological investigations showed a markedly raised erythrocyte sedimentation rate (73mm / hr and a positive C-reactive protein. Surgical excision of the mass revealed rice bodies. DNA PCR was positive for tuberculosis and patient was started on anti-tubercular treatment( Category I for six months. Conclusion: Any patient coming with the complaints of long standing painful restriction of the movements of the shoulder associated with or without complaints swelling, shall be evaluated to rule out skeletal tuberculosis along with other differential diagnosis of periarthritis of shoulder and adhesive capsulitis. Most of the patients with skeletal tuberculosis may not necessarily present with the constitutional symptoms of fever, weight loss, etc and also because of the widespread prevalence of the organism in India. Keywords: Shoulder Tuberculosis, Caries Sicca, rice bodies.

  1. Diabetes mellitus: an important risk factor for reactivation of tuberculosis

    Science.gov (United States)

    Rivera, Carmen; Mangual, Michelle; Martinez, José; Rivera, Kelvin; Fernandez, Ricardo

    2016-01-01

    Summary Diabetes mellitus was identified as a risk factor for developing tuberculosis (TB) infection, and relapse after therapy. The risk of acquiring TB is described as comparable to that of HIV population. The fact that diabetics are 3× times more prone to develop pulmonary TB than nondiabetics cannot be overlooked. With DM recognized as global epidemic, and TB affecting one-third of the world population, physicians must remain vigilant. We present a 45-year-old woman born in Dominican Republic (DR), with 10-year history of T2DM treated with metformin, arrived to our Urgency Room complaining of dry cough for the past 3months. Interview unveiled unintentional 15lbs weight loss, night sweats, occasional unquantified fever, and general malaise but denied bloody sputum. She traveled to DR 2years before, with no known ill exposure. Physical examination showed a thin body habitus, otherwise well appearing woman with stable vital signs, presenting solely right middle lung field ronchi. LDH, ESR, hsCRP and Hg A1C were elevated. Imaging revealed a right middle lobe cavitation. Sputum for AFB disclosed active pulmonary TB. Our case portrays that the consideration of TB as differential diagnosis in diabetics should be exercised with the same strength, as it is undertaken during the evaluation of HIV patients with lung cavitation. Inability to recognize TB will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace. Learning points Diabetes mellitus should be considered an important risk factor for the reactivation of pulmonary tuberculosis. High clinical suspicious should be taken into consideration as radiological findings for pulmonary tuberculosis in patients with diabetes mellitus may be atypical, involving middle and lower lobes. Inability to recognize pulmonary tuberculosis will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace. PMID:27482384

  2. Extensively drug-resistant tuberculosis.

    Science.gov (United States)

    Jassal, Mandeep; Bishai, William R

    2009-01-01

    Extensively drug-resistant (XDR) tuberculosis is defined as disease caused by Mycobacterium tuberculosis with resistance to at least isoniazid and rifampicin, any fluoroquinolone, and at least one of three injectable second-line drugs (amikacin, capreomycin, or kanamycin). The definition has applicable clinical value and has allowed for more uniform surveillance in varied international settings. Recent surveillance data have indicated that the prevalence of tuberculosis drug resistance has risen to the highest rate ever recorded. The gold standard for drug-susceptibility testing has been the agar proportion method; however, this technique requires several weeks for results to be determined. More sensitive and specific diagnostic tests are still unavailable in resource-limited settings. Clinical manifestations, although variable in different settings and among different strains, have in general shown that XDR tuberculosis is associated with greater morbidity and mortality than non-XDR tuberculosis. The treatment of XDR tuberculosis should include agents to which the organism is susceptible, and should continue for a minimum of 18-24 months. However, treatment continues to be limited in tuberculosis-endemic countries largely because of weaknesses in national tuberculosis health-care models. The ultimate strategy to control drug-resistant tuberculosis is one that implements a comprehensive approach incorporating innovation from the political, social, economic, and scientific realms. PMID:18990610

  3. An atypical presentation of antiphospholipid antibody syndrome

    Directory of Open Access Journals (Sweden)

    Deepti D′Souza

    2015-01-01

    Full Text Available Cutaneous manifestations in antiphospholipid antibody syndrome (APS though common, are extremely diverse and it is important to know which dermatological finding should prompt consideration of antiphospholipid syndrome. The cutaneous manifestations of APS vary from livedo reticularis to cutaneous necrosis, and systemic involvement is invariably an accomplice in APS. Cutaneous ulcers with sharp margins can be seen in APS and they are usually seen on the legs. This case had an atypical presentation, as the initial presentation was painful necrotic ulcers over the legs, which resembled pyoderma gangrenosum and she had no systemic manifestations. There was no history of any arterial or venous thrombosis or any abortions. Antiphospholipid syndrome can be tricky to diagnose when cutaneous lesions are atypical. Nonetheless, it is very important to pin down this syndrome early due to its systemic complications.

  4. Primary lateral sclerosis mimicking atypical parkinsonism

    DEFF Research Database (Denmark)

    Norlinah, Ibrahim M; Bhatia, Kailash P; Østergaard, Karen;

    2007-01-01

    the atypical parkinsonian syndromes. Here we describe five patients initially referred with a diagnosis of levodopa-unresponsive atypical parkinsonism (n = 4) or primary progressive multiple sclerosis (n = 1), but subsequently found to have features consistent with PLS instead. Onset age varied from......Primary lateral sclerosis (PLS), the upper motor neurone variant of motor neurone disease, is characterized by progressive spinal or bulbar spasticity with minimal motor weakness. Rarely, PLS may present with clinical features resembling parkinsonism resulting in occasional misdiagnosis as one of...... eventually seen in all patients. Anterior horn cell involvement developed in three cases. Early gait disturbances resulting in falls were seen in all patients and none of them responded to dopaminergic medications. Two patients underwent dopamine transporter (DaT) SPECT scanning with normal results. Other...

  5. Tuberculosis of spine

    Directory of Open Access Journals (Sweden)

    Vinod Agrawal

    2010-01-01

    Full Text Available Tuberculosis of the spine is one of the most common spine pathology in India. Over last 4 decades a lot has changed in the diagnosis, medical treatment and surgical procedures to treat this disorder. Further developments in diagnosis using molecular genetic techniques, more effective antibiotics and more aggressive surgical protocols have become essential with emergence of multidrug resistant TB. Surgical procedures such as single stage anterior and posterior stabilization, extrapleral dorsal spine anterior stabilization and endoscopic thoracoscopic surgeries have reduced the mortality and morbidity of the surgical procedures. is rapidly progressing. It is a challenge to treat MDR-TB Spine with late onset paraplegia and progressive deformity. Physicians must treat tuberculosis of spine on the basis of Culture and sensitivity.

  6. Atypical retroperitoneal extension of iliopsoas bursitis

    Energy Technology Data Exchange (ETDEWEB)

    Coulier, B.; Cloots, V. [Department of Diagnostic Imaging, Cliniques St. Luc, Rue St Luc 8, 5004, Bouge, Namur (Belgium)

    2003-05-01

    We report two rare cases of iliopsoas bursitis extending into the retroperitoneal space. The first lesion contained much gas, mimicking a retroperitoneal abscess, and the second was responsible for atypical inguinal pain. The diagnosis was made by contrast-enhanced CT in both cases and arthrography in the first case. Iliopsoas bursitis in these two patients, it is hypothesized, extended into the retroperitoneum, at least in part, by way of intraneural or perineural structures. (orig.)

  7. Atypical burkitt's lymphoma transforming from follicular lymphoma

    OpenAIRE

    Chung Lap P; Loong Florence; Hwang Yu Y; Chim Chor S

    2011-01-01

    Amongst follicular lymphoma that transforms into a high-grade lymphoma, majority are diffuse large B cell lymphoma. Here we reported a rare atypical Burkitt's lymphoma transformation from an asymptomatic follicular lymphoma. Lymph node biopsy showed a composite lymphoma with infiltration of the inter-follicular areas by high grade small non-cleaved lymphoma cells amongst neoplastic follicles. Moreover, FISH and molecular genetic study confirmed concomitant MYC translocations and t(14;18) in t...

  8. Atypical anti-glomerular basement membrane disease

    OpenAIRE

    Troxell, Megan L.; Donald C Houghton

    2015-01-01

    Background Anti-glomerular basement membrane (anti-GBM) disease classically presents with aggressive necrotizing and crescentic glomerulonephritis, often with pulmonary hemorrhage. The pathologic hallmark is linear staining of GBMs for deposited immunoglobulin G (IgG), usually accompanied by serum autoantibodies to the collagen IV alpha-3 constituents of GBMs. Methods Renal pathology files were searched for cases with linear anti-GBM to identify cases with atypical or indolent course. Histopa...

  9. Tuberculosis como enfermedad ocupacional Tuberculosis as occupational disease

    Directory of Open Access Journals (Sweden)

    Alberto Mendoza-Ticona

    2012-06-01

    Full Text Available Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto.There is enough evidence to declare tuberculosis as an occupational disease among healthcare workers. In Peru, there are regulations granting employment rights regarding tuberculosis as an occupational disease, such as healthcare coverage for temporary or permanent disability. However, these rights have not been sufficiently socialized. This study presents information on the risk of acquiring tuberculosis in the workplace, and a review of the evidence to declare tuberculosis as an occupational disease among health care workers, presenting the current Peruvian law related.

  10. Tuberculosis Endometrial Polyp

    OpenAIRE

    Julien Seror; Erika Faivre; Sophie Prevot; Xavier Deffieux

    2013-01-01

    Tuberculosis can cause infertility when it infects the genital tract (e.g., endometritis). A 31-year-old woman (origin: Algeria) was referred to our academic gynecological institute for unexplained primary infertility. The patient presented with no complaint. Hysteroscopy showed a 10 mm sized endometrial polyp. The polyp was removed. Pathology showed lymphocytic and plasmacytic chronic inflammatory modification, granulomatous modification, and gigantocellular modification,which lead to the ...

  11. Diagnostics for pulmonary tuberculosis

    Science.gov (United States)

    Cudahy, Patrick

    2016-01-01

    Tuberculosis (TB) remains a leading cause of human suffering and mortality despite decades of effective treatment being available. Accurate and timely diagnosis remains an unmet goal. The HIV epidemic has also led to new challenges in the diagnosis of TB. Several new developments in TB diagnostics have the potential to positively influence the global campaign against TB. We aim to review the performance of both established as well as new diagnostics for pulmonary TB in adults, and discuss the ongoing challenges. PMID:27005271

  12. Diagnostics for pulmonary tuberculosis

    OpenAIRE

    Cudahy, Patrick; Shenoi, Sheela

    2016-01-01

    Tuberculosis (TB) remains a leading cause of human suffering and mortality despite decades of effective treatment being available. Accurate and timely diagnosis remains an unmet goal. The HIV epidemic has also led to new challenges in the diagnosis of TB. Several new developments in TB diagnostics have the potential to positively influence the global campaign against TB. We aim to review the performance of both established as well as new diagnostics for pulmonary TB in adults, and discuss the...

  13. Chemotherapy of osteoarticular tuberculosis

    OpenAIRE

    Hazra Avijit; Laha Baisakhi

    2005-01-01

    Tuberculosis (TB) of the bones and joints is rampant in India with the dorsolumbar spine as the most common site of osseous involvement. For diagnosis, clinical suspicion needs to be confirmed through appropriate laboratory and imaging investigations, and increasingly nowadays, nucleic acid amplification techniques. Chemotherapy remains the cornerstone of management complemented by rest, nutritional support and splinting, as necessary. Operative intervention is required if response to chemoth...

  14. Multidrug-Resistant Tuberculosis

    Centers for Disease Control (CDC) Podcasts

    2008-10-28

    In this podcast, Dr. Oeltmann discusses multidrug-resistant tuberculosis. An outbreak occurred in Thailand, which led to 45 cases in the U.S. This serious illness can take up to 2 years to treat. MDR TB is a real threat and a serious condition.  Created: 10/28/2008 by Emerging Infectious Diseases.   Date Released: 10/28/2008.

  15. Axial skeletal CT densitometry

    International Nuclear Information System (INIS)

    Since the discovery of the Roentgen ray a precise and accurate assessment of bone mineral content has been a challenge to many investigators. A number of methods have been developed but no one satisfied. Considering its technical possibilities computed tomography is very promising in determination of bone mineral content (BMC). The new modality enables BMC estimations in the axial skeletal trabecular bone. CT densitometry can be performed on a normal commercially available third generation whole body CT scanner. No dedicated device in a special clinical set-up is necessary. In this study 106 patients, most of them clinically suspected of osteoporosis, were examined. The new method CT densitometry has been evaluated. The results have been correlated to alternative BMC determination methods. (Auth.)

  16. [Tuberculosis. Future perspectives].

    Science.gov (United States)

    Marques Gomes, M João

    2004-01-01

    Tuberculosis remains a major health problem around the world and its incidence is growing 0.4% each year. There are 2 billions of infected, 8.4 millions new cases every year and 16 million patients. The association of VIH and tuberculosis, the increasing number of multidrug resistance, failure of health systems, greater mobility of people, poverty, wars and social exclusion, are the major causes of the epidemiological situation. Faster, more specific and sensible diagnostic methods are being investigated. Some of them use molecular biology techniques, some uses radioisotopes and some others are based on colour and fluorescence modifications of dyes. New drugs, new routes of administration and ways for increasing compliance are under investigation. More potent drugs, with greater biodisponibility and adequate pharmacokinetics for shorter treatments for multidrug and latent forms of bacilli are needed. New vaccines are under investigations, namely Adjuvant Subunits Vaccines, DNA Vaccines DNA, no micobacterianos vectors, and attenuated living vaccines are being tested. Finally some considerations are made concerning the need of global committement to win the fight against tuberculosis in the near future. PMID:15202032

  17. Shoulder joint tuberculosis

    International Nuclear Information System (INIS)

    Despite the fact that joint tuberculosis is one of the most common forms of extrapulmonary tuberculosis, it is a disease entity that is very rare in Poland (less than 100 cases a year in the last 10 years). The symptoms are non-specific, and thus the disease is rarely taken into account in preliminary differential diagnosis. A 68-year-old female patient was admitted to the Internal Diseases Clinic due to oedema and pain of the right shoulder joint. The pain has been increasing for about 8 months. Physical examination revealed increased circumference and elevated temperature of the right shoulder joint. Limb function was retained. The full range of radiological and laboratory diagnostic examinations was performed, including the biopsy of the affected tissue which revealed the presence of Mycobacterium tuberculosis in the bacterial culture. Clinical improvement was obtained after introduction of TB drugs. Radiological diagnostic methods (X-ray, CT scans, MRI scans) provide high precision monitoring of articular lesions. However, the decisive diagnosis requires additional laboratory tests as well as histopathological and bacteriological assays

  18. An atlas of normal skeletal scintigraphy

    International Nuclear Information System (INIS)

    This atlas was compiled to provide the neophyte as well as the experienced radiologist and the nuclear medicine physician with a reference on normal skeletal scintigraphy as an aid in distinguishing normal variations in skeletal uptake from abnormal findings. Each skeletal scintigraph is labeled, and utilizing an identical scale, a relevant skeletal photograph and radiograph are placed adjacent to the scintigraph

  19. Diffuse Pulmonary Uptake of Tc-99m Methylene Diphosphonate in a Patient with Non-tuberculosis Mycobacterial Infection

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hyun Woo; Chung, June Key; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of); Ab-Aziz, Aini [University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, (Morocco)

    2010-06-15

    Extra-osseous uptake of bone-seeking radiopharmaceuticals has been reported at various sites and it is known to be induced by various causes. Diffuse pulmonary infection, such as tuberculosis, can be a cause of lung uptake of bone-scan agent. Here we report on a patient with non-tuberculosis mycobacterial infection (NTM) who demonstrated diffuse pulmonary uptake on Tc-99m MDP bone scan. After medical treatment for NTM, the patient's lung lesions improved. Estra skeletal lung Tc-99m MDP uptake on bone scan may suggest lung parenchymal damage associated with disease activity.

  20. Diffuse Pulmonary Uptake of Tc-99m Methylene Diphosphonate in a Patient with Non-tuberculosis Mycobacterial Infection

    International Nuclear Information System (INIS)

    Extra-osseous uptake of bone-seeking radiopharmaceuticals has been reported at various sites and it is known to be induced by various causes. Diffuse pulmonary infection, such as tuberculosis, can be a cause of lung uptake of bone-scan agent. Here we report on a patient with non-tuberculosis mycobacterial infection (NTM) who demonstrated diffuse pulmonary uptake on Tc-99m MDP bone scan. After medical treatment for NTM, the patient's lung lesions improved. Estra skeletal lung Tc-99m MDP uptake on bone scan may suggest lung parenchymal damage associated with disease activity.

  1. Tuberculosis Endometritis Presenting as A Leiomyoma

    Directory of Open Access Journals (Sweden)

    Mahboobeh Shirazi

    2015-02-01

    Full Text Available Genitourinary tuberculosis is a common extrapulmonary manifestation of tuberculosis. Taking into consideration that genitourinary tuberculosis may be associated with a diversity of presentations, its diagnoses may be difficult. A young woman with an initial presumptive diagnosis of a uterine leiomyoma presented with abdominal pain and a pelvic mass that after further investigations, she was diagnosed with genital tuberculosis.

  2. Tuberculosis Endometritis Presenting as A Leiomyoma

    OpenAIRE

    Mahboobeh Shirazi; Fatemeh Shahbaz; Leila Pirzadeh; Seyed Rahim Mohammadi; Parisa Ghaffari; Tahereh Eftekhar

    2015-01-01

    Genitourinary tuberculosis is a common extrapulmonary manifestation of tuberculosis. Taking into consideration that genitourinary tuberculosis may be associated with a diversity of presentations, its diagnoses may be difficult. A young woman with an initial presumptive diagnosis of a uterine leiomyoma presented with abdominal pain and a pelvic mass that after further investigations, she was diagnosed with genital tuberculosis.

  3. Transpupillary thermotherapy for atypical central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Kawamura R

    2012-01-01

    Full Text Available Ryosuke Kawamura1,2, Hidenao Ideta1, Hideyuki Hori1, Kenya Yuki2, Tsuyoshi Uno1, Tatsurou Tanabe1, Kazuo Tsubota2, Tsutomu Kawasaki11Ideta Eye Hospital, Kumamoto, Japan; 2Keio University, School of Medicine, Department of Ophthalmology, Tokyo, JapanBackground: Central serous chorioretinopathy (CSC has been traditionally treated with laser photocoagulation. We thought that transpupillary thermotherapy (TTT utilizing a lower temperature than that of conventional laser photocoagulation might minimize permanent retinal and choroidal damage. Studies suggest that undesirable effects on vision due to TTT are minimal even if it is applied to foveal and/or parafoveal lesions when TTT requires a larger irradiation spot. The aim of this study was to evaluate the efficacy of TTT in the management of atypical CSC.Methods: We defined atypical CSC as bullous retinal detachment with diffuse or several leakages, severe leakage with fibrin formation under serous retinal detachment, or leakage within a pigment epithelium detachment. Eight consecutive patients with atypical CSC underwent visual acuity testing, ophthalmic examination, color photography, fluorescein angiography, and optical coherence tomography to evaluate the results of transpupillary thermotherapy. Retreatment of atypical CSC was based on ophthalmic examination, optical coherence tomography, and fluorescein angiography. TTT was performed on the leaking spots shown in fluorescein angiography, with a power of 50–250 mW, spot size of 500–1200 µm, and exposure time of 13–60 seconds to minimize retinal damage.Results: In five of eight affected eyes, serous detachments completely resolved within 1 month after the initial TTT. One eye had persistent subretinal fluid and required a second TTT treatment. Two eyes showed no resolution of CSC and were treated by conventional photocoagulation. Initial best-corrected visual acuity (BCVA ranged from 20/600 to 20/20 (mean, 20/40; median, 20/30. Final BCVA

  4. Tuberculosis extrapulmonar: Forma articular

    Directory of Open Access Journals (Sweden)

    Julio C. Escarpanter Buliés

    2008-06-01

    Full Text Available Se realizó una revisión del tema de la Tuberculosis extrapulmonar de forma articular, por haber encontrado un paciente con esta patología de presentación "pura" sin otras manifestaciones sistémicas. Se trata del primer paciente diagnosticado en el Hospital Comunitario Integral de "San Andrés", del municipio de Caracollo, provincia Cercado, en el departamento de Oruro, Bolivia. En la revisión del tema se demuestra la infrecuencia de esta forma de presentación de la enfermedad a pesar de ser la Tuberculosis pulmonar frecuente en la región por sumarse los factores: frío, altura con poco tenor de oxígeno, desnutrición, tormentas de polvo, muchos trabajadores mineros, etc. Se realiza la presentación del paciente, se muestra su evolución satisfactoria en cuanto a la patología de base y se arriban a conclusiones dentro de las que se destacan que la Tuberculosis en su forma articular es infrecuente en apariencia y su diagnóstico se hace difícil al no existir, por la misma razón, patrones ecográficos o radiográficos definidos. El diagnóstico anatomopatológico es el único que puede definir la etiología de la Tuberculosis de una lesión proliferativa de la sinovial y que la sinovectomía es una intervención generalmente invalidante por lo que un diagnóstico precoz y un tratamiento médico adecuado, a tiempo, evitaría limitaciones funcionales a posteriori. Se recomienda que en todo caso portador de una sinovitis de rodilla de larga evolución, se le realice una ecografía diagnóstica, y en los pacientes en los que se observen imágenes complejas de bordes regulares, del tipo "copos de nieve", se le efectúen estudios específicos para la detección de la Tuberculosis.

  5. PENILE TUBERCULOSIS PRESENTING AS PHIMOSIS

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    Mahalakshmi

    2015-03-01

    Full Text Available We report a case of penile tuberculosis presenting as phimosis . A dorsal slit revealed an ulceroproliferative growth which resembled Carcinoma. The diagnosis of tuberculosis was based on histopathology. Successful treatment was achieved by Antituberculosis therapy. We report this case because of its unsual presentati on and its rarity

  6. PENILE TUBERCULOSIS PRESENTING AS PHIMOSIS

    OpenAIRE

    Mahalakshmi; Yuwarani; Narayanan; Sudha

    2015-01-01

    We report a case of penile tuberculosis presenting as phimosis . A dorsal slit revealed an ulceroproliferative growth which resembled Carcinoma. The diagnosis of tuberculosis was based on histopathology. Successful treatment was achieved by Antituberculosis therapy. We report this case because of its unsual presentati on and its rarity

  7. Risk for tuberculosis among children

    DEFF Research Database (Denmark)

    Nakaoka, Hiroshi; Lawson, Lovett; Squire, S Bertel;

    2006-01-01

    Contacts of adults with tuberculosis (TB) are at risk for infection. Tests based on interferon-gamma (IFN-gamma) expression in response to Mycobacterium tuberculosis antigens may be more sensitive than the tuberculin skin test (TST). Risk for infection was assessed by using TST and an IFN...

  8. TUBERCULOSIS IN AFRICA - ANY NEWS

    NARCIS (Netherlands)

    VANDERWERF, TS

    1994-01-01

    The tuberculosis situation in Africa in the AIDS era has become bleak. The tuberculosis incidence has increased in most sub-Saharan African countries, diagnosis has become more difficult, response to treatment, though initially good, is eventually less effective, and patient compliance, which has be

  9. Tuberculosis, Fiji, 2002-2013.

    Science.gov (United States)

    Pezzoli, Lorenzo; Gounder, Shakti; Tamani, Talatoka; Daulako, Mary Raori; Underwood, Frank; Mainawalala, Sakiusa; Nawadra-Taylor, Vasiti; Rafai, Eric; Gillini, Laura

    2016-03-01

    During 2002-2013, a total of 1,890 tuberculosis cases were recorded in Fiji. Notification rates per 100,000 population increased from 17.4 cases in 2002 to 28.4 in 2013. Older persons were most affected, but tuberculosis also increased sharply in persons 25-44 years of age. PMID:26890215

  10. Respiratory tuberculosis and current potenti

    International Nuclear Information System (INIS)

    Materials on possibility of diagnosing the lungs bronchi tuberculosis on the background of development failures are presented. It is noted that for a faster tuberculosis diagnostics it is necessary to use not only the clinical-roentgenological data but also the data on diagnostical bronchoscopy and bioscopy of bronchial mucous membrane and lungs tissue

  11. Pancreatic Tuberculosis or Autoimmune Pancreatitis

    OpenAIRE

    Ayesha Salahuddin; Muhammad Wasif Saif

    2014-01-01

    Introduction. Isolated pancreatic and peripancreatic tuberculosis is a challenging diagnosis due to its rarity and variable presentation. Pancreatic tuberculosis can mimic pancreatic carcinoma. Similarly, autoimmune pancreatitis can appear as a focal lesion resembling pancreatic malignancy. Endoscopic ultrasound-guided fine needle aspiration provides an effective tool for differentiating between benign and malignant pancreatic lesions. The immune processes involved in immunoglobulin G4 relate...

  12. Osseous Tuberculosis Of The Right Proximal Tibia With Tuberculous Tenosynovitis Of Left Hand Flexor Carpi Ulnaris Sheath- An Interesting Case Report

    Directory of Open Access Journals (Sweden)

    Dr Satish Shervegar

    2012-08-01

    Full Text Available India has almost 30% of the global burden of tuberculosis and one person dies of disease every minute Abdelwahab et al (1993 1. Currently in India there are about 14 million suspected and about 3.5 million bacteriologic ally proved cases of pulmonary tuberculosis and prevalence of 4.84/ 1000 cases2. Incidence of tuberculosis is about 1.5 per 1000 population. More recently, average prevalence of all forms of tuberculosis in India estimated to be about 5.05 per 1000 3 .Musculoskeletal tuberculosis accounts for 1.3% of all patients with tuberculosis. Only one case of isolated tuberculosis of the synovial sheath of flexor carpi ulnaris in a 17 year old female has been reported in the English literature Ish k.Dhammi et al (2006 9.We present one such case with combined extra pulmonary osseous Tuberculosis involving the proximal Tibia (fig 2a, b with Tuberculous tenosynovitis of left hand flexor carpi ulnaris sheath (fig3 who presented with abscess in the distal forearm space of parona. It is prudent to be aware of this condition due to its nonspecific and indolent clinical presentation. Early recognition will help to prevent serious complications like dysfunction of tendons, destruction of joints and skeletal deformities

  13. Student Pharmacists as Tuberculosis Screeners.

    Science.gov (United States)

    McKennon, Skye A; Arnold, Jennifer

    2016-03-25

    Objective. To develop, implement, and evaluate a targeted educational module on tuberculosis screening with second-year professional pharmacy students that improves their knowledge, skills, and attitudes regarding tuberculosis screening. Design. A tuberculosis-screening educational module was developed in collaboration with the Washington State Pharmacy Association and Department of Health and incorporated in a core student pharmacist class. Students completed online didactic training and a live practicum, each lasting 90 minutes. Assessment. Students were assessed using a pre/postdidactic assessment, live practicum tuberculin skin testing (TST) administration and evaluation assessment, and postprogram written reflection. Student pre/postknowledge assessment scores improved in all areas except in documentation. Conclusion. The tuberculosis screening educational module significantly improved student knowledge, skills, and attitudes regarding tuberculosis screening. PMID:27073277

  14. Skeletal changes in tuberous sclerosis

    International Nuclear Information System (INIS)

    This paper is based on the skeletal changes which were found in six cases with confirmed tuberous sclerosis. The bone changes of this rare condition are summarised. The differential diagnosis is discussed. (orig.)

  15. PDH regulation in skeletal muscle

    DEFF Research Database (Denmark)

    Kiilerich, Kristian

    state is determined by the overall content / activity of the regulatory proteins PDH kinase (PDK), of which there are 4 isoforms, and PDH phosphatase (PDP), of which there are 2 isoforms. The overall aim of the PhD project was to elucidate 4 issues. 1: Role of muscle type in resting and exercise......-induced PDH regulation in human skeletal muscle. 2: Effect of muscle glycogen on PDH regulation in human skeletal muscle at rest and during exercise. 3: The impact of physical inactivity on PDH regulation in human skeletal muscle at rest and during exercise. 4: Elucidating the importance of PGC-1? in PDH...... regulation in mouse skeletal muscle at rest and in response to fasting and during recovery from exercise. The studies indicate that the content of PDH-E1? in human muscle follows the metabolic profile of the muscle, rather than the myosin heavy chain fiber distribution of the muscle. The larger lactate...

  16. Neurology of endemic skeletal fluorosis

    Directory of Open Access Journals (Sweden)

    Reddy D

    2009-01-01

    Full Text Available Endemic skeletal fluorosis is widely prevalent in India and is a major public health problem. The first ever report of endemic skeletal fluorosis and neurological manifestation was from Prakasam district in Andhra Pradesh in the year 1937. Epidemiological and experimental studies in the endemic areas suggest the role of temperate climate, hard physical labor, nutritional status, presence of abnormal concentrations of trace elements like strontium, uranium, silica in water supplies, high fluoride levels in foods and presence of kidney disease in the development of skeletal fluorosis. Neurological complications of endemic skeletal fluorosis, namely radiculopathy, myelopathy or both are mechanical in nature and till date the evidence for direct neurotoxicity of fluoride is lacking. Prevention of the disease should be the aim, knowing the pathogenesis of fluorosis. Surgery has a limited role in alleviating the neurological disability and should be tailored to the individual based on the imaging findings.

  17. [Key regulators of skeletal myogenesis].

    Science.gov (United States)

    Kopantseva, E E; Belyavsky, A V

    2016-01-01

    Skeletal myogenesis has been extensively studied at both morphological and molecular levels. This review considers the main stages of embryonic skeletal myogenesis and myogenic factors that trigger their initiation, focusing on specific protein interactions involved in somitic myogenesis, head myogenesis, and limb myogenesis. The second part of the review describes the role of noncoding RNAs (microRNAs and long noncoding RNAs) in myogenesis. This information is of particular interest, because regulation of cell processes by noncoding RNAs is an actively developing field of molecular biology. Knowledge of mechanisms of skeletal myogenesis is of applied significance. Various transcription factors, noncoding RNAs, and other myogenic regulators can be employed in the induction of myogenic reprogramming in stem cells and differentiated somatic cells. Current trends and strategies in the field of skeletal myogenic reprogramming are discussed in the last part of the review. PMID:27239841

  18. Bovine Tuberculosis, A Zoonotic Disease

    Directory of Open Access Journals (Sweden)

    Tarmudji

    2008-12-01

    Full Text Available Bovine tuberculosis is caused by the infection of Mycobacterium tuberculosis var. bovis (M. bovis. This species is one of Mycobacterium tuberculosis complex, can infect wide range of hosts: cattle and other domesticated animals, wild mammals and humans (zoonotic. M. bovis bacterium from infected hosts can be transmitted to other susceptible animals and humans through respiratory excretes and secretion materials. Humans can be infected with M. bovis by ingested M. bovis contaminated animal products, unpasteurised milk from tuberculosis cows or through respiratory route of contaminated aerosol. Bovine tuberculosis at the first stage does not show any clinical sign but as the disease progress in the next stage which may take several months or years, clinical signs may arise, suh as: fluctuative body temperature, anorexia, lost body weight, coughing, oedema of lymph nodes, increased respiratory frequencies. Pathological lesion of bovine tuberculosis is characterised by the formation of granulomas (tubercles, in which bacterial cells have been localised, most in lymph nodes and pulmonum, but can occur in other organs. The granulomas usually arise in small nodules or tubercles appear yellowish either caseus, caseo-calcareus or calcified. In Indonesia, bovine tuberculosis occurred in dairy cattle since 1905 through the imported dairy cows from Holland and Australian. It was unfortunate that until recently, there were not many research and surveilances of bovine tuberculosis conducted in this country, so the distribution of bovine tuberculosis is unknown. Early serological diagnosis can be done on live cattle by means of tuberculin tests under field conditions. Confirmation can be done by isolation and identification of excreted and secreted samples from the slaughter house. Antibiotic treatment and vaccination were uneffective, therefore the effective control of bovine tuberculosis is suggested by tuberculin tests and by slaughtering the selected

  19. Regulation of skeletal muscle proteolysis

    OpenAIRE

    Slee, Adrian

    2005-01-01

    Proteolysis is a component of protein turnover, controlled by multiple proteolytic systems. Alterations in system components within skeletal muscle has been associated with hypertrophy, remodelling, atrophy, apoptosis and metabolic dysregulation. Key components may have novel regulatory roles, e. g. calpain-3 and cathepsin-L. Experiments described within this thesis investigated the hypothesis that the gene expression of specific proteolytic system components within skeletal muscle may be co-...

  20. Simvastatin effects on skeletal muscle

    DEFF Research Database (Denmark)

    Larsen, Steen; Stride, Nis; Hey-Mogensen, Martin;

    2013-01-01

    Glucose tolerance and skeletal muscle coenzyme Q(10) (Q(10)) content, mitochondrial density, and mitochondrial oxidative phosphorylation (OXPHOS) capacity were measured in simvastatin-treated patients (n = 10) and in well-matched control subjects (n = 9).......Glucose tolerance and skeletal muscle coenzyme Q(10) (Q(10)) content, mitochondrial density, and mitochondrial oxidative phosphorylation (OXPHOS) capacity were measured in simvastatin-treated patients (n = 10) and in well-matched control subjects (n = 9)....

  1. Tuberculosis peritonitis: gallium-67 scintigraphic appearance.

    Science.gov (United States)

    Sumi, Y; Ozaki, Y; Hasegawa, H; Shindoh, N; Katayama, H; Tamamoto, F

    1999-06-01

    Tuberculosis peritonitis is a rare manifestation of extrapulmonary tuberculosis. The results of gallium-67 scintigraphy of three patients with tuberculosis peritonitis were reviewed to assess its usefulness in the diagnosis of this condition. Tuberculosis peritonitis was associated with diffuse or focal abdominal localization and decreased hepatic accumulation of gallium-67. These gallium-67 scan features of tuberculosis peritonitis may help to optimize the diagnosis and management of this disease. PMID:10435380

  2. Disseminated tuberculosis presenting as acute lung injury

    OpenAIRE

    Mary Grace; V K Shameer; Renjith Bharathan; Kavitha Chandrikakumari

    2014-01-01

    Tuberculosis presenting as acute lung injury is distinctly uncommon, even in India where tuberculosis an endemic disease. Simultaneously, acute lung injury is a highly fatal complication of tuberculosis. A high index of suspicion is needed to diagnose tuberculosis in such cases. Failure to initiate early treatment can have disastrous consequences as exemplified in this case report. This case attempts to highlight the need to consider tuberculosis as one of the likely causative factors for acu...

  3. Characterization of the atypical lymphocytes in African swine fever

    Science.gov (United States)

    Karalyan, Z. A.; Ter-Pogossyan, Z. R.; Abroyan, L. O.; Hakobyan, L. H.; Avetisyan, A. S.; Yu, Karalyan N.; Karalova, E. M.

    2016-01-01

    Aim: Atypical lymphocytes usually described as lymphocytes with altered shape, increased DNA amount, and larger size. For analysis of cause of genesis and source of atypical lymphocytes during African swine fever virus (ASFV) infection, bone marrow, peripheral blood, and in vitro model were investigated. Materials and Methods: Atypical lymphocytes under the influence of ASFV were studied for morphologic, cytophotometric, and membrane surface marker characteristics and were used in vivo and in vitro models. Results: This study indicated the increased size, high metabolic activity, and the presence of additional DNA amount in atypical lymphocytes caused by ASFV infection. Furthermore, in atypical lymphocytes, nuclear-cytoplasmic ratio usually decreased, compared to normal lymphocytes. In morphology, they looking like lymphocytes transformed into blasts by exposure to mitogens or antigens in vitro. They vary in morphologic detail, but most of them are CD2 positive. Conclusions: Our data suggest that atypical lymphocytes may represent an unusual and specific cellular response to ASFV infection. PMID:27536044

  4. Management of Typical and Atypical Hangman's Fractures

    Science.gov (United States)

    Al-Mahfoudh, Rafid; Beagrie, Christopher; Woolley, Ele; Zakaria, Rasheed; Radon, Mark; Clark, Simon; Pillay, Robin; Wilby, Martin

    2015-01-01

    Study Design Retrospective study of a prospectively maintained database. Objective Our aim was to retrospectively review management and outcomes of patients with low-grade hangman's fractures, specifically looking at differences in outcomes between collars and halo immobilization. We also studied fracture patterns and their treatment outcomes. Methods Forty-one patients with hangman's fractures were identified from 105 patients with axis fractures between 2007 and 2013. Typical hangman's fractures were defined as traumatic spondylolisthesis of the axis causing a bilateral pars interarticularis fracture. Fractures involving the posterior cortex of C2 on one or both sides or an asymmetrical pattern were defined as atypical. Results There were 41 patients with a mean age of 59 years, with 13 (31.7%) typical and 28 (68.2%) atypical fractures. There were 22 (53.6%) type 1 fractures, 7 (41.4%) type 2 fractures, and 2 (4.9%) type 2a fractures in this series. Cervical collars were used to manage 11 patients (27% of all patients with hangman's fractures) and halo orthosis was used in 27 (65.8%). Three (7.3%) patients underwent surgical fixation of the fracture. Bony union was achieved in all patients on radiologic follow-up. Permanent neurologic deficit occurred in one patient due to associated injuries. Neck pain and stiffness were reported more commonly in the atypical group, but this finding was not statistically significant. Conclusions The majority of hangman type fractures can be treated nonoperatively. We found no difference in outcomes between a rigid collar or halo immobilization for treatment of low-grade fractures. Radiologic follow-up is essential to identify cases of nonunion. PMID:27099816

  5. Hematological Side Effects of Atypical Antipsychotic Drugs

    Directory of Open Access Journals (Sweden)

    Serap Erdogan

    2009-10-01

    Full Text Available Atypical antipsychotics cause less frequently extrapyramidal system symptoms, neuroleptic malignant syndrome and hyperprolactinemia than typical antipsychotics. However hematological side effects such as leukopenia and neutropenia could occur during treatment with atypical antipsychotics. These side effects could lead to life threatening situations and the mortality rate due to drug related agranulocytosis is about 5-10%. There are several hypothesis describing the mechanisms underlying drug induced leukopenia and/or neutropenia such as direct toxic effects of these drugs upon the bone marrow or myeloid precursors, immunologic destruction of the granulocytes or supression of the granulopoiesis. Clozapine is the antipsychotic agent which has been most commonly associated with agranulocytosis. A nitrenium ion which is formed by the bioactivation of clozapine is thought to have an important role in the pathophysiogy of this adverse effect. Aside from clozapine, there are several case reports reporting an association between olanzapine, quetiapine, risperidone, ziprasidone, aripiprazole and leukopenia. We did not find any study or case report presenting amisulpride or sulpride related hematological side effects in our literature search. Patients who had hematological side effects during their previous antipsychotic drug treatments and who had lower baseline blood leukocyte counts, have higher risk to develop leukopenia or neutropenia during their current antipsychotic treatment. Once leukopenia and neutropenia develops, drugs thought to be responsible for this side effect should be discontinued or dosages should be lowered. In some cases iniatition of lithium or G-CSF (granulocyte colony-stimulating factor therapy may be helpful in normalizing blood cell counts. Clinicans should avoid any combination of drugs known to cause hematological side effects. Besides during antipsychotic treatment, infection symptoms such as fever, cough, sore throat or

  6. Tuberculosis extrapulmonar: Forma articular

    OpenAIRE

    Julio C Escarpanter Buliés; Yoel García Rodríguez; Marta A. Gutiérrez Guillén

    2008-01-01

    Se realizó una revisión del tema de la Tuberculosis extrapulmonar de forma articular, por haber encontrado un paciente con esta patología de presentación "pura" sin otras manifestaciones sistémicas. Se trata del primer paciente diagnosticado en el Hospital Comunitario Integral de "San Andrés", del municipio de Caracollo, provincia Cercado, en el departamento de Oruro, Bolivia. En la revisión del tema se demuestra la infrecuencia de esta forma de presentación de la enfermedad a pesar de ser la...

  7. Trisomy 18 with unilateral atypical ectrodactyly

    Energy Technology Data Exchange (ETDEWEB)

    Rogers, R.C. [Greenwood Genetic Center, SC (United States)

    1994-01-01

    Becerra et al. recently reported on an infant with multiple congenital anomalies who had trisomy 18. This preterm infant presented with bilateral ectrodactyly of feet, small cleft palate, esophageal atresia with associated tracheoesophageal fistula, congenital heart disease and other anomalies. The authors referenced article by Castle and Bernstein, in which they reported a male with trisomy 18 and cleft foot as well as a review of the literature which showed 2 other infants with trisomy 18 and ectrodactyly of the feet. An additional case of trisomy 18 associated with multiple congenital anomalies, including unilaterial, atypical ectrodactyly of the left foot.

  8. Gorlin’s syndrome: Atypical case report

    Directory of Open Access Journals (Sweden)

    Sanjay N. Agrawal

    2014-10-01

    Full Text Available Gorlin syndrome or basal cell nevus syndrome (BCNS is a rare autosomal dominant disorder. The condition appears to have complete penetrance and variable expressivity, which makes clinilcal presentation among families variable. All known BCNS carry mutations in PATCHED gene. A 65 years old male patient presented with complaints of characteristic skin lesions on his face, back, palms since early adulthood. The lesions were pigmented nodules with characteristic border. The histopathology showed characteristic features suggestive of Basal Cell Carcinoma (BCC. This case was atypical due to appearance of lesions quite later in life.

  9. Atypical Trigeminal Neuralgia Secondary to Meningioma

    OpenAIRE

    Premeshwar Niwant; Mukta Motwani; Sushil Naik

    2015-01-01

    Trigeminal neuralgia is a disorder of the fifth cranial nerve that causes episodes of intense, stabbing, electric shock-like pain that lasts from few seconds to few minutes in the areas of the face where the branches of the nerve are distributed. More than one nerve branch can be affected by the disorder. We report an unusual case of trigeminal neuralgia affecting right side of face presenting atypical features of neuralgia and not responding to the usual course of treatment. The magnetic res...

  10. Atypical calcific tendinitis with cortical erosions

    International Nuclear Information System (INIS)

    Objective. To present and discuss six cases of calcific tendinitis in atypical locations (one at the insertion of the pectoralis major and five at the insertion of the gluteus maximus).Patients and results. All cases were associated with cortical erosions, and five had soft tissue calcifications. The initial presentation was confusing and the patients were suspected of having infection or neoplastic disease.Conclusion. Calcific tendinitis is a self-limiting condition. It is important to recognize the imaging features of this condition to avoid unnecessary investigation and surgery. (orig.)

  11. Atypical calcific tendinitis with cortical erosions

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, E.J. [College of Medicine, Univ. of Iowa, Iowa City, IA (United States); El-Khoury, G.Y. [Dept. of Radiology and Orthopaedics, Univ. of Iowa, Iowa City, IA (United States)

    2000-12-01

    Objective. To present and discuss six cases of calcific tendinitis in atypical locations (one at the insertion of the pectoralis major and five at the insertion of the gluteus maximus).Patients and results. All cases were associated with cortical erosions, and five had soft tissue calcifications. The initial presentation was confusing and the patients were suspected of having infection or neoplastic disease.Conclusion. Calcific tendinitis is a self-limiting condition. It is important to recognize the imaging features of this condition to avoid unnecessary investigation and surgery. (orig.)

  12. Atypical Teratoid/Rrhabdoid Tumour of Brain

    Directory of Open Access Journals (Sweden)

    Meena Sidhu,P.Sakhuja,V.Malhotra,R.Gondal S.Kumar

    2003-04-01

    Full Text Available Primitive neuroectodermal tumor (PNET / medulloblastoma (MB are the most commonmalignantcentral nervous tumors of the first decade of life. Atypical teratoid / rhabdoid tumor (ATT / RT isa tumor of infancy and childhood although occasional cases have also been described in adults.ATT/RT has a characteristic histopathological, immunocytochemical and ultrastructural features.ATT /RT is a rare tumor, incidence of which remains to be defined with only hundred publishedcases. The present report docurilents the clinical features, histological and immunohistochemicalfindings of a case ofATT / RT.

  13. Tuberculosis diagnostic methods in buffaloes

    Directory of Open Access Journals (Sweden)

    Gabriela Capriogli Oliveira

    2015-07-01

    Full Text Available The low productivity of buffalo herds and condemnation of carcasses in slaughterhouses due to tuberculosis lesions have resulted in increasing economic losses because these animals cannot be treated and must be destroyed by sanitary slaughter. Tuberculosis is a widely distributed zoonosis that affects the beef supply chain of the Brazilian agribusiness economically and socially. Like cattle, buffaloes are sensitive to Mycobacterium bovis, which is the main causative agent of zoonotic tuberculosis. Tuberculosis in buffaloes has been reported in several countries, including Brazil. In order to control and eradicate this disease among cattle and buffaloes in Brazil, the Ministry of Agriculture, Livestock, and Supply created the National Program for the Control and Eradication of Brucellosis and Tuberculosis with the main objective of finding a significant number of disease-free herds throughout the national territory using reliable methods. This review summarizes the main data on the history of occurrence of M. bovis in Brazilian herds and the diagnostic methods for the disease in buffaloes. Little information is available on buffalo tuberculosis. Due to the increasing population of buffaloes and their economic importance, more studies investigating the occurrence and identification of tuberculosis in this species are clearly needed.

  14. Characteristics of pulmonary tuberculosis in HIV seropositive and seronegative patients in a Northeastern region of Brazil

    Directory of Open Access Journals (Sweden)

    Liberato Isabella Ramos de Oliveira

    2004-01-01

    Full Text Available The aim of this study was to analyse the clinical, epidemiological and bacteriological features present in 60 pulmonary tuberculosis patients who were also infected with human immunodeficiency virus (HIV and to compare these with 120 TB patients who were not infected with HIV. The patients with pulmonary tuberculosis and HIV coinfection were mostly male (p = 0.001, showed a higher frequency of weight loss >10 kilos (p <0.001, had a higher rate of non-reaction result to the tuberculin skin test (p <0.001, a higher frequency of negative sputum smear examination for acid-fast bacilli (p = 0.001 and negative sputum culture for Mycobacterium tuberculosis (p = 0.001. Treatment failure was more common in those who were HIV positive (p <0.000. No higher frequency of resistance to antituberculosis drugs was found to be associated with TB/HIV coinfection (p = 0.407. Association between extrapulmonary and pulmonary tuberculosis was more frequent in those seropositive to HIV than those without HIV virus, 30% and 1.6% respectively. These findings showed a predominance of atypical clinical laboratory features in co-infected patients, and suggest that health care personnel should consider the possibility this diagnosis.

  15. Chest radiology in HIV-positive patients with tuberculosis - analysis of 104 cases

    International Nuclear Information System (INIS)

    Radiological examinations from 104 patients HIV-positive with tuberculosis were revised at HUGG/Uni-Rio, during the period from June/86 to June/89. From these, 91.4% were male patients, the predominant risk group was homosexual. Among the women, the most affected group was the intravenous drug consumer. The general age group mostly presented was the one from 20 to 39 years. The main tuberculosis confirmation came from the BAAR research in the sputum (57.6%); the necropsy contributed with 13.5% of the patients. The extrathoracic manifestations occurred in 27% of the cases. The most common radiological patterns were interstitial infiltrate 71.2%, bilateral in 48% of the cases, in the alveolar patterns 63.5%, mostly upper lobes, frequently they were simultaneous. Other important findings were: mediastinal lymphatic involvement, pleural effusion, cavity and X-ray without particularities with pulmonary tuberculosis. A comparison study was performed based on literature data and it was observed atypical patterns for the secondary tuberculosis. (author)

  16. Functional and Structural Characterization of a Thiol Peroxidase from Mycobacterium tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Rho,B.; Hung, L.; Holton, J.; Vigil, D.; Kim, S.; Park, M.; Terwilliger, T.; Pedelacq, j.

    2006-01-01

    A thiol peroxidase (Tpx) from Mycobacterium tuberculosis was functionally analyzed. The enzyme shows NADPH-linked peroxidase activity using a thioredoxin-thioredoxin reductase system as electron donor, and anti-oxidant activity in a thiol-dependent metal-catalyzed oxidation system. It reduces H{sub 2}O{sub 2}, t-butyl hydroperoxide, and cumene hydroperoxide, and is inhibited by sulfhydryl reagents. Mutational studies revealed that the peroxidatic (Cys60) and resolving (Cys93) cysteine residues are critical amino acids for catalytic activity. The X-ray structure determined to a resolution of 1.75 Angstroms shows a thioredoxin fold similar to that of other peroxiredoxin family members. Superposition with structural homologues in oxidized and reduced forms indicates that the M. tuberculosis Tpx is a member of the atypical two-Cys peroxiredoxin family. In addition, the short distance that separates the Ca atoms of Cys60 and Cys93 and the location of these cysteine residues in unstructured regions may indicate that the M. tuberculosis enzyme is oxidized, though the side-chain of Cys60 is poorly visible. It is solely in the reduced Streptococcus pneumoniae Tpx structure that both residues are part of two distinct helical segments. The M. tuberculosis Tpx is dimeric both in solution and in the crystal structure. Amino acid residues from both monomers delineate the active site pocket.

  17. A school microepidemic of tuberculosis.

    OpenAIRE

    Bredin, C. P.; Godfrey, M; McKiernan, J.

    1991-01-01

    BACKGROUND: Microepidemics of tuberculosis continue to occur in countries with a low incidence of tuberculosis. METHODS AND RESULTS: A microepidemic of tuberculosis in a secondary school with 604 girls in Cork city, Ireland, in 1986 with follow up to 1990 is described. Neonatal BCG vaccination was discontinued in the city in December 1972 so most of the 342 pupils who had received BCG were aged 14 years or more. Six active cases and 75 tuberculin positive cases were found. Four of the six gir...

  18. Pontine Infarct Presenting with Atypical Dental Pain: A Case Report.

    Science.gov (United States)

    Goel, Rajat; Kumar, Sanjeev; Panwar, Ajay; Singh, Abhishek B

    2015-01-01

    Orofacial pain' most commonly occurs due to dental causes like caries, gingivitis or periodontitis. Other common causes of 'orofacial pain' are sinusitis, temporomandibular joint(TMJ) dysfunction, otitis externa, tension headache and migraine. In some patients, the etiology of 'orofacial pain' remains undetected despite optimal evaluation. A few patients in the practice of clinical dentistry presents with dental pain without any identifiable dental etiology. Such patients are classified under the category of 'atypical odontalgia'. 'Atypical odontalgia' is reported to be prevalent in 2.1% of the individuals. 'Atypical orofacial pain' and 'atypical odontalgia' can result from the neurological diseases like multiple sclerosis, trigeminal neuralgia and herpes infection. Trigeminal neuralgia has been frequently documented as a cause of 'atypical orofacial pain' and 'atypical odontalgia'. There are a few isolated case reports of acute pontine stroke resulting in 'atypical orofacial pain' and 'atypical odontalgia'. However, pontine stroke as a cause of atypical odontalgia is limited to only a few cases, hence prevalence is not established. This case is one, where a patient presented with acute onset atypical dental pain with no identifiable dental etiology, further diagnosed as an acute pontine infarct on neuroimaging. A 40 years old male presented with acute onset, diffuse teeth pain on right side. Dental examination was normal. Magnetic resonance imaging(MRI) of the brain had an acute infarct in right pons near the trigeminal root entry zone(REZ). Pontine infarct presenting with dental pain as a manifestation of trigeminal neuropathy, has rarely been reported previously. This stresses on the importance of neuroradiology in evaluation of atypical cases of dental pain. PMID:26464604

  19. Cellular therapy in Tuberculosis

    Directory of Open Access Journals (Sweden)

    Shreemanta K. Parida

    2015-03-01

    Full Text Available Cellular therapy now offer promise of potential adjunct therapeutic options for treatment of drug-resistant tuberculosis (TB. We review here the role of Mesenchymal stromal cells, (MSCs, as well as other immune effector cells in the therapy of infectious diseases with a focus on TB. MSCs represent a population of tissue-resident non-hematopoietic adult progenitor cells which home into injured tissues increase the proliferative potential of broncho-alveolar stem cells and restore lung epithelium. MSCs have been shown to be immune-modulatory and anti-inflammatory mediated via cell-cell contacts as well as soluble factors. We discuss the functional profile of MSCs and their potential use for adjunct cellular therapy of multi-drug resistant TB, with the aim of limiting tissue damage, and to convert unproductive inflammatory responses into effective anti-pathogen directed immune responses. Adjunct cellular therapy could potentially offer salvage therapy options for patients with drug-resistant TB, increase clinically relevant anti-M.tuberculosis directed immune responses and possibly shorten the duration of anti-TB therapy.

  20. Cellular therapy in tuberculosis.

    Science.gov (United States)

    Parida, Shreemanta K; Madansein, Rajhmun; Singh, Nalini; Padayatchi, Nesri; Master, Iqbal; Naidu, Kantharuben; Zumla, Alimuddin; Maeurer, Markus

    2015-03-01

    Cellular therapy now offer promise of potential adjunct therapeutic options for treatment of drug-resistant tuberculosis (TB). We review here the role of Mesenchymal stromal cells, (MSCs), as well as other immune effector cells in the therapy of infectious diseases with a focus on TB. MSCs represent a population of tissue-resident non-hematopoietic adult progenitor cells which home into injured tissues increase the proliferative potential of broncho-alveolar stem cells and restore lung epithelium. MSCs have been shown to be immune-modulatory and anti-inflammatory mediated via cell-cell contacts as well as soluble factors. We discuss the functional profile of MSCs and their potential use for adjunct cellular therapy of multi-drug resistant TB, with the aim of limiting tissue damage, and to convert unproductive inflammatory responses into effective anti-pathogen directed immune responses. Adjunct cellular therapy could potentially offer salvage therapy options for patients with drug-resistant TB, increase clinically relevant anti-M.tuberculosis directed immune responses and possibly shorten the duration of anti-TB therapy. PMID:25809753

  1. The resurgence of tuberculosis.

    Science.gov (United States)

    Parry, C; Davies, P D

    1996-01-01

    A lack of reliable statistics makes tuberculosis (TB) trends in developing countries difficult to estimate. Nonetheless, the World Health Organization and the International Union against Tuberculosis and Lung Disease estimated in 1990 that one-third of the world's population was infected with the tubercle bacillus and that there were 7-8 million new cases of TB annually. 95% of the new cases occurred in the developing world, with more than 5 million in Asia and the Western Pacific and more than 1 million in sub-Saharan Africa. Almost 80% of TB cases in developing countries occur among those under age 50 years. The global annual mortality was estimated at 2.5 million, with 98% of deaths occurring in developing countries. Worldwide, TB is believed to be responsible for 25% of avoidable deaths in young adults. There has been no significant decline in the average annual risk of infection in most developing countries due to incomplete coverage by control programs and inadequate cure rates. The interaction of HIV infection with TB is another factor which contributes to the deteriorating TB situation in many developing countries. Countries with a high population growth rate and little decline in the annual risk of infection should expect either a static or increasing level of TB disease. Immigration from developing countries, HIV infection, poverty, unemployment, homelessness, overcrowding, and population aging contribute to the spread of TB in developed countries. Drug resistance thwarts the control of TB worldwide. PMID:8972116

  2. Simultaneous immunization against tuberculosis.

    Directory of Open Access Journals (Sweden)

    Elma Z Tchilian

    Full Text Available BACKGROUND: BCG, the only licensed vaccine against tuberculosis, provides some protection against disseminated disease in infants but has little effect on prevention of adult pulmonary disease. Newer parenteral immunization prime boost regimes may provide improved protection in experimental animal models but are unproven in man so that there remains a need for new and improved immunization strategies. METHODS AND FINDINGS: Mice were immunized parenterally, intranasally or simultaneously by both routes with BCG or recombinant mycobacterial antigens plus appropriate adjuvants. They were challenged with Mycobacterium tuberculosis (Mtb and the kinetics of Mtb growth in the lungs measured. We show that simultaneous immunization (SIM of mice by the intranasal and parenteral routes is highly effective in increasing protection over parenteral BCG administration alone. Intranasal immunization induces local pulmonary immunity capable of inhibiting the growth of Mtb in the early phase (the first week of infection, while parenteral immunization has a later effect on Mtb growth. Importantly, these two effects are additive and do not depend on priming and boosting the immune response. The best SIM regimes reduce lung Mtb load by up to 2 logs more than BCG given by either route alone. CONCLUSIONS: These data establish SIM as a novel and highly effective immunization strategy for Mtb that could be carried out at a single clinic visit. The efficacy of SIM does not depend on priming and boosting an immune response, but SIM is complementary to prime boost strategies and might be combined with them.

  3. Atypical Celiac Disease: From Recognizing to Managing

    Directory of Open Access Journals (Sweden)

    B. Admou

    2012-01-01

    Full Text Available The nonclassic clinical presentation of celiac disease (CD becomes increasingly common in physician’s daily practice, which requires an awareness of its many clinical faces with atypical, silent, and latent forms. Besides the common genetic background (HLA DQ2/DQ8 of the disease, other non-HLA genes are now notably reported with a probable association to atypical forms. The availability of high-sensitive and specific serologic tests such as antitissue transglutuminase, antiendomysium, and more recent antideamidated, gliadin peptide antibodies permits to efficiently uncover a large portion of the submerged CD iceberg, including individuals having conditions associated with a high risk of developing CD (type 1 diabetes, autoimmune diseases, Down syndrome, family history of CD, etc., biologic abnormalities (iron deficiency anemia, abnormal transaminase levels, etc., and extraintestinal symptoms (short stature, neuropsychiatric disorders, alopecia, dental enamel hypoplasia, recurrent aphtous stomatitis, etc.. Despite the therapeutic alternatives currently in developing, the strict adherence to a GFD remains the only effective and safe therapy for CD.

  4. A review of Vitamin D effects on common respiratory diseases: Asthma, chronic obstructive pulmonary disease, and tuberculosis

    OpenAIRE

    Hejazi, Mohammad Esmaeil; Modarresi-Ghazani, Faezeh; Entezari-Maleki, Taher

    2016-01-01

    Despite the classic role of Vitamin D in skeletal health, new aspects of Vitamin D have been discovered in tissues and organs other than bones. Epidemiological and observational studies demonstrate a link between Vitamin D deficiency and risk of developing respiratory diseases including asthma, chronic obstructive pulmonary disease (COPD), and tuberculosis (TB). To review the literature, we searched the terms “Vitamin D” (using the set operator) and “asthma,” “COPD” and “TB” in electronic dat...

  5. Skeletal muscle involvement in cardiomyopathies.

    Science.gov (United States)

    Limongelli, Giuseppe; D'Alessandro, Raffaella; Maddaloni, Valeria; Rea, Alessandra; Sarkozy, Anna; McKenna, William J

    2013-12-01

    The link between heart and skeletal muscle disorders is based on similar molecular, anatomical and clinical features, which are shared by the 'primary' cardiomyopathies and 'primary' neuromuscular disorders. There are, however, some peculiarities that are typical of cardiac and skeletal muscle disorders. Skeletal muscle weakness presenting at any age may indicate a primary neuromuscular disorder (associated with creatine kinase elevation as in dystrophinopathies), a mitochondrial disease (particularly if encephalopathy, ocular myopathy, retinitis, neurosensorineural deafness, lactic acidosis are present), a storage disorder (progressive exercise intolerance, cognitive impairment and retinitis pigmentosa, as in Danon disease), or metabolic disorders (hypoglycaemia, metabolic acidosis, hyperammonaemia or other specific biochemical abnormalities). In such patients, skeletal muscle weakness usually precedes the cardiomyopathy and dominates the clinical picture. Nevertheless, skeletal involvement may be subtle, and the first clinical manifestation of a neuromuscular disorder may be the occurrence of heart failure, conduction disorders or ventricular arrhythmias due to cardiomyopathy. ECG and echocardiogram, and eventually, a more detailed cardiovascular evaluation may be required to identify early cardiac involvement. Paediatric and adult cardiologists should be proactive in screening for neuromuscular and related disorders to enable diagnosis in probands and evaluation of families with a focus on the identification of those at risk of cardiac arrhythmia and emboli who may require specific prophylactic treatments, for example, pacemaker, implantable cardioverter-defibrillator and anticoagulation. PMID:24149064

  6. Keloidal Atypical Fibroxanthoma: Case and Review of the Literature

    Science.gov (United States)

    Tongdee, Emily; Touloei, Khasha; Shitabata, Paul K.; Shareef, Shahjahan; Maranda, Eric L.

    2016-01-01

    Keloidal atypical fibroxanthoma (KAF) has recently been categorized as a variant of atypical fibroxanthoma. This paper will emphasize the importance of including KAF in both clinical and histological differential diagnosis of benign and malignant lesions which exhibit keloidal collagen and will also review the current literature on epidemiology, pathogenesis, histology, immunochemistry and treatments. PMID:27462224

  7. Comparison of sensitivity of quantiferon-tb gold test and tuberculin skin test in active pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Objective: To compare the sensitivity of tuberculin skin test (TST) and quantiFERON-TB gold test (QFT-G) in active pulmonary tuberculosis. Study Design: Analytical study. Place and Duration of Study: Department of Pulmonology, Fauji Foundation Hospital, Rawalpindi, from July 2011 to January 2012. Methodology: QuantiFERON-TB gold test (QFT-G) was evaluated and compared it with tuberculin skin test (TST) in 50 cases of active pulmonary tuberculosis, in whom tuberculous infection was suspected on clinical, radiological and microbiological grounds. Sensitivity was determined against positive growth for Mycobacterium tuberculosis. Results: Out of 50 cases, 43 were females and 7 were males. The mean age was 41.84 A+- 19.03 years. Sensitivity of QFT-G was 80% while that of TST was 28%. Conclusion: QFT-G has much higher sensitivity than TST for active pulmonary tuberculosis. It is unaffected by prior BCG administration and prior exposure to atypical mycobacteria. A positive QFT-G result can be an adjunct to diagnosis in patients having clinical and radiological data compatible with pulmonary tuberculosis. (author)

  8. Tuberculosis treatment and drug regimens.

    Science.gov (United States)

    Sotgiu, Giovanni; Centis, Rosella; D'ambrosio, Lia; Migliori, Giovanni Battista

    2015-05-01

    Tuberculosis is an airborne infectious disease treated with combination therapeutic regimens. Adherence to long-term antituberculosis therapy is crucial for maintaining adequate blood drug level. The emergence and spread of drug-resistant Mycobacterium tuberculosis strains are mainly favored by the inadequate medical management of the patients. The therapeutic approach for drug-resistant tuberculosis is cumbersome, because of the poor, expensive, less-effective, and toxic alternatives to the first-line drugs. New antituberculosis drugs (bedaquiline and delamanid) have been recently approved by the health authorities, but they cannot represent the definitive solution to the clinical management of drug-resistant tuberculosis forms, particularly in intermediate economy settings where the prevalence of drug resistance is high (China, India, and former Soviet Union countries). New research and development activities are urgently needed. Public health policies are required to preserve the new and old therapeutic options. PMID:25573773

  9. Skeletal complications of eating disorders.

    Science.gov (United States)

    Donaldson, Abigail A; Gordon, Catherine M

    2015-09-01

    Anorexia nervosa (AN) is a psychiatric illness with profound medical consequences. Among the many adverse physical sequelae of AN, bone health is impacted by starvation and can be permanently impaired over the course of the illness. In this review of skeletal complications associated with eating disorders, we discuss the epidemiology, neuroendocrine changes, adolescent vs. adult skeletal considerations, orthopedic concerns, assessment of bone health, and treatment options for individuals with AN. The focus of the review is the skeletal sequelae associated with anorexia nervosa, but we also briefly consider other eating disorders that may afflict adolescents and young adults. The review presents updates to the field of bone health in AN, and also suggests knowledge gaps and areas for future investigation. PMID:26166318

  10. [Atypical cerebellar neurocytoma resembling a hemangioblastoma. A case report].

    Science.gov (United States)

    Lista Martínez, Olalla; Rivas López, Luis Alfredo; Pombo Otero, Jorge Francisco; Amaro Cendón, Santiago; Bravo García, Christian; Villa Fernández, Juan Manuel

    2014-01-01

    Through August 2013, 105 cases of intracranial extraventricular neurocytoma (EVN) had been described; 6% were located in cerebellum and 22% were atypical EVN. A rare morphologic form of neurocytoma, atypical EVN has had only 24 cases reported to date. Its prognosis is poorer than the typical central neurocytoma. This case report describes an atypical cerebellar EVN, a form that has not been reported yet, hence the interest of this article. We emphasise its cystic nature and mural nodule, in an infrequent presentation. EVN are low-incidence tumours that we need to take into consideration when making the differential diagnosis of cystic cerebellar lesions with mural nodule. Given that the prognosis of atypical EVNs depends on the atypical nature and on the grade of resection, medical follow up has to be more constant, due to the greater degree of recurrence. PMID:24837842

  11. Tuberculosis involving the oral cavity

    OpenAIRE

    Ferguson, Kathleen A.; McCormack, David G

    1993-01-01

    The oral cavity is a rare site for extrapulmonary tuberculosis. A case is reported of a young woman with dysphagia and oral ulceration. The original mucosal biopsy was negative on smear for acid-fast bacilli, and the patient subsequently developed pulmonary symptoms. A diagnosis of Mycobacterium tuberculosis was ultimately made on open lung biopsy. Complete resolution of both mouth lesion and chest involvement occurred with standard antituberculous therapy.

  12. Peritonitis due to genital tuberculosis

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Mikkelsen, A L; Siemssen, O J

    1985-01-01

    A case of genital tuberculosis is presented. The diagnosis was made by laparotomy and histological examination of biopsies from peritoneum and the Fallopian tube. The literature is reviewed and the diagnostic approach and treatment discussed.......A case of genital tuberculosis is presented. The diagnosis was made by laparotomy and histological examination of biopsies from peritoneum and the Fallopian tube. The literature is reviewed and the diagnostic approach and treatment discussed....

  13. Protect your child against tuberculosis

    OpenAIRE

    Gauci, Charmaine; Pace, David; Malta. Health Promotion & Disease Prevention Directorate; Malta. Advisory committee on immunisation policy Malta; Malta. Sptar Mater Dei; Malta. Primary Health Directorate

    2013-01-01

    Tuberculosis (TB) is a serious infection that can affect the lungs, brain, bones, joints and lymph glands and can result in serious disability or even death. The bacteria that cause TB are spread through close contact such as from coughing or sneezing. Babies and children less than 5 years old can be protected against tuberculosis with the Bacille-Calmette Guérin (BCG) vaccine.

  14. Tuberculosis cysts of the mediastinum

    International Nuclear Information System (INIS)

    A 71-year-old woman was admitted to the hospital with polycystic deformations in the left pulmonary hilus in the mediastinum, found in a routine chest X-ray. The patient had earlier been treated for pulmonary tuberculosis. Mediastinotomia was performed and thin-walled cysts with a creamy type of were found. Microbiological examinations revealed evidence of bacilli tubercles. Medical treatment for tuberculosis was begun, which led to recovery with regression of the cysts. (orig.)

  15. Tuberculosis Susceptibility of Diabetic Mice

    OpenAIRE

    Martens, Gregory W.; Arikan, Meltem Cevik; Lee, Jinhee; Ren, Fucheng; Greiner, Dale; Kornfeld, Hardy

    2007-01-01

    Increased susceptibility to infections, including tuberculosis (TB), is a major cause of morbidity and mortality in patients with diabetes. Despite the clinical importance of this problem, little is known about how diabetes impairs protective immunity. We modeled this phenomenon by infecting acute (⩽ 1 mo) or chronic (⩾ 3 mo) diabetic mice with a low aerosol dose of Mycobacterium tuberculosis (Mtb) Erdman. Diabetes was induced by streptozotocin (STZ) treatment of C57BL/6 mice, while another m...

  16. Increased skeletal muscle capillarization enhances insulin sensitivity

    DEFF Research Database (Denmark)

    Åkerström, Thorbjörn; Laub, Lasse; Vedel, Kenneth;

    2014-01-01

    Increased skeletal muscle capillarization is associated with improved glucose tolerance and insulin sensitivity. However, a possible causal relationship has not previously been identified. We therefore investigated whether increased skeletal muscle capillarization increases insulin sensitivity. S...

  17. Detection and molecular characterization of 9,000-year-old Mycobacterium tuberculosis from a Neolithic settlement in the Eastern Mediterranean.

    Directory of Open Access Journals (Sweden)

    Israel Hershkovitz

    Full Text Available BACKGROUND: Mycobacterium tuberculosis is the principal etiologic agent of human tuberculosis. It has no environmental reservoir and is believed to have co-evolved with its host over millennia. This is supported by skeletal evidence of the disease in early humans, and inferred from M. tuberculosis genomic analysis. Direct examination of ancient human remains for M. tuberculosis biomarkers should aid our understanding of the nature of prehistoric tuberculosis and the host/pathogen relationship. METHODOLOGY/PRINCIPAL FINDINGS: We used conventional PCR to examine bone samples with typical tuberculosis lesions from a woman and infant, who were buried together in the now submerged site of Atlit-Yam in the Eastern Mediterranean, dating from 9,250-8,160 years ago. Rigorous precautions were taken to prevent contamination, and independent centers were used to confirm authenticity of findings. DNA from five M tuberculosis genetic loci was detected and had characteristics consistent with extant genetic lineages. High performance liquid chromatography was used as an independent method of verification and it directly detected mycolic acid lipid biomarkers, specific for the M. tuberculosis complex. CONCLUSIONS/SIGNIFICANCE: Human tuberculosis was confirmed by morphological and molecular methods in a population living in one of the first villages with evidence of agriculture and animal domestication. The widespread use of animals was not a source of infection but may have supported a denser human population that facilitated transmission of the tubercle bacillus. The similarity of the M. tuberculosis genetic signature with those of today gives support to the theory of a long-term co-existence of host and pathogen.

  18. Tuberculosis: looking beyond BCG vaccines.

    Directory of Open Access Journals (Sweden)

    Mustafa Abu S

    2003-01-01

    Full Text Available Tuberculosis (TB is an infectious disease of international importance and ranks among the top 10 causes of death in the World. About one-third of the world′s population is infected with Mycobacterium tuberculosis. Every year, approximately eight million people develop active disease and two million die of TB. The currently used BCG vaccines have shown variable protective efficacies against TB in different parts of the world. Moreover, being a live vaccine, BCG can be pathogenic in immunocompromised recipients. Therefore, there is an urgent need to develop new vaccines against TB. The comparative genome analysis has revealed the existence of several M. tuberculosis-specific regions that are deleted in BCG. The work carried out to determine the immunological reactivity of proteins encoded by genes located in these regions revealed several major antigens of M. tuberculosis, including the 6 kDa early secreted antigen target (ESAT6. Immunization with ESAT6 and its peptide (aa51-70 protects mice challenged with M. tuberculosis. The protective efficacy of immunization further improves when ESAT6 is recombinantly fused with M. tuberculosis antigen 85B. In addition, ESAT6 delivered as a DNA vaccine is also protective in mice. Whether these vaccines would be safe or not cannot be speculated. The answer regarding the safety and efficacy of these vaccines has to await human trials in different parts of the world.

  19. EFFECT OF SOME MEDICINAL PLANTS ON GROWTH OF MYCOBACTERIUM TUBERCULOSIS, MULTI DRUG RESISTANT MYCOBACTERIUM TUBERCULOSIS AND MYCOBACTERIUM OTHER THAN TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Prashant Shukla

    2013-12-01

    Full Text Available Six plants of medicinal uses were tried for their inhibitory effect on Mycobacterium tuberculosis (MTB, multi drug resistant Mycobacterium tuberculosis (MDR MTB and Mycobacterium other than tuberculosis (MOTT. MTB, MDR MTB and MOTT were cultured in 12B medium vials for Bacterc 460 TB system and incubated at 37˚C. The vials were read in Bacterc 460 TB system. Garlic, Ocimum sanctum, onion and neem showed effectiveness towards Mycobacterium tuberculosis and multi drug resistant Mycobacterium tuberculosis to some extent but ginger showed no effect at all. None of the plants studied had any inhibitory effect on Mycobacterium other than tuberculosis. Aloe vera had opposite effect on the growth and it was found to be assisting the growth of Mycobacterium tuberculosis and multi drug resistant Mycobacterium tuberculosis. The tests performed were in-vitro and the authors conlude that in-vivo the results may vary.

  20. Imaging the neurobiological substrate of atypical depression by SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Pagani, Marco [Institute of Cognitive Sciences and Technologies, CNR, Rome (Italy); Karolinska University Hospital, Department of Nuclear Medicine, Stockholm (Sweden); Salmaso, Dario [Institute of Cognitive Sciences and Technologies, CNR, Rome (Italy); Nardo, Davide [University of Rome La Sapienza, Department of Psychology, Rome (Italy); Jonsson, Cathrine; Larsson, Stig A. [Karolinska University Hospital, Department of Nuclear Medicine, Stockholm (Sweden); Jacobsson, Hans [Karolinska University Hospital, Department of Radiology, Stockholm (Sweden); Gardner, Ann [Karolinska University Hospital Huddinge, Karolinska Institutet, Department of Clinical Neuroscience, Section of Psychiatry, Stockholm (Sweden)

    2007-01-15

    Neurobiological abnormalities underlying atypical depression have previously been suggested. The purpose of this study was to explore differences at functional brain imaging between depressed patients with and without atypical features and healthy controls. Twenty-three out-patients with chronic depressive disorder recruited from a service for patients with audiological symptoms were investigated. Eleven fulfilled the DSM-IV criteria for atypical depression (mood reactivity and at least two of the following: weight gain, hypersomnia, leaden paralysis and interpersonal rejection sensitivity). Twenty-three healthy subjects served as controls. Voxel-based analysis was applied to explore differences in {sup 99m}Tc-HMPAO uptake between groups. Patients in the atypical group had a higher prevalence of bilateral hearing impairment and higher depression and somatic distress ratings at the time of SPECT. Significantly higher tracer uptake was found bilaterally in the atypical group as compared with the non-atypicals in the sensorimotor (Brodmann areas, BA1-3) and premotor cortex in the superior frontal gyri (BA6), in the middle frontal cortex (BA8), in the parietal associative cortex (BA5, BA7) and in the inferior parietal lobule (BA40). Significantly lower tracer distribution was found in the right hemisphere in the non-atypicals compared with the controls in BA6, BA8, BA44, BA45 and BA46 in the frontal cortex, in the orbito-frontal cortex (BA11, BA47), in the postcentral parietal cortex (BA2) and in the multimodal association parietal cortex (BA40). The differences found between atypical and non-atypical depressed patients suggest different neurobiological substrates in these patient groups. The putative links with the clinical features of atypical depression are discussed. These findings encourage the use of functional neuroimaging in psychiatric disorders. (orig.)

  1. Imaging the neurobiological substrate of atypical depression by SPECT

    International Nuclear Information System (INIS)

    Neurobiological abnormalities underlying atypical depression have previously been suggested. The purpose of this study was to explore differences at functional brain imaging between depressed patients with and without atypical features and healthy controls. Twenty-three out-patients with chronic depressive disorder recruited from a service for patients with audiological symptoms were investigated. Eleven fulfilled the DSM-IV criteria for atypical depression (mood reactivity and at least two of the following: weight gain, hypersomnia, leaden paralysis and interpersonal rejection sensitivity). Twenty-three healthy subjects served as controls. Voxel-based analysis was applied to explore differences in 99mTc-HMPAO uptake between groups. Patients in the atypical group had a higher prevalence of bilateral hearing impairment and higher depression and somatic distress ratings at the time of SPECT. Significantly higher tracer uptake was found bilaterally in the atypical group as compared with the non-atypicals in the sensorimotor (Brodmann areas, BA1-3) and premotor cortex in the superior frontal gyri (BA6), in the middle frontal cortex (BA8), in the parietal associative cortex (BA5, BA7) and in the inferior parietal lobule (BA40). Significantly lower tracer distribution was found in the right hemisphere in the non-atypicals compared with the controls in BA6, BA8, BA44, BA45 and BA46 in the frontal cortex, in the orbito-frontal cortex (BA11, BA47), in the postcentral parietal cortex (BA2) and in the multimodal association parietal cortex (BA40). The differences found between atypical and non-atypical depressed patients suggest different neurobiological substrates in these patient groups. The putative links with the clinical features of atypical depression are discussed. These findings encourage the use of functional neuroimaging in psychiatric disorders. (orig.)

  2. EFFECT OF SOME MEDICINAL PLANTS ON GROWTH OF MYCOBACTERIUM TUBERCULOSIS, MULTI DRUG RESISTANT MYCOBACTERIUM TUBERCULOSIS AND MYCOBACTERIUM OTHER THAN TUBERCULOSIS

    OpenAIRE

    Prashant Shukla; Ajay Sharma

    2013-01-01

    Six plants of medicinal uses were tried for their inhibitory effect on Mycobacterium tuberculosis (MTB), multi drug resistant Mycobacterium tuberculosis (MDR MTB) and Mycobacterium other than tuberculosis (MOTT). MTB, MDR MTB and MOTT were cultured in 12B medium vials for Bacterc 460 TB system and incubated at 37˚C. The vials were read in Bacterc 460 TB system. Garlic, Ocimum sanctum, onion and neem showed effectiveness towards Mycobacterium tuberculosis and multi drug resistant Mycobacterium...

  3. Foot and ankle tuberculosis: case series and literature review.

    Science.gov (United States)

    Korim, Muhammad; Patel, Rizwan; Allen, Patricia; Mangwani, Jitendra

    2014-12-01

    Foot and ankle tuberculosis (TB) is a rare presentation of skeletal TB. The uncommon site along with low index of clinical suspicion in the western world leads to delays in the diagnosis and treatment. This can make joint sparing procedures less successful, especially in the midfoot where the joints can often be interconnected. Plain radiographs have low sensitivity and specificity and cross sectional imaging in the form of MRI or CT is more reliable. Treatment involves the use of multiple anti-tuberculous drugs in the first instance, followed by surgery to address any symptomatic deformity and/or secondary degenerative changes. We present our experience on the management of this rare problem and review the literature on the clinical presentation, diagnosis, imaging modalities and treatment. PMID:25178156

  4. Pediatric postprimary pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Heading AbstractBackground. Postprimary pulmonary tuberculosis (TB) is not commonly seen in children.Objective. The purpose of this study was to determine the radiographic findings and patient characteristics of pediatric postprimary pulmonary TB.Materials and methods. We reviewed the clinical charts and chest radiographs in six patients.Results. The radiographic findings of pediatric postprimary pulmonary TB include upper-lobe consolidation and cavitation, multifocal ill-defined airspace opacities, evidence of prior pulmonary TB, and apical pleural thickening. Pleural effusions and lymphadenopathy are not commonly present. Although postprimary disease typically does not affect young children, five of the children in this series were less than ten years of age at the time of presentation.Conclusion The possibility of postprimary TB should be considered in pediatric patients at risk for this disease who present with upper-lobe pulmonary consolidation and cavitation. These patients are highly infectious and early recognition and treatment can limit transmission of TB. (orig.)

  5. HIV-Associated Tuberculosis.

    Science.gov (United States)

    Naidoo, Kogieleum; Naidoo, Kasavan; Padayatchi, Nesri; Abdool Karim, Quarraisha

    2011-01-01

    The intersecting HIV and Tuberculosis epidemics in countries with a high disease burden of both infections pose many challenges and opportunities. For patients infected with HIV in high TB burden countries, the diagnosis of TB, ARV drug choices in treating HIV-TB coinfected patients, when to initiate ARV treatment in relation to TB treatment, managing immune reconstitution, minimising risk of getting infected with TB and/or managing recurrent TB, minimizing airborne transmission, and infection control are key issues. In addition, given the disproportionate burden of HIV in women in these settings, sexual reproductive health issues and particular high mortality rates associated with TB during pregnancy are important. The scaleup and resource allocation to access antiretroviral treatment in these high HIV and TB settings provide a unique opportunity to strengthen both services and impact positively in meeting Millennium Development Goal 6. PMID:20871843

  6. Skeletal Muscle Hypertrophy after Aerobic Exercise Training

    OpenAIRE

    Konopka, Adam R.; Harber, Matthew P.

    2014-01-01

    Current dogma suggests aerobic exercise training has minimal effect on skeletal muscle size. We and others have demonstrated that aerobic exercise acutely and chronically alters protein metabolism and induces skeletal muscle hypertrophy. These findings promote an antithesis to the status quo by providing novel perspective on skeletal muscle mass regulation and insight into exercise-countermeasures for populations prone to muscle loss.

  7. Skeletal stem cells in space and time

    DEFF Research Database (Denmark)

    Kassem, Moustapha; Bianco, Paolo

    2015-01-01

    The nature, biological characteristics, and contribution to organ physiology of skeletal stem cells are not completely determined. Chan et al. and Worthley et al. demonstrate that a stem cell for skeletal tissues, and a system of more restricted, downstream progenitors, can be identified in mice...... and demonstrate its role in skeletal tissue maintenance and regeneration....

  8. Atypical Radiological Manifestation of Pulmonary Metastatic Calcification

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Hae; Kim, Eun Sun; Kim, Chul Hwan; Ham, Soo Youn; Oh, Yu Whan [Korea University College of Medicine, Seoul (Korea, Republic of)

    2008-04-15

    Metastatic pulmonary calcification is a condition of calcium deposition in the normal pulmonary parenchyma, and this is secondary to abnormal calcium metabolism without any prior soft tissue damage. The predisposing factors for this condition include chronic renal failure, hypercalcemia and increased tissue alkalinity. The most common radiologic manifestation consists of poorly defined nodular opacities in the upper lung zone. These opacities reflect the deposition of calcium salts in the pulmonary interstitium. We present here a case of metastatic pulmonary calcification in a patient who recovered from pneumonia with sepsis and whose high-resolution CT (HRCT) images demonstrated localized parenchymal airspace calcification that was limited to the bilateral lower lobes. These lower lobes had been involved with pneumonic consolidation without calcification, as seen on the previous CT scan. In summary, we report here on an atypical presentation of metastatic pulmonary calcification that showed dense airspace consolidation localized to the bilateral lower lobes in a patient with primary hyperparathyroidism and pneumonia.

  9. [Atypical early posttraumatic syndromes (author's transl)].

    Science.gov (United States)

    Muller, G E

    1974-01-01

    In a consecutive series of 1,925 head injuries, 283 patients (14.7%), could not be classified, neither in the group of simple head injuries without cerebral symptoms, nor in the group of typical concussions characterized by immediate amnesia or observed coma. We have prefered the rather neutral term of atypical early posttraumatic syndromes. In this group, apart from neurovegetative manifestations, partial disturbances of consciousness and perception, we have also classified delayed disturbances of consciousness. Special attention has been given to migraineous phenomena and to a syndrome, characteristic for children, described by Mealey. This is an intermediate group important from a medico-legal point of view because certain transient cerebral manifestations risk to be mistaken for psychological reactions. On the other hand symptoms probably of psychic origin were discussed. PMID:4469864

  10. Pedal edema associated with atypical antipsychotics

    Directory of Open Access Journals (Sweden)

    Santanu Munshi

    2016-01-01

    Full Text Available This study describes a patient diagnosed as a case of bipolar affective disorder complaining of bothersome incidence of pedal edema 1 month after the initiation of atypical antipsychotic regimen with risperidone and quetiapine. All hematological and biochemical profiles were found to be normal. On discontinuation of risperidone, the condition remained unresolved even after 2 weeks, and the edema progressed reaching her calves. On tapering the dose of quetiapine, she started showing gradual improvement in edematous condition. Quetiapine was slowly discontinued. No further recurrence of edema occurred, and hence, no further medication changes were implemented. Pedal edema was found to be resolved within weeks of dechallenge of the regimen. Naranjo adverse drug reaction probability scale gave a score of 7 which denotes "probable" adverse drug reaction with quetiapine.

  11. [Treatment of atypical and neurotic depression].

    Science.gov (United States)

    Leitner, P; Umann, E; Kulawik, H

    1986-10-01

    Hitherto it has not been usual to talk in the German language about the therapy-oriented concept of two forms of the progress of atypical depression (Type A and Type V). The characteristic symptom of Type A is angst, together with phobias, physical complaints, etc. In Type V there are vegetative symptoms, often towards evening (Hypersomnia, difficulty in getting to sleep, increased appetite, increased weight, increased libido), accompanied by hysterical extrovert personality traits, and of intermittent occurrence. These clinical pictures are amenable to psychopharmalogical therapy. In conformity with the assumption of "somatic accommodation" treatment with antidepressives is recommended in the case neurotic depression, too, at least in the initial stages of treatment. PMID:3809300

  12. Atypical subtrochanteric and diaphyseal femoral fractures

    DEFF Research Database (Denmark)

    Shane, Elizabeth; Burr, David; Abrahamsen, Bo;

    2014-01-01

    Bisphosphonates (BPs) and denosumab reduce the risk of spine and nonspine fractures. Atypical femur fractures (AFFs) located in the subtrochanteric region and diaphysis of the femur have been reported in patients taking BPs and in patients on denosumab, but they also occur in patients with no...... exposure to these drugs. In this report, we review studies on the epidemiology, pathogenesis, and medical management of AFFs, published since 2010. This newer evidence suggests that AFFs are stress or insufficiency fractures. The original case definition was revised to highlight radiographic features that...... distinguish AFFs from ordinary osteoporotic femoral diaphyseal fractures and to provide guidance on the importance of their transverse orientation. The requirement that fractures be noncomminuted was relaxed to include minimal comminution. The periosteal stress reaction at the fracture site was changed from a...

  13. Case Report: Atypical Cornelia de Lange Syndrome.

    Science.gov (United States)

    Leanza, Vito; Rubbino, Gabriella; Leanza, Gianluca

    2014-01-01

    Cornelia de Lange Syndrome (CdLS) (also called Bushy Syndrome or Amsterdam dwarfism), is a genetic disorder that can lead to several alterations. This disease affects both physical and neuropsychiatric development. The various abnormalities include facial dysmorphia (arched eyebrows, synophrys, depressed nasal bridge, long philtrum, down-turned angles of the mouth), upper-extremity malformations, hirsutism, cardiac defects, and gastrointestinal alterations. The prevalence of this syndrome is approximately one per 15,000. Ultrasound is not the perfect means to diagnose CdLS, however, many abnormalities can be detected prenatally by scrupulous image observation. We report an atypical CdLS case characterized by increased nuchal translucency in the first trimester, normal karyotype, saddle nose, micrognathia with receding jaw, low set ears, facies senilis, arthrogryposis of the hands, absence of the Aranzio ductus venous, dilatation of gallbladder and bowel, a unique umbilical artery, increased volume of amniotic fluid, and intrauterine growth retardation ending with the interruption of pregnancy. PMID:26834972

  14. Thymic carcinoma presenting as atypical chest pain.

    Science.gov (United States)

    Siddiqui, Sadiq; Connelly, Tara; Keita, Luther; Blazkova, Sylvie; Veerasingam, Dave

    2015-01-01

    A 58-year-old woman with a 2-month history of atypical chest pain was referred to the chest pain clinic by the general practitioner. Exercise stress test was positive and subsequent coronary angiogram revealed significant triple vessel disease with left ventricular impairment requiring a coronary artery bypass graft (CABG). The patient had a chest X-ray as part of the preoperative work up. Chest X-ray revealed a large anterior mediastinal mass. Subsequent thorax CT revealed a 7.2 cm anterior mediastinal mass. CT-guided biopsy of the mass revealed the diagnosis of a poorly differentiated thymic basaloid carcinoma. The patient was successfully treated with concomitant surgery involving complete resection of the mass and a CABG procedure. PMID:26607199

  15. Comparative Study of Skeletal Stability between Postoperative Skeletal Intermaxillary Fixation and No Skeletal Fixation after Bilateral Sagittal Split Ramus Osteotomy

    DEFF Research Database (Denmark)

    Hartlev, Jens; Godtfredsen, Erik; Andersen, Niels Trolle; Jensen, Thomas

    2014-01-01

    OBJECTIVES: The purpose of the present study was to evaluate skeletal stability after mandibular advancement with bilateral sagittal split osteotomy. MATERIAL AND METHODS: Twenty-six patients underwent single-jaw bilateral sagittal split osteotomy (BSSO) to correct skeletal Class II malocclusion...... between the skeletal IMF group and the no skeletal group regarding advancement nor relapse at B-point or Pog. CONCLUSIONS: Bilateral sagittal split osteotomy is characterized as a stable treatment to correct Class II malocclusion. This study demonstrated no difference of relapse between the skeletal...

  16. A case of atypical progressive supranuclear palsy

    Directory of Open Access Journals (Sweden)

    Spaccavento S

    2013-12-01

    Full Text Available Simona Spaccavento, Marina Del Prete, Angela Craca, Anna Loverre IRCCS Salvatore Maugeri Foundation, Cassano Murge, Bari, Italy Background: Progressive supranuclear palsy (PSP is a neurodegenerative extrapyramidal syndrome. Studies have demonstrated that PSP can present clinically as an atypical dementing syndrome dominated by a progressive apraxia of speech (AOS and aphasia. Aim: We aimed to investigate the clinical presentation of PSP, using a comprehensive multidimensional evaluation, and the disease response to various pharmacological treatments. Methods: A 72-year-old right-handed male, with 17 years education, who first presented with aphasia, AOS, depression, apathy, and postural instability at 69 years; a complete neuropsychological evaluation, tapping the different cognitive domains, was performed. Results: Testing revealed a moderate global cognitive deficit (Mini-Mental State Examination test score =20, low memory test scores (story recall, Rey’s 15-word Immediate and Delayed Recall, and poor phonemic and semantic fluency. The patient’s language was characterized by AOS, with slow speech rate, prolonged intervals between syllables and words, decreased articulatory accuracy, sound distortions, and anomia. Behavioral changes, such as depression, anxiety, apathy, and irritability, were reported. The neurological examination revealed supranuclear vertical gaze palsy, poor face miming, and a mild balance deficit. Magnetic resonance imaging showed only widespread cortical atrophy. Single photon emission computed tomography demonstrated left > right frontotemporal cortical abnormalities. After 6 months, a further neuropsychological assessment showed a progression in cognitive deficits, with additional attention deficits. The patient reported frequent falls, but the neurological deficits remained unchanged. Neuroimaging tests showed the same brain involvement. Conclusion: Our case highlights the heterogeneity of the clinical features in

  17. An unusual presentation of tuberculosis in pregnancy

    Institute of Scientific and Technical Information of China (English)

    GAO Xue-lian; Rajat Gyaneshwar

    2007-01-01

    @@ Tuberculosis (TB) is a systemic infection caused by Mycobacterium tuberculosis. Extrapulmonary TB accounts for 10% to 27% of all the patients with TB.1 Here we report an unusual case of extrapulmonary TB in a pregnant woman.

  18. CDC WONDER: Online Tuberculosis Information System (OTIS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Online Tuberculosis Information System (OTIS) on CDC WONDER contains information on verified tuberculosis (TB) cases reported to the Centers for Disease Control...

  19. Tuberculosis, advanced - chest x-rays (image)

    Science.gov (United States)

    Tuberculosis is an infectious disease that causes inflammation, the formation of tubercules and other growths within tissue, ... death. These chest x-rays show advanced pulmonary tuberculosis. There are multiple light areas (opacities) of varying ...

  20. Tuberculosis health belief gaps of tuberculosis and suspected tuberculosis cases in New York City

    Directory of Open Access Journals (Sweden)

    Ikoli Llongo

    2004-01-01

    Full Text Available Se realizó un estudio transversal no aleatorio en el que se evaluaban las creencias sobre la tuberculosis. Se empleó un instrumento de 51 ítem dividido en los cinco constructos del modelo de creencias de salud, que fue administrado a sujetos con una posible tuberculosis (n=89 y a casos de tuberculosis activa (n=110 en un hospital de Nueva York. El objetivo de este estudio fue identificar la congruencia/incongruencia de las creencias mediante el análisis detallado de los ítem sobre tuberculosis, con el fin de realizar comparaciones intragrupo sobre las diferencias demográficas en los casos activos de tuberculosis (n=110. El análisis de ítem realizado con la población estudiada mostró diferentes fallos en el sistema de creencias. Existían diferencias demográficas intragrupo según el análisis multivariado t de Hotelling, con significación estadística en cuanto a las creencias religiosas (p= 0,022 y el tipo de vivienda (p=0,025. Algunos que mostraban variación significativa en la prueba F estaban basados en la religión, como la severidad/eficacia (p=0,003/0,024 y en la vivienda (Beneficios p=0,002 en los 110 casos de tuberculosis. Finalmente, se discuten las implicaciones de estos hallazgos.

  1. LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statement

    DEFF Research Database (Denmark)

    Mack, U; Migliori, G B; Sester, M;

    2009-01-01

    Tuberculosis control relies on the identification and preventive treatment of individuals who are latently infected with Mycobacterium tuberculosis. However, direct identification of latent tuberculosis infection is not possible. The diagnostic tests used to identify individuals latently infected...... improved, if we were to gain a better understanding on M. tuberculosis latency and reactivation. This statement by the TBNET summarises knowledge and limitations of the currently available tests used in adults and children for the diagnosis of latent tuberculosis infection. In summary, the main issue...

  2. Atypical post operative discharging sinus - a case report.

    Science.gov (United States)

    Akhter, S N; Khondker, N S; Tasneem, S

    2015-04-01

    Surgical site infections (SSIs) are the second most common health care associated infection reported to the National Health Safety Network of the centre of disease control and prevention. SSIs by Mycobacterium tuberculosis are uncommon and diagnosis can be missed. Our patient had primary tuberculosis at surgical site without any evidence of tuberculosis at initial investigation. She presented with repeated discharging sinus at the wound of elective lower uterine caesarean section (LUCS). The case was diagnosed by histo-pathological evidence of chronic granulomatous lesion suggestive of tuberculosis from the excised tissue from wound and detection of acid fast bacilli (AFB) from swab by Ziehl Neelsen staining. After proper diagnosis the patient was treated with anti-tubercular drugs regiment for six months as per schedule of national guidelines for management of tuberculosis of Bangladesh Government. Then the patient was cured from unusual long sufferings. PMID:26007279

  3. Primer Parotid Tuberculosis in Two Siblings

    OpenAIRE

    Baylan, Muzeyyen Yildirim; Ozmen, Cihan Akgul; Samanci, Baver

    2013-01-01

    Tuberculosis of the parotid gland is an uncommon disease. In this study, we present primary parotid tuberculosis in two siblings. Two female siblings, of 16 and 14 years of age, presented with unilateral masses in the parotid region. Acid-fast bacilli were found in the aspiration fluid of the lesion. After the tuberculosis treatment, the patients were doing well. In this study, we discussed clinical presentation, diagnosis, treatment of primary parotid tuberculosis, and noteworthiness the tra...

  4. Triple trouble : tuberculosis, HIV infection and malnutrition

    OpenAIRE

    Lettow, Monique Hendrika Elizabeth van

    2005-01-01

    Tuberculosis has emerged as the second commonest cause of death from infectious disease worldwide, after HIV/AIDS, killing nearly 2 million people each year. Most cases occur in less-developed countries. The human immunodeficiency virus (HIV) is the greatest single risk factor for the development of active tuberculosis in adults. Hence, over the past decade, tuberculosis incidence has increased in Africa, mainly as a result of the burden of HIV infection. The association between tuberculosis ...

  5. Choosing a skeletal muscle relaxant.

    Science.gov (United States)

    See, Sharon; Ginzburg, Regina

    2008-08-01

    Skeletal muscle relaxants are widely used in treating musculoskeletal conditions. However, evidence of their effectiveness consists mainly of studies with poor methodologic design. In addition, these drugs have not been proven to be superior to acetaminophen or nonsteroidal anti-inflammatory drugs for low back pain. Systematic reviews and meta-analyses support using skeletal muscle relaxants for short-term relief of acute low back pain when nonsteroidal anti-inflammatory drugs or acetaminophen are not effective or tolerated. Comparison studies have not shown one skeletal muscle relaxant to be superior to another. Cyclobenzaprine is the most heavily studied and has been shown to be effective for various musculoskeletal conditions. The sedative properties of tizanidine and cyclobenzaprine may benefit patients with insomnia caused by severe muscle spasms. Methocarbamol and metaxalone are less sedating, although effectiveness evidence is limited. Adverse effects, particularly dizziness and drowsiness, are consistently reported with all skeletal muscle relaxants. The potential adverse effects should be communicated clearly to the patient. Because of limited comparable effectiveness data, choice of agent should be based on side-effect profile, patient preference, abuse potential, and possible drug interactions. PMID:18711953

  6. Patterns and predictors of atypical language representation in epilepsy.

    Science.gov (United States)

    Dijkstra, Krijn Kristian; Ferrier, Cyrille Henri

    2013-04-01

    In the majority of the normal population, the left hemisphere is dominant for language. In epilepsy, a higher proportion of 'atypical' language representation is encountered. This can follow one of three patterns: (1) altered interhemispheric representation, where the spectrum of lateralisation is shifted to the right; (2) interhemispheric dissociation of linguistic subfunctions; or (3) intrahemispheric changes in representation. Knowledge of these patterns is essential for avoiding postoperative language deficits in epilepsy patients undergoing surgery. Several predictors of atypical language representation exist. It is more prevalent in left-handed individuals. Lesions in rough proximity to classical language areas are more associated with atypical language, although in some cases, remote lesions, such as in the hippocampus, can also lead to altered language representation. The more disruptive the lesion, the more likely atypical language is to be found. Widespread and frequent interictal epileptiform discharges are also associated with atypical language. Atypical language representation is more likely to be present when injury or epilepsy onset occurred at a young age. Thus, a subgroup of patients can be defined in whom atypical language representation is more likely to be found. PMID:22942215

  7. Malignant atypical cell in urine cytology: a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Kakkar Nandita

    2006-01-01

    Full Text Available Abstract Aims The aim of this study was to find out the characteristic morphology of malignant atypical cells which were missed on routine cytology of urine. Materials and methods In this retrospective study, we examined detailed cytomorphology of 18 cases of atypical urinary cytology which were missed on routine examination and were further proved on histopathology as transitional cell carcinoma (TCC of bladder. The cytological features of these cases were compared with 10 cases of benign urine samples. Results There were 11 cases of high grade TCC and 7 cases of low grade TCC on histopathology of the atypical urine samples. Necrosis in the background and necrosed papillae were mostly seen in malignant atypical cells. The comet cells and cells with India ink nuclei (single cells with deep black structure-less nuclei were only observed in malignant atypical cells. The most consistent features in malignant atypical cells were: i high nuclear and cytoplasmic (N/C ratio ii nuclear pleomorphism iii nuclear margin irregularity iv hyperchromasia and v chromatin abnormalities Conclusion The present study emphasizes that nuclear features such as high N/C ratio, hyperchromasia and chromatin abnormalities are particularly useful for assessing the malignant atypical cells. Other cytological features such as comet cells and cells with India ink nuclei are also helpful for diagnosis but have limited value because they are less frequently seen.

  8. Langerhans cell histiocytosis: unusual skeletal manifestations observed in thirty-four cases

    Energy Technology Data Exchange (ETDEWEB)

    Hindman, B.W.; Thomas, R.D.; Young, Lionel W. [Loma Linda University Medical Center, 11234 Anderson Street, Loma Linda, CA 92354 (United States); Yu, Leisure [Department of Orthopedic Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354 (United States)

    1998-04-01

    Objective. Unusual manifestations are occasionally encountered in Langerhans cell histiocytosis and may be a source of confusion. The objective of this study was to determine the frequency of occurrence of the unusual manifestations in our case material. Design and patients. Thirty-four children, average age 4.4 years (range 3 months to 16 years) with 262 skeletal lesions of biopsy-proven Langerhans cell histiocytosis (LCH) were retrospectively reviewed to determine the frequency of occurrence of unusual manifestations defined either as an atypical location of a skeletal lesion or an atypical radiographic appearance of the lesion. Results. Twenty-four unusual lesions were found in this retrospective review. Among these were epiphyseal lesions, transphyseal lesions, extracranial `button` sequestra, posterior vertebral arch lesions, dural extension of vertebral lesions, and fluid-fluid levels. The finding of fluid-fluid levels has not previously been described in the radiologic literature. Involvement of unusual sites included clavicles and small bones of the hands and feet. Conclusions. Radiographic, computed tomographic, and magnetic resonance imaging of LCH yield a variety of unusual manifestations. Recognition of these varied appearances of LCH may prevent confusion of such appearances with other pathologic processes. When the unusual manifestation occurs as the initial finding of the disease, LCH should be included in the differential diagnosis. (orig.) With 7 figs., 10 refs.

  9. Langerhans cell histiocytosis: unusual skeletal manifestations observed in thirty-four cases

    International Nuclear Information System (INIS)

    Objective. Unusual manifestations are occasionally encountered in Langerhans cell histiocytosis and may be a source of confusion. The objective of this study was to determine the frequency of occurrence of the unusual manifestations in our case material. Design and patients. Thirty-four children, average age 4.4 years (range 3 months to 16 years) with 262 skeletal lesions of biopsy-proven Langerhans cell histiocytosis (LCH) were retrospectively reviewed to determine the frequency of occurrence of unusual manifestations defined either as an atypical location of a skeletal lesion or an atypical radiographic appearance of the lesion. Results. Twenty-four unusual lesions were found in this retrospective review. Among these were epiphyseal lesions, transphyseal lesions, extracranial 'button' sequestra, posterior vertebral arch lesions, dural extension of vertebral lesions, and fluid-fluid levels. The finding of fluid-fluid levels has not previously been described in the radiologic literature. Involvement of unusual sites included clavicles and small bones of the hands and feet. Conclusions. Radiographic, computed tomographic, and magnetic resonance imaging of LCH yield a variety of unusual manifestations. Recognition of these varied appearances of LCH may prevent confusion of such appearances with other pathologic processes. When the unusual manifestation occurs as the initial finding of the disease, LCH should be included in the differential diagnosis. (orig.)

  10. Mycobacterium tuberculosis monoarthritis in a child

    Directory of Open Access Journals (Sweden)

    Rosenberg Alan M

    2008-09-01

    Full Text Available Abstract A child with isolated Mycobacterium tuberculosis monoarthritis, with features initially suggesting oligoarthritis subtype of juvenile idiopathic arthritis, is presented. This patient illustrates the need to consider the possibility of tuberculosis as the cause of oligoarthritis in high-risk pediatric populations even in the absence of a tuberculosis contact history and without evidence of overt pulmonary disease.

  11. Pancreaticoduodenal Tuberculosis Simulating Metastatic Ovarian Carcinoma

    OpenAIRE

    1997-01-01

    A patient from Thailand presented with symptoms suggestive of peptic ulceration. Radiology showed an ulcerated duodenal stricture, a pancreaticoduodenal mass and extensive retroperitoneal lymphadenopathy suggestive of metastatic carcinoma. Tuberculosis was diagnosed only at laparotomy. The incidence of tuberculosis is increasing, and alimentary tuberculosis should be considered in patients from populations at risk presenting with obscure abdominal complaints or unexplained radiologic findings.

  12. 9 CFR 381.81 - Tuberculosis.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Tuberculosis. 381.81 Section 381.81 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... § 381.81 Tuberculosis. Carcasses of poultry affected with tuberculosis shall be condemned....

  13. Tuberculosis Facts - You Can Prevent TB

    Science.gov (United States)

    Tuberculosis (TB) Facts You Can Prevent TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination TB Facts: You Can Prevent TB What ...

  14. 38 CFR 3.959 - Tuberculosis.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Tuberculosis. 3.959..., Compensation, and Dependency and Indemnity Compensation Protection § 3.959 Tuberculosis. Any veteran who, on...) tuberculosis may receive compensation under 38 U.S.C. 1114(q) and 1156 as in effect before August 20,...

  15. Tuberculosis Facts - TB Can Be Treated

    Science.gov (United States)

    Tuberculosis (TB) Facts TB Can Be Treated What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination Page 1 of 2 TB Facts: TB ...

  16. Frequency of a typical radiological pattern of pulmonary tuberculosis in adults and elderly (dissertation based article)

    International Nuclear Information System (INIS)

    Tuberculosis is one of the oldest diseases and one third of the world's population is affected. Typical pattern (infiltration and or nodules with or without cavitations involving upper zone lung field) of pulmonary tuberculosis is the most common mode of radiological presentation in adults. There is a trend towards a relative increase in the unusual radiological presentations. This study was conducted to determine the frequency of atypical radiological trend of pulmonary tuberculosis in adults and elderly. Subjects and Methods: The objective of the study was to determine frequency of a typical radiological pattern of pulmonary tuberculosis in adults and elderly. It was a descriptive (case series) study and was conducted in the Department of Pulmonology, Nishtar Hospital Multan. The study duration was six months from 24 May 2006 to 23 November 2006. 300 patients presenting with pulmonary tuberculosis were selected. History and clinical examination was done. Relevant investigations and x-ray chest were carried out. Lesions like infiltration with or without cavitation were localized in upper, middle and lower zones. Groups of patients with their x-ray findings in different zones were made and analyzed accordingly, data collected were entered in specific proforma. Results: 205 (97.6%) adults and 85 (94.4%) elderly presented with cough while 205 (97.6%) adults and 75 (83.3%) elderly presented with fever. Out of 300 cases infiltration was found in 141 (46.19% vs 48.88%) young adult and elderly cases. There were 99 cases with nodule (35.71% vs 26.66%) and 60 cases had cavitation (18.09% vs 24.44%). Conclusion: There is a trend towards a relative increase in the frequency of unusual radiological presentations which is more common in elderly. (author)

  17. [The modern concept of atypical depression: four definitions].

    Science.gov (United States)

    Ohmae, Susumu

    2010-01-01

    This report describes and compares four current concepts and definitions of atypical depression. Since its emergence, atypical depression has been considered a depressive state that can be relieved by MAO inhibitors. Davidson classified the symptomatic features of atypical depression into type A, which is predominated by anxiety symptoms, and type V, which is represented by atypical vegetative symptoms, such as hyperphagia, weight gain, oversleeping, and increased sexual drive. Features that are shared by both subtypes include: early onset, female predominance, outpatient predominance, mildness, few suicide attempts, nonbipolarity, nonendogeneity, and few psychomotor changes. Based on these features, bipolar depression can also be defined as atypical depression type V. Herein, we examine and classify four concepts of atypical depression according to the endogenous-nonendogenous (melancholic-nonmelancholic) and unipolar-bipolar dichotomies. The Columbia University group (see Quitkin, Stewart, McGrath, Klein et al.) and the New South Wales University group (see Parker) consider atypical depression to be chronic, mild, nonendogenous (nonmelancholic), unipolar depression. The former group postulates that mood reactivity is necessary, while the latter asserts the structural priority of anxiety symptoms over mood symptoms and the significance of interpersonal rejection sensitivity. For the Columbia group, the significance of mood reactivity reflects the theory that mood nonreactivity is the essential symptom of "endogenomorphic depression", which was proposed by Klein as typical depression. Thus, mood reactivity is not related to overreactivity or hyperactivity, which are often observed in atypical depressives. However, Parker postulates that psychomotor symptoms are the essential features of melancholia, which he recognizes as typical depression; therefore, the New South Wales group does not recognize the significance of mood reactivity. The New South Wales group

  18. [Tuberculosis--a neverending story].

    Science.gov (United States)

    Dzieciołowska-Baran, Edyta; Gawlikowska-Sroka, Aleksandra

    2013-01-01

    It is estimated that over one third of the human population is now exposed or has been exposed in the past to Mycobacterium tuberculosis, and new infections occur in the world at a rate of one per second. The history of tuberculosis is long and very interesting, because before the isolation of mycobacteria and the finding of a cure, the disease mercilessly killed thousands of people and deprived doctors of hope. Robert Koch's momentous discovery was a major breakthrough in the fight against tuberculosis. Unfortunately, the disease has never been fully controlled. Tuberculosis is a chronic infectious disease localized in 90-95% of cases in the lungs, and therefore it is extremely difficult to diagnose unequivocally in paleopathological material. Only the form of osteo-arthritis leaves traces in archaeological material. The earliest evidence of tuberculosis (the location of the spine, Pott's disease) in the form of fossils is dated to before 8000 BC. Another very old trace is considered to be human remains from the Neolithic period (ca 5000 BC), found near Heidelberg, where changes in the thoracic spine are typical for spondylitis in tuberculosa. Constant growth in the incidence of new cases in the world can be observed today. Not everyone infected will develop the full-blown disease. The infection may remain dormant. However, one in ten latent infections will subsequently be activated, leading, if not treated, to the death of almost half of the patients. PMID:25026769

  19. [The child in tuberculosis hotbeds].

    Science.gov (United States)

    Răduţă, Mihaela

    2002-01-01

    The city of Cluj-Napoca and the Cluj County, once situated in the comfortable zone of tuberculosis incidence, below the country, average, have registered a permanent and alarming increase in the both adult and child incidence of tuberculosis the last 5 years, which made us find the analysis of the phenomenon useful and constructive--having in view children mainly. Therefore we started to study all the adult bacillary hotbeds, bacteriologically confirmed in the city (150, totaling 172 cases) and having in contact between 1995-2000 with 280 children; superposing period of the 1995-2000. Antituberculosis National Programme reviewed in 1997. Statistical correlation between clinical forms of tuberculosis identified in children has been analyzed as well as aspects connected to: sources (number, contagiousness, intimacy of contact etc), epidemiological inquiry, intradermoreaction, groups of age, bacteriological confirmation (of adults and children), X-ray aspects, B.C.G, treatment (place of application, regime), prophylaxis. In spite of the growing incidence, the clinical forms of tuberculosis registered in children have been benign, no death registered and a positive evaluation after a year (90% achieved healing and treatment) which demonstrates a good epidemiological, therapeutical and prophylactic covering of a pediatric cases from the patent hotbeds of adult tuberculosis, but which must be completed and sustained by a socio-economical and better cultural context. PMID:12043273

  20. Pancreatic Tuberculosis or Autoimmune Pancreatitis

    Directory of Open Access Journals (Sweden)

    Ayesha Salahuddin

    2014-01-01

    Full Text Available Introduction. Isolated pancreatic and peripancreatic tuberculosis is a challenging diagnosis due to its rarity and variable presentation. Pancreatic tuberculosis can mimic pancreatic carcinoma. Similarly, autoimmune pancreatitis can appear as a focal lesion resembling pancreatic malignancy. Endoscopic ultrasound-guided fine needle aspiration provides an effective tool for differentiating between benign and malignant pancreatic lesions. The immune processes involved in immunoglobulin G4 related systemic diseases and tuberculosis appear to have some similarities. Case Report. We report a case of a 59-year-old Southeast Asian male who presented with fever, weight loss, and obstructive jaundice. CT scan revealed pancreatic mass and enlarged peripancreatic lymph nodes. Endoscopic ultrasound-guided fine needle aspiration confirmed the presence of mycobacterium tuberculosis. Patient also had high immunoglobulin G4 levels suggestive of autoimmune pancreatitis. He was started on antituberculosis medications and steroids. Clinically, he responded to treatment. Follow-up imaging showed findings suggestive of chronic pancreatitis. Discussion. Pancreatic tuberculosis and autoimmune pancreatitis can mimic pancreatic malignancy. Accurate diagnosis is imperative as unnecessary surgical intervention can be avoided. Endoscopic ultrasound-guided fine needle aspiration seems to be the diagnostic test of choice for pancreatic masses. Long-term follow-up is warranted in cases of chronic pancreatitis.

  1. Tuberculosis vaccine: time to change?

    Directory of Open Access Journals (Sweden)

    Fontalvo-Rivera Dilia

    2015-01-01

    Full Text Available Tuberculosis has been frequently related to poverty. There is an increase as prevalence of morbidity and growing amount of tuberculosis cases in coinfection with HIV/ AIDS, which overtake control strategies to control the aforementioned illness. This is worsened by the appearance of resistance to antitubercular agents. The WHO in its twentieth report notified that by 2014 there were 9.6 million new cases and 1.5 million of deaths due to this disease. Of these deaths 890.000 were men, 480.000 women and 140.000 children (1. 490.000 tuberculosis cases and 64.000 deaths with negative HIV were documented in children under the age of 15. For the multidrug-resistant tuberculosis in (TBMDR, the joint resistance to isoniazid and rifampin was 3.5% in new cases and 20.5% in previously treated cases (1. The illness is still a public health problem; therefore, it generates promotion and prevention activities with the purpose of stopping its spreading. One of the alternatives to prevent the spreading is the elaboration of vaccines against noxae in the human being. The Mycobacterium tuberculosis is a microorganism which is a part of the groups composed by: M. bovis, M. bovis BCG, M. canneti, M. pinnipedii, M. africanum, M. microti, M.caprae, M. mungi y M. orygis.

  2. Navicular tuberculosis: A rare localization of bone tuberculosis

    Directory of Open Access Journals (Sweden)

    Abdelhay Lemnouer

    2015-01-01

    We report a rare case of navicular osteitis associated with tarso-metatarsal arthritis caused by tuberculosis in a 68-year-old man. This case illustrates an exceptional location of osteoarticular TB and support diagnostic difficulties encountered: (i imaging is not specific; (ii lesions are paucibacillary which reduces conventional microbiological methods sensitivity and (iii the peripheral location of the Koch bacillus within the lesion dictates surgical biopsy than percutaneous puncture. We recommend testing for tuberculosis in any case of chronic osteolysis and/or arthritis of the foot, especially in TB endemic countries.

  3. [Apropos of atypical melancholia with Sustiva (efavirenz)].

    Science.gov (United States)

    Lang, J P; Halleguen, O; Picard, A; Lang, J M; Danion, J M

    2001-01-01

    The treatment of HIV infection has changed dramatically in recent years as a result of the development of new drugs which allows a variety of multitherapy combinations more adapted to patients' needs and thereby improving compliance. Efavirenz is a non-nucleoside reverse transcriptase inhibitor. In addition to a potent antiretroviral activity, efavirenz is an easy-to-take drug with once-daily dosing and is usually well tolerated. Efavirenz, however, may induce psychic alterations which are variable and atypical in both their clinical presentation and severity. As early as the first days of treatment, efavirenz may provoke surprising phenomena such as nightmares, vivid dreams, hallucinations or illusions, and twilight states. Depersonalization and derealization episodes, personality alterations, stream of thought troubles and unusual thought contents, atypical depression and cognitive disorders have also been observed. These phenomena may occur either early or later on treatment. The prevalence of severe psychic disorders is less than 5%, but they are often responsible for harmful treatment discontinuations. Psychiatric side effects are heterogeneous and probably not related to pre-existing psychologic weakness. We do not have enough data to evaluate these side effects and their etiopathogeny. The drug could act directly on the central nervous system since it crosses the blood-brain barrier, on the serotoninergic and dopaminergic systems. Some authors have compared efavirenz-induced psychic effects to those associated with LSD and found structural similarities between the two molecules. However, the heterogeneity and low prevalence of the psychiatric side effects of efavirenz suggest and individual sensitivity. In order to improve patient care, a better clinical approach, neuropsychological evaluation, and functional brain imagery should be used to progress in the analysis and comprehension of these disorders. We discuss in this paper the case of Mister H. This HIV

  4. Bone scintigraphy, radiography and MRI in the diagnosis and evaluation of treatment response of calcaneal tuberculosis

    International Nuclear Information System (INIS)

    Aim: We describe the role of various imaging modalities in the diagnosis and follow up of calcaneal tuberculosis. Materials and methods: Six patients (5 males, 1 female; age range 16-49 years) presented with heel pain. All patients underwent routine laboratory and radiological investigations e.g. radiographs, MRI and skeletal scintigraphy as part of initial diagnostic work-up. In all patients the diagnosis of tuberculosis was confirmed based on histopathology or culture. Standard multi-drug anti-tubercular therapy (ATT) was administered for 15 months. All patients were subsequently followed up with clinical evaluation, laboratory investigations and imaging. Skeletal scintigraphy, MRI and radiographs were repeated at 12 to 15 months from the initiation of anti-tubercular treatment in all patients. Results: Five out of six patients had lytic lesions at presentation on radiographs. Four of these 5 patients also had surrounding sclerosis. Follow-up radiographs obtained 12-15 months after starting ATT, showed an increase in surrounding sclerosis with progressive reduction in area of osteopenia in four and mild sclerotic changes in one. In the remaining one patient radiograph were normal both at presentation and follow up. Three phase bone scintigraphy revealed increased blood flow and blood pool activity and 'hot spots' in 5 and a central photopenic area in the calcaneum in one patient at the time of diagnosis. After starting ATT, significant reduction in vascularity and reactive bone changes in 5 patients and mild improvement in one patient. MRI was done in three patients, which revealed hyperintense lesion with erosion of the superior articular surface in 2 and 'Bull's eye' lesion with a hypointense centre and a surrounding hyperintense rim on post contrast T1W images in one patient. Follow-up MRI showed intermediate signal intensity on T2 weighted images that corresponded to caseous necrosis and high signal intensity related to granulomas or effusion. Conclusion

  5. Intestinal tuberculosis sometimes mimics Crohn's disease.

    Directory of Open Access Journals (Sweden)

    Esfandiar Shojaei

    2013-11-01

    Full Text Available Intestinal tuberculosis is an uncommon presentation of tuberculosis (TB and has clinicopathological similarities with Crohn's disease. In regions where TB is endemic clinicians must aware of this condition and fully evaluate their patients when Crohn's disease is diagnosed. We recommend all pathologic specimens be evaluate effectively for TB.Smear,culture and PCR for Mycobacterium.tuberculosis from samples aside the pathological reviews help for better diagnosis. Here we present a case of intestinal tuberculosis which initially diagnosed as Crohn's disease but after starting immunosuppressive agents he presented with disseminated tuberculosis.

  6. Disseminated tuberculosis presenting as acute lung injury

    Directory of Open Access Journals (Sweden)

    Mary Grace

    2014-01-01

    Full Text Available Tuberculosis presenting as acute lung injury is distinctly uncommon, even in India where tuberculosis an endemic disease. Simultaneously, acute lung injury is a highly fatal complication of tuberculosis. A high index of suspicion is needed to diagnose tuberculosis in such cases. Failure to initiate early treatment can have disastrous consequences as exemplified in this case report. This case attempts to highlight the need to consider tuberculosis as one of the likely causative factors for acute lung injury and the importance of starting empirical antituberculous therapy in suspected cases early.

  7. Acute rhabdomyolysis associated with atypical Guillain-Barré syndrome.

    OpenAIRE

    Scott, A. J.; Duncan, R; Henderson, L.; Jamal, G A; Kennedy, P G

    1991-01-01

    We report a patient with atypical Guillain-Barré syndrome associated with acute rhabdomyolysis. Rhabdomyolysis may be the cause of elevation of creatine kinase sometimes seen in patients with Guillain-Barré syndrome.

  8. Quantitative methods for somatosensory evaluation in atypical odontalgia

    DEFF Research Database (Denmark)

    Porporatti, André Luís; Costa, Yuri Martins; Stuginski-Barbosa, Juliana;

    2015-01-01

    A systematic review was conducted to identify reliable somatosensory evaluation methods for atypical odontalgia (AO) patients. The computerized search included the main databases (MEDLINE, EMBASE, and Cochrane Library). The studies included used the following quantitative sensory testing (QST...

  9. Teaching strategies for atypical presentation of illness in older adults.

    Science.gov (United States)

    Gray-Miceli, Deanna; Aselage, Melissa; Mezey, Mathy

    2010-07-01

    Atypical presentation of illness is a phenomenon where "seeing is believing." Expert geriatric nurses and clinicians know all too well the early signs and symptoms of this phenomenon, which frequently masquerades bacterial infections, pain, acute myocardial infarction, heart failure, or other serious medical ailments in older adults. Students, however, as novices to clinical practice, require interactive learning approaches to reflect on the patient's illness presentations, help with developing the necessary skills to analyze and synthesize clinically relevant data, and witness resolution of an atypical presentation when found and treated. Use of a case study as an educational tool can facilitate critical thinking about a clinical problem, such as atypical presentation of illness, for students within a problem-based learning format. Furthermore, we highlight strategies for teaching students atypical presentation of illness with consideration of student learning preferences, which include visual, auditory, reading, and kinesthetic modes of learning. PMID:20608591

  10. Optimal intervention strategies for tuberculosis

    Science.gov (United States)

    Bowong, Samuel; Aziz Alaoui, A. M.

    2013-06-01

    This paper deals with the problem of optimal control of a deterministic model of tuberculosis (abbreviated as TB for tubercle bacillus). We first present and analyze an uncontrolled tuberculosis model which incorporates the essential biological and epidemiological features of the disease. The model is shown to exhibit the phenomenon of backward bifurcation, where a stable disease-free equilibrium co-exists with one or more stable endemic equilibria when the associated basic reproduction number is less than the unity. Based on this continuous model, the tuberculosis control is formulated and solved as an optimal control problem, indicating how control terms on the chemoprophylaxis and detection should be introduced in the population to reduce the number of individuals with active TB. Results provide a framework for designing the cost-effective strategies for TB with two intervention methods.

  11. Guinea pig model of tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Pushpa Gupta; U.D.Gupta

    2009-01-01

    Animal models are being developed for testing different vaccine candidates as well as testing of new antituber-cular since a long time.Mice,guinea pigs and rabbits are animals which are frequently used.Though each model has got its merits as well as demerits and each of them differ from human tuberculosis in one aspect or the other but none of the model completely mimics the human disease.Out of the different animal species, guinea pig model is one of the better models as it is very sensitive to M.tuberculosis infection but it has certain limitations like paucity of immunological reagents.However,it is the best model for tuberculosis research.

  12. Tuberculosis in Aboriginal Canadians

    Directory of Open Access Journals (Sweden)

    Vernon H Hoeppner

    2000-01-01

    Full Text Available Endemic tuberculosis (TB was almost certainly present in Canadian aboriginal people (aboriginal Canadians denotes status Indians, Inuit, nonstatus Indians and metis as reported by Statistics Canada before the Old World traders arrived. However, the social changes that resulted from contact with these traders created the conditions that converted endemic TB into epidemic TB. The incidence of TB varied inversely with the time interval from this cultural collision, which began on the east coast in the 16th century and ended in the Northern Territories in the 20th century. This relatively recent epidemic explains why the disease is more frequent in aboriginal children than in Canadian-born nonaboriginal people. Treatment plans must account for the socioeconomic conditions and cultural characteristics of the aboriginal people, especially healing models and language. Prevention includes bacillus Calmette-Guerin vaccination and chemoprophylaxis, and must account for community conditions, such as rates of suicide, which have exceeded the rate of TB. The control of TB requires a centralized program with specifically directed funding. It must include a program that works in partnership with aboriginal communities.

  13. Tuberculosis lymphadenitis in Ethiopia.

    Science.gov (United States)

    Biadglegne, Fantahun; Tesfaye, Weghata; Anagaw, Belay; Tessema, Belay; Debebe, Tewodrose; Anagaw, Berhanu; Mulu, Andargachew; Sack, Ulrich; Rodloff, Arne C

    2013-01-01

    Tuberculosis (TB) is one of the most serious public health challenges in Ethiopia. Indeed, Ethiopia ranks 7th among 22 countries with a high burden of TB worldwide. Both pulmonary TB and extrapulmonary TB (EPTB) are issues of concern. Ethiopia ranks 3rd in terms of the number of EPTB patients worldwide, with TB lymphadenitis (TBL) being the most common. According to the World Health Organization's Global TB Report 2009, the estimated number of TB patients in Ethiopia was 314,267 in 2007, with an estimated incidence rate of 378 patients per 100,000 population. Furthermore, 36% patients suffered from EPTB, with TBL accounting for 80% of these patients. In Ethiopia, pathological services, culture, and drug susceptibility testing for mycobacterium species are not available as routine tests, not even for cases with suspected infection by drug-resistant strains. Therefore, the management of multidrug-resistant (MDR) TB in Ethiopia is currently unsatisfactory. Against this background, a high index of clinical doubt and timely use of diagnostic methods, prompt confirmation of diagnosis, and early initiation of specific anti-TB treatment are the key factors for the successful management of MDR-TB and TBL in Ethiopia. PMID:23883834

  14. Transmission models of tuberculosis in heterogeneous population

    Institute of Scientific and Technical Information of China (English)

    JIA Zhong-wei; LI Xiao-wen; FENG Dan; CAO Wu-chun

    2007-01-01

    Objective To review the transmission models of tuberculosis in heterogeneous population.Data sources The data used in this review were adopted mainly from the studies of models of tuberculosis reported from 1995 to 2006.Study selection Relevant literature on transmission models of tuberculosis in heterogeneous populations are referenced.Results Casual/random factors and genetic factors are the main reasons for epidemics of tuberculosis in recent years.Mass public transport is playing the primary role in casually close contact which can facilitate the transmission of tuberculosis. Genetic susceptibility not only varies endemic prevalence levels, but also drastically alters the effects of treatment for tuberculosis patients. Detailed studies further exhibit that casual contact and genetic factor are responsible for over 30%-40% of the total new cases in recent years. The prevalence of tuberculosis could double (from 33% to 60%)if a genetically susceptible phenotype is present in only 30% of the population. And some challenges have emerged along with these exciting results.Conclusions Casual/random contact, public transport and genetic susceptibility are responsible for most new tuberculosis cases and a wide variation in endemic tuberculosis levels between regions. Hence, the transmission model of tuberculosis in a heterogeneous population can provide more clues to underlying mechanism of tuberculosis transmission than in a homogeneous population. However, many challenges remain for us in understanding transmission of disease.

  15. A rare cause of pleurisy in pregnancy: Tuberculosis

    OpenAIRE

    Baysak, Aysegul; Ece, Gulfem; Emre, Julide Celdir; Oz, Adnan Tolga; Sahin, Erkan

    2013-01-01

    Tuberculosis is a granulomatous infectious disease of lungs due to Mycobacterium tuberculosis. Tuberculosis is a chronic disease and tuberculosis pleurisy takes place with acute disease symptoms. We aimed to present a rare case of young pregnant woman with pleural effusion due to tuberculosis in light of literature.

  16. REVIEW ON TUBERCULOSIS AND MENTAL DISORDERS COMMON

    Directory of Open Access Journals (Sweden)

    Gleide Santos de Araújo

    2014-05-01

    Full Text Available Despite having vaccine and treatment , TB remains a public health problem . Publications have described high proportion of TB among people with anxiety , depression and mental disorders . This study aimed to identify publications on the association between common mental disorders and tuberculosis and describe the state of the art . This is a literature review with keywords tuberculosis,common mental disorders , anxiety and depression , we excluded studies of extra- pulmonary tuberculosis and animals. 09 articles, only on a specific common mental disorders , comparing the proportion of these in tuberculosis cases ( 46.7 % and tuberculosis infected by the human immunodeficiency virus ( 63.7 % , there are few studies concerning the topic were elected , the most specific problems of anxiety and depression , are from countries where the incidence of tuberculosis is high, ethodological strategies have low analytical power and do not investigate the causal mechanisms underlying the relationship between mental health and tuberculosis.

  17. Atypical fibroxanthoma: An unusual skin neoplasm in xeroderma pigmentosum

    Directory of Open Access Journals (Sweden)

    Ranjana Bandyopadhyay

    2012-01-01

    Full Text Available Xeroderma pigmentosum (XP is a rare autosomal recessive disorder related to defective deoxyribonucleic acid (DNA repair. Various cutaneous manifestations related to ultraviolet (UV damage characterize the clinical course. Primary malignant cutaneous neoplasms like squamous cell carcinoma, basal cell carcinoma and malignant melanoma have been reported. Atypical fibroxanthoma is a rare dermal neoplasm occurring in UV-damaged skin. We report an unusual case of atypical fibroxanthoma in a 20-year-old male with XP.

  18. Atypical Fibroxanthoma: An Unusual Skin Neoplasm in Xeroderma Pigmentosum

    OpenAIRE

    Ranjana Bandyopadhyay; Dipanwita Nag; Sanjay Bandyopadhyay; Swapan Kumar Sinha

    2012-01-01

    Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder related to defective deoxyribonucleic acid (DNA) repair. Various cutaneous manifestations related to ultraviolet (UV) damage characterize the clinical course. Primary malignant cutaneous neoplasms like squamous cell carcinoma, basal cell carcinoma and malignant melanoma have been reported. Atypical fibroxanthoma is a rare dermal neoplasm occurring in UV-damaged skin. We report an unusual case of atypical fibroxanthoma in a 20-y...

  19. Atypical presentation of macrophagic myofasciitis 10 years post vaccination.

    LENUS (Irish Health Repository)

    Ryan, Aisling M

    2012-02-03

    Macrophagic myofasciitis (MMF) is an uncommon inflammatory disorder of muscle believed to be due to persistence of vaccine-derived aluminium hydroxide at the site of injection. The condition is characterised by diffuse myalgias, arthralgia and fatigue. We describe a patient with histologically confirmed MMF whose presentation was atypical with left chest and upper limb pain beginning more than 10 years post vaccination. Treatment with steroids led to symptomatic improvement. Although rare, clinicians should consider MMF in cases of atypical myalgia.

  20. An Atypical Case of Pityriasis Rosea Gigantea after Influenza Vaccination

    Directory of Open Access Journals (Sweden)

    Dimitrios Papakostas

    2014-04-01

    Full Text Available Pityriasis rosea is a common erythematosquamous eruption, typically presenting along the cleavage lines of the skin. A wide spectrum of atypical manifestations may challenge even the most experienced physician. Here we report a rare case of a suberythrodermic pityriasis rosea with gigantic plaques after an influenza vaccination, and we discuss the possible triggers of atypical manifestations of such a common dermatological disease in the setting of an altered immunity.

  1. Orthostatic Hypotension in Patients with Parkinson's Disease and Atypical Parkinsonism

    OpenAIRE

    Seyed-Mohammad Fereshtehnejad; Johan Lökk

    2014-01-01

    Orthostatic hypotension (OH) is one of the commonly occurring nonmotor symptoms in patients with idiopathic Parkinson’s disease (IPD) and atypical parkinsonism (AP). We aimed to review current evidences on epidemiology, diagnosis, treatment, and prognosis of OH in patients with IPD and AP. Major electronic medical databases were assessed including PubMed/MEDLINE and Embase up to February 2013. English-written original or review articles with keywords such as “Parkinson’s disease,” “atypical p...

  2. Persistent consequences of atypical early number concepts

    Directory of Open Access Journals (Sweden)

    MichèleM. M.Mazzocco

    2013-09-01

    Full Text Available How does symbolic number knowledge performance help identify young children at risk for poor mathematics achievement outcomes? In research and practice, classification of mathematics learning disability (MLD, or dyscalculia is typically based on composite scores from broad measures of mathematics achievement. These scores do predict later math achievement levels, but do not specify the nature of math difficulties likely to emerge among students at greatest risk for long-term mathematics failure. Here we report that gaps in 2nd and 3rd graders’ number knowledge predict specific types of errors made on math assessments at Grade 8. Specifically, we show that early whole number misconceptions predict slower and less accurate performance, and atypical computational errors, on Grade 8 arithmetic tests. We demonstrate that basic number misconceptions can be detected by idiosyncratic responses to number knowledge items, and that when such misconceptions are evident during primary school they persist throughout the school age years, with variable manifestation throughout development. We conclude that including specific qualitative assessments of symbolic number knowledge in primary school may provide greater specificity of the types of difficulties likely to emerge among students at risk for poor mathematics outcomes.

  3. DENGUE WITH ATYPICAL MANIFESTATIONS AND WHO CLASSIFICATION

    Directory of Open Access Journals (Sweden)

    Jayant Mahadeorao

    2015-09-01

    Full Text Available Dengue fever and dengue haemorrhagic fever are important arboviral diseases. Dengue virus belongs to family Flaviviridae , has four serotypes that spread by the bite of infected Aedes mosquitoes . Dengue epidemics can have a significant economic and health t oll. Worldwide, an estimated 3.6 billion people are at risk of infection with about 50 - 100 million new cases each year Illness produced by any of the four dengue virus serotypes varies from mild asymptomatic illness to severe fatal dengue haemorrhagic fe ver/dengue shock syndrome (DHF/DSS. During the early febrile stage clinicians cannot predict which patients will progress to severe disease. Atypical manifestations were reported are associated with high risk of mortality. The existing WHO dengue classific ation scheme and case definitions have some drawbacks. A global strategy to reduce the disease burden using integrated vector management in conjunction with early and accurate diagnosis has been advocated. Antiviral drugs and vaccines that are currently un der development could also make an important contribution to dengue control in the future

  4. Atypical proliferating mucinous tumors of gigantic dimensions

    Directory of Open Access Journals (Sweden)

    Likić-Lađević Ivana

    2008-01-01

    Full Text Available Background. Ovarian tumors of low malignant potential (LMP are also known as atypically proliferating tumors. Ovarian tumors of LPM account for approximately 15% of all epithelial ovarian cancers. Mean age of occurrence is 40 years and they are 15-20 cm in diameter. Case report. A 32-year-old female patient was hospitalized as an urgent case with a large tumor mass that filled the entire abdomen. Cyst was 100 × 70 cm dimensions belonging to the right ovary and filled with 18 liters of content. Right adnexectomy, resection of the second ovary, as well as biopsy of the omentum were performed. Lymphadenectomy of the right iliac and obturator area was also performed. After receiving definitive histopathological results it was decided to perform a radical reoperation. On the 10th postoperative day relaparotomy, total hysterectomy and left adnexectomy were performed. The patient was released on the 6th postoperative day. She used to come to regular examinations up to date. Conclusion. This case is a proof that LMP tumors have low malignant potential, they grow slowly and can reach great proportions.

  5. Atypical focal nodular hyperplasia of the liver

    Institute of Scientific and Technical Information of China (English)

    Muhammad Rizwan Khan; Taimur Saleem; Tanveer Ul Haq; Kanwal Aftab

    2011-01-01

    BACKGROUND: Focal nodular hyperplasia, a benign hepatic tumor, is usually asymptomatic. However, rarely the entity can cause symptoms, mandating intervention. METHOD: We present a case of focal nodular hyperplasia of the liver, which caused a considerable diagnostic dilemma due to its atypical presentation. RESULTS: A 29-year-old woman presented with a 15-year history of a progressively increasing mass in the right upper quadrant which was associated with pain and emesis. Examination showed a firm, mobile mass palpable below the right subcostal margin. A computed tomography scan of the abdomen showed an exophytic mass arising from hepatic segments III and IVb. Trucut biopsy of the hepatic mass was equivocal. Angiography showed a vascular tumor that was supplied by a tortuous branch of the proper hepatic artery. Surgical intervention for removal of the mass was undertaken. Intra-operatively, two large discrete tumors were found and completely resected. Histopathological examination showed features consistent with focal nodular hyperplasia. CONCLUSION: This description of an unusual case of focal nodular hyperplasia of the liver highlights the point that the diagnosis of otherwise benign hepatic tumors may be difficult despite extensive work-up in some cases.

  6. Atypical mitochondrial inheritance patterns in eukaryotes.

    Science.gov (United States)

    Breton, Sophie; Stewart, Donald T

    2015-10-01

    Mitochondrial DNA (mtDNA) is predominantly maternally inherited in eukaryotes. Diverse molecular mechanisms underlying the phenomenon of strict maternal inheritance (SMI) of mtDNA have been described, but the evolutionary forces responsible for its predominance in eukaryotes remain to be elucidated. Exceptions to SMI have been reported in diverse eukaryotic taxa, leading to the prediction that several distinct molecular mechanisms controlling mtDNA transmission are present among the eukaryotes. We propose that these mechanisms will be better understood by studying the deviations from the predominating pattern of SMI. This minireview summarizes studies on eukaryote species with unusual or rare mitochondrial inheritance patterns, i.e., other than the predominant SMI pattern, such as maternal inheritance of stable heteroplasmy, paternal leakage of mtDNA, biparental and strictly paternal inheritance, and doubly uniparental inheritance of mtDNA. The potential genes and mechanisms involved in controlling mitochondrial inheritance in these organisms are discussed. The linkage between mitochondrial inheritance and sex determination is also discussed, given that the atypical systems of mtDNA inheritance examined in this minireview are frequently found in organisms with uncommon sexual systems such as gynodioecy, monoecy, or andromonoecy. The potential of deviations from SMI for facilitating a better understanding of a number of fundamental questions in biology, such as the evolution of mtDNA inheritance, the coevolution of nuclear and mitochondrial genomes, and, perhaps, the role of mitochondria in sex determination, is considerable. PMID:26501689

  7. Atypical moral judgment following traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Angelica Muresan

    2012-07-01

    Full Text Available Previous research has shown an association between emotions, particularly social emotions, and moral judgments. Some studies suggested an association between blunted emotion and the utilitarian moral judgments observed in patients with prefrontal lesions. In order to investigate how prefrontal brain damage affects moral judgment, we asked a sample of 29 TBI patients (12 females and 17 males and 41 healthy participants (16 females and 25 males to judge 22 hypothetical dilemmas split into three different categories (non-moral, impersonal and personal moral. The TBI group presented a higher proportion of affirmative (utilitarian responses for personal moral dilemmas when compared to controls, suggesting an atypical pattern of utilitarian judgements. We also found a negative association between the performance on recognition of social emotions and the proportion of affirmative responses on personal moral dilemmas. These results suggested that the preference for utilitarian responses in this type of dilemmas is accompanied by difficulties in social emotion recognition. Overall, our findings suggest that deontological moral judgments are associated with normal social emotion processing and that frontal lobe plays an important role in both emotion and moral judgment.

  8. Skeletal fluorosis in immobilized extremities.

    Science.gov (United States)

    Rosenquist, J B

    1975-11-01

    The effect of immobilization on skeletal fluorosis was studied in growing rabbits. One hind leg was immobilized by an external fixation device extending below the wrist joint and above the knee joint, the extremity being in a straight position after severance of the sciatic nerve. The animals, aged 7 weeks at the beginning of the experiment, were given 10 mg of fluoride per kg body weight and day during 12 weeks. In the tibiae, development of the skeletal fluorosis was more irregular than that observed in previous studies of normally active animals, being most excessive in the mobile bone. The immobilization effect was most profound in the femora as the cortical thickness and the femur score were significantly higher than those in the mobile femora. It was suggested that an altered muscular activity was the reason for the observed changes. PMID:1189918

  9. Drug resistance in mycobacterium tuberculosis

    OpenAIRE

    Abate, Getahun

    1999-01-01

    Drug-resistant tuberculosis is a global public health problem. This investigation was performed to find ways of improving regimens that could be used for the treatment of drug- and multidrug-resistant TB and also to find a rapid method of diagnosis of drug resistant TB, particularly MDR-TB. Among 107 isolates of M. tuberculosis from re-treatment cases of pulmonary TB in Ethiopia (study 1), 48% were resistant at least to one of the four first-line drugs tested and 12 % were A...

  10. Tuberculosis Notification: Issues and Challenges.

    OpenAIRE

    Manisha Nagpal; Naresh Chawla

    2013-01-01

    Tuberculosis (TB) is a major public health problem. An emerging menace in India is drug resistant forms of TB. In order to ensure proper TB diagnosis and case management, reduce TB transmission and address the problems of emergence of spread of Drug Resistant-TB, it is essential to have complete information of all TB cases. Therefore, Govt. of India declared Tuberculosis a notifiable disease on 7th May 2012. This paper highlights the fact that notification of TB in the absence of regulation o...

  11. Ultrasonographic and CT findings of hepatosplenic tuberculosis

    International Nuclear Information System (INIS)

    To evaluate the ultrasonographic and CT findings of hepatosplenic tuberculosis Materials and Methods: We retrospectively reviewed the ultrasonographic and CT findings of confirmed hepatosplenic tuberculosis in 12 patients. Six were men and six were women ; their average age was 41, and most were in their twenties. Lesions of the liver and spleen, as well as associated findings such as abdominal tuberculosis and other organ involvement of tuberculosis were analyzed. Results : There were three cases of hepatic tuberculosis, seven of splenic tuberculosis, and two of hepatosplenic involvement of tuberculosis. On the basis of the ultrasonographic and CT findings, hepatosplenic tuberculosis was classified as one of two patterns : miliary or micronodular, ormacronodular. The micronodular type was more common (9/12 cases) being characterized by innumerable micronodules,and with easy coalescence in the liver and spleen in five of the nine cases. The macronodular type of low density mass was noted in the other three patients. Splenomegaly was noted in 12 cases and hepatomegaly in ten. Pulmonary tuberculosis-including the miliary type(n=5)-was noted in eight patients. Associated abdominal tuberculosis such as lymphadenopathy with central low density and peripheral rim enhancement (n=6), tuberculous peritonitis(n=3),highly attenuated ascites(n=6), adrenal tuberculosis(n=1), renal tuberculosis(n=1), ovarian abscess(n=1), psoasabscess(n=1), and systemic tuberculosis such as central nervous system tuberculoma(n=2), cervical lymphadenopathy(n=4) and tuberculous spondylitis(n=1) were noted. Conclusion : Ultrasonography and CT were valuable in the detection and diagnosis of hepatosplenic tuberculosis

  12. Atypical sonographic patterns of fibroadenoma of the breast : pathologic correlation

    International Nuclear Information System (INIS)

    To correlate the atypical sonographic patterns of fibroadenoma of the breast with the pathologic findings. Among 203 surgically proven 43 which were sonographically atypical fibroadenomas, were retrospectively reviewed. The diagnostic criteria for atypical variety, as seen on sonography, were an ill-defined margin, microlobulated or irregular shape, heterogeneous internal echo-pattern, posterior shadowing, microcalcification, and clefts. The atypical sonographic patterns of these 43 fibroadenomas were analysed and compared with the pathologic findings. Among 43 lesions, ill-defined margins or irregular shapes were seen in 15 cases, heterogeneous internal echo-patterns in 27, posterior attenuation in nine, and clefts in seven. Thirty-seven (86%) of the 43 were predominantly ductal or had a mixed ductal and stromal component. Eleven (73.3%) of fifteen ill-defined margin or irregular shaped lesions were caused by interdigitation of surrounding normal breast parenchyma and mass. Twenty two (81.5%) of 27 heterogeneous internal echo-pat-terns were related to dilated ducts, phyllodes features, collagen bundles, adenosis, microcalcification, or fat vacuoles. Eight (88.9%) of nine posterior attenuations were caused by collagen bundles, microcalcification, ductal proliferation or dilatation. All seven cases showing clefts revealed phyllodes features and dilated ducts. Most atypical fibroadenomas had a predominantly ductal or mixed component. Ill-defined margin or irregular shape was mainly due to interdigitation of normal surrounding parenchyma. Variable histologic features were related to the heterogeneous internal echo-pattern, posterior shadowing, and the clefts revealed by atypical sonographic findings

  13. Immune responses to the Mycobacterium tuberculosis-specific antigen ESAT-6 signal subclinical infection among contacts of tuberculosis patients

    DEFF Research Database (Denmark)

    Doherty, T Mark; Demissie, Abebech; Olobo, Joseph; Wolday, Dawit; Britton, Sven; Eguale, Tewodros; Ravn, Pernille; Andersen, Peter

    2002-01-01

    Diagnosis of latent Mycobacterium tuberculosis infection is considered essential for tuberculosis control but is hampered by the lack of specific reagents. We report that strong recognition of tuberculosis complex-specific antigen ESAT-6 by healthy household contacts of tuberculosis patients...... correlates with the subsequent development of active tuberculosis during a 2-year follow-up period....

  14. Tuberculosis como enfermedad ocupacional Tuberculosis as an occupational disease

    Directory of Open Access Journals (Sweden)

    J. A. Cascante

    2005-01-01

    Full Text Available Los trabajadores sanitarios están expuestos a múltiples enfermedades infecciosas que padecen los pacientes a los que atienden y que han sido reconocidas como enfermedades infecciosas ocupacionales. Las declaradas con más frecuencia son las adquiridas por vía hematógena, en especial la hepatitis por virus B. Existen múltiples enfermedades infecciosas trasmitidas por vía aérea y hasta el advenimiento del síndrome respiratorio agudo severo ocasionado por un coronavirus, la tuberculosis era una de las más temidas. En el presente trabajo analizaremos las causas por las que la tuberculosis se considera una enfermedad ocupacional en el personal sanitario, cuáles son las actividades con más riesgo y las medidas que deben adoptarse para disminuir la transmisión nosocomial.Health workers are exposed to numerous infectious diseases from which the patients they attend are suffering and that have been recognised as occupational infectious diseases. Those most frequently reported are acquired by the haematogenous path, especially hepatitis due to virus B. Numerous infectious diseases are transmitted through airways and until the coming of acute severe respiratory syndrome caused by a coronavirus, tuberculosis was one of the most dreaded. In this paper we analyse the reasons why tuberculosis is considered to be an occupational disease in health personnel; which activities entail most risk and the measures that should be adopted to reduce nosocomial transmission.

  15. Controlling the seedbeds of tuberculosis: diagnosis and treatment of tuberculosis infection.

    Science.gov (United States)

    Rangaka, Molebogeng X; Cavalcante, Solange C; Marais, Ben J; Thim, Sok; Martinson, Neil A; Swaminathan, Soumya; Chaisson, Richard E

    2015-12-01

    The billions of people with latent tuberculosis infection serve as the seedbeds for future cases of active tuberculosis. Virtually all episodes of tuberculosis disease are preceded by a period of asymptomatic Mycobacterium tuberculosis infection; therefore, identifying infected individuals most likely to progress to disease and treating such subclinical infections to prevent future disease provides a crucial opportunity to interrupt tuberculosis transmission and reduce the global burden of tuberculosis disease. Programmes focusing on single strategies rather than comprehensive programmes that deliver an integrated arsenal for tuberculosis control might continue to struggle. Tuberculosis preventive therapy is a poorly used method that is essential for controlling the reservoirs of disease that drive the epidemic. Comprehensive control strategies that combine preventive therapy for the most high-risk populations and communities with improved case-finding and treatment, control of transmission, and health systems strengthening could ultimately lead to worldwide tuberculosis elimination. In this Series paper we outline challenges to implementation of preventive therapy and provide pragmatic suggestions for overcoming them. We further advocate for tuberculosis preventive therapy as the core of a renewed worldwide focus to implement a comprehensive epidemic control strategy that would reduce new tuberculosis cases to elimination targets. This strategy would be underpinned by accelerated research to further understand the biology of subclinical tuberculosis infections, develop novel diagnostics and drug regimens specifically for subclinical tuberculosis infection, strengthen health systems and community engagement, and enhance sustainable large scale implementation of preventive therapy programmes. PMID:26515679

  16. The exercised skeletal muscle: a review

    Directory of Open Access Journals (Sweden)

    Marina Marini

    2010-09-01

    Full Text Available The skeletal muscle is the second more plastic tissue of the body - second to the nervous tissue only. In fact, both physical activity and inactivity contribute to modify the skeletal muscle, by continuous signaling through nerve impulses, mechanical stimuli and humoral clues. In turn, the skeletal muscle sends signals to the body, thus contributing to its homeostasis. We'll review here the contribute of physical exercise to the shaping of skeletal muscle, to the adaptation of its mass and function to the different needs imposed by different physical activities and to the attainment of the health benefits associated with active skeletal muscles. Focus will primarily be on the molecular pathways and on gene regulation that result in skeletal muscle adaptation to exercise.

  17. New tuberculosis vaccines.

    Science.gov (United States)

    Martín Montañés, Carlos; Gicquel, Brigitte

    2011-03-01

    The current tuberculosis (TB) vaccine, bacille Calmette-Guerin (BCG), is a live vaccine used worldwide, as it protects against severe forms of the disease, saving thousands of lives every year, but its efficacy against pulmonary forms of TB, responsible for transmission of the diseases, is variable. For more than 80 years now no new TB vaccines have been successfully developed. Over the last decade the effort of the scientific community has resulted in the design and construction of promising vaccine candidates. The goal is to develop a new generation of vaccines effective against respiratory forms of the disease. We will focus this review on new prophylactic vaccine candidates that aim to prevent TB diseases. Two are the main strategies used to improve the immunity conferred by the current BCG vaccine, by boosting it with new subunit vaccines, and a second strategy is focused on the construction of new more effective live vaccines, capable to replace the current BCG and to be used as prime vaccines. After rigorous preclinical studies in different animal models new TB vaccine candidates enter in clinical trials in humans. First, a small Phase I for safety followed by immunological evaluation in Phase II trials and finally evaluated in large population Phase III efficacy trials in endemic countries. At present BCG prime and boost with different subunit vaccine candidates are the more advanced assessed in Phase II. Two prime vaccines (based on recombinant BCG) have been successfully evaluated for safety in Phase I trials. A short number of live attenuated vaccines are in advance preclinical studies and the candidates ready to enter Phase I safety trials are produced under current good manufacturing practices. PMID:21420568

  18. Chemotherapy of osteoarticular tuberculosis

    Directory of Open Access Journals (Sweden)

    Hazra Avijit

    2005-01-01

    Full Text Available Tuberculosis (TB of the bones and joints is rampant in India with the dorsolumbar spine as the most common site of osseous involvement. For diagnosis, clinical suspicion needs to be confirmed through appropriate laboratory and imaging investigations, and increasingly nowadays, nucleic acid amplification techniques. Chemotherapy remains the cornerstone of management complemented by rest, nutritional support and splinting, as necessary. Operative intervention is required if response to chemotherapy is unsatisfactory and for spinal stabilization. The drugs and regimens are fundamentally similar to those for pulmonary TB. However, there is lack of consensus on the appropriate duration of treatment. The prevailing practice of extending treatment till radiological evidence of healing is complete, may be unnecessary in view of recent reports that 6-9 months of therapy is sufficient for the majority of cases. Relapse rates are not drastically improved by extending treatment to 12 months or even longer, except perhaps in pediatric cases. However, prolonged treatment may be required if surgical debridement is indicated but cannot be done. Multidrug-resistant TB should be suspected if disease activity shows no signs of abating after 4-6 months of uninterrupted therapy. These cases are therapeutically challenging and will require second line or experimental antiTB drugs, supported by resistance testing where feasible. Coexistent HIV/AIDS may also necessitate prolonged treatment. Interactions between first line antiTB drugs and antiretroviral medication can complicate matters. Close monitoring is essential in all cases, with dechallenge and cautious reinstitution of drugs in the event of toxicity. While awaiting the arrival of long overdue new antiTB medication, existing drugs and regimens must be used in an informed manner with emphasis on patient compliance.

  19. Atypical antipsychotics in bipolar disorder: systematic review of randomised trials

    Directory of Open Access Journals (Sweden)

    Moore R Andrew

    2007-08-01

    Full Text Available Abstract Background Atypical antipsychotics are increasingly used for treatment of mental illnesses like schizophrenia and bipolar disorder, and considered to have fewer extrapyramidal effects than older antipsychotics. Methods We examined efficacy in randomised trials of bipolar disorder where the presenting episode was either depression, or manic/mixed, comparing atypical antipsychotic with placebo or active comparator, examined withdrawals for any cause, or due to lack of efficacy or adverse events, and combined all phases for adverse event analysis. Studies were found through systematic search (PubMed, EMBASE, Cochrane Library, and data combined for analysis where there was clinical homogeneity, with especial reference to trial duration. Results In five trials (2,206 patients participants presented with a depressive episode, and in 25 trials (6,174 patients the presenting episode was manic or mixed. In 8-week studies presenting with depression, quetiapine and olanzapine produced significantly better rates of response and symptomatic remission than placebo, with NNTs of 5–6, but more adverse event withdrawals (NNH 12. With mania or mixed presentation atypical antipsychotics produced significantly better rates of response and symptomatic remission than placebo, with NNTs of about 5 up to six weeks, and 4 at 6–12 weeks, but more adverse event withdrawals (NNH of about 22 in studies of 6–12 weeks. In comparisons with established treatments, atypical antipsychotics had similar efficacy, but significantly fewer adverse event withdrawals (NNT to prevent one withdrawal about 10. In maintenance trials atypical antipsychotics had significantly fewer relapses to depression or mania than placebo or active comparator. In placebo-controlled trials, atypical antipsychotics were associated with higher rates of weight gain of ≥7% (mainly olanzapine trials, somnolence, and extrapyramidal symptoms. In active controlled trials, atypical antipsychotics

  20. Skeletal scintigraphy manifestations of hematologic disorders

    International Nuclear Information System (INIS)

    Skeletal manifestations are common in hematologic disorders. Benign entities such as Sickle cell disease develop microvascular embolization causing skeletal crisis. Leukemia, acute myeloblastic or lymphoblastic may develop bone marrow infarcts. Compromised immunity makes them susceptible to secondary infection leading to osteomyelitis or septic arthritis. Exposure to steroids may lead to osteonecrosis in these cases. Presented here is an atlas of various scintigraphic skeletal manifestations encountered over the past 10 years, in hematologic disorders

  1. The Effects of Lactate on Skeletal Muscle

    OpenAIRE

    Willkomm, Lena

    2014-01-01

    Regular exercise and physical activity are cornerstones in the prevention and treatment of numerous chronic conditions, such as type 2 diabetes, coronary heart disease, and age-related sarcopenia. The associated health benefits arise from a number of tissues but due to its high plasticity skeletal muscle plays a pivotal role. The resident stem cells of skeletal muscle tissue, so called Satellite cells (SCs), contribute significantly to skeletal muscle adaptation and hence, maintenance of heal...

  2. Nutrient and energy sensing in skeletal muscle

    OpenAIRE

    Deshmukh, Atul S.

    2009-01-01

    Nutrient overload and physical inactivity often leads to the development of obesity and type 2 diabetes. Acute over-nutrition can induce insulin resistance, while physical exercise enhances skeletal muscle insulin sensitivity. Like every living cell, skeletal muscle senses nutrient and energy signals and to adjust metabolic flux. This thesis focuses on some of the key nutrient and energy sensing (exercise/contraction-induced) pathways in skeletal muscle that regulate metabol...

  3. Tuberculosis and chronic respiratory disease: a systematic review

    Directory of Open Access Journals (Sweden)

    Anthony L. Byrne

    2015-03-01

    Conclusion: In tuberculosis endemic areas, tuberculosis is strongly associated with the presence of chronic respiratory disease in adults. Efforts to improve long-term lung health should be part of tuberculosis care.

  4. Facing multi-drug resistant tuberculosis.

    Science.gov (United States)

    Sotgiu, Giovanni; Migliori, Giovanni Battista

    2015-06-01

    Multi-drug resistant tuberculosis (MDR-TB) is caused by Mycobacterium tuberculosis strains resistant to at least two of the most effective anti-tuberculosis drugs (i.e., isoniazid and rifampicin). Therapeutic regimens based on second- and third-line anti-tuberculosis medicines showed poor efficacy, safety, and tolerability profiles. It was estimated that in 2012 the multi-drug resistant tuberculosis incidence ranged from 300,000 to 600,000 cases, mainly diagnosed in the Eastern European and Central Asian countries. The highest proportion of cases is among individuals previously exposed to anti-tuberculosis drugs. Three main conditions can favour the emergence and spread of multi-drug resistant tuberculosis: the poor implementation of the DOTS strategy, the shortage or the poor quality of the anti-tuberculosis drugs, and the poor therapeutic adherence of the patients to the prescribed regimens. Consultation with tuberculosis experts (e.g., consilium) is crucial to tailor the best anti-tuberculosis therapy. New therapeutic options are necessary: bedaquiline and delamanid seem promising drugs; in particular, during the development phase they demonstrated a protective effect against the emergence of further resistances towards the backbone drugs. In the recent past, other antibiotics have been administered off-label: the most relevant efficacy, safety, and tolerability profile was proved in linezolid-, meropenem/clavulanate-, cotrimoxazole-containing regimens. New research and development activities are needed in the diagnostic, therapeutic, preventive fields. PMID:24792579

  5. Sternal Tuberculosis: An Uncommon Presentation

    OpenAIRE

    Manish Narang; Archana Dwivedi; Shiva Narang; Gopesh Mehrotra

    2011-01-01

    Primary tubercular osteomyelitis of sternum presenting as an acute swelling over chest is an extremely rare presentation in pediatric population. We herein report such a case which was diagnosed by CT scan showing lytic lesion and aspiration revealed positive culture for Mycobacterium tuberculosis. Child improved with antitubercular treatment.

  6. Sternal Tuberculosis: An Uncommon Presentation

    Directory of Open Access Journals (Sweden)

    Manish Narang

    2011-12-01

    Full Text Available Primary tubercular osteomyelitis of sternum presenting as an acute swelling over chest is an extremely rare presentation in pediatric population. We herein report such a case which was diagnosed by CT scan showing lytic lesion and aspiration revealed positive culture for Mycobacterium tuberculosis. Child improved with antitubercular treatment.

  7. Pancardiac tuberculosis - a case report.

    Science.gov (United States)

    Lad, Shilpa K; Amonkar, Gayathri

    2016-01-01

    Tuberculous involvement of the heart though not common has been reported in literature. Pericardium is commonly involved followed by the myocardium. Endocardial involvement is rare. We would like to report a case of a 14-year-old female with florid and extensive involvement of all the layers of the heart by tuberculosis. PMID:26507144

  8. Tuberculosis awareness in Gezira, Sudan

    DEFF Research Database (Denmark)

    Suleiman, M M A; Sahal, N; Sodemann, Morten;

    2014-01-01

    This case-control study aimed to assess tuberculosis (TB) awareness and its associated sociodemographic characteristics in Gezira, Sudan. New smear-positive TB patients registered in Gezira in 2010 (n = 425) and age-matched controls who attended the same health facilities for other reasons (n = 850...

  9. Tuberculosis 2004: Challenges and Opportunities

    OpenAIRE

    Glassroth, Jeffrey

    2005-01-01

    Tuberculosis (TB) continues as a major public health challenge worldwide. HIV-TB coinfection is especially concerning as it accelerates progression of infection to active disease and amplifies spread of TB including drug resistant disease. Application of molecular biology and insights from classic microbiology to TB control have resulted in important innovations in diagnosis and treatment.

  10. Tuberculosis diagnostics: Challenges and opportunities

    Directory of Open Access Journals (Sweden)

    Vijay Nema

    2012-01-01

    Full Text Available Tuberculosis (TB has been a disease affecting almost all parts of the world since ages. Lot many efforts came in the past for improving diagnosis and treatment. Also, an effective vaccine has been sought after for long. With the emergence of resistant strains of Mycobacterium tuberculosis, the causal organisms of tuberculosis, and complexities emerging due to other associated infections and disease conditions, there is a desperate need for further research input in the field. Be it the better medication and care or better resistance management, proper diagnostics holds the key to success. It has been observed that a high burden of the disease was accompanied by resource limitations and poor research set-up. The scenario remained like this for several decades. With the refreshed vision of resourceful countries and funding agencies, funding is being provided in many areas of research in tuberculosis diagnosis and treatment. This review has been written with an aim to bring forth the limitations of available methods in the field of diagnostics and making researchers aware about the changing scenario with better funding opportunities and support. The author visualizes an enthusiasm from all over the world for the development of better modalities and urges scientists to join the struggle at this very perfect time to take the challenge and come forward with innovations in this field.

  11. Crack Cocaine and Infectious Tuberculosis

    OpenAIRE

    Story, A.; Bothamley, G.; Hayward, A.

    2008-01-01

    We hypothesize that crack cocaine is independently associated with smear-positive tuberculosis (TB). In a case-control study of TB in London, 19 (86%) of 22 crack cocaine users with pulmonary TB were smear positive compared with 302 (36%) of 833 non-drug users. Respiratory damage caused by crack cocaine may predispose drug users to infectivity.

  12. Disseminated tuberculosis with rare involvements

    International Nuclear Information System (INIS)

    We report a case of disseminated tuberculosis involving the middle ear, the central nervous system, the spine and the lung. The tuberculous epidural abscess and otomastoiditis don't have any specific imaging features. But their coexistence with an other tuberculous involvement might suggest their tuberculous nature. The epidural abscess may result from direct extension from otomastoiditis. (authors)

  13. Immunotherapy for tuberculosis: future prospects

    Directory of Open Access Journals (Sweden)

    Abate G

    2016-04-01

    Full Text Available Getahun Abate,1 Daniel F Hoft1,2 1Department of Internal Medicine, Division of Infectious Diseases, Allergy and Immunology, 2Department of Molecular Microbiology and Immunology, Saint Louis University, St. Louis, MO, USA Abstract: Tuberculosis (TB is still a major global health problem. A third of the world's population is infected with Mycobacterium tuberculosis. Only ~10% of infected individuals develop TB but there are 9 million TB cases with 1.5 million deaths annually. The standard prophylactic treatment regimens for latent TB infection take 3–9 months, and new cases of TB require at least 6 months of treatment with multiple drugs. The management of latent TB infection and TB has become more challenging because of the spread of multidrug-resistant and extremely drug-resistant TB. Intensified efforts to find new TB drugs and immunotherapies are needed. Immunotherapies could modulate the immune system in patients with latent TB infection or active disease, enabling better control of M. tuberculosis replication. This review describes several types of potential immunotherapies with a focus on those which have been tested in humans. Keywords: tuberculosis, HDT, immunotherapy, treatment

  14. Mycobacterium tuberculosis: factores de virulencia

    Directory of Open Access Journals (Sweden)

    Reinier Borrero

    2011-04-01

    Full Text Available Mycobacterium tuberculosis es el agente causal de la tuberculosis, una de las enfermedades infecciosas más letales en el mundo. La única vacuna disponible para su control es el BCG, sin embargo, falla en la protección contra la tuberculosis pulmonar, siendo esta la forma más frecuente y responsable de la diseminación. La identificación de factores de virulencia del microorganismo causal pudiera ayudar en el desarrollo de un nuevo candidato vacunal que sea capaz de neutralizar la acción de esos determinantes patogénicos. El empleo de diferentes modelos animales ha permitido reproducir las etapas de la enfermedad, así como medir o cuantificar la virulencia de las distintas cepas circulantes de Mycobacterium tuberculosis. Las mutaciones génicas y otras técnicas de biología molecular han posibilitado dilucidar los genes específicos involucrados en la virulencia de este microorganismo que codifican para múltiples y complejos factores de diferente naturaleza.

  15. HIV and tuberculosis in India

    Indian Academy of Sciences (India)

    Soumya Swaminathan; G Narendran

    2008-11-01

    The global impact of the converging dual epidemics of tuberculosis (TB) and human immunodeficiency virus (HIV) is one of the major public health challenges of our time. The World Health Organization (WHO) reports 9.2 million new cases of TB in 2006 of whom 7.7% were HIV-infected. Tuberculosis is the most common opportunistic infection in HIV-infected patients as well as the leading cause of death. Further, there has been an increase in rates of drug resistant tuberculosis, including multi-drug (MDRTB) and extensively drug resistant TB (XDRTB), which are difficult to treat and contribute to increased mortality. The diagnosis of TB is based on sputum smear microscopy, a 100-year old technique and chest radiography, which has problems of specificity. Extra-pulmonary, disseminated and sputum smear negative manifestations are more common in patients with advanced immunosuppression. Newer diagnostic tests are urgently required that are not only sensitive and specific but easy to use in remote and resource-poor settings. Treatment of HIV-TB co-infection is complex and associated with high pill burden, overlapping drug toxicities, risk of immune reconstitution inflammatory syndrome (IRIS) and challenges related to adherence. From a programmatic point of view, screening of all HIV-infected persons for tuberculosis and vice-versa will help identify co-infected patients who require treatment for both infections. This requires good coordination and communication between the TB and AIDS control programs, in India.

  16. PET/CT Imaging of Tuberculosis with 68ga-Citrate

    Directory of Open Access Journals (Sweden)

    Mariza Vorster

    2015-02-01

    Full Text Available Objective: The impact of tuberculosis (TB on mortality and morbidity is indisputable worldwide and even more so in countries with a high prevalence of Human Immunodeficiency Virus (HIV co-infection. The development of a non-invasive diagnostic tool that is capable of early and accurate detection, staging and follow-up evaluation of tuberculosis is crucial in minimizing its devastating effects. We evaluated PET/CT imaging with a novel tracer, 68Ga-citrate,in this setting. Methods: Thirteen patients with tuberculosis were included in this prospective pilot study and were imaged with 68Gacitrate. A diagnosis of TB was reached with bacteriological or histopathology studies (n=8 or based on a combination of clinical data, biochemistry and imaging (n=5. PET images were acquired at 60 minutes (and 120 minutes where possible and analyzed qualitatively (relative to the liver and semi-quantitatively (using SUVmax and change in SUVmax. PET findings were also compared to that of CT. Results: All 13 patients demonstrated abnormal tracer accumulation in the lungs or extra-pulmonary or both. 68Ga-citrate accumulated in every lung lesion noted on CT in six cases (46%. In seven cases (54% some of the lung lesions noted on CT were not 68Ga-citrate avid, which is suggestive of non-active tuberculosis lesions. Ten patients (77% demonstrated extrapulmonary involvement, which included various lymph node groups, skeletal lesions, pleural-, splenic- and gastro-intestinal tract involvement. More extra-pulmonary lesions were detected on PET compared to CT in eight cases (80%. The results of dual-time point imaging varied significantly amongst study participants. Conclusion: Pulmonary and extra-pulmonary tuberculosis lesions demonstrate 68Ga-citrate accumulation; with more extrapulmonary lesions detected on PET compared to CT. 68Ga-citrate PET may also provide a way of distinguishing active from inactive lesions for treatment response evaluation.

  17. Atypical Hemolytic-Uremic Syndrome: A Clinical Review.

    Science.gov (United States)

    Nayer, Ali; Asif, Arif

    2016-01-01

    Atypical hemolytic-uremic syndrome (HUS) is a rare life-threatening disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, and ischemic injury to organs, especially the kidneys. Microvascular injury and thrombosis are the dominant histologic findings. Complement activation through the alternative pathway plays a critical role in the pathogenesis of atypical HUS. Genetic abnormalities involving complement regulatory proteins and complement components form the molecular basis for complement activation. Endothelial cell dysfunction, probably because of the effects of complement activation, is an intermediate stage in the pathophysiologic cascade. Atypical HUS has a grave prognosis. Although mortality approaches 25% during the acute phase, end-stage renal disease develops in nearly half of patients within a year. Atypical HUS has a high recurrence rate after renal transplantation, and recurrent disease often leads to graft loss. Plasma therapy in the form of plasma exchange or infusion has remained the standard treatment for atypical HUS. However, many patients do not respond to plasma therapy and some require prolonged treatment. Approved by the Food and Drug Administration in the treatment of atypical HUS, eculizumab is a humanized monoclonal antibody that blocks cleavage of complement C5 into biologically active mediators of inflammation and cytolysis. Although case reports have shown the efficacy of eculizumab, randomized clinical trials are lacking. Therapeutic strategies targeting endothelial cells have demonstrated promising results in experimental settings. Therefore, inhibitors of angiotensin-converting enzyme, HMG-CoA reductase, and xanthine oxidase as well as antioxidants, such as ascorbic acid, may have salutary effects in patients with atypical HUS. PMID:24681522

  18. Epidemiology and clinical management of tuberculosis in children in Canada

    Science.gov (United States)

    Morris, Shaun K; Demers, Anne-Marie; Lam, Ray; Pell, Lisa G; Giroux, Ryan JP; Kitai, Ian

    2015-01-01

    Although often regarded as a foreign disease, latent tuberculosis or tuberculosis disease will be encountered in many clinical situations by the Canadian child health practitioner. There are key differences between tuberculosis in children and adults. In the present article, the changing epidemiology of tuberculosis in children in Canada and around the world, the pathogenesis of infection, diagnostic tests, and clinical management of childhood latent tuberculosis and tuberculosis disease are reviewed. PMID:25838781

  19. Tuberculosis: medico-legal aspects.

    Science.gov (United States)

    Vetrugno, G; De-Giorgio, F; D'Alessandro, F; Scafetta, I; Berloco, F; Buonsenso, D; Abbate, F; Scalise, G; Pascali, V L; Valentini, P

    2014-01-01

    Tuberculosis is a diffusive infectious disease whose typical behaviour differentiates it from other infectious diseases spread by human-to-human transmission (flu, chicken pox, cholera, etc.) that follow a classic epidemic pattern. Indeed, in the presence of a known source of Koch bacilli that is capable of spreading the bacteria by air, not all exposed individuals inhale the bacteria, not all those who inhale them absorb them, not all those who absorb the bacteria are unable to eliminate them, not all who are able to eliminate them do so using delayed hypersensitivity, not all those who react with delayed hypersensitivity suffer lasting tissue damage (among other things, minor), not all who suffer tissue damage have anatomical sequelae, and not all those who have anatomical sequelae, however minimal, become carriers of bacilli in the latent period. The vast majority (90-95%) of the latter - which are in any case a portion, not the totality of those exposed - remain asymptomatic throughout their lives and never develop active tuberculosis. Based on these biological characteristics and the legal concepts of "epidemic" and "disease," it becomes highly problematic, if not impossible, to assert both that tuberculosis can cause events of sufficient magnitude to be associated with the crime of "epidemic," and that the mere diagnosis of a latent tuberculosis infection is sufficient to assume the presence of an illness legally prosecutable in criminal proceedings or a disability prosecutable in civil proceedings. Furthermore, clinically apparent tuberculosis is a temporarily-and in some cases permanently-disabling condition, and in certain work environments, even with the difficulties caused by the lack of available effective diagnostic tools and the insidious behaviour of the disease in the early stages, targeted monitoring to identify other persons who may become ill is appropriate. PMID:24804006

  20. TUBERCULOSIS: MEDICO-LEGAL ASPECTS

    Directory of Open Access Journals (Sweden)

    Giuseppe Vetrugno

    2014-04-01

    Full Text Available Tuberculosis is a diffusive infectious disease whose typical behavior differentiates it from other infectious diseases spread by human-to-human transmission (flu, chicken pox, cholera, etc. which follow a classically epidemic pattern. Indeed, in the presence of a known source of Koch bacilli capable of spreading them by air, not all exposed individuals inhale the bacteria, not all those who inhale them absorb them, not all those who absorb them are unable to eliminate them, not all who are able to eliminate them do so using delayed hypersensitivity, not all those who react with delayed hypersensitivity suffer lasting tissue damage (among other things, minor, not all who suffer tissue damage have anatomical sequelae, not all those who have anatomical sequelae, however minimal, become carriers of bacilli in the latent period. The vast majority (90-95% of the latter – which are in any case a portion, not the totality of those exposed – remain asymptomatic throughout their lives and never develop active tuberculosis. Based on these biological characteristics and the legal concepts of “epidemic” and “disease,” it becomes highly problematic, if not impossible, to assert both that tuberculosis can cause events of sufficient magnitude to be associated with the crime of “epidemic,” and that the mere diagnosis of a latent tuberculosis infection is sufficient to assume the presence of an illness legally prosecutable in criminal proceedings or a disability prosecutable in civil proceedings. Further, clinically apparent tuberculosis is a temporarily—in some cases permanently—disabling condition, and in certain work environments, even with the difficulties caused by the lack of available effective diagnostic tools and the insidious behavior of the disease in the early stages, it appears appropriate to engage in targeted monitoring, also for the early identification of persons who may become ill.

  1. The changes in mycolic acid structures caused by hadC mutation have a dramatic effect on the virulence of Mycobacterium tuberculosis.

    Science.gov (United States)

    Slama, Nawel; Jamet, Stevie; Frigui, Wafa; Pawlik, Alexandre; Bottai, Daria; Laval, Françoise; Constant, Patricia; Lemassu, Anne; Cam, Kaymeuang; Daffé, Mamadou; Brosch, Roland; Eynard, Nathalie; Quémard, Annaïk

    2016-02-01

    Understanding the molecular strategies used by Mycobacterium tuberculosis to invade and persist within the host is of paramount importance to tackle the tuberculosis pandemic. Comparative genomic surveys have revealed that hadC, encoding a subunit of the HadBC dehydratase, is mutated in the avirulent M. tuberculosis H37Ra strain. We show here that mutation or deletion of hadC affects the biosynthesis of oxygenated mycolic acids, substantially reducing their production level. Additionally, it causes the loss of atypical extra-long mycolic acids, demonstrating the involvement of HadBC in the late elongation steps of mycolic acid biosynthesis. These events have an impact on the morphotype, cording capacity and biofilm growth of the bacilli as well as on their sensitivity to agents such as rifampicin. Furthermore, deletion of hadC leads to a dramatic loss of virulence: an almost 4-log drop of the bacterial load in the lungs and spleens of infected immunodeficient mice. Both its unique function and importance for M. tuberculosis virulence make HadBC an attractive therapeutic target for tuberculosis drug development. PMID:26538472

  2. [Increased IL-4 production in response to virulent Mycobacterium tuberculosis in tuberculosis patients with advanced disease].

    Science.gov (United States)

    Ordway, Diane J; Martins, Marta S; Costa, Leonor M; Freire, Mónica S; Arroz, Maria J; Dockrell, Hazel M; Ventura, Fernando A

    2005-01-01

    The study was designed to compare immune responses to Mycobacterium tuberculosis bacilli and antigens in healthy Portuguese subjects and pulmonary tuberculosis patients (TB), and to correlate immune status with clinical severity of tuberculosis disease. PBMC were cultured and stimulated with live and killed M. tuberculosis H37Rv and purified protein derivative (PPD) and lymphoproliferation and production of IFN-gamma and IL-5/IL-4 by these cultures were evaluated by the use of ELISA and multi-parameter flow cytometry. PBMC from 30 tuberculosis patients demonstrated significantly reduced amounts of proliferation and IFN-gamma when stimulated with live M. tuberculosis compared the control group. Of 15 tuberculosis patients tested for intracellular IL-4 following stimulation with M. tuberculosis, 7 showed greatly increased IL-4 production in CD8+ and gammadelta+ T cells. Tuberculosis patients demonstrated an increase of intracellular IL-4 after PBMC were stimulated with live M. tuberculosis in the CD4+ phenotype, but more notably in CD8+ and gammadelta TCR+ subsets. Increased production of IL-4 in tuberculosis patients was primarily in individuals with advanced involvement of lung parenchymal with high bacterial loads in sputum. These results suggest that an alteration in type 1 and type 2 cytokine balance can occur in patients with tuberculosis at an advanced clinical stage of disease. PMID:16202332

  3. Determination of Urinary Neopterin/Creatinine Ratio to Distinguish Active Tuberculosis from Latent Mycobacterium tuberculosis Infection

    Directory of Open Access Journals (Sweden)

    Michael Eisenhut

    2016-01-01

    Full Text Available Background. Biomarkers to distinguish latent from active Mycobacterium (M. tuberculosis infection in clinical practice are lacking. The urinary neopterin/creatinine ratio can quantify the systemic interferon-gamma effect in patients with M. tuberculosis infection. Methods. In a prospective observational study, urinary neopterin levels were measured by enzyme linked immunosorbent assay in patients with active tuberculosis, in people with latent M. tuberculosis infection, and in healthy controls and the urinary neopterin/creatinine ratio was calculated. Results. We included a total of 44 patients with M. tuberculosis infection and nine controls. 12 patients had active tuberculosis (8 of them culture-confirmed. The median age was 15 years (range 4.5 to 49. Median urinary neopterin/creatinine ratio in patients with active tuberculosis was 374.1 micromol/mol (129.0 to 1072.3, in patients with latent M. tuberculosis infection it was 142.1 (28.0 to 384.1, and in controls it was 146.0 (40.3 to 200.0, with significantly higher levels in patients with active tuberculosis (p<0.01. The receiver operating characteristics curve had an area under the curve of 0.84 (95% CI 0.70 to 0.97 (p<0.01. Conclusions. Urinary neopterin/creatinine ratios are significantly higher in patients with active tuberculosis compared to patients with latent infection and may be a significant predictor of active tuberculosis in patients with M. tuberculosis infection.

  4. Symptomatic atypical femoral fractures are related to underlying hip geometry.

    Science.gov (United States)

    Taormina, David P; Marcano, Alejandro I; Karia, Raj; Egol, Kenneth A; Tejwani, Nirmal C

    2014-06-01

    The benefits of bisphosphonates are well documented, but prolonged use has been associated with atypical femur fractures. Radiographic markers for fracture predisposition could potentially aid in safer medication use. In this case-control designed study, we compared hip radiographic parameters and the demographic characteristics of chronic bisphosphonate users who sustained an atypical femoral fracture with a group of chronic bisphosphonate users who did not sustain an atypical femur fracture and also a group who sustained an intertrochanteric hip fracture. Radiographic parameters included were neck-shaft angle (NSA), hip-axis length (HAL) and center-edge angle (CE). Multivariate regression was used to evaluate the relationship between radiographic measures and femur fracture. Receiver-operating characteristic analysis determined cut-off points for neck-shaft angle and risk of atypical femur fracture. Ultimately, pre-fracture radiographs of 53 bisphosphonate users who developed atypical fracture were compared with 43 asymptomatic chronic bisphosphonate users and 64 intertrochanteric fracture patients. Duration of bisphosphonate use did not statistically differ between users sustaining atypical fracture and those without fracture (7.9 [±3.5] vs. 7.7 [±3.3] years, p=0.7). Bisphosphonate users who fractured had acute/varus pre-fracture neck-shaft angles (p<0.001), shorter hip-axis length (p<0.01), and narrower center-edge angles (p<0.01). Regression analysis revealed associations between neck-shaft angle (OR=0.89 [95% CI=0.81-0.97; p=0.01), center edge angle (OR=0.89 [95% CI=0.80-0.99]; p=0.03), and BMI (OR=1.15 [95% CI=1.02-1.31; p=0.03) with fracture development. ROC curve analysis (AUC=0.67 [95% CI=0.56-0.79]) determined that a cut-off point for neck-shaft angle <128.3° yielded 69% sensitivity and 63% specificity for development of atypical femoral fracture. Ultimately, an acute/varus angle of the femoral neck, high BMI, and narrow center-edge angle were

  5. An Unusual Case of Cervical Tuberculosis

    Directory of Open Access Journals (Sweden)

    Prashant S Joshi

    2011-04-01

    Full Text Available Tuberculosis of the cervix is a rare disease and accounts to 0.1 – 0.65% of all cases of tuberculosis and 5 – 24 % of genital tract tuberculosis. We present an unusual case of 40 years old lady who presented with irregular bleeding per vagina and foul smelling white discharge for 1 year. Per speculum examination revealed an unhealthy looking cervix which bled on touch. A clinical diagnosis of carcinoma cervix was made. However, cervix biopsy revealed granulomatous lesion suggestive of tuberculosis. The patient responded to antitubercular therapy. In women with abnormal cervical appearance, there should be high index of suspicion of tuberculosis cervix, especially from areas where tuberculosis is common as it can be easily treated.

  6. Primary disseminated extrapulmonary multidrug resistant tuberculosis

    Directory of Open Access Journals (Sweden)

    S K Das

    2012-01-01

    Full Text Available Disseminated tuberculosis is a common mode of presentation of tuberculosis in patients both with and without HIV/AIDS in India. However, primary multidrug resistance in disseminated tuberculosis involving only the extrapulmonary sites in an immunocompetent adult is rare. Here, we report a case of a 19-year-old man who had disseminated tuberculosis involving left pleura, pericardium, peritoneum and intraabdominal lymph nodes. He was initially taking WHO category I antituberculous drugs, but was not responding in spite of 5 months of chemotherapy. Culture of the pleural biopsy specimen grew Mycobacterium tuberculosis which was resistant to isoniazid and rifampicin. He was put on therapy for multidrug resistant tuberculosis,following 24 months of chemotherapyhe had an uneventful recovery.

  7. Expression of Gla proteins during fish skeletal development

    OpenAIRE

    Gavaia, Paulo J.

    2006-01-01

    Senegal sole skeletal development; Skeletal malformations; Skeletal malformation in mediterranean species; Senegal sole skeletal deformities; Zebra fish as model system: skeletal development; Identification of bone cells / skeletal development; Spatial - temporal pattern of bgp expression; Single cell resolution: localization of bgp mRNA; Single cell resolution: Immunolocalization of Bgp; Single cell resolution: localization of mgp mRNA; Single cell resolution: Immunolocalization of Mgp; An i...

  8. Skeletal scintigraphy following incidental trauma

    International Nuclear Information System (INIS)

    The significance of antecedent trauma in skeletal scintigraphy was assessed in 503 patients, of whom 241 (46%) had prior fracture or tooth extraction. In patients with sufficiently accurate histories for site-by-site analysis, 33 of 131 fracture sites and 16 of 83 dental-procedure sites were positive scintigraphically. In general, the frequency of scan positivity diminished as the interval between trauma and scanning increased, but a significant number of patients showed prolonged uptake at fracture sites. Several patterns of uptake suggested trauma rather than metastatic disease. Knowledge of a history of trauma is often critical in bone scan interpretation

  9. Computational radiology in skeletal radiography

    Energy Technology Data Exchange (ETDEWEB)

    Peloschek, Ph.; Nemec, S. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Widhalm, P. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Pattern Recognition and Image Processing Group, Department of Computer Aided Automation, Vienna University of Technology, Wiedner Hauptstrasse 8-10/020, A-1040 Vienna (Austria); Donner, R. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Pattern Recognition and Image Processing Group, Department of Computer Aided Automation, Vienna University of Technology, Wiedner Hauptstrasse 8-10/020, A-1040 Vienna (Austria); Institute for Computer Graphics and Vision, Graz University of Technology, Inffeldgasse 16, A-8010 Graz (Austria); Birngruber, E. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Thodberg, H.H. [Visiana Aps, Sollerodvej 57C, DK-2840 Holte (Denmark); Kainberger, F. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Langs, G. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)], E-mail: georg.langs@meduniwien.ac.at

    2009-11-15

    Recent years have brought rapid developments in computational image analysis in musculo-skeletal radiology. Meanwhile the algorithms have reached a maturity that makes initial clinical use feasible. Applications range from joint space measurement to erosion quantification, and from fracture detection to the assessment of alignment angles. Current results of computational image analysis in radiography are very promising, but some fundamental issues remain to be clarified, among which the definition of the optimal trade off between automatization and operator-dependency, the integration of these tools into clinical work flow and last not least the proof of incremental clinical benefit of these methods.

  10. Computational radiology in skeletal radiography

    International Nuclear Information System (INIS)

    Recent years have brought rapid developments in computational image analysis in musculo-skeletal radiology. Meanwhile the algorithms have reached a maturity that makes initial clinical use feasible. Applications range from joint space measurement to erosion quantification, and from fracture detection to the assessment of alignment angles. Current results of computational image analysis in radiography are very promising, but some fundamental issues remain to be clarified, among which the definition of the optimal trade off between automatization and operator-dependency, the integration of these tools into clinical work flow and last not least the proof of incremental clinical benefit of these methods.

  11. Ichthyosiform mycosis fungoides with alopecia and atypical membranous nephropathy

    Directory of Open Access Journals (Sweden)

    Qiang Zhou

    2011-01-01

    Full Text Available We describe here a rare case of variant of mycosis fungoides (MF: ichthyosiform MF with alopecia and atypical membranous nephropathy. The diagnosis was made based on the following findings: generalized ichthyosis-like eruption, alopecia, enlarged superficial lymph nodes, proteinuria, and hematuria, the histological features of the skin biopsy from both ichthyotic and alopecic lesions with immunohistochemical staining, and the renal biopsy examination with immunofluorescence. The histological examination of ichthyotic and alopecic lesions displayed a predominant infiltration of atypical lymphocytes in the upper dermis with the characteristics of epidermotropism and folliculotropism. Immunohistochemical studies demonstrated that most infiltrated atypical lymphocytes were CD3, CD4, and CD45RO positive, whereas negative for CD5, CD7, CD20, CD30, and CD56. A renal biopsy examination revealed atypical membranous nephropathy with deposition of immunoglobulin G (IgG, IgM, IgA, C1q, and C3. In this case atypical membranous nephropathy was involved, which is very uncommon and has never been presented in the literature to date. Although ichthyosiform MF usually features a relatively favorable course, diffuse alopecia and the renal involvement in this case might indicate aggressive disease and poor prognosis.

  12. Atypical growth of Renibacterium salmoninarum in subclinical infections.

    Science.gov (United States)

    Hirvelä-Koski, V; Pohjanvirta, T; Koski, P; Sukura, A

    2006-01-01

    Two growth types of Renibacterium salmoninarum were isolated from subclinically infected rainbow trout, one producing the smooth colonies typical of R. salmoninarum and the other forming a thin film on the surface of the agar with no separate colonies. The atypical growth was present on kidney disease medium agar in primary cultures of the kidney but not on selective kidney disease medium (SKDM). Fluorescent antibody staining of the fresh isolate and polymerase chain reaction amplification were the most reliable techniques to identify the atypical growth of R. salmoninarum. The condition was reversible, with growth reverting from atypical to the smooth colony form in experimentally infected rainbow trout and under laboratory conditions. There was no mortality, or any clinical signs of bacterial kidney disease (BKD) in the fish challenged with the atypical growth, although small numbers of smooth colonies of R. salmoninarum were isolated from 8% of these fish. The atypical growth reported here may explain some of the failures of culture, when SKDM agar alone is used for the detection of BKD in subclinically infected fish. PMID:16351695

  13. Mycobacterium tuberculosis produces pili during human infection

    OpenAIRE

    Alteri, Christopher J.; Xicohténcatl-Cortes, Juan; Hess, Sonja; Caballero-Olín, Guillermo; Girón, Jorge A.; Friedman, Richard L.

    2007-01-01

    Mycobacterium tuberculosis is responsible for nearly 3 million human deaths worldwide every year. Understanding the mechanisms and bacterial factors responsible for the ability of M. tuberculosis to cause disease in humans is critical for the development of improved treatment strategies. Many bacterial pathogens use pili as adherence factors to colonize the host. We discovered that M. tuberculosis produces fine (2- to 3-nm-wide), aggregative, flexible pili that are recognized by IgG antibodie...

  14. Tuberculosis of the foot: An osteolytic variety

    OpenAIRE

    Dhillon, Mandeep S; Sameer Aggarwal; Sharad Prabhakar; Vikas Bachhal

    2012-01-01

    Background: Foot involvement in osteoarticular tuberculosis is uncommon and isolated bony involvement of foot bones with an osteolytic defect is even more rare; diagnostic and therapeutic delays can occur, worsening the prognosis. We present a retrospective series of osteolytic variety of foot tuberculosis. Materials and Methods: We present 24 osteolytic variety of foot tuberculosis (Eleven calcaneus, four cuboid, two cunieforms, one talus, three metatarsals, three phalanges) out of 92 fo...

  15. Monkey Models of Tuberculosis: Lessons Learned

    OpenAIRE

    Peña, Juliet C.; Ho, Wen-Zhe

    2014-01-01

    The use of animal models has been invaluable for studying the pathogenesis of Mycobacterium tuberculosis infection, as well as for testing the efficacy of vaccines and drug regimens for tuberculosis. Among the applied animal models, nonhuman primates, particularly macaques, share the greatest anatomical and physiological similarities with humans. As such, macaque models have been used for investigating tuberculosis pathogenesis and preclinical testing of drugs and vaccines. This review focuse...

  16. Periodontitis in patients with focal tuberculosis

    Directory of Open Access Journals (Sweden)

    Alexandrova Е.А.

    2010-12-01

    Full Text Available The research goal is to investigate the mechanisms of formation and peculiarities of periodontitis in patients with focal tuberculosis. Patients with periodontitis and focal tuberculosis are proved to develop local inflammatory reaction with increased infection and activation of proinflammatory cytokines in parodontal pockets fluid. The main risk factor of frequent and durable recurrence of parodontal pathology in case of focal tuberculosis was the development of pathologic process as a cause of disbalance of lipid peroxidation and antioxidant system, endotoxicosis syndrome

  17. Tuberculosis Extremadamente Drogorresistente (XDR: una Amenaza Permanente

    Directory of Open Access Journals (Sweden)

    Virginia Victoria Cortez Romero

    2009-06-01

    Full Text Available La tuberculosis (TB es una enfermedad que afecta al mundo entero, sobretodo a países pobres. Durante mucho tiempoconstituyó la primera causa de muerte por enfermedades infecciosas a nivel mundial, siendo después superada por la pandemiadel VIH/SIDA. Ahora, nuevamente la tuberculosis ha tomado importancia por el surgimiento de cepas multidrogorresistentesen cuyo extremo de letalidad esta la tuberculosis extremadamente drogoresistente (TB XDR.

  18. Peritoneal tuberculosis. Also important in Germany

    International Nuclear Information System (INIS)

    As a result of the increase in the number of foreigners living in Germany and in the number of patients with AIDS, there will also be an increase in the incidence of abdominal tuberculosis in Germany. The following report describes the case of a 24-year-old female patient with peritoneal tuberculosis, the most common manifestation of abdominal tuberculosis. Computed tomography showed typical pathological alterations; the diagnosis was confirmed by intralaparascopic biopsy. (orig.)

  19. New drug candidates in tuberculosis treatment

    OpenAIRE

    Begüm Evranos Aksöz

    2014-01-01

    Tuberculosis is a very old infectious and mortal disease that continues to threaten the world. It is a growing health problem for all over the world although it has high prevalence mostly in poor African and Asian countries. This is because of the increasing pathology of tuberculosis with HIV and the resistance to antibiotic therapy. The treatment period is at least six months in tuberculosis. This causes the development of resistance to drugs and using multidrug therapy. The long duration of...

  20. Controlling strategy of dormant Mycobacterium tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Gan Yiling; Guo Shuliang

    2014-01-01

    Objective This study aimed to review the available literatures on control of latent tuberculosis (TB) infection and propose a new control strategy to shorten the course of TB chemotherapy.Data sources The data used in this review were mainly obtained from articles listed in PubMed.The search terms were "therapy (treatment) of tuberculosis," "therapy (treatment) of latent TB infection," and "vaccine of TB."Study selection Articles regarding treatment and vaccine of TB were selected and reviewed.Results The most crucial reason causing the prolonged course of TB chemotherapy is the dormant state of Mycobacterium tuberculosis (M.tuberculosis).Nevertheless,there are,to date,no effective drugs that can directly kill the dormant cells of M.tuberculosis in clinical therapy.In accordance with the growth cycle of dormant M.tuberculosis in the body,the methods for controlling dormant M.tuberculosis include direct killing with drugs,prevention of dormant M.tuberculosis resuscitation with vaccines,and resuscitating dormant M.tuberculosis with preparations or drugs and then thoroughly killing these resuscitated M.tuberculosis by using anti-TB therapy.Conclusions The comprehensive analysis of the above three methods suggests that the drugs directly killing dormant cells are in clinical trials,TMC207 is the most beneficial for controlling TB.Because the side effect of vaccines is less and their action period is long,prevention of dormant cells resuscitation with vaccines is promising.The last control method makes it probable that when a huge number of active cells of M.tuberculosis have been killed and eradicated after 1-month short chemotherapy,only a strong short-term subsequent chemotherapy can completely kill and eradicate the remaining M.tuberculosis.This control strategy is expected to significantly shorten the course of TB chemotherapy and bring a new change and breakthrough in TB treatment.

  1. Perinatal tuberculosis: Diagnostic and therapeutic approach

    Directory of Open Access Journals (Sweden)

    Čegar Svetlana

    2012-01-01

    Full Text Available Introduction. The number of people suffering from tuberculosis has increased rapidly in the whole world over the past three decades. The classical age distribution of disease has also changed. According to the epidemiological data the number of pregnant women having tuberculosis has also risen with the resulting increase in the incidence of perinatal tuberculosis. Pregnancy and Tuberculosis. The presentation of tuberculosis in pregnancy varies. The effects of tuberculosis on pregnancy depend upon various factors: site and extent of the disease, nutritional status and immune status of mother, concomitant diseases, stage of pregnancy when the treatment started and others. A delay between the onset and diagnosis occurs regularly. Treatment response, time to clearance of bacilli from sputum, and prognosis are similar to non pregnant women. Prinatal tuberculosis. Perinatal tuberculosis is extremely rare if the mother is effectively treated in pregnancy, but disease is usually fatal if untreated. Diagnosis of perinatal tuberculosis is very often problematic and difficult. The reason of this is the fact that the initial manifestations of disease are nonspecific and may be delayed. In practice, congenital and early neonatal infections have almost the same mode of presentations, treatment and prognosis. Epidemiological data on the active tuberculosis in mother or some other family member are of the utmost importance in diagnoing tuberculosis. Differences in immune responses in the fetus and neonate add to the diagnostic difficulties already recognised in young children. Tuberculin tests are negative in at least 75% of cases. Conclusion. If the condition is recognized and treated according to existing tuberculosis protocols, the outcome is favourable.

  2. Tratamiento de la tuberculosis pulmonar Treatment of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    J. Boldú

    2007-01-01

    Full Text Available El tratamiento de la tuberculosis es importante tanto para preservar la salud del paciente como para prevenir la propagación de la enfermedad entre la población. Sus bases bacteriológicas estriban en el elevado número de bacilos que existen en la mayor parte de lesiones humanas de la TB y en la capacidad de mutar que tiene el M. tuberculosis cuando alcanza un número elevado de divisiones; ello hace imprescindible la asociación de fármacos que eviten la selección de mutantes resistentes. En nuestro medio la terapia farmacológica que se ha demostrado más eficaz consiste en la asociación durante dos meses de isoniacida, rifampicina y piracinamida seguida durante cuatro meses más con los dos primeros fármacos. En general los tuberculostáticos de primera elección son bien tolerados, pero pueden producir efectos secundarios potencialmente graves que conviene conocer y saber manejar. En el presente trabajo describimos también cómo se debe actuar desde el punto de vista terapéutico ante determinadas situaciones especiales y cuando los tratamientos iniciales se han abandonado o han fracasado. En los últimos cinco años en Navarra, se ha incrementado de forma importante la presencia de inmigrantes procedentes de países en vías de desarrollo con altas tasas de tuberculosis y de resistencias primarias. Este colectivo genera con frecuencia, como consecuencia de sus particulares condiciones socioeconómicas y su idiosincrasia cultural, dificultades respecto al cumplimiento del tratamiento, así como en los seguimientos y controles. El tratamiento de la tuberculosis siempre debe ser realizado por médicos expertos en el tema.The treatment of tuberculosis is important both to preserve the health of the patient and to prevent the spread of the disease amongst the population. Its bacteriological bases are found in the high number of bacillae existing in the majority of human TB lesions and the capacity to mutate of Mycobacterium tuberculosis

  3. Tuberculose entérica Instestinal tuberculosis

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    Luiz Alberto Mendonça de Freitas

    2000-02-01

    Full Text Available The authors reports two patients with operated from enteric tuberculosis. Tuberculosis involving the intestinal tract may be due to either Mycobacterium tuberculosis or M. bovis. In the former situation, the disease is primary to the lungs and is carried to the intestinal tract by swallowing sputum. The latter organism produces infection associated with swallowed nonpasteurized milk. This condition is extremely unusual in most western countries, since pasteurization of milk is standardized. The diagnosis was performed through laparotomy because of symptoms suggestive of intestine obstruction. Inflammatory reactions were observed on the small intestine (jejunum-ileum in both cases. The presence of tuberculosis of the lungs was observed in one patient. The chemotherapic treatment was estabilished after the histopathologic diagnosis. The distinction between tuberculosis and Crohn's disease may not be possible by radiography or endoscopy. Videolaparoscopy has been found to be an useful procedure for the early diagnosis of Enteric Tuberculosis. In spite of the epidemiology knowledge, clinical control and improvement in treatment, extra pulmonary tuberculosis rate from concealed focus has been increased, due to AIDS poverty in certain populational groups and immigration from Asia to wertern countries. Compared with immunocompetent patients, the proportion of extrapulmonary tuberculosis is much higher in patients with AIDS, justfying the increased frequency of reports of intestinal tuberculosis in these patients.

  4. Improving the tuberculosis drug development pipeline.

    Science.gov (United States)

    Evangelopoulos, Dimitrios; McHugh, Timothy D

    2015-11-01

    Mycobacterium tuberculosis is considered one of the most successful pathogens and multidrug-resistant tuberculosis, a disease that urgently requires new chemical entities to be developed for treatment. There are currently several new molecules under clinical investigation in the tuberculosis (TB) drug development pipeline. However, the complex lifestyle of M. tuberculosis within the host presents a barrier to the development of new drugs. In this review, we highlight the reasons that make TB drug discovery and development challenging as well as providing solutions, future directions and alternative approaches to new therapeutics for TB. PMID:25772393

  5. A Rare Cause of Hypopituitarism: Pituitary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Şazi İmamoğlu

    2012-03-01

    Full Text Available Pituitary tuberculosis is a rare condition that can present with hypopituitarism even without any evidence of systemic tuberculosis and is easily confused with pituitary adenomas. Headache and hypopituitarism are the most common presenting symptoms. We report the case of pituitary tuberculosis in a 39-year-old male patient who presented with panhypopituitarism. Although it is rare and difficult to diagnose, pituitary tuberculosis should be considered in every nonfunctional sellar masses, especially in fairly small ones with unexpected hypopituitarism. Turk Jem 2012; 16: 26-8

  6. Dormancy models for Mycobacterium tuberculosis: A minireview

    Directory of Open Access Journals (Sweden)

    Amani M. Alnimr

    2015-09-01

    Full Text Available Dormancy models for Mycobacterium tuberculosis play important roles in understanding various aspects of tuberculosis pathogenesis and in the testing of novel therapeutic regimens. By simulating the latent tuberculosis infection, in which the bacteria exist in a non-replicative state, the models demonstrate reduced susceptibility to antimycobacterial agents. This minireview outlines the models available for simulating latent tuberculosis both in vitro and in several animal species. Additionally, this minireview discusses the advantages and disadvantages of these models for investigating the bacterial subpopulations and susceptibilities to sterilization by various antituberculosis drugs.

  7. Dormancy models for Mycobacterium tuberculosis: A minireview.

    Science.gov (United States)

    Alnimr, Amani M

    2015-01-01

    Dormancy models for Mycobacterium tuberculosis play important roles in understanding various aspects of tuberculosis pathogenesis and in the testing of novel therapeutic regimens. By simulating the latent tuberculosis infection, in which the bacteria exist in a non-replicative state, the models demonstrate reduced susceptibility to antimycobacterial agents. This minireview outlines the models available for simulating latent tuberculosis both in vitro and in several animal species. Additionally, this minireview discusses the advantages and disadvantages of these models for investigating the bacterial subpopulations and susceptibilities to sterilization by various antituberculosis drugs. PMID:26413043

  8. [Tuberculosis control of urban areas in Japan].

    Science.gov (United States)

    2000-10-01

    The rates of tuberculosis remain high in urban areas. The declining speed of tuberculosis incidence rate in urban areas has been slower than other areas. Efforts and resources to tuberculosis control must be concentrated on urban locations to eradicate tuberculosis in Japan. 1. Tuberculosis control in a public health center of urban area: Teru OGURA and Chiyo INOGUCHI (Toshima City, Ikebukuro Public Health Center, Tokyo Metropolitan) A wide range of TB control measures is implemented by public health centers, such as a patient registration, home-visit guidance, contact examination in urban areas. Directors of every health center have the direct responsibility for tuberculosis control measures in their jurisdiction. Ikebukuro is urban areas where there are many offices, shopping and amusement facilities. Urban people is often on the move looking for job, so public health centers are often not easy to carry out contact examinations as planned. In recent years, homelessness has been recognized as a growing urban social problem. Their incidence of tuberculosis is high. Special TB control program must be carried out in urban areas. 2. Tuberculosis Control in Tokyo Metropolitan: Kazumasa MATSUKI (Department of Infectious Diseases and Tuberculosis, Bureau of Public Health, Tokyo Metropolitan) There has been a steady decline in the TB wards. The beds for TB patients are running short and even smear positive TB cases cannot be put in a hospital without waiting several days. Staffs of an urban emergency department must protect tuberculosis infection by environmental controls of emergency room. Tokyo Metropolitan government supports the engineering improvements of emergency room to hospitals. Directly observed therapy for tuberculosis patients at a district has been implemented to complete their therapy. On DOT, a trained health worker observes the patient take anti-TB medication. 3. Usefulness of Molecular Epidemiologic approach on Tuberculosis Control: Atsushi HASE (Osaka

  9. Cardiac, Skeletal, and smooth muscle mitochondrial respiration

    DEFF Research Database (Denmark)

    Park, Song-Young; Gifford, Jayson R; Andtbacka, Robert H I; Hyngstrom, John R; Garten, Ryan S; Diakos, Nikolaos A; Ives, Stephen J; Dela, Flemming; Larsen, Steen; Drakos, Stavros; Richardson, Russell S

    2014-01-01

    Unlike cardiac and skeletal muscle, little is known about vascular smooth muscle mitochondrial function. Therefore, this study examined mitochondrial respiratory rates in the smooth muscle of healthy human feed arteries and compared with that of healthy cardiac and skeletal muscle. Cardiac, skele...

  10. Mechanical modeling of skeletal muscle functioning.

    NARCIS (Netherlands)

    Linden, van der Bart Jochem Julius Joost

    1998-01-01

    For movement of body or body segments is combined effort needed of the central nervous system and the muscular-skeletal system. This thesis deals with the mechanical functioning of skeletal muscle. That muscles come in a large variety of geometries, suggest the existence of a relation between muscle

  11. Navicular tuberculosis: A rare localization of bone tuberculosis

    OpenAIRE

    Abdelhay Lemnouer; Mohammed Frikh; Bouchra Belfquih; Abdelwahab Jaafar; Ayoub Bouya; Mohamed Jidal; Mustapha Boussouga; Mostafa Elouennass

    2015-01-01

    Tuberculosis (TB) is a global public health problem endemic to Morocco. While extrapulmonary TB uncommonly presents in osteoarticular anatomic locations, tarsal or metatarsal osteitis can occur when TB presents in the tarsal bones. Clinical symptoms are often insidious causing a delay in diagnosis that may lead to bone destruction. While diagnosis can be guided by X-ray imaging, bacteriologic and histologic examination of the tissue allows for pathogen isolation, identification of the bacillu...

  12. Microbiología de la tuberculosis Microbiology of tuberculosis

    Directory of Open Access Journals (Sweden)

    I. Dorronsoro

    2007-01-01

    Full Text Available Durante un siglo, el diagnóstico microbiológico de la tuberculosis, basado en la baciloscopia y en el aislamiento e identificación de Mycobacterium tuberculosis en los cultivos, ha sido poco sensible y lento lo que obligaba en ocasiones a iniciar de forma empírica tratamiento con tuberculostáticos. La incorporación rutinaria de medios de cultivo líquidos y técnicas de genética molecular, en la última década del siglo XX, ha supuesto un avance importante al aumentar claramente la sensibilidad, precisión y rapidez en el diagnóstico. La actual eclosión de las técnicas moleculares está permitiendo un mejor conocimiento de la epidemiología de la enfermedad, de los factores de virulencia y de los mecanismos de resistencia lo que dará lugar, en un futuro inmediato, a nuevas estrategias de prevención y tratamiento de la enfermedad.For a century, the diagnosis of tuberculosis, based on bacilloscopy and the isolation and identification of Mycobacterium tuberculosis in cultures, has been slow and not very sensitive. This has made it necessary on occasions to initiate treatment with tuberculostatics in an empirical way. The routine incorporation of liquid mediums and molecular genetic techniques in the final decade of the XX century brought an important advance by clearly increasing the sensitivity, precision and rapidity of diagnosis. The present blossoming of molecular techniques is making possible a better understanding of the disease’s epidemiology, the factors of virulence and the mechanisms of resistance, which in the near future will give rise to new strategies of prevention and for treating the disease.

  13. Atypical Imaging Findings in Primary Central Nervous System Lymphoma

    Directory of Open Access Journals (Sweden)

    Zahra Afravi

    2010-05-01

    Full Text Available Background/Objective: The incidence of primary CNS lymphomas (PCNSL is increasing. Timely diagnosis of PCNSL can lead to proper therapeutic management. There are some atypical imaging findings that may easily be misdiagnosed as other pathologic processes such as infectious and demyelinative diseases. As a result, histopathologic diagnosis is necessary for all suspected lesions."nPatients and Methods: In this research we studied 120 cases of PCNSL over the past 16 years. Some of them had atypical imaging findings, suggesting many differential diagnoses. Having said that, stereotactic biopsy was performed for all cases and the diagnosis was proved."nResults: We selected some interesting cases with atypical imaging findings of PCNSL, which were unlikely to be diagnosed without histopathologic evaluation. "nConclusion: PCNSL must be kept in mind as a differential diagnosis for other brain lesions. Histopathologic diagnosis is necessary for prompt management.

  14. Genetics Underlying Atypical Parkinsonism and Related Neurodegenerative Disorders.

    Science.gov (United States)

    Scholz, Sonja W; Bras, Jose

    2015-01-01

    Atypical parkinsonism syndromes, such as dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy and corticobasal degeneration, are neurodegenerative diseases with complex clinical and pathological features. Heterogeneity in clinical presentations, possible secondary determinants as well as mimic syndromes pose a major challenge to accurately diagnose patients suffering from these devastating conditions. Over the last two decades, significant advancements in genomic technologies have provided us with increasing insights into the molecular pathogenesis of atypical parkinsonism and their intriguing relationships to related neurodegenerative diseases, fueling new hopes to incorporate molecular knowledge into our diagnostic, prognostic and therapeutic approaches towards managing these conditions. In this review article, we summarize the current understanding of genetic mechanisms implicated in atypical parkinsonism syndromes. We further highlight mimic syndromes relevant to differential considerations and possible future directions. PMID:26501269

  15. Genetics Underlying Atypical Parkinsonism and Related Neurodegenerative Disorders

    Directory of Open Access Journals (Sweden)

    Sonja W. Scholz

    2015-10-01

    Full Text Available Atypical parkinsonism syndromes, such as dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy and corticobasal degeneration, are neurodegenerative diseases with complex clinical and pathological features. Heterogeneity in clinical presentations, possible secondary determinants as well as mimic syndromes pose a major challenge to accurately diagnose patients suffering from these devastating conditions. Over the last two decades, significant advancements in genomic technologies have provided us with increasing insights into the molecular pathogenesis of atypical parkinsonism and their intriguing relationships to related neurodegenerative diseases, fueling new hopes to incorporate molecular knowledge into our diagnostic, prognostic and therapeutic approaches towards managing these conditions. In this review article, we summarize the current understanding of genetic mechanisms implicated in atypical parkinsonism syndromes. We further highlight mimic syndromes relevant to differential considerations and possible future directions.

  16. Atypical femur fractures associated with bisphosphonates: from prodrome to resolution

    Directory of Open Access Journals (Sweden)

    Braulio Sastre-Jala

    2015-10-01

    Full Text Available Atypical fractures related to the prolonged use of bisphosphonates are caused by low energy mechanisms and are characterized by oblique and transverse lines and frequent bilateralism. We present a clinical case of a patient who we believe illustrates, both in clinical and radiological aspects, the new definition of atypical femur fracture related to treatment using bisphosphonates treated conservatively and successfully with discharge and teriparatide 20 mcg/80 mcl s.c./24h. The appearance of painful symptoms in the upper thigh, especially if bilateral, in patients treated with bisphosphonates for long periods of time, makes it necessary to dismiss bone lesions that might otherwise suggest atypical fracture. In those cases where the fracture is incomplete, restoring bone metabolism through the administration of teriparatide 20 mcg/80 mcl s.c./24h could prevent displaced fractures.

  17. Atypical language representation in children with intractable temporal lobe epilepsy.

    Science.gov (United States)

    Maulisova, Alice; Korman, Brandon; Rey, Gustavo; Bernal, Byron; Duchowny, Michael; Niederlova, Marketa; Krsek, Pavel; Novak, Vilem

    2016-05-01

    This study evaluated language organization in children with intractable epilepsy caused by temporal lobe focal cortical dysplasia (FCD) alone or dual pathology (temporal lobe FCD and hippocampal sclerosis, HS). We analyzed clinical, neurological, fMRI, neuropsychological, and histopathologic data in 46 pediatric patients with temporal lobe lesions who underwent excisional epilepsy surgery. The frequency of atypical language representation was similar in both groups, but children with dual pathology were more likely to be left-handed. Atypical receptive language cortex correlated with lower intellectual capacity, verbal abstract conceptualization, receptive language abilities, verbal working memory, and a history of status epilepticus but did not correlate with higher seizure frequency or early seizure onset. Histopathologic substrate had only a minor influence on neuropsychological status. Greater verbal comprehension deficits were noted in children with atypical receptive language representation, a risk factor for cognitive morbidity. PMID:27064828

  18. EPR dosimetry with synthetic A-type carbonated apatite

    International Nuclear Information System (INIS)

    Synthetic A-type carbonated apatite prepared in reproducible conditions were irradiated at room temperature with 60 Co γ rays. The EPR spectrum is associated to axial CO2- and orthorhombic CO3- species. Radicals used as dose marker in biological apatite are long live paramagnetic species. The stability of the post-irradiation signal of A-type apatite was investigated for more than one year. Measurements showed variations in the spectra attributed to unstable CO3- species, which can be eliminated by thermal treatments at 100 deg C for 24 hours. The CO2- spectrum can be identified in samples irradiated up to 0.2 Gy. All results indicate the A-type apatite as an appropriate material for radiotherapy dosimetry. (author)

  19. Atypical pyoderma gangrenosum in a patient with osteomyelofibrosis

    Directory of Open Access Journals (Sweden)

    Živanović Dubravka

    2007-01-01

    Full Text Available Background. Atypical forms of pyoderma gangrenosum generally appear on the upper extremities; most frequently they are associated with myeloproliferative disorders, including osteomyelofibrosis. A response to systemic steroids is more pronounced than in classical form. Sometimes it may be the first sign of an underlying malignancy. Case report. We reported a patient with atypical pyoderma gangrenosum developed during the course of a myeloid malignancy - osteomyelofibrosis. The lesions occurred after a minor trauma. Painful blistering plaques, with an elevated, bluish-gray border were located on the dorsal aspect of hands. No skin malignancy was found. The lesions resolved rapidly to systemic steroids. Conclusion. Considering the unusual clinical presentation which makes the diagnosis difficult, as well as the fact that atypical forms of pyoderma gangrenosum can be the first sign of malignancies, especially myeloproliferative ones, recognizing this entity enables timely guiding future investigations toward their prompt detection.

  20. Gender-Atypical Mental Illness as Male Gender Threat.

    Science.gov (United States)

    Michniewicz, Kenneth S; Bosson, Jennifer K; Lenes, Joshua G; Chen, Jason I

    2016-07-01

    The present study examined whether men view gender-atypical (i.e., feminine) psychological disorders as threats to their gender status. Men and women (N = 355) rated their expectations of gender status loss, feelings of distress, and help-seeking intentions in response to 10 different stereotypically masculine and feminine psychological disorders. Men as compared to women expected greater gender status loss for, and reported more distress to, gender-atypical versus gender-typical disorders. Expectations of gender status loss partially mediated the link between participant gender and distress at the thought of gender-atypical disorders. These findings suggest that feminine disorders pose more powerful gender status threats for men than masculine disorders do and that men's expectations of gender status loss for feminine disorders drive their negative reactions to these mental illnesses. The discussion emphasizes the importance of considering the gender-typicality of disorders, and the implications of these findings for clinical interventions. PMID:25595020

  1. Human skeletal muscle releases leptin in vivo

    DEFF Research Database (Denmark)

    Wolsk, Emil; Grøndahl, Thomas Sahl; Pedersen, Bente Klarlund;

    2012-01-01

    Leptin is considered an adipokine, however, cultured myocytes have also been found to release leptin. Therefore, as proof-of-concept we investigated if human skeletal muscle synthesized leptin by measuring leptin in skeletal muscle biopsies. Following this, we quantified human skeletal muscle and...... adipose tissue leptin release in vivo. We recruited 16 healthy male human participants. Catheters were inserted into the femoral artery and vein draining skeletal muscle, as well as an epigastric vein draining the abdominal subcutaneous adipose tissue. By combining the veno-arterial differences in plasma...... leptin with measurements of blood flow, leptin release from both tissues was quantified. To induce changes in leptin, the participants were infused with either saline or adrenaline in normo-physiological concentrations. The presence of leptin in skeletal muscle was confirmed by western blotting. Leptin...

  2. Assessment of mandibular growth by skeletal scintigraphy

    International Nuclear Information System (INIS)

    Accurate assessment of facial skeletal growth remains a major problem in craniomaxillofacial surgery. Current methods include: (1) comparisons of chronologic age with growth histories of the patient and the family, (2) hand-wrist radiographs compared with a standard, and (3) serial cephalometric radiographs. Uptake of technetium-99m methylene diphosphonate into bone is a reflection of current metabolic activity and blood flow. Therefore, scintigraphy with this radiopharmaceutical might serve as a good method of assessing skeletal growth. Thirty-four patients, ranging in age from 15 months to 22 years, who were undergoing skeletal scintigrams for acute pathologic conditions of the extremities, were used to develop standards of uptake based on age and skeletal maturation. The results indicate that skeletal scintigraphy may be useful in evaluation of mandibular growth

  3. Computerized tomography findings on schizophrenia and atypical psychosis

    International Nuclear Information System (INIS)

    The brain CTs of 54 endogenous psychotics (27 males, 27 females) who were less than 40 years of age and were first adimitted in Aichi Medical University from 1982 to 1986, and 20 controls (10 males, 10 females) were examined. Using Mitsuda's classification, we devided all the cases into 29 schizophrenics (18 males, 11 females) and 25 atypical psychotics (9 males, 16 females). In order to investigate the differences of CT findings between the two patient groups, the 3rd ventricle index (the ratio of 3rd ventricle width to the internal diameter of the skull), Evans'ratio, lateral ventricle brain ratio (VBR), Sylvian fissure to brain ratio, 4th ventricle to cerebellum ratio were determined. Schizophrenics had larger 3rd and lateral ventricles as well as Sylvian fissures when compared to controls, but atypical psychotics had not. Moreover, schizophrenics had larger 3rd and lateral ventricle than atypical psychotics. But in widths of Sylvian fissures there was no statistical significant difference between the two groups. Ventricle enlargements of schizophrenics did not correlate with duration of illness as well as age, and were not results of prior psychiatric treatment such as medication and EST. Therefore the following is suggested that, this abnormal CT findings predate the onset of schizophrenic psychoses. In atypical psychotics the changes of Sylvian fissures correlated with duration of illness, but not with age. Such observations may possibly suggest that recurrence of the illness might finally attain irreversible changes even in atypical psychotics. Finally, the heterogeneity of schizophrenia and the independence of atypical psychosis were also discussed. (author) 53 refs

  4. Uremic parkinsonism with atypical phenotypes and radiologic features.

    Science.gov (United States)

    Yoon, Jee-Eun; Kim, Ji Sun; Park, Jeong-Ho; Lee, Kyung-Bok; Roh, Hakjae; Park, Sung Tae; Cho, Jin Whan; Ahn, Moo-Young

    2016-04-01

    Uremic encephalopathy with bilateral basal ganglia lesions has been reported as an acute neurometabolic disease which shows reversible clinical course and brain imaging features. The exact nature and pathophysiology have not been well established. We encountered two patients who showed a relapsing and aggravating course and an atypical phenotype including parkinsonism with paroxysmal dystonic head tremor and acute onset monoparesis of the lower extremity. They also showed unusual radiological findings which revealed combined lesions in the basal ganglia and cortex, persistent hemorrhagic transformation, and focal ischemic lesion in the internal capsule. Herein, we present the unusual phenomenology with atypical radiologic findings and suggest the possible multifactorial pathogenesis of uremic encephalopathy. PMID:26631408

  5. Renal tuberculosis: a case report

    Science.gov (United States)

    TOCCACELI, S.; STELLA, L. PERSICO; DIANA, M.; TACCONE, A.; GIULIANI, G.; DE PAOLA, L.; VALVANO, M.; DE PADUA, C.; DI BIASIO, G.; RANUCCI, C.; ORSI, E.; LA TORRE, F.

    2015-01-01

    Tuberculosis or TB (tubercle bacillus) remains a major public health problem in developing countries. Over the last decades extra-pulmonary locations of the disease have become more frequent due to the increased prevalence of acquired immune deficiency syndrome and the increase number of organ transplants. The urogenital localization represents about 27% of all extra-pulmonary localizations of TB and may be due either to a disseminated infection or to a primitive genitourinary localization. The majority of patients, has pyuria, sometimes with hematuria. The diagnosis of urinary tuberculosis is based on the finding of pyuria in the absence of infection by common bacteria. The initial medical treatment includes isoniazide, rifampicin, pyrazinami-de, ethambutol and streptomycin. This disease should be suspected in patients with unexplained urinary tract infections, especially if immunocompromised and/or coming from endemic areas. PMID:26017107

  6. Serum calcium in pulmonary tuberculosis

    OpenAIRE

    Subhash C. Sharma

    1981-01-01

    Serum calcium was studied serially in 94 patients with active pulmonary tuberculosis. An equal number of age- and sex-matched patients with chronic obstructive pulmonary disease were controls. Seventy patients in the study group were normocalcaemic and 10 were hypercalcaemic. These 10 were on a higher supplement of vitamin D than the 70 normocalcaemic patients. There was a positive correlation between the daily vitamin intake and the degree and duration of hypercalcaemia. None of the controls...

  7. Novel approaches in diagnosing tuberculosis

    Science.gov (United States)

    Kolk, Arend H. J.; Dang, Ngoc A.; Kuijper, Sjoukje; Gibson, Tim; Anthony, Richard; Claassens, Mareli M.; Kaal, Erwin; Janssen, Hans-Gerd

    2011-06-01

    The WHO declared tuberculosis (TB) a global emergency. An estimated 8-9 million new cases occur each year with 2-3 million deaths. Currently, TB is diagnosed mostly by chest-X ray and staining of the mycobacteria in sputum with a detection limit of 1x104 bacteria /ml. There is an urgent need for better diagnostic tools for TB especially for developing countries. We have validated the electronic nose from TD Technology for the detection of Mycobacterium tuberculosis by headspace analysis of 284 sputum samples from TB patients. We used linear discriminant function analysis resulting in a sensitivity of 75% a specificity of 67% and an accuracy of 69%. Further research is still required to improve the results by choosing more selective sensors and sampling techniques. We used a fast gas chromatography- mass spectrometry method (GC-MS). The automated procedure is based on the injection of sputum samples which are methylated inside the GC injector using thermally assisted hydrolysis and methylation (THM-GC-MS). Hexacosanoic acid in combination with tuberculostearic acid was found to be specific for the presence of M. tuberculosis. The detection limit was similar to microscopy. We found no false positives, all microscopy and culture positive samples were also found positive with the THM-GC-MS method. The detection of ribosomal RNA from the infecting organism offers great potential since rRNA molecules outnumber chromosomal DNA by a factor 1000. It thus may possible to detect the organism without amplification of the nucleic acids (NA). We used a capture and a tagged detector probe for the direct detection of M. tuberculosis in sputum. So far the detection limit is 1x106 bacteria / ml. Currently we are testing a Lab-On-A-Chip Interferometer detection system.

  8. Reactive thrombocytosis in pulmonary tuberculosis.

    OpenAIRE

    Baynes, R D; Bothwell, T H; Flax, H.; McDonald, T P; Atkinson, P.; Chetty, N.; Bezwoda, W. R.; Mendelow, B V

    1987-01-01

    The incidence of reactive thrombocytosis in active pulmonary tuberculosis was studied in 122 patients. Thrombocytosis was common, platelet counts often exceeding 1 X 10(12)/1. A significant inverse correlation was noted between the mean platelet volume and the platelet count (r = -0.54, p less than 0.0001). Interval estimation suggested that this relation was non-linear. Further studies were done in a small group of six patients. Platelet survival was considerably shortened, the platelets agg...

  9. Perspectives on tuberculosis in pregnancy

    OpenAIRE

    Matthew Bates; Yusuf Ahmed; Nathan Kapata; Markus Maeurer; Peter Mwaba; Alimuddin Zumla

    2015-01-01

    Tuberculosis (TB) has been recognized as an important cause of morbidity and mortality in pregnancy for nearly a century, but research and efforts to roll out comprehensive TB screening and treatment in high-risk populations such as those with a high prevalence of HIV or other diseases of poverty, have lagged behind similar efforts to address HIV infection in pregnancy and the prevention of mother-to-child-transmission. Immunological changes during pregnancy make the activation of latent TB i...

  10. Mechanical complication of endobronchial tuberculosis

    Directory of Open Access Journals (Sweden)

    Quratulain Fatima Kizilbash

    2015-01-01

    Full Text Available A 19-year-old Vietnamese lady was diagnosed with culture positive, left upper lobe pulmonary tuberculosis for which medical treatment was initiated. Four months into treatment, she developed a 'rubber-band-like' stretching sensation in her left chest with wheezing and shortness of breath. Decreased respiratory excursion over the left lung was present on physical-examination. Chest-Xray revealed left-upper-lobe collapse with leftward deviation of the trachea and mediastinum. CT thorax revealed a long segment of stenosis in the left mainstem bronchus. FEV1 was 1.26 L (45% predicted, FVC 1.53 L (49% predicted, FEV1/FVC 82% (95% predicted indicating airway limitation. Ventilation-perfusion scan noted 9.8% ventilation to the left lung and 92.8% to the right lung and 7.6% perfusion to the left lung and 92.4% to the right lung. Bronchoscopy was notable for pin point stenosis of the left mainstem bronchus beyond which was inflamed mucosa and abnormal cartilage rings in the left upper and middle lobe bronchi. Nine months of medical therapy for tuberculosis along with oral steroid taper was completed successfully; however the patient has required six serial bronchscopies with dilatations without stent placement at four to six week intervals due to partial restenosis, with the last bronchoscopy at four months after completion of tuberculosis therapy.

  11. Tuberculosis-HIV Coinfection: The Relationship Between Manifestation Of Tuberculosis And The Degree Of Immunosuppression (CD4 Counts

    Directory of Open Access Journals (Sweden)

    C K Ong

    2008-12-01

    Full Text Available The incidence of tuberculosis (TB iscurrently increasing. HIV induced immuno-suppressionmodifies the clinical presentation of TB. Our aim is todetermine the differences in clinical presentation ofHIV-TB co-infection based on their CD4 counts.This retrospective study looked at cases of adult activeTB and HIV-1 co-infection treated in Penang Hospitalfrom January 2004 to December 2005. Of the820 patients treated for active TB, HIV-1 seropositivityrate was 12.6% (103 patients. Majority of HIV-1co-infected patients presented with prolonged insidiousand non-specific symptoms like weight loss, fever andnight sweats. The clinical presentation of TB dependedon the stage of HIV-1 infection and associateddegree of immunodeficiency. Compared to the lessimmuno-compromised HIV-1 and TB co-infectedpopulation (CD4 > 200/mm3, patients with CD4counts ² 200 are more likely to have atypical chestradiographs (P = 0.009. During active TB, theMantoux test was positive in 12 (14.5% HIV-1 infectedpatients with a CD4 counts ² 200/mm3 and in 16 (80%of those with CD4 counts > 200/mm3 (P = 0.0001.In our series, the AFB smear / AFB culture and typeof TB did not show obvious correlation withCD4 counts. Therefore to diagnose TB in severelyimmuno-compromised HIV patients, we need to have ahigh index of suspicion.

  12. Ancient skeletal evidence for leprosy in India (2000 B.C..

    Directory of Open Access Journals (Sweden)

    Gwen Robbins

    Full Text Available BACKGROUND: Leprosy is a chronic infectious disease caused by Mycobacterium leprae that affects almost 250,000 people worldwide. The timing of first infection, geographic origin, and pattern of transmission of the disease are still under investigation. Comparative genomics research has suggested M. leprae evolved either in East Africa or South Asia during the Late Pleistocene before spreading to Europe and the rest of the World. The earliest widely accepted evidence for leprosy is in Asian texts dated to 600 B.C. METHODOLOGY/PRINCIPAL FINDINGS: We report an analysis of pathological conditions in skeletal remains from the second millennium B.C. in India. A middle aged adult male skeleton demonstrates pathological changes in the rhinomaxillary region, degenerative joint disease, infectious involvement of the tibia (periostitis, and injury to the peripheral skeleton. The presence and patterning of lesions was subject to a process of differential diagnosis for leprosy including treponemal disease, leishmaniasis, tuberculosis, osteomyelitis, and non-specific infection. CONCLUSIONS/SIGNIFICANCE: Results indicate that lepromatous leprosy was present in India by 2000 B.C. This evidence represents the oldest documented skeletal evidence for the disease. Our results indicate that Vedic burial traditions in cases of leprosy were present in northwest India prior to the first millennium B.C. Our results also support translations of early Vedic scriptures as the first textual reference to leprosy. The presence of leprosy in skeletal material dated to the post-urban phase of the Indus Age suggests that if M. leprae evolved in Africa, the disease migrated to India before the Late Holocene, possibly during the third millennium B.C. at a time when there was substantial interaction among the Indus Civilization, Mesopotamia, and Egypt. This evidence should be impetus to look for additional skeletal and molecular evidence of leprosy in India and Africa to confirm

  13. SKIBO diseases: a concept to avoid bloody diagnostic procedures in ambiguous skeletal lesions

    International Nuclear Information System (INIS)

    In cases with an ''atypical'' radiologic pattern-osteolytic as well as osteosclerotic or mixed - the radiologist should pay attention to the patient's skin. There he will often find specific changes that are the key to a correct interpretation of the radiologic abnormalities. In such cases the synopsis is of more value in differential diagnosis than more or less unspecific histologic findings. Entities with a non-arbitrary conjunction of changes of the skin and bones we call SKIBO diseases. Some of them have a high potential for mimicking malignant bone lesions, often with the consequence of unnecessary biopsies. In this article we present the typical dermatologic and radiologic signs and symptoms of neurofibromatosis, sarcoidosis and pustulotic arteroosteitis (PAO) with special focus on such skeletal lesions that may mimic malignancy. (orig.)

  14. Evidence for Broadening Criteria for Atypical Depression Which May Define a Reactive Depressive Disorder

    OpenAIRE

    Brett Silverstein; Jules Angst

    2015-01-01

    Objective. Arguing that additional symptoms should be added to the criteria for atypical depression. Method. Published research articles on atypical depression are reviewed. Results. (1) The original studies upon which the criteria for atypical depression were based cited fatigue, insomnia, pain, and loss of weight as characteristic symptoms. (2) Several studies of DSM depressive criteria found patients with atypical depression to exhibit high levels of insomnia, fatigue, and loss of appetit...

  15. Tuberculosis Facts - TB and HIV/AIDS

    Science.gov (United States)

    Tuberculosis (TB) Facts TB and HIV/AIDS What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one person to another. ... HIV) infection affect TB? The HIV, or the AIDS virus, helps TB germs make you sick because ...

  16. Colorectal cancer in pregnancy mimicking tuberculosis

    Directory of Open Access Journals (Sweden)

    Leena Wadhwa

    2013-04-01

    Full Text Available Colorectal cancer in pregnancy is extremely rare and presentation may mimic symptoms of pregnancy or abdominal tuberculosis delaying diagnosis. We hereby report a case presenting to us in late pregnancy misdiagnosed as a case of abdominal tuberculosis. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 226-228

  17. Congenital Tuberculosis Complicated by Interstitial Pulmonary Emphysema

    OpenAIRE

    Singh, Tarsem; Natt, Navreet Kaur; Sharma, Manu; Singh, Harmanjit

    2014-01-01

    We report a case of congenital tuberculosis, a rare entity itself; complicated by pulmonary interstitial emphysema, thus leading to air entrapment in lungs and prolonged oxygen dependence. The diagnosis of congenital tuberculosis is often missed and under-reported due to low index of suspicion and less sensitivity of diagnostic tools.

  18. A Case of Tuberculosis of Maxillary Sinus

    OpenAIRE

    Ashfak R. Kakeri

    2008-01-01

    Tuberculosis of the maxillary sinus is rare. Although involvement of long bones and vertebral column is common, its quite uncommon in flat bones. We describe here a case of tuberculosis of the maxillary sinus, and discuss the clinical features and its management.

  19. Tuberculosis - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Community Health Resource Center French (français) Tuberculosis (TB) Tuberculose (TB) - français (French) Bilingual PDF Health Information Translations ... Minnesota Department of Health Portuguese (português) Tuberculosis (TB) ... (TB) - português (Portuguese) Bilingual PDF Health Information Translations ...

  20. Detection of Mycobacterium Tuberculosis by using PCR

    International Nuclear Information System (INIS)

    Polymerase Chain Reaction (PCR) procedure using three primary set derived from repetitive DNA sequence specific to mycobacteria was used to diagnose pathogenic Mycobacterium tuberculosis. The assay was specific for M. tuberculosis and could be used to detect the amount DNA less than 10-9g

  1. Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part II

    OpenAIRE

    Suleman Merchant; Alpa Bharati; Neesha Merchant

    2013-01-01

    This article reviews the computed tomography and magnetic resonance imaging (MRI) features of renal tuberculosis (TB), including TB in transplant recipients and immunocompromised patients. Multi detector computed tomography (MDCT) forms the mainstay of cross-sectional imaging in renal TB. It can easily identify calcification, renal scars, mass lesions, and urothelial thickening. The combination of uneven caliectasis, with urothelial thickening and lack of pelvic dilatation, can also be demons...

  2. Tuberculosis risk factors among tuberculosis patients in Kampala, Uganda: implications for tuberculosis control

    OpenAIRE

    Kirenga, B.J.; Ssengooba, W.; Muwonge, C.; Nakiyingi, L; Kyaligonza, S.; Kasozi, S; Mugabe, F.; Boeree, M.J.; Joloba, M.; Okwera, A.

    2015-01-01

    BACKGROUND: Slow decline in the incidence of tuberculosis (TB) has been observed in most high TB burden countries. Knowledge of the prevalence of different TB risk factors can help expand TB control strategies. However with the exception of Human Immunodeficiency Virus (HIV) the prevalence of the other TB risk factors are poorly studied in Uganda. We aimed to determine the prevalence of different TB risk factors and TB disease presentation among TB patients in Kampala Uganda. METHODS: We asse...

  3. Early severe scoliosis in a patient with atypical progressive pseudorheumatoid dysplasia (PPD): Identification of two WISP3 mutations, one previously unreported.

    Science.gov (United States)

    Montané, Lucia Sentchordi; Marín, Oliver R; Rivera-Pedroza, Carlos I; Vallespín, Elena; Del Pozo, Ángela; Heath, Karen E

    2016-06-01

    Progressive pseudorheumatoid dysplasia (PPD) is a rare autosomal recessive disorder characterized by spondyloepiphyseal dysplasia associated with pain and stiffness of multiple joints, enlargement of the interphalangeal joints, normal inflammatory parameters, and absence of extra-skeletal manifestations. Homozygous or compound heterozygous WISP3 mutations cause PPD. We report two siblings from a non-consanguineous Ecuadorian family with a late-onset spondyloepiphyseal dysplasia. Mutation screening was undertaken in the two affected siblings using a customized skeletal dysplasia next generation sequencing (NGS) panel and confirmed by Sanger sequencing. Two compound heterozygous mutations were identified in WISP3 exon 2, c.[190G>A];[197G>A] (p.[(Gly64Arg)];[(Ser66Asn)]) in the two siblings, both of which had been inherited. The p. (Gly64Arg) mutation has not been previously described whilst the p. (Ser66Asn) mutation has been reported in two PPD families. The two siblings presented with atypical PPD, as they presented during late childhood, yet the severity was different between them. The progression was particularly aggressive in the male sibling who suffered severe scoliosis by the age of 13 years. This case reaffirms the clinical heterogeneity of this disorder and the clinical utility of NGS to genetically diagnose skeletal dysplasias, enabling adequate management, monitorization, and genetic counseling. © 2016 Wiley Periodicals, Inc. PMID:26991965

  4. Role of laboratory in rapid diagnosis of atypical mumps

    Directory of Open Access Journals (Sweden)

    KE Vandana

    2010-04-01

    Full Text Available Fairly large number of mumps virus infections present atypically without parotitis leading to delay in diagnosis and increased morbidity. Awareness of such presentations and inclusion of serological test for detecting IgM-specific antibodies could help in solving diagnostic dilemma, especially in unvaccinated individuals from developing countries.

  5. Use of atypical antipsychotics in the elderly: a clinical review

    Directory of Open Access Journals (Sweden)

    Gareri P

    2014-08-01

    Full Text Available Pietro Gareri,1 Cristina Segura-García,2 Valeria Graziella Laura Manfredi,1 Antonella Bruni,2 Paola Ciambrone,2 Gregorio Cerminara,2 Giovambattista De Sarro,2 Pasquale De Fazio2 1Elderly Health Care, Azienda Sanitaria Provinciale Catanzaro, Catanzaro, Italy; 2Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy Abstract: The use of atypical antipsychotic drugs in the elderly has become wider and wider in recent years; in fact, these agents have novel receptor binding profiles, good efficacy with regard to negative symptoms, and reduced extrapyramidal symptoms. However, in recent years, the use of both conventional and atypical antipsychotics has been widely debated for concerns about their safety in elderly patients affected with dementia and the possible risks for stroke and sudden death. A MEDLINE search was made using the words elderly, atypical antipsychotics, use, schizophrenia, psychosis, mood disorders, dementia, behavioral disorders, and adverse events. Some personal studies were also considered. This paper reports the receptor binding profiles and the main mechanism of action of these drugs, together with their main use in psychiatry and the possible adverse events in elderly people. Keywords: atypical antipsychotics, dementia, elderly, psychosis, mood disorders, side effects

  6. ATYPICAL BULLOUS PYODERMA GANGRENOSUM WITH EARLY LESIONS MIMICKING CHICKEN POX

    OpenAIRE

    Ramesh; Kavya Raju; Gopal; Sharath Kumar; Nandini

    2013-01-01

    ABSTRACT : Pyoderma Gangrenosum (PG) rare neutrophilic dermatoses (1/100,00 0), of which Bullous Pyoderma gangrenosum is an atypical form, which is very rare. Bullous PG is usually associated with haematological disorders like myeloproliferative disorders, haematological malignancies specially AML and several other haematological disorders. It presents as a superficial haemorrhagic bulla which ulcerates, ulcers increase in size and heal with scarring. Treatmen...

  7. Atypical Autism and Tuberous Sclerosis in a Sibling Pair.

    Science.gov (United States)

    Williamson, David A.; Bolton, Patrick

    1995-01-01

    This report describes a sibling pair (ages 21 and 18), both with tuberous sclerosis. One sibling has atypical autism (but no mental retardation or seizure disorder) and the other has a seizure disorder but no autism or mental retardation. Both siblings had multiple bilateral brain lesions. Clinical findings are discussed in relationship to the…

  8. Treatment of atypical trigeminal neuralgia with microvascular decompression

    Directory of Open Access Journals (Sweden)

    Hai Jian

    2006-01-01

    Full Text Available Aim: To explore the methods for achieving pain relief in patients with atypical trigeminal neuralgia (TN using microvascular decompression (MVD. Study Design and Settings: Retrospective study of 26 patients treated during the years 2000 to 2004. Materials and Methods: Twenty-six patients in whom vascular compression of the trigeminal nerve was identified by high definition magnetic resonance tomographic angiography (MRTA were treated with MVD for atypical TN in our department. Clinical presentations, surgical findings and clinical outcomes were analyzed retrospectively. Results: In this study, single trigeminal division was involved in only 2 patients (8% and two or three divisions in the other 24 patients (92%. Of prime importance is the fact that in 46.2% of the patients, several conflicting vessels were found in association. Location of the conflicts around the circumference of the trigeminal root was supero-medial to the root in 53.5%, supero-lateral in 30.8% and inferior in 15.7%. MVD for atypical TN resulted in complete pain relief in 50% of the patients with complete decompression, partial pain relief in 30.8% and poor pain relief or pain recurrence in 19.2% of the patients without complete decompression postoperatively. Conclusions: Complete decompression of the entire trigeminal root plays an important role in achieving pain relief in patients with atypical TN with MVD.

  9. Characterization of atypical Aeromonas salmonicida by different methods

    DEFF Research Database (Denmark)

    Austin, B.; Austin, D.A.; Dalsgaard, Inger; Gudmundsdottir, B.K.; Høie, S.; Thornton, J.M.; Larsen, J.L.; O'Hici, B.; Powell, R.

    1998-01-01

    Fifty two isolates of atypical Aeromonas salmonicida, recovered from a wide range of hosts and geographical locations, were heterogeneous in terms of molecular and phenotypic characteristics, and represented taxa which could not be accommodated by the current classification of four subspecies. Ge...

  10. Einstein A-values of A-type methanol

    International Nuclear Information System (INIS)

    This paper uses the model of a slightly asymmetric top with hindered internal rotation to calculate the total energies, the transition frequencies and Einstein A-values of the A-type CH3OH-molecule. The levels are lower than 352cm-1 above the ground state. It means that there are 340 Levels in total

  11. Benzisoxazole derivatives as Atypical Antipsychotic drugs: A Review

    Directory of Open Access Journals (Sweden)

    Sharath Chandra S P

    2014-12-01

    Full Text Available Antipsychotic medications constitute a diverse series of heterocyclic compounds that are used to treat psychotic problems, particularly schizophrenia and bipolar affective disorders. Heterocyclic molecules such as benzisoxazole derivatives, especially 3-(piperidin-4-yl-1,2-benzisoxazole have been widely used as antipsychotic drugs. Atypical antipsychotic drugs which are derived from benzisoxazole include risperidone, iloperidone and paliperidone.

  12. Characterization of atypical Aeromonas salmonicida by different methods

    DEFF Research Database (Denmark)

    Austin, B.; Austin, D.A.; Dalsgaard, Inger; Gudmundsdottir, B.K.; Høie, S.; Thornton, J.M.; Larsen, J.L.; O'Hici, B.; Powell, R.

    1998-01-01

    Fifty two isolates of atypical Aeromonas salmonicida, recovered from a wide range of hosts and geographical locations, were heterogeneous in terms of molecular and phenotypic characteristics, and represented taxa which could not be accommodated by the current classification of four subspecies...

  13. Early Freezing of Gait: Atypical versus Typical Parkinson Disorders.

    Science.gov (United States)

    Lieberman, Abraham; Deep, Aman; Dhall, Rohit; Tran, An; Liu, Ming-Jai

    2015-01-01

    In 18 months, 850 patients were referred to Muhammad Ali Parkinson Center (MAPC). Among them, 810 patients had typical Parkinson disease (PD) and 212 had PD for ≤5 years. Among the 212 patients with early PD, 27 (12.7%) had freezing of gait (FOG). Forty of the 850 had atypical parkinsonism. Among these 40 patients, all of whom had symptoms for ≤5 years, 12 (30.0%) had FOG. FOG improved with levodopa in 21/27 patients with typical PD but did not improve in the 12 patients with atypical parkinsonism. FOG was associated with falls in both groups of patients. We believe that FOG unresponsive to levodopa in typical PD resembles FOG in atypical parkinsonism. We thus compared the 6 typical PD patients with FOG unresponsive to levodopa plus the 12 patients with atypical parkinsonism with the 21 patients with typical PD responsive to levodopa. We compared them by tests of locomotion and postural stability. Among the patients with FOG unresponsive to levodopa, postural stability was more impaired than locomotion. This finding leads us to believe that, in these patients, postural stability, not locomotion, is the principal problem underlying FOG. PMID:25785228

  14. Atypical sporadic bovine leukosis in a beef feedlot heifer

    OpenAIRE

    Hendrick, Steven H.

    2002-01-01

    This case is considered atypical because the clinical signs are exemplary of both the systemic and localized forms of the disease. Although diseases are commonly described and differentiated as either multisystemic or localized, as demonstrated here, disease expression can be a continuum between 2 distinct phenotypes.

  15. Large saphenous venous graft aneurysm mimicking atypical mediastinal mass

    Directory of Open Access Journals (Sweden)

    Krotin Mirjana

    2009-01-01

    Full Text Available Background. Saphenous venous graft (SVG aneurysm is a very rare but potentially fatal complication of the coronary artery bypass surgery. Case report. We reported a case of 72-year-old man admitted to hospital because of atypical chest pain related to body motions in horizontal position, especially to the left side. Pain was followed by dispnea, palpitations, fatigue, cough, yellow sputum expectorations, as well as elevated temperature. He had had coronary artery bypass grafting (CABG surgery with saphenous vein grafts (SVGs to the left anterior descending artery (LAD and right coronary artery (RCA 27 years earlier. Chest X-ray revealed a poor-defined shadow in the region of the right atrium. A transthoracic echocardiogram revealed an atypical tumorous mediastinal mass near the right atrium and right ventricle that seemed partially calcified on transesophaeal echocardiography (TEE. CT scan confirmed an atypical mediastinal mass in contact with the right ventricle that might be a right ventricle aneurysm, pericardial cyst or SVG aneurysm. Coronary angiography was performed subsequently and it revealed a big saphenous venous graft aneurysm originating from the previous venous graft to the RCA. The aneurysm was resected and a new bypass graft was placed. Histopathology confirmed a true aneurysm of the venous graft. Conclusion. Although SVG aneurysm is a very rare complication of CABG surgery, patients presenting with atypical hilar or mediastinal mass following CABG should always be evaluated firstly for existence of this cardiosurgical complication.

  16. A Unified Anatomy Ontology of the Vertebrate Skeletal System

    OpenAIRE

    Dahdul, Wasila M.; Balhoff, James P.; Blackburn, David C.; Diehl, Alexander D; Haendel, Melissa A; Hall, Brian K.; Lapp, Hilmar; Lundberg, John G.; Mungall, Christopher J; Ringwald, Martin; Segerdell, Erik; Van Slyke, Ceri E.; Vickaryous, Matthew K.; Westerfield, Monte; Mabee, Paula M.

    2012-01-01

    The skeleton is of fundamental importance in research in comparative vertebrate morphology, paleontology, biomechanics, developmental biology, and systematics. Motivated by research questions that require computational access to and comparative reasoning across the diverse skeletal phenotypes of vertebrates, we developed a module of anatomical concepts for the skeletal system, the Vertebrate Skeletal Anatomy Ontology (VSAO), to accommodate and unify the existing skeletal terminologies for the...

  17. Trends in Scientific Literature on Atypical Antipsychotics in South Korea: A Bibliometric Study

    OpenAIRE

    López-Muñoz, Francisco; Shen, Winston W.; Pae, Chi-un; Moreno, Raquel; Rubio, Gabriel; Molina, Juan D.; Noriega, Concha; Pérez-Nieto, Miguel A.; Huelves, Lorena; Álamo, Cecilio

    2013-01-01

    Objective We have carried out a bibliometric study on the scientific publications in relation to atypical or second-generation antipsychotic drugs (SGAs) in South Korea. Methods With the EMBASE and MEDLINE databases, we selected those publications made in South Korea whose title included the descriptors atypic* (atypical*) antipsychotic*, second-generation antipsychotic*, clozapine, risperidone, olanzapine, ziprasidone, quetiapine, sertindole, aripiprazole, paliperidone, amisulpride, zotepine...

  18. [Unilateral to bilateral pleurisy: Pleural tuberculosis?].

    Science.gov (United States)

    Ben Ameur, S; Smaoui, S; Kamoun, F; Chabchoub, I; Kamoun, T; Messaadi, F; Aloulou, H; Hachicha, M

    2016-04-01

    Pleural tuberculosis is the first or second most common form of extrapulmonary tuberculosis as well as the main cause of pleural effusion in many countries. It is rare in young infants and is more common in children over 10 years of age. We report the case of a 19-month-old girl admitted for prolonged fever with unilateral pleural effusion. The mother reported a history of lymph node tuberculosis 6 years previously. Intravenous antibiotics with cefotaxime and vancomycin were started. Thoracocentesis yielded a serosanguinous exudate fluid with a lymphocyte predominance. The tuberculin skin test and PCR GeneXpert(©) on pleural fluid were negative. The initial outcome was favorable, but the chest X-rays 10 days after discharge showed bilateral pleural effusion. Pleural biopsy was proposed but the culture of pleural fluid was positive for Mycobacterium tuberculosis. The child was put under standard treatment for tuberculosis. The outcome was favorable. PMID:26922570

  19. Peripartum disseminated extrapulmonary tuberculosis simulating ovarian carcinoma.

    Science.gov (United States)

    Sherer, David M; Osho, Joseph A; Zinn, Harry; Demetus, Spiro; Huang, Jennifer; Temkin, Sarah; Abulafia, Ovadia

    2005-10-01

    Disseminated extrapulmonary tuberculosis is an uncommon complication of pregnancy. We present a 26-year-old multiparous immigrant from Haiti who was admitted following an extramural preterm delivery. Marked ascites was confirmed by computerized tomography, which also revealed a thickened greater omentum. These findings were considered suggestive of advanced ovarian carcinoma, although extrapulmonary tuberculosis was also considered despite negative tuberculin skin test screening. Image-guided omental biopsy demonstrated caseating granulomas substantiating the diagnosis of abdominal tuberculosis, which was later confirmed by cultures. The patient responded well to antituberculosis medications. This case describes the unusual peripartum presentation of abdominal tuberculosis simulating advanced ovarian carcinoma, and demonstrates the importance of considering extrapulmonary tuberculosis when encountering ascites and omental thickening during pregnancy despite negative tuberculin skin test screening. PMID:16215926

  20. Assessment of treatment response in tuberculosis.

    Science.gov (United States)

    Rockwood, Neesha; du Bruyn, Elsa; Morris, Thomas; Wilkinson, Robert J

    2016-06-01

    Antibiotic treatment of tuberculosis has a duration of several months. There is significant variability of the host immune response and the pharmacokinetic-pharmacodynamic properties of Mycobacterium tuberculosis sub-populations at the site of disease. A limitation of sputum-based measures of treatment response may be sub-optimal detection and monitoring of Mycobacterium tuberculosis sub-populations. Potential biomarkers and surrogate endpoints should be benchmarked against hard clinical outcomes (failure/relapse/death) and may need tailoring to specific patient populations. Here, we assess the evidence supporting currently utilized and future potential host and pathogen-based models and biomarkers for monitoring treatment response in active and latent tuberculosis. Biomarkers for monitoring treatment response in extrapulmonary, pediatric and drug resistant tuberculosis are research priorities. PMID:27030924

  1. Mathematical Models of Tuberculosis Reactivation and Relapse

    Science.gov (United States)

    Wallis, Robert S.

    2016-01-01

    The natural history of human infection with Mycobacterium tuberculosis (Mtb) is highly variable, as is the response to treatment of active tuberculosis. There is presently no direct means to identify individuals in whom Mtb infection has been eradicated, whether by a bactericidal immune response or sterilizing antimicrobial chemotherapy. Mathematical models can assist in such circumstances by measuring or predicting events that cannot be directly observed. The 3 models discussed in this review illustrate instances in which mathematical models were used to identify individuals with innate resistance to Mtb infection, determine the etiologic mechanism of tuberculosis in patients treated with tumor necrosis factor blockers, and predict the risk of relapse in persons undergoing tuberculosis treatment. These examples illustrate the power of various types of mathematic models to increase knowledge and thereby inform interventions in the present global tuberculosis epidemic. PMID:27242697

  2. Pancreatic tuberculosis masquerading as pancreatic serous cystadenoma

    Institute of Scientific and Technical Information of China (English)

    Seung Goun Hong; Jae Seon Kim; Moon Kyung Joo; Kwang Gyun Lee; Key Hyeon Kim; Cho Rong Oh; Jong-Jae Park; Young-Tae Bak

    2009-01-01

    Solitary pancreatic involvement of tuberculosis is rare,especially in an immunocompetent individual, and it may be misdiagnosed as pancreatic cystic neoplasms.Pancreatic cystic neoplasms are being identified in increasing numbers, probably because of the frequent use of radiology and advances in endoscopic techniques.However, they are composed of a variety of neoplasms with a wide range of malignant potential,and it is often difficult to differentiate pancreatic tuberculosis mimicking cystic neoplasms from benign or malignant pancreatic cystic neoplasms. Non-surgical diagnosis of pancreatic tuberculosis is inconclusive and continues to be a challenge in many cases. If so,then laparotomy should be employed to establish the diagnosis. Therefore, pancreatic tuberculosis should be kept in mind during the differential diagnosis of solitary cystic masses in the pancreas. We report a patient who had solitary pancreatic tuberculosis masquerading as pancreatic serous cystadenoma.

  3. CT and MR findings of genitourinary tuberculosis

    International Nuclear Information System (INIS)

    Genitourinary tuberculosis is a disease spread hematogenously from a small tuberculous abscess of the lung. The renal cortex is initially involved, and multiple granulomas form. Ultimately the cortex may cavitate and communicate with the collecting system, allowing downward extension of the infection and subsequent focal caliectasis with infundibular stenosis, ureteral fibrosis, and calcifications of urinary tract organs. The female genitourinary organ is also infected by the hematogenous spread of tuberculosis, the most common lesion being hydrosalpynx with salpingitis. The clinical and radiologic features of genitourinary tuberculosis may mimic other acute abdominal diseases, and the diagnosis of tuberculosis remains difficult. This report describes the ways in which computed tomography and magnetic resonance imaging are valuable aids in the recognition and diagnosis of genitourinary tuberculosis. (author)

  4. Exercise Promotes Healthy Aging of Skeletal Muscle.

    Science.gov (United States)

    Cartee, Gregory D; Hepple, Russell T; Bamman, Marcas M; Zierath, Juleen R

    2016-06-14

    Primary aging is the progressive and inevitable process of bodily deterioration during adulthood. In skeletal muscle, primary aging causes defective mitochondrial energetics and reduced muscle mass. Secondary aging refers to additional deleterious structural and functional age-related changes caused by diseases and lifestyle factors. Secondary aging can exacerbate deficits in mitochondrial function and muscle mass, concomitant with the development of skeletal muscle insulin resistance. Exercise opposes deleterious effects of secondary aging by preventing the decline in mitochondrial respiration, mitigating aging-related loss of muscle mass and enhancing insulin sensitivity. This review focuses on mechanisms by which exercise promotes "healthy aging" by inducing modifications in skeletal muscle. PMID:27304505

  5. SPECT/CT diagnostics for skeletal infections

    International Nuclear Information System (INIS)

    Skeletal infections are often a diagnostic and clinical challenge. Nuclear imaging modalities used in the diagnostic workup of acute and chronic skeletal infections include three-phase bone scintigraphy and scintigraphy with labelled leucocytes. The introduction of hybrid technologies, such as single photon emission computed tomography/computed tomography (SPECT/CT) has dramatically changed nuclear medical imaging of infections. In general SPECT/CT leads to a considerably more accurate diagnosis than planar or SPECT imaging. Given the integrated acquisition of metabolic, functional and morphological information, SPECT/CT has increased in particular the specificity of three-phase skeletal scanning and scintigraphy with labeled leucocytes. (orig.)

  6. The association between smoking and tuberculosis La asociación entre tabaquismo y tuberculosis

    Directory of Open Access Journals (Sweden)

    K.M. Hassmiller

    2006-01-01

    Full Text Available OBJECTIVE: To review epidemiological evidence on the association between smoking and tuberculosis. METHODS: Reviewed articles were identified by searching Pubmed for the terms "smoking" or "tobacco" and "tuberculosis". Additional articles were obtained from the bibliographies of identified papers. RESULTS: Thirty-four studies were reviewed: five investigate the association between smoking and mortality from tuberculosis, 13 investigate the association between smoking and development of tuberculosis, eigth investigate the association between smoking and infection with Mycobacterium tuberculosis, and nine estimate the impact of smoking on characteristics of tuberculosis and disease outcomes. CONCLUSIONS: Taken together, evidence suggests that smoking (both current and former is associated with: risk of being infected with Mycobacterium tuberculosis, risk of developing tuberculosis, development of more severe forms of tuberculosis, and risk of dying of tuberculosis. In many cases, there is a strong dose-response relationship -both in terms of quantity and duration of smoking. These relationships are not explained away by controlling for potentially confounding variables such as age, gender, alcohol consumption, and HIV status.OBJETIVO: Revisar evidencia epidemiológica relativa a la asociación entre el tabaquismo y la tuberculosis. MATERIALES Y MÉTODOS: Se identificaron artículos de revisión mediante la búsqueda en Pubmed de los términos "tabaquismo", "tabaco" y "tuberculosis". Se obtuvieron artículos adicionales de las bibliografías de los trabajos identificados. RESULTADOS: Se revisaron 34 estudios: cinco investigan la asociación entre tabaquismo y mortalidad a partir de la tuberculosis; 13, la asociación entre tabaquismo y el desarrollo de tuberculosis; ocho, la asociación entre tabaquismo y la infección con Mycobacterium tuberculosis; y nueve estiman el impacto del tabaquismo en las características de la tuberculosis y las

  7. Implementing rapid testing for tuberculosis in Mozambique

    Directory of Open Access Journals (Sweden)

    James Cowan

    2015-02-01

    Full Text Available Problem In Mozambique, pulmonary tuberculosis is primarily diagnosed with sputum smear microscopy. However this method has low sensitivity, especially in people infected with human immunodeficiency virus (HIV. Patients are seldom tested for drug-resistant tuberculosis. Approach The national tuberculosis programme and Health Alliance International introduced rapid testing of smear-negative sputum samples. Samples were tested using a polymerase-chain-reaction-based assay that detects Mycobacterium tuberculosis deoxyribonucleic acid and a mutation indicating rifampicin resistance; Xpert® MTB/RIF (Xpert®. Four machines were deployed in four public hospitals along with a sputum transportation system to transfer samples from selected health centres. Laboratory technicians were trained to operate the machines and clinicians taught to interpret the results. Local setting In 2012, Mozambique had an estimated 140 000 new tuberculosis cases, only 34% of which were diagnosed and treated. Of tuberculosis patients, 58% are HIV-infected. Relevant changes From 2012–2013, 1558 people were newly diagnosed with tuberculosis using sputum smears at intervention sites. Xpert® detected M. tuberculosis in an additional 1081 sputum smear-negative individuals, an increase of 69%. Rifampicin resistance was detected in 58/1081 (5% of the samples. However, treatment was started in only 82% of patients diagnosed by microscopy and 67% of patients diagnosed with the rapid test. Twelve of 16 Xpert® modules failed calibration within 15 months of implementation. Lessons learnt Using rapid tests to diagnose tuberculosis is promising but logistically challenging. More affordable and durable platforms are needed. All patients diagnosed with tuberculosis need to start and complete treatment, including those who have drug resistant strains.

  8. Use of Atypical Antipsychotics in Nursing Homes and Pharmaceutical Marketing

    Science.gov (United States)

    Pimentel, Camilla B.; Donovan, Jennifer L.; Field, Terry S.; Gurwitz, Jerry H.; Harrold, Leslie R.; Kanaan, Abir O.; Lemay, Celeste A.; Mazor, Kathleen M.; Tjia, Jennifer; Briesacher, Becky A.

    2014-01-01

    BACKGROUND Many nursing home (NH) residents are prescribed atypical antipsychotics despite US Food and Drug Administration warnings of increased risk of death in older adults with dementia. Aggressive pharmaceutical marketing has been cited as a potential cause, although data are scarce. The objectives of this study were to describe the current extent and type of pharmaceutical marketing in NHs in one state, and to provide preliminary evidence for the potential influence of pharmaceutical marketing on the use of atypical antipsychotics in NHs. DESIGN Nested mixed-methods, cross-sectional study of NHs in a cluster randomized trial. SETTING 41 NHs in Connecticut. PARTICIPANTS NH administrators, directors of nursing and medical directors (n = 93, response rate 75.6%). MEASUREMENTS Quantitative data, including prescription drug dispensing data (September 2009–August 2010) linked with Nursing Home Compare data (April 2011), were used to determine facility-level prevalence of atypical antipsychotic use, facility-level characteristics, NH staffing and NH quality. Qualitative data, including semi-structured interviews and surveys of NH leaders conducted in the first quarter of 2011, were used to determine encounters with pharmaceutical marketing. RESULTS Leadership at 46.3% of NHs (19/41) reported pharmaceutical marketing encounters, consisting of educational training, written/Internet-based materials and/or sponsored training. No association was detected between the level of atypical antipsychotic prescribing and reports of any pharmaceutical marketing by at least one NH leader. CONCLUSION NH leaders frequently encounter pharmaceutical marketing through a variety of ways, although the impact on atypical antipsychotic prescribing is unclear. PMID:25688605

  9. Cutaneous and Subcutaneous Metastases From Atypical Laryngeal Carcinoids

    Science.gov (United States)

    Wang, Kui-Rong; Jia, Yuan-Jing; Zhou, Shui-Hong; Wang, Qin-Ying; Bao, Yang-Yang; Feng, Zhi-Ying; Yao, Hong-Tian; Fan, Jun

    2016-01-01

    Abstract The incidence of cutaneous and subcutaneous metastases from atypical laryngeal carcinoids is approximately 20%. However, the pathogenesis and natural history of, and prognostic factors for, the condition remain poorly understood. We reported a 54-year-old female presented with cutaneous and subcutaneous metastases from atypical laryngeal carcinoid. Laryngoscopy revealed a 0.5 × 1.5-cm reddish mass on the laryngeal surface of the epiglottis. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy. Routine pathology revealed atypical laryngeal carcinoid. Immunohistochemical staining of the sections of primary tumor was positive for cytokeratin, chromogranin A, synaptophysin, hypoxia-inducible factor-1α, P53, and CD56. GLUT-1, p-Akt, and PI3K were negative. The Ki-67 index was 15%. Supraglottic laryngectomy and selective right-neck dissection were performed. After 6 months, the patient complained of pain in the right wall of the chest; multiple cutaneous and subcutaneous nodules were evident at that site and in the abdomen. An abdominal nodule was biopsied and pathology revealed that the atypical metastatic carcinoid had metastasized to both cutaneous and subcutaneous areas of the abdomen. Chemotherapy was then prescribed. Currently, the intrathecal drug delivery system remains in place. No local recurrence has been detected. Furthermore, we systematically reviewed clinical manifestations of the disease, pathogenesis, prognostic factors, and treatment. The metastasis rate (cutaneous and subcutaneous) was approximately 12.2%. Thirty patients (62.5%) with cutaneous and subcutaneous metastases exhibited contemporaneous lymph node invasion. The 3-, 5-, and 10-year survival rates were 44.0%, 22.0%, and 13.0%, respectively. The prognosis of patients with atypical laryngeal carcinoids was poor. Relevant prognostic factors included the level of p53, human papilloma virus status, certain hypoxic markers, and distant metastasis. No

  10. Primary Nasal Tuberculosis in a 10-Year-Old Girl

    Science.gov (United States)

    Özer, Murat; Özsurekçi, Yasemin; Cengiz, Ali Bülent; Özçelik, Uğur; Yalçın, Ebru; Gököz, Özay

    2016-01-01

    Nasal tuberculosis is a rare clinical entity which mainly presents in elderly people. Nasal tuberculosis has always been considered to be secondary to tuberculosis of the lungs, and in rare instances it is a primary infection, usually when mycobacteria are inhaled. We describe the case of a 10-year-old girl who was successfully treated for primary nasal tuberculosis. This patient is one of the very few children who have been reported to have primary nasal tuberculosis. PMID:27366187

  11. Isolated Pancreatic/Periampullary Tuberculosis Remains a Diagnosis of Exclusion

    Directory of Open Access Journals (Sweden)

    Mallika Tewari

    2009-05-01

    Full Text Available Dear Sir, Although tuberculosis is endemic in this part of the world, isolated pancreatic tuberculosis is extremely rare. Thus, all lesions are first suspected as carcinoma and not tuberculosis unless the clinical features are suggestive of tuberculosis, for example, a history of miliary tuberculosis with enlarged peripancreatic nodes especially in an immunocompromised host. As our patient had none of these findings, we investigated her as one with possible periampullary carcinoma.

  12. Tuberculosis surveillance using death certificate data, New York City, 1992.

    OpenAIRE

    Washko, R M; Frieden, T. R.

    1996-01-01

    OBJECTIVE. To determine the accuracy and frequency of reporting tuberculosis as either the contributing or underlying cause of death on death certificates in New York City during 1992. METHODS. Death certificates from 1992 that listed tuberculosis were matched with the New York City tuberculosis registry. For those persons who had tuberculosis listed as a cause of death, but who were not listed in the registry, medical records were reviewed. The frequency of reporting tuberculosis on death ce...

  13. Models of Latent Tuberculosis: Their Salient Features, Limitations, and Development

    OpenAIRE

    Kamlesh Patel; Sarbjit Singh Jhamb; Prati Pal Singh

    2011-01-01

    Latent tuberculosis is a subclinical condition caused by Mycobacterium tuberculosis, which affects about one-third of the population across the world. To abridge the chemotherapy of tuberculosis, it is necessary to have active drugs against latent form of M. tuberculosis. Therefore, it is imperative to devise in vitro and models of latent tuberculosis to explore potential drugs. In vitro models such as hypoxia, nutrient starvation, and multiple stresses are based on adverse conditions encount...

  14. Tuberculosis en el personal de salud Tuberculosis in healthcare workers

    OpenAIRE

    Alberto Fica C; Marcela Cifuentes D; M. Cristina Ajenjo H; M. Irene Jemenao P; Alejandra Zambrano O; Naldy Febré V; Luis Delpiano M.; Alexis Diomedi P.; Paulina Ramonda C

    2008-01-01

    La tuberculosis (TBC) es un riesgo ocupacional que explica entre 5 y 5.361 casos por 100.000 personas en el personal de salud (PS) por sobre la población general en países en vías de desarrollo. Cada caso clínico implica que han ocurrido muchos casos de infección. Esta infección puede ser detectada por la prueba de conversión de tuberculina entre personas no vacunadas o por prueba de liberación de gama interferón. Los factores de riesgo incluyen la frecuencia de pacientes con TBC atendidos, l...

  15. Skeletal and dental indicators of health in the late mediaeval (12-15th century) population from Nin, southern Croatia.

    Science.gov (United States)

    Novak, M; Martinčić, O; Strinović, D; Slaus, M

    2012-12-01

    A comprehensive bioarchaeological study of the late mediaeval (12-15th century) skeletal sample from Nin was carried out in order to test the historically documented hypothesis that during the late mediaeval period Nin sustained a period of rapid development that resulted in it becoming one of the major urban centres on the eastern Adriatic coast. The analysed pathological changes (alveolar bone disease, dental caries, dental enamel hypoplasia, cribra orbitalia, periostitis, tuberculosis, Schmorl's nodes, vertebral osteoarthritis, and bone fractures) indicate a relatively good quality of life for the majority of the population from this late mediaeval site. A low prevalence of dental pathologies suggests an adequate diet while a low frequency of long bone trauma testifies to a relatively peaceful life for the inhabitants of mediaeval Nin. Increased urban development during this period resulted in a worsening of sanitary conditions most likely caused by overcrowding, which is reflected in the presence of tuberculosis and the relatively high frequencies of dental enamel hypoplasia and cribra orbitalia. An additional health concern for the late mediaeval inhabitants of Nin may have been the presence of malaria, as recorded in numerous historical sources. Comparison with other Croatian mediaeval skeletal samples suggests that the inhabitants of late mediaeval Nin experienced somewhat better living conditions than their contemporaries from other parts of Croatia. PMID:23102923

  16. Proteomic profiling of skeletal muscle plasticity.

    Science.gov (United States)

    Ohlendieck, Kay

    2011-10-01

    One of the most striking physiological features of skeletal muscle tissues are their enormous capacity to adapt to changed functional demands. Muscle plasticity has been extensively studied by histological, biochemical, physiological and genetic methods over the last few decades. With the recent emergence of high-throughput and large-scale proteomic techniques, mass spectrometry-based surveys have also been applied to the global analysis of the skeletal muscle protein complement during physiological modifications and pathophysiological alterations. This review outlines and discusses the impact of recent proteomic profiling studies of skeletal muscle transitions, including the effects of chronic electro-stimulation, physical exercise, denervation, disuse atrophy, hypoxia, myotonia, motor neuron disease and age-related fibre type shifting. This includes studies on the human skeletal muscle proteome, animal models of muscle plasticity and major neuromuscular pathologies. The biomedical importance of establishing reliable biomarker signatures for the various molecular and cellular transition phases involved in muscle transformation is critically examined. PMID:23738259

  17. Advances and challenges in skeletal muscle angiogenesis

    DEFF Research Database (Denmark)

    Olfert, I Mark; Baum, Oliver; Hellsten, Ylva;

    2016-01-01

    on metabolism, endocrine function, and locomotion, and is tightly regulated at many different levels. Skeletal muscle is also high adaptable, and thus one of the few organ systems which can be experimentally manipulated (e.g. by exercise) to study physiologic regulation of angiogenesis. This review will focus...... during health, but poorly controlled in disease - resulting in either excessive capillary growth (pathological angiogenesis) or losses in capillarity (rarefaction). Given that skeletal muscle comprises nearly 40% of body mass in humans, skeletal muscle capillary density has a significant impact...... on 1) the methodological concerns that have arisen in determining skeletal muscle capillarity, and 2) highlight the concepts that are reshaping our understanding of the angio-adaptation process. We also summarize selected new findings (physical influences, molecular changes and ultrastructural...

  18. Pathogenesis of Insulin Resistance in Skeletal Muscle

    Directory of Open Access Journals (Sweden)

    Muhammad A. Abdul-Ghani

    2010-01-01

    Full Text Available Insulin resistance in skeletal muscle is manifested by decreased insulin-stimulated glucose uptake and results from impaired insulin signaling and multiple post-receptor intracellular defects including impaired glucose transport, glucose phosphorylation, and reduced glucose oxidation and glycogen synthesis. Insulin resistance is a core defect in type 2 diabetes, it is also associated with obesity and the metabolic syndrome. Dysregulation of fatty acid metabolism plays a pivotal role in the pathogenesis of insulin resistance in skeletal muscle. Recent studies have reported a mitochondrial defect in oxidative phosphorylation in skeletal muscle in variety of insulin resistant states. In this review, we summarize the cellular and molecular defects that contribute to the development of insulin resistance in skeletal muscle.

  19. Increased skeletal muscle capillarization enhances insulin sensitivity.

    Science.gov (United States)

    Akerstrom, Thorbjorn; Laub, Lasse; Vedel, Kenneth; Brand, Christian Lehn; Pedersen, Bente Klarlund; Lindqvist, Anna Kaufmann; Wojtaszewski, Jørgen F P; Hellsten, Ylva

    2014-12-15

    Increased skeletal muscle capillarization is associated with improved glucose tolerance and insulin sensitivity. However, a possible causal relationship has not previously been identified. Therefore, we investigated whether increased skeletal muscle capillarization increases insulin sensitivity. Skeletal muscle-specific angiogenesis was induced by adding the α1-adrenergic receptor antagonist prazosin to the drinking water of Sprague-Dawley rats (n = 33), whereas 34 rats served as controls. Insulin sensitivity was measured ≥40 h after termination of the 3-wk prazosin treatment, which ensured that prazosin was cleared from the blood stream. Whole body insulin sensitivity was measured in conscious, unrestrained rats by hyperinsulinemic euglycemic clamp. Tissue-specific insulin sensitivity was assessed by administration of 2-deoxy-[(3)H]glucose during the plateau phase of the clamp. Whole body insulin sensitivity increased by ∼24%, and insulin-stimulated skeletal muscle 2-deoxy-[(3)H]glucose disposal increased by ∼30% concomitant with an ∼20% increase in skeletal muscle capillarization. Adipose tissue insulin sensitivity was not affected by the treatment. Insulin-stimulated muscle glucose uptake was enhanced independent of improvements in skeletal muscle insulin signaling to glucose uptake and glycogen synthesis, suggesting that the improvement in insulin-stimulated muscle glucose uptake could be due to improved diffusion conditions for glucose in the muscle. The prazosin treatment did not affect the rats on any other parameters measured. We conclude that an increase in skeletal muscle capillarization is associated with increased insulin sensitivity. These data point toward the importance of increasing skeletal muscle capillarization for prevention or treatment of type 2 diabetes. PMID:25352432

  20. Proteomic profiling of skeletal muscle plasticity

    OpenAIRE

    Ohlendieck, Kay

    2012-01-01

    One of the most striking physiological features of skeletal muscle tissues are their enormous capacity to adapt to changed functional demands. Muscle plasticity has been extensively studied by histological, biochemical, physiological and genetic methods over the last few decades. With the recent emergence of high-throughput and large-scale proteomic techniques, mass spectrometry-based surveys have also been applied to the global analysis of the skeletal muscle protein complement during physio...

  1. Skeletal Aging and Osteoporosis Biomechanics and Mechanobiology

    CERN Document Server

    2013-01-01

    The focus of this book is on mechanical aspects of skeletal fragility related to aging and osteoporosis. Topics include: Age-related changes in trabecular structure and strength; age-related changes in cortical material properties; age-related changes in whole-bone structure; predicting bone strength and fracture risk using image-based methods and finite element analysis; animal models of osteoporosis and aging; age-related changes in skeletal mechano responsiveness; exercise and physical interventions for osteoporosis.

  2. Stem cells for skeletal muscle repair

    OpenAIRE

    Shadrach, Jennifer L.; Wagers, Amy J.

    2011-01-01

    Skeletal muscle is a highly specialized tissue composed of non-dividing, multi-nucleated muscle fibres that contract to generate force in a controlled and directed manner. Skeletal muscle is formed during embryogenesis from a subset of muscle precursor cells, which generate both differentiated muscle fibres and specialized muscle-forming stem cells known as satellite cells. Satellite cells remain associated with muscle fibres after birth and are responsible for muscle growth and repair throug...

  3. Radiometric studies of mycobacterium tuberculosis

    Directory of Open Access Journals (Sweden)

    Edwaldo E. Camargo

    1987-02-01

    Full Text Available An in vitro assay system that included automated radiometric quantification of 14CO2 released as a result of oxidation of 14C- substrates was applied for studying the metabolic activity of M. tuberculosis under various experimental conditions. These experiments included the study of a mtabolic pathways, b detection times for various inoculum sizes, c effect of filtration on reproducibility of results, d influence of stress environment e minimal inhibitory concentrations for isoniazid, streptomycin, ethambutol and rifampin, and f generation times of M. tuberculosis and M. bovis. These organisms were found to metabolize 14C-for-mate, (U-14C acetate, (U-14C glycerol, (1-14C palmitic acid, 1-14C lauric acid, (U-14C L-malic acid, (U-14C D-glucose, and (U-14C D-glucose, but not (1-14C L-glucose, (U-14C glycine, or (U-14C pyruvate to 14CO2. By using either 14C-for-mate, (1-14C palmitic acid, or (1-14C lauric acid, 10(7 organisms/vial could be detected within 24 48 hours and as few as 10 organisms/vial within 16-20 days. Reproducible results could be obtained without filtering the bacterial suspension, provided that the organisms were grown in liquid 7H9 medium with 0.05% polysorbate 80 and homogenized prior to the study. Drugs that block protein synthesis were found to have lower minimal inhibitory concentrations with the radiometric method when compared to the conventional agar dilution method. The mean generation time obtained for M. bovis and different strains of M. tuberculosis with various substrates was 9 ± 1 hours.

  4. Forced removals embodied as tuberculosis.

    Science.gov (United States)

    Richardson, Eugene T; Morrow, Carl D; Ho, Theodore; Fürst, Nicole; Cohelia, Rebekkah; Tram, Khai Hoan; Farmer, Paul E; Wood, Robin

    2016-07-01

    South Africa has one of the worst tuberculosis burdens in the world. Several ecological forces have contributed to this, including high HIV prevalence; failing TB control strategies; crowded, poorly ventilated indoor environments-including the complex web of political and economic interests which produce them; the development of racial capitalism; and mining and migration. In the following study, we measure CO2 levels in public transport to investigate the role extended commutes from peri-urban settlements to urban sites of work-a direct result of forced removals-potentially play in propagating the TB epidemic in Cape Town, South Africa. PMID:27239703

  5. Redox control of skeletal muscle atrophy.

    Science.gov (United States)

    Powers, Scott K; Morton, Aaron B; Ahn, Bumsoo; Smuder, Ashley J

    2016-09-01

    Skeletal muscles comprise the largest organ system in the body and play an essential role in body movement, breathing, and glucose homeostasis. Skeletal muscle is also an important endocrine organ that contributes to the health of numerous body organs. Therefore, maintaining healthy skeletal muscles is important to support overall health of the body. Prolonged periods of muscle inactivity (e.g., bed rest or limb immobilization) or chronic inflammatory diseases (i.e., cancer, kidney failure, etc.) result in skeletal muscle atrophy. An excessive loss of muscle mass is associated with a poor prognosis in several diseases and significant muscle weakness impairs the quality of life. The skeletal muscle atrophy that occurs in response to inflammatory diseases or prolonged inactivity is often associated with both oxidative and nitrosative stress. In this report, we critically review the experimental evidence that provides support for a causative link between oxidants and muscle atrophy. More specifically, this review will debate the sources of oxidant production in skeletal muscle undergoing atrophy as well as provide a detailed discussion on how reactive oxygen species and reactive nitrogen species modulate the signaling pathways that regulate both protein synthesis and protein breakdown. PMID:26912035

  6. A Case of Sarcoidosis with Unusual Radiographic Findings that Developed 5 Years after Silicone Augmentation Mammoplasty Complicated by Miliary Tuberculosis during Corticosteroid Treatment

    Directory of Open Access Journals (Sweden)

    Tomoko Miyashita

    2011-01-01

    Full Text Available A 54-year-old woman with a past history of silicone augmentation mammoplasty was admitted with fever and dyspnea with diffuse interstitial shadows on computed tomography (CT. Although radiological findings were atypical, we diagnosed sarcoidosis by laboratory, microbiological, and bronchoalveolar lavage fluid analysis. Corticosteroids ameliorated the condition, but she had recurrent of fever and CT revealed miliary nodules while interstitial shadows disappeared. Liver biopsy showed that noncaseating granuloma and Ziehl-Neelsen stain was positive. We diagnosed miliary tuberculosis which developed during corticosteroid therapy. Antituberculotic therapy resulted in favorable outcome. Possibility exists that onset of sarcoidosis was induced by mammoplasty, namely, human adjuvant disease.

  7. Diagnostic value of CT on hepatic tuberculosis

    International Nuclear Information System (INIS)

    Objective: To assess CT manifestations and diagnostic value in patients with hepatic tuberculosis. Methods: Ten cases of hepatic tuberculosis proved by hepatic biopsy or surgical specimens were analyzed retrospectively. Results: This group of hepatic tuberculosis included three types. (1) Five cases of miliary hepatic tuberculosis demonstrated that the liver swelled diffusely associated with multiple miliary low attenuations, and showed no enhancement after contrast agents administration. (2) Three cases of tubercle hepatic tuberculosis depicted multiple hypodensity areas or mixed density regions in the liver. The extension of lesions reduced in arterial phase, and a ring-like enhancement was displayed in the portal phase. (3) One case of hepatic tuberculoma illustrated solitary space occupying lesion accompanied with central necrosis. The envelope was thin and smooth which enhanced slightly after injecting Gd-DTPA. Another one was hepatic abscess and depicted fluid-fluid level inside the lesion. Conclusions: The CT manifestations of miliary hepatic tuberculosis lack of characteristics, it is hard to make the diagnosis clear-cut unless integrating the medical history and lab test. The 'powder calcification' findings of tubercle hepatic tuberculosis is propitious to draw a qualitative diagnosis. And the feature of hepatic tuberculomas with fluid- fluid level is in favor of making a differential diagnosis against parallel tumors. (authors)

  8. CLINICAL AND HISTOPATHOLOGICAL STUDY OF CUTANEOUS TUBERCULOSIS

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    Ashok S

    2014-09-01

    Full Text Available Extrapulmonary tuberculosis constitutes about 10% of all cases of tuberculosis, and cutaneous tuberculosis makes up only a small proportion of these cases. Despite prevention programs, tuberculosis is still progressing endemically in developing countries. Commonest clinical variant of cutaneous tuberculosis in our study was tuberculous verrucosa cutis (TBVC seen in 46.66% patients followed by Lupus vulgaris seen in 33.33% patients followed by scrofuloderma (13.33%, papulonecrotic tuberculide (6.66%. The commonest site of involvement was upper limbs seen in 46.66% patients followed by lower limb seen in 20% patients, face, neck, inguinal region, axilla, chest in 6.66% and generalized pappilary eruptions in 6.66% patients. Maximum percentage of patients (53.3% had duration of cutaneous tuberculosis between 1-3 years followed by 33.33% between 1-6 months, 6.66% had duration of cutaneous tuberculosis between 7-12 months, and rest 6.66% had duration between 4-6 years. The commonest histopathological feature in our study was tuberculoid granuloma with epithelioid and Langhans giant cells seen in 70% patients, hyperkeratosis was seen in 13.33% patients and AFB bacilli were seen in 6.66% patients.

  9. Tuberculosis in wildlife in the Ruwenzori National Park, Uganda (Part II).

    Science.gov (United States)

    Woodford, M H

    1982-08-01

    The results of post-mortem examinations of 90 warthog (Phacochoerus aethiopicus) conducted in the Ruwenzori National Park, Uganda during a survey of tuberculous infection in wildlife are described. Nine per cent of warthog were found to show gross lesions on autopsy and of these organisms which could by typed, Mycobacterium bovis was isolated in 2 of 6 cases and 5 atypical mycobacterial strains were isolated from the remaining 4. The distribution and character of the lesions is described and it is concluded that the route of infection in the warthog is alimentary. A mycobacterial survey of 8 other species of mammals, 7 species of birds, 5 species of fish and 1 species of amphibian is described. None of the mammals (except possibly 1 elephant), birds, fish or amphibia is described. None of the mammals (except possibly 1 elephant), birds, fish or amphibia was found to be infected with M. bovis but several individuals were found to harbour atypical, probably saprophytic, mycobacterial types. The origin of tuberculosis in buffalo and warthog in the Ruwenzori National Park is discussed and is concluded to have been previous contact with domestic cattle. PMID:7123664

  10. Atypical depression in the structure of organic mental disorders (literature review

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    Leonov S.F.

    2014-09-01

    Full Text Available The review of literature presents current data on cli¬nical picture and diagnostics of atypical depression. Rubric “atypical depression” includes a variety of depressive states characterized by reactively caused changes of mood, sensitivity to interpersonal contacts, inverted vegetative and somatic symptoms such as increased appetite and hypersomnia. The article considers the place of atypical depression in the structure of organic mental disorders. Positions of foreign authors that produce atypical depression as a clinical entity in the structure of Bipolar affective disorder II type are represented, the views of other authors on the structure of atypical depression are considered. The analysis of national concept of non-circular depression is carried out. Questions of atypical affective conditions acquire special significance due to preparation of International Classification of Diseases of the 11th revision, because inclusion in it of Bipolar affective disorder II type, a manifestation of which is considered to be atypical depressions, is under discussion.

  11. Genetic Diversity of Mycobacterium tuberculosis Isolates from a Tertiary Care Tuberculosis Hospital in South Korea▿

    OpenAIRE

    Shamputa, Isdore Chola; Lee, Jongseok; Allix-Béguec, Caroline; Cho, Eun-Jin; Lee, Ji-im; Rajan, Vignesh; Lee, Eun Gae; Min, Jin Hong; Carroll, Matthew W.; Lisa C. Goldfeder; Kim, Jin Hee; Kang, Hyung Seok; Hwang, Soohee; Eum, Seok-Yong; Park, Seung Kyu

    2009-01-01

    Tuberculosis (TB) remains an immense public health problem in the Republic of Korea despite a more than fivefold decrease in the prevalence of the disease over the last 3 decades. The rise in drug-resistant TB has compounded the situation. We analyzed 208 clinical isolates of M. tuberculosis from the National Masan Tuberculosis Hospital by spoligotyping, IS6110 restriction fragment length polymorphism (RFLP), and 24-locus-based mycobacterial interspersed repetitive unit-variable number tandem...

  12. Extrapulmonary Tuberculosis: Mycobacterium tuberculosis Strains and Host Risk Factors in a Large Urban Setting in Brazil

    OpenAIRE

    Gomes, Teresa; Vinhas, Solange Alves; Reis-Santos, Bárbara; Palaci, Moisés; Peres, Renata Lyrio; Paola P Aguiar; Ribeiro, Fabiola Karla Correa; Marques, Hebert Silva; Dettoni, Valdério do Valle; Johnson, John L.; Riley, Lee W.; Maciel, Ethel Leonor

    2013-01-01

    Background Factors related to the development of extrapulmonary forms of tuberculosis (EPTB) are still poorly understood, particularly in high-endemic countries like Brazil. The objective of the paper is to determine host and Mycobacterium tuberculosis (MTB) strain-related factors associated with the development of EPTB in Espírito Santo state, Brazil. Methods and Findings We conducted a retrospective laboratory-based surveillance study of new tuberculosis (TB) cases diagnosed in Espírito San...

  13. Vitamin D Deficiency in Patients with Tuberculosis

    International Nuclear Information System (INIS)

    Objective: To determine the frequency and association of Vitamin D deficiency in patients with tuberculosis. Study Design: Case control study. Place and Duration of Study: Medical Department, Combined Military Hospital, Kharian, from July 2010 to June 2012. Methodology: One hundred and five outdoor patients of tuberculosis were selected with 255 gender matched controls. Tuberculosis was diagnosed by presence of acid fast bacilli in sputum smears, positive culture for Mycobacterium tuberculosis or demonstration of chronic caseating granulomatous inflammation in tissue specimens. Controls were drawn randomly from general population. Serum 25 hydroxyvitamin D [25 (OH) D3] levels < 25 ng/ml was considered Vitamin D deficiency. The results were analyzed on SPSS version 17. Results: Mean Vitamin D levels were 23.23 A+- 6.81 ng/ml in cases, 29.27 A+- 8.89 ng/ml in controls (p < 0.0001). Vitamin D deficiency was found in 57% of cases and 33% controls (p < 0.0001). Mean Vitamin D levels were significantly lower in females with tuberculosis (20.84 ng/ml) as compared to males (25.03 ng/ml, p = 0.002). Mean BMI in patients of tuberculosis with Vitamin D deficiency were 19.51 A+- 1.77 kg/m2 and in patients with normal Vitamin D were 21.65 A+- 1.79 kg/m2 (p < 0.0001). Mean Vitamin D levels in patients with multi-drug resistant tuberculosis was lower to a mean of 15.41 A+- 4.67 ng/ml (p < 0.0001). Conclusion: There is significant deficiency of Vitamin D in patients with tuberculosis as compared to controls. This deficiency is more pronounced in females, individuals with low BMI, extra pulmonary and MDR tuberculosis. (author)

  14. An Unusual Case of Cervical Tuberculosis

    OpenAIRE

    Prashant. S. Joshi; Vijay Shankar S; Pushpee Sinha

    2011-01-01

    Tuberculosis of the cervix is a rare disease and accounts to 0.1 – 0.65% of all cases of tuberculosis and 5 – 24 % of genital tract tuberculosis. We present an unusual case of 40 years old lady who presented with irregular bleeding per vagina and foul smelling white discharge for 1 year. Per speculum examination revealed an unhealthy looking cervix which bled on touch. A clinical diagnosis of carcinoma cervix was made. However, cervix biopsy revealed granulomatous lesion suggestive of tubercu...

  15. Trends in multidrug-resistant tuberculosis

    Directory of Open Access Journals (Sweden)

    I. M. F. Dias-Baptista

    2008-01-01

    Full Text Available Multidrug-resistant tuberculosis (MDR-TB is an increasing global problem. The extent and burden of MDR-TB varies significantly from country to country and region to region. Globally, about three per cent of all newly diagnosed patients have MDR-TB and the proportion is higher in patients who had previously received anti-tuberculosis (anti-TB treatment reflecting the failure of programs designed to ensure complete cure of patients with tuberculosis. The management of MDR-TB is a challenge that should be undertaken by experienced clinicians at centers equipped with reliable laboratory services and implementation of DOTS-Plus strategy.

  16. Drug Resistant Tuberculosis — Is There Hope?

    OpenAIRE

    Manish Kumar Goel; Pardeep Khanna

    2010-01-01

    Tuberculosis remains a worldwide public healthproblem. India has the highest burden of tuberculosis inthe world and accounts for nearly 2/5th of global burdenand 2/3rd of burden in SEAR countries. The XDR- TB wasfirst described in March 2006 and has also beenreported in India. The emergence of XDR – TB isassociated with a very low probability cure and a highcase fatality as evidenced by various researchers.Extensively drug-resistant tuberculosis is rapidly fatal ifnot treated. Some studies re...

  17. Computerized tomography study in peritoneal tuberculosis

    International Nuclear Information System (INIS)

    Abdominal tuberculosis usually involves a combination of organs (hepatosplenic, intestinal and/or genitourinary), lymph nodes (peritoneal and mesenteric) and peritoneum, mesentery and omentum. It preferentially affects immuno compromised patients (diabetic, cirrhotic, HIV-positive individuals). We present four cases in which abdominal tuberculosis involved only peritoneum, mesentery and omentum, with no radiological evidence of retroperitoneal lymph node or hepatosplenic disease. Exclusively peritoneal involvement is rare and the radiologic findings are nonspecific as they are also observed in other more common disorders. Despite this fact, tuberculosis should be included in the differential diagnosis, especially in immunocompromised patients. (Author) 8 refs

  18. Splenic tuberculosis. Report of twelve cases

    International Nuclear Information System (INIS)

    Tuberculosis of the spleen is not exceptional. The authors report ten cases which occurred with a predominance in young male adults. All patients had at least one other site of tuberculosis without any HIV infection. All patients had focal splenic lesions in the form of scattered hypo-echogenic and hypodense nodules. These nodules had a pseudo-tumor appearance in one case. CT-guided puncture was performed in one case. Splenic tuberculosis is not as rare as is sometimes thought. The CT-guided splenic puncture is now performed routinely and remains the ideal diagnostic approach. (authors). 9 refs., 5 figs

  19. Tuberculosis: New Aspects of an Old Disease

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    Luisa Jordao

    2011-01-01

    Full Text Available Tuberculosis is an ancient infectious disease that remains a threat for public health around the world. Although the etiological agent as well as tuberculosis pathogenesis is well known, the molecular mechanisms underlying the host defense to the bacilli remain elusive. In this paper we focus on the innate immunity of this disease reviewing well-established and consensual mechanisms like Mycobacterium tuberculosis interference with phagosome maturation, less consensual mechanism like nitric oxide production, and new mechanisms, such as mycobacteria translocation to the cytosol, autophagy, and apoptosis/necrosis proposed mainly during the last decade.

  20. Typical and unusual cases of female genital tuberculosis

    Directory of Open Access Journals (Sweden)

    E. Kulchavenya

    2014-01-01

    Full Text Available Tuberculosis is a disease with myriad presentations and manifestations; it can affect any organ or tissue, excluding only hair and nails. Doctors who are not familiar with extrapulmonary tuberculosis often overlook this disease. Urogenital tuberculosis (UGTB is the second most common form of TB in countries with severe epidemic situation and the third most common form in regions with low incidence of TB. The term “Urogenital tuberculosis” includes kidney tuberculosis; male and female tuberculosis and urinary tract tuberculosis as complication of kidney tuberculosis. We describe rarest case of tuberculosis of a placenta in young woman, suffered from genital tuberculosis, which was overlooked before delivery, as well as typical tubo-ovarian tuberculomas.