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
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.
Elena Morán López
Full Text Available En la actualidad la incidencia de la tuberculosis ha aumentado. El Mycobacterium tuberculosis infecta frecuentemente a las personas con SIDA, debido a que en estos pacientes hay una reducción de la resistencia mediada por células T, lo que propicia que este bacilo pueda desarrollar la enfermedad con una frecuencia superior a la de las personas sanas. La transmisión de la enfermedad puede ser por vía directa, de un individuo afectado a otro, fundamentalmente por las gotitas de saliva que contengan a este microorganismo, o por vía indirecta por la inhalación del bacilo que se puede encontrar por meses en los objetos de uso diario, debido a su gran resistencia. Las micobacterias que producen tuberculosis en el hombre inmunocompetente son la Mycobacterium tuberculosis y la bovis, otros tipos pueden provocar tuberculosis en individuos inmunocomprometidos. La patogenicidad de este bacilo está relacionada con su capacidad para escapar de la destrucción inducida por los macrófagos y para provocar hipersensibilidad de tipo retardado. Esta enfermedad tiene muy pocas manifestaciones bucales, lo que se observa generalmente es una úlcera que toma como asiento fundamental el dorso de la lengua. La tuberculosis amenaza con convertirse en una enfermedad incurable por la deficiente administración de los programas contra ésta, por lo que la OMS plantea para su detección y tratamiento el DOTS (tratamiento observado directamente, de corta duración que comienza a tener resultados satisfactorios, aunque en el último quinquenio, el 88 % de los pacientes que se estimaban como infectados por tuberculosis no recibieron DOTS.At present, the incidence of tuberculosis is on the rise. Mycobacterium tuberculosis often infests AIDS patients due to the fact that these persons´T-cell mediated resistance is reduced, which favors the development of the disease at a higher rate than in healthy people. The disease can be transmitted directly, that is , from an
Full Text Available La eficacia protectora de la actual vacuna (BCG contra la tuberculosis, para contrarrestar las formas pulmonares de esta enfermedad y su reactivación, resulta variable o poco eficiente, lo cual impone la búsqueda urgente de nuevas alternativas profilácticas contra esta enfermedad. Basados en las ventajas inmunogénicas que ofrece el uso de vacunas vivas, se han encaminado diferentes estrategias de este tipo empleando mutantes auxotróficos de Mycobacterium tuberculosis , BCG recombinante o micobacterias no tuberculosas. Existen evidencias experimentales acerca de la protección conferida tras la vacunación con cepas vivas, inactivadas o fracciones proteicas de Mycobacterium'habana' TMC-5135 contra la infección por Mycobacterium tuberculosis. Esta respuesta protectora parece ir aparejada de escasos signos de virulencia en los modelos animales ensayados, lo cual coloca a M.´habana´ dentro de los posibles candidatos vacunales contra la tuberculosis al ajustarse a la condición que impone una vacuna clásica de reproducir la infección y los eventos inmunes que le suceden lo más fielmente posible a como ocurren de manera natural, sin causar extensos daños en el receptor.
Juan Carlos Rodríguez, D.
La tuberculosis sigue constituyendo un problema de salud pública a nivel mundial con casi nueve millones de casos nuevos en 2012 y se estima que un tercio de la humanidad está infectada. A nivel nacional, si bien las tasas son alentadoras, la variación regional es muy importante. En los últimos años se han registrado progresos importantes tanto en el conocimiento de la conducta del bacilo de Koch, el causante de la enfermedad, como en los métodos para detectarlo. Así los IGRAS (Interferon G R...
Classification of clinical forms of tuberculosis of respiratory organs is m ade. It is shown, that diagnosis, determination of the clinical form of pulmona ry tuberculosis, extent and phase of the process are mainly based on the data of roentgenologic studies and in certain cases tomography is preferable. Roentgenologic picture of primary tuberculosis, tuberculosis of intrathoracis l ymp nodes, dissemenated tuberculosis, focal and infiltrative tuberculosis of lungs, tuberculomas of lungs, cavernous and fibrocavernous form of pulmonary tub erculosis, cirrhotic tuberculosis of lungs, tuberculosis of upper respiratory tracks, tuberculous pleurite and tuberculosis of respiratory organs, combined wi th dust occupational diseases, has been described
C. Robert Horsburgh, Jr
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.
This book chapter for medical students and researcher Tuberculosis is still one of the leading causes of death by infectious diseases with 2 million deaths per year and 9.2 million new cases of tuberculosis disease annually [1-3]. Besides, more than 2 milliard people are infected with latent tuberculosis infection (LTBI) [1-3]. Despite continuous effort in the prevention, monitoring and treatment of tuberculosis, the disease remains a major health problem in many countries [4-6...
Peixoto Filho, Anibal Araujo Alves; Peixoto, Mila Correia Gois [Hospital Sao Luiz, Sao Paulo, SP (Brazil). Setor de US/TC/RM; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: firstname.lastname@example.org
The peritoneum is a frequent site of involvement by peritoneal tuberculosis. Generally, computed tomography appears to be the imaging modality of choice in the detection and assessment of abdominal tuberculosis. The computed tomography findings can help in the diagnosis of peritoneal tuberculosis, that is confirmed by a positive culture or hystologic analysis of biopsy obtained through laparoscopic examination. Peritoneal carcinomatosis is the main differential diagnosis. In this article we present the spectrum of tomographic manifestation of peritoneal tuberculosis and how we can differentiate it from peritoneal carcinomatosis. (author)
Latorre Tortello, Pablo
The tuberculosis is an infection bacterial chronicle of world distribution. Three organisms of the family of the mycobacterium, the m. tuberculosis, the m. bovis and m. africanum, phenotypic and genetically similar, produce it, but only the m. tuberculosis has importance; the others rarely produce illness in the human. By definition, the lung tuberculosis is the localization of the m. tuberculosis in the breathing tract, the most common and main form in the affection and the only able to contaminate to other people. The koch bacillus, transmits the illness directly person to person. The paper Includes topics like pathogenesis, natural history, epidemiology, diagnose, symptomatology and treatment
Tarik Bajrović; Mahmud Nurkić; Šukrija Zvizdić
Tuberculosis, known as the "White Plague" in the early 19th century, is the infectious disease, which is being researched today even in some of the most developed countries in the world. Epidemiological- epizootiological research points to the importance of pasteurizing milk as well as the transmission in aerosolized droplets in humans and animals. Mycobacterium tuberculosis (Mtb), M. bovis, M. africanum and M. microti are the mycobacteria that cause tuberculosis. Other mycobacteria cause dis...
Ankrah, Alfred O; Glaudemans, Andor W J M; Maes, Alex; Van de Wiele, Christophe; Dierckx, Rudi A J O; Vorster, Mariza; Sathekge, Mike M
Tuberculosis (TB) is currently the world's leading cause of infectious mortality. Imaging plays an important role in the management of this disease. The complex immune response of the human body to Mycobacterium tuberculosis results in a wide array of clinical manifestations, making clinical and
Tabbara, Khalid F
The purpose of this report is to present an update on the manifestations and management of ocular tuberculosis. Tuberculosis affects one-third of the world's population. The incidence of tuberculosis has increased with the increase in the HIV infected population. Following a resurgence of the disease in the US, the incidence has recently declined. Patients may develop scleritis that can be focal, nodular or diffuse with or without keratitis. Anterior granulomatous uveitis may occur. The posterior segment reveals vitritis, choroiditis, and can mimic serpiginous choroiditis and other entities. Patients who are immunosuppressed or HIV infected may develop active mycobacterial disease in the eye leading to rapid destruction of the ocular structures. The diagnosis of ocular tuberculosis is made by isolation of Mycobacterium tuberculosis on Löwestein-Jensen medium or by PCR. The diagnosis is supported by the clinical findings, imaging techniques including optical coherence tomography, fluorescein angiography, indocyanine green and ultrasonography. Tuberculin skin test helps to confirm the diagnosis. Ocular tuberculosis may occur in the absence of pulmonary disease. Patients present with a spectrum of clinical signs. The disease may mimic several clinical entities. Early diagnosis and prompt treatment of ocular tuberculosis may prevent ocular morbidity and blindness.
... Here, the primary infection has resolved, but the bacteria are dormant , or hibernating. When conditions become favorable (for instance, a lowered immunity), the bacteria become active. Tuberculosis in older children and adults ...
Background: In the era of HIV/AIDS epidemic understanding the nature of sexual debuts among female adolescents is critical in developing effective preventive strategies. Objectives: The objectives of the study where to investigate the specific age at sex-debuts, to identify the specific reasons for sex-debuts, and to examine ...
Rodrigo X Armijos
Full Text Available OBJECTIVE: To assess the effect of micronutrient supplementation on tuberculosis (TB patient outcomes. MATERIAL AND METHODS: The randomized, double-blinded, placebo-controlled study was conducted in pulmonary TB patients undergoing directly observed treatment short course/ tratamiento acortado estrictamente supervisado (TAES/ DOTS at IMSS in Ciudad Juarez, Chihuahua, Mexico, who were recruited during August 2005-July 2006. Consecutive patients received zinc and vitamin A supplements or matched placebo for four months. Dietary intake, blood zinc and vitamin A, immune response (IFN-γ,TNF-α, and IL-10 mRNA, and sputum smear conversion were measured. RESULTS: The proportion of micronutrient compared to placebo group subjects with a negative sputum smear by month 3 was significantly increased (p= 0.03. This occurred subsequent to increased TNF-α and IFN-γ and decreased IL-'0 observed at month 2. Micronutrient supplementation appeared to accelerate the beneficial therapeutic effect of chemotherapy. CONCLUSIONS: The earlier elimination of bacilli from sputum was associated with improved zinc status and Th' immune response. The therapeutic effect of vitamin A was less evident.OBJETIVO: Determinar el efecto de la suplementación con zinc y vitamina A o placebo en pacientes tratados por tuberculosis (TB. MATERIAL Y MÉTODOS: Se realizó un ensayo aleatorizado en pacientes tuberculosos que iniciaron el tratamiento acortado estrictamente supervisado/ directly observed treatment short course (TAES/DOTS en las clínicas del IMSS, Ciudad Juárez, Chihuahua, México, reclutados durante agosto 2005-julio 2006. A cada paciente en forma aleatoria se le designó un código para recibir ya sea micronutrientes o placebo por cuatro meses, bajo el diseño doble ciego. Se evaluó la ingesta dietética, niveles de zinc y vitamina A en sangre, respuesta inmune (IFN-γ,TNF-α, IL-l0 mRNA en sangre y bacilo ácido alcohol resistente (BAAR en esputo. RESULTADOS: Al
Latorre Tortello, Pablo
Por definición, la tuberculosis pulmonar es la localizaci6n del M. tuberculosis en el tracto respiratorio, la forma más común y principal de la afección y la única capaz de contagiar a otras personas. El M. tuberculosis, descubierto por Robert Koch en 1882, el bacilo de Koch, es un bacilo delgado, inmóvil, de 4 micras de longitud media, aerobio obligado, que se tiñe de rajo por la tinción de Ziehl-Neelsen. Debido a la coraza lipídica de su pared, lo hace resistente a la decoloración con ácido...
Pablo Latorre Tortello
Full Text Available Por definición, la tuberculosis pulmonar es la localizaci6n del M. tuberculosis en el tracto respiratorio, la forma más común y principal de la afección y la única capaz de contagiar a otras personas. El M. tuberculosis, descubierto por Robert Koch en 1882, el bacilo de Koch, es un bacilo delgado, inmóvil, de 4 micras de longitud media, aerobio obligado, que se tiñe de rajo por la tinción de Ziehl-Neelsen. Debido a la coraza lipídica de su pared, lo hace resistente a la decoloración con ácidos y alcohol, de ahí el nombre de bacilos ácido-alcohol resistente (BAAR. Su transmisión es directa, de persona a persona.
Pablo Latorre Tortello
Por definición, la tuberculosis pulmonar es la localizaci6n del M. tuberculosis en el tracto respiratorio, la forma más común y principal de la afección y la única capaz de contagiar a otras personas. El M. tuberculosis, descubierto por Robert Koch en 1882, el bacilo de Koch, es un bacilo delgado, inmóvil, de 4 micras de longitud media, aerobio obligado, que se tiñe de rajo por la tinción de Ziehl-Neelsen. Debido a la coraza lipídica de su pared, lo hace resistente a la decoloración con ácido...
Elena Morán López; Yaima Lazo Amador
En la actualidad la incidencia de la tuberculosis ha aumentado. El Mycobacterium tuberculosis infecta frecuentemente a las personas con SIDA, debido a que en estos pacientes hay una reducción de la resistencia mediada por células T, lo que propicia que este bacilo pueda desarrollar la enfermedad con una frecuencia superior a la de las personas sanas. La transmisión de la enfermedad puede ser por vía directa, de un individuo afectado a otro, fundamentalmente por las gotitas de saliva que conte...
Mendoza Zuñiga, Marleny; Bastidas Párraga, Gustavo; León Untiveros, Paúl Albert
La tuberculosis es una enfermedad infectocontagiosa producida por el bacilo de Koch, que ataca a los pulmones pero puede ser difuminada por todo el cuerpo. El siguiente artículo de información nos da una visión amplia de la detección, diagnóstico y tratamiento de la misma.
Ochoa Ramírez Á
Full Text Available Extranodal MALT lymphomas are a type of lymphoproliferative syndrome belonging to non-Hodgkin's lymphomas. The most common affectation of these types of lymphomas is the digestive tract (80%, the lung being only 14% of cases. We present the case of a 73 years old woman who goes to progressive dyspnea, with a large right pleural effusion on the chest x-ray. After screening and differential diagnosis of the different types of pleural effusion and the clinical etiological processes involved in its production, the diagnosis of lymphoproliferative process was reached, starting chemotherapy treatment with good evolution of both the pleural effusion and the patient's clinic.
Full Text Available Parenting style and its effect on the timing of Jewish adolescents’ sexual debuts were examined in the reported study. One hundred sixty-eight research participants between the ages of 18 and 22 from a large university in the Southeast participated in the study. A survey instrument was administered at three fraternities and two sororities to examine parenting style and sexual debut retrospectively. Data were analyzed using descriptive statistics, frequency chi square tests, and Analysis of Variance (ANOVA; while post hoc results were determined through Tukey’s honestly significant difference. Results found that authoritative parenting provides a delay in the age of sexual debut for Jewish adolescents. All other parenting styles had mean ages less than the overall mean age of sexual debut, 17.10 years old, with indifferent parenting having the earliest debut. These findings suggest that parenting style may affect the timing of Jewish adolescents’ sexual debut. The study has implications for understanding factors that may affect the timing of a Jewish adolescent’s sexual debut and may help parents protect their adolescent from the negative effects associated with early sexual debut, such as low academic achievement. Recommendations for future research include exploring the effects of family structure and peer networks to understand fully the many factors that affect the timing of adolescents’ sexual debut.
Anglewicz, Philip; VanLandingham, Mark; Phuengsamran, Dusita
Migration from one's parents' home and sexual debut are common features of the transition to adulthood. Although many studies have described both of these features independently, few have examined the relationship between migration and sexual debut in a systematic manner. In this study, we explore this link for young adults in Thailand. With relatively high rates of internal migration, rapid modernization, a moderate HIV epidemic, and a declining average age of sexual debut, Thailand presents an instructive environment in which to examine migration and sexual debut. We use two waves of a longitudinal data set (2005 and 2007) that includes a subsample of young adults who migrated to urban areas during that period. We identify characteristics and behaviors associated with sexual debut and examine the role of migration on debut. Our approach reduces several common sources of bias that hamper existing work on both migration and sexual debut: (1) the longitudinal nature of the data enables us to examine the effects of characteristics that predate both behaviors of interest; (2) the survey on sexual behavior employed a technique that reduces response bias; and (3) we examine differences in debut by marital status. We find that migrants have a higher likelihood of sexual debut than nonmigrants.
While men appeared to hold greater decision-making power than women at sexual debut, descriptions of men's early sexual experiences were often characterised by respect, intimacy and vulnerability. Many men attributed the timing of their sexual debut to peer pressure, which typically generated higher social status and ...
A. Yu. Ischenko
Full Text Available Systemic lupus erythematosus — a chronic autoimmune disease that is often associated with infectious processes. The paper presents two clinical cases of systemic lupus erythematosus , debuted with acute respiratory infection.
Glynn, Judith R; Kayuni, Ndoliwe; Floyd, Sian; Banda, Emmanuel; Francis-Chizororo, Monica; Tanton, Clare; Molesworth, Anna; Hemmings, Joanne; Crampin, Amelia C; French, Neil
Age at sexual debut is a key behavioural indicator used in HIV behavioural surveillance. Early age at menarche may precipitate early sex through perceived readiness for sex, or through school drop-out, but this is rarely studied. We investigated trends and circumstances of sexual debut in relation to schooling and age at menarche. A cross-sectional sexual behaviour survey was conducted on all individuals age 15-59 within a demographic surveillance site in Karonga District, Malawi. Time trends were assessed using birth cohorts. Survival analysis was used to estimate the median age at menarche, sexual debut and first marriage. The 25(th) centile was used to define "early" sex, and analyses of risk factors for early sex were restricted to those who had reached that age, and were done using logistic regression. Of the 8232 women and 7338 men resident in the area, 88% and 78%, respectively, were seen, and, 94% and 92% of these were interviewed. The median reported age at first sex was 17.5 for women and 18.8 for men. For women, ages at menarche, sexual debut and first marriage did not differ by birth cohort. For men, age at sexual debut and first marriage decreased slightly in later birth cohorts. For both men and women increased schooling was associated with later sexual debut and a longer delay between sexual debut and first marriage, but the associations were stronger for women. Earlier age at menarche was strongly associated with earlier sexual debut and marriage and lower schooling levels. In women early sexual debut (<16 years) was less likely in those with menarche at age 14-15 (odds ratio (OR) 0.31, 95%CI 0.26-0.36), and ≥16 (OR 0.04, 95%CI 0.02-0.05) compared to those with menarche at <14. The proportion of women who completed primary school was 46% in those with menarche at <14, 60% in those with menarche at 14-15 and 70% in those with menarche at ≥16. The association between age at menarche and schooling was partly explained by age at sexual debut. The
Judith R Glynn
Full Text Available Age at sexual debut is a key behavioural indicator used in HIV behavioural surveillance. Early age at menarche may precipitate early sex through perceived readiness for sex, or through school drop-out, but this is rarely studied. We investigated trends and circumstances of sexual debut in relation to schooling and age at menarche.A cross-sectional sexual behaviour survey was conducted on all individuals age 15-59 within a demographic surveillance site in Karonga District, Malawi. Time trends were assessed using birth cohorts. Survival analysis was used to estimate the median age at menarche, sexual debut and first marriage. The 25(th centile was used to define "early" sex, and analyses of risk factors for early sex were restricted to those who had reached that age, and were done using logistic regression. Of the 8232 women and 7338 men resident in the area, 88% and 78%, respectively, were seen, and, 94% and 92% of these were interviewed. The median reported age at first sex was 17.5 for women and 18.8 for men. For women, ages at menarche, sexual debut and first marriage did not differ by birth cohort. For men, age at sexual debut and first marriage decreased slightly in later birth cohorts. For both men and women increased schooling was associated with later sexual debut and a longer delay between sexual debut and first marriage, but the associations were stronger for women. Earlier age at menarche was strongly associated with earlier sexual debut and marriage and lower schooling levels. In women early sexual debut (<16 years was less likely in those with menarche at age 14-15 (odds ratio (OR 0.31, 95%CI 0.26-0.36, and ≥16 (OR 0.04, 95%CI 0.02-0.05 compared to those with menarche at <14. The proportion of women who completed primary school was 46% in those with menarche at <14, 60% in those with menarche at 14-15 and 70% in those with menarche at ≥16. The association between age at menarche and schooling was partly explained by age at sexual
Full Text Available Objective. To estimate calendar of sexual debut in Mexico and its trends using national representative household surveys. Materials and methods. Analysis of five birth cohorts extracted from four national population based household surveys in Mexico (National Health Survey 2000, National Survey on Demographic Dynamics 2009, National Youth Survey 2010, and National Health and Nutrition Survey 2012, using as outcome the proportion of individuals that reported sexual debut before the age of 16 and before the age of 20. Results. Overall, the four analyzed surveys produce consistent results, although some differences were found. While a larger proportion among younger cohorts reported sexual debut before the age of 20, that was not the case for sexual debut before 16 years. Conclusions. While data seems to reflect a relative stable age of sexual debut in Mexico, there is a recent trend to prepone sexual initiation that highlights the need to strengthen comprehensive sexual education and the supply of sexual and reproductive health services that are accessible and friendly to adolescents thus responding to the growing demand from this age group.
Feliciano Milián Suazo
Full Text Available El diagnóstico rápido de tuberculosis en ganado es crítico para decidir si un hato debe someterse a cuarentena de manera definitiva o despoblarse. El objetivo del presente trabajo fue evaluar la sensibilidad y la especificidad relativa de dos PCR´s (MPB70 y IS6110 y spoligotyping como pruebas rápidas de diagnóstico de tuberculosis bovina en tejido fresco. Se usaron 50 muestras de tejido con lesión, provenientes de un hato con 25 % de prevalencia de la enfermedad y 50 muestras de tejido sin lesión, provenientes de un hato libre de la enfermedad. Las muestras se dividieron en dos partes y cada parte analizada en ciego por dos laboratorios diferentes con un mismo protocolo. Las tres pruebas fueron utilizadas para el diagnóstico en tejido macerado tomado inmediatamente antes del cultivo. La sensibilidad y la especificidad relativa de las pruebas diagnósticas se determinaron usando el resultado de presencia/ ausencia de lesiones, histopatología y cultivo como ¿pruebas de oro.¿ La PCR MPB70 demostró de manera consistente mayor sensibilidad (85 a 91 % y especificidad (77 a 86 % en uno de los laboratorios con todas las pruebas de oro. Sin embargo, se observaron diferencias inter-laboratorio: en el segundo laboratorio la sensibilidad fue de 89 a 91 %, pero la especificidad fue baja (57 a 63 %. La PCR IS6110 anidada y spoligotyping tuvieron un pobre comportamiento. La sensibilidad y la especificidad relativa para la PCR MPB70 sugiere que esta prueba puede ser de utilidad como prueba complementaria para el diagnóstico rápido.
Helí Jaime Barrón-Pastor
Full Text Available Introducción: La tuberculosis (TB sigue siendo uno de las principales causas de muerte en el mundo. La TB meníngea como complicación requiere detección pronta e instalación inmediata de la terapia apropiada. Dada la baja sensibilidad de la baciloscopia y del cultivo del bacilo tuberculoso, se presenta el estudio de las isoenzimas adenosina deaminasa (ADA como contribución al diagnóstico diferencial de la TB meníngea. Objetivo: Determinar la actividad de isoenzimas ADA en líquido cefalorraquídeo (LCR de pacientes con TB meníngea. Diseño: Investigación descriptiva, con muestreo no probabilístico. Institución: Centro de Investigación de Bioquímica y Nutrición, Universidad Nacional Mayor de San Marcos. Material biológico: Muestras de LCR de pacientes con TB. Intervenciones: Se consideró muestras de LCR con actividad ADA mayor a 9 U/L, que fueron conservadas a -40 °C hasta la corrida electroforética en sistema vertical. El análisis estadístico se realizó aplicando Mann - Withney, con un nivel de significancia de 0,1 para comparar los valores ADA de TB meníngea frente a otras enfermedades del sistema nervioso central (SNC. Principales medidas de resultados: Isoenzimas ADA1m, ADA1cp y ADA2. Resultados: Las medianas de la actividad de ADA total en LCR de pacientes tuberculosos fueron mayores que en otras enfermedades parainfectivas del SNC. ADA1cp tuvo mayor contribución para ADA total en ambos casos, mostrando mayor incremento en tuberculosis meníngea. También, ADA2 aumentó en TB meníngea frente a otras enfermedades del SNC. Conclusiones: Las isoenzimas ADA en LCR expresan niveles elevados de ADA2 en tuberculosis meníngea, como consecuencia del incremento de la línea celular monocito-macrófago.
Background: Early sexual debut, voluntary or coerced, increases risks to sexual and reproductive health. Sexual coercion is increasingly receiving attention as an important public health issue owing to its association with adverse health and social outcomes. Objective: To describe voluntary and coerced experience at ...
Early sexual debut among young women and men. (commonly defined as having had first sexual intercourse at or before age 14 years) is associated with risks to sexual and reproductive health. These include risky sexual behaviours such as multiple partners, sex under the influence of alcohol or drugs, unplanned ...
Tasting the Forbidden Fruit: The Social Context of Debut Sexual Encounters Among Young Persons in a Rural Nigerian Community. ... Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader. To download the PDF, click the Download link above.
Early sexual debut: prevalence and risk factors among secondary school students in Ido-ekiti, Ekiti state, South-West Nigeria. Kabir Adekunle Durowade, Oluwole Adeyemi Babatunde, Lukman Omotayo Omokanye, Olusegun Elijah Elegbede, Lawrence Majekodunmi Ayodele, Kayode Razaq Adewoye, Stella Adetokunbo, ...
Sep 3, 2017 ... Abstract. Background: Early adolescent sexual activity remains a recurring problem with negative psychosocial and health outcomes. The age at sexual debut varies from place to place and among different individuals and is associated with varying factors. The aim was to determine the prevalence and risk ...
German A Acevedo
Full Text Available La tuberculosis es una enfermedad infecciosa causada por el Mycobacterium tuberculosis. En el año 2010 se registraron 8.8 millones de casos incidentes en el mundo y en los últimos años han aparecido poblaciones bacterianas de micobacterias con resistencia a los fármacos de primera línea. Se ha definido la presencia de resistencia a rifampicina e isoniacida como multidrogoresistencia, estimándose una incidencia mundial aproximada de 3.6%. Esta revisión de tema se centrará en la situación de la tuberculosis multidrogoresistente en el mundo, incluyendo un análisis regional de la casuística Colombiana. Se comentarán los principales mecanismos de resistencia del microorganismo, los genes implicados en la misma y los factores de riesgo asociados a la generación de resistencia en algunas comunidades.
Delaying sexual debut as a strategy for reducing HIV epidemic in Kenya. EO Onsomu, JK Kimani, BA Abuya, AA Arif, D Moore, V Duren-Winfield, G Harwell. Abstract. The study purpose was to determine the association between sexual debut and HIV sero-status, and factors contributing to a positive HIV sero-status.
Full Text Available Objectives: We described the duration from symptom debut to assessment at specialist healthcare outpatient clinics for dementia in Norway and explored whether educational level was associated with time from symptom debut to dementia assessment. Methods: The study comprised 835 persons from a register for individuals with cognitive symptoms (NorCog. The outcome variable was time in months from symptom debut to assessment. The main independent variable was the number of years of education. Also age, gender, marital status, cognitive function, neuropsychiatric symptoms, assistance and location were assessed. Results: In an adjusted linear mixed model, a higher educational level was associated with a longer duration from symptom debut to assessment, where 5 additional years of education increased the time from symptom debut to consultation by 10%. Conclusion: The findings may perhaps be explained by the hypothesis that highly educated people may be able to compensate better for cognitive impairment, which is in line with a hypothesis of cognitive reserve.
... with facebook share with twitter share with linkedin Tuberculosis Go to Information for Researchers ► Tuberculosis (TB) is ... are drug resistant. Why Is the Study of Tuberculosis a Priority for NIAID? Tuberculosis is one of ...
Full Text Available Non-Hodgkin lymphomas (NHL are rare extranodal and primary genitourinary involvement is usually exceptional. The most common manifestation of genital lymphomas is bleeding or vaginal mass, the most common histological subtype is diffuse large cell NHL and the prognosis is good in localized forms.
This report examines early sexual debut (age 15) among 15-year-old in-school adolescents in eight African countries. The total sample included 10 070 school children aged 15 years from nationally representative samples from eight African countries. Univariate and multivariate analyses were conducted to assess the relationship between early sexual debut and alcohol, tobacco and other drug use, mental distress, physical activity, protective factors and socioeconomic status variables. A total of 27.3% had experienced sexual debut before age 15, 38.1% among boys and 15.8% among girls. Boys and girls with sexual debut at less than age 15 were more likely to report alcohol, tobacco and drug use, truancy, poor parental or guardian connectedness, sedentary behaviour, having been in a physical fight and seriously injured, while for girls, mental distress and poor economic status and for boys, bullied and poor parental or guardian supervision were associated with early coital debut. In multivariable analysis, early sexual debut was among boys associated with currently smoking (OR = 4.45, p = 0.002) and truancy (OR = 2.02, p = 0.007) and, among girls, associated with lower education (OR = 0.22, p = 0.004), ever drunk (OR = 3.94, p = 0.016), having no close friends (OR = 3.36, p = 0.014) and poor parental connectedness (OR = 2.43, p = 0.037). The study found a high prevalence of early sexual debut among 15-year-olds in eight African countries. Risk factors identified were consistent with problem behaviour theory in which early onset of adolescent sexual behaviour is shared with other problem behaviours. Prevention programmes should broaden sexual health promotion including problem behaviour such as substance use and mental distress for boys and girls in the preteen years, before sexual debut.
Masho, Saba W; Chambers, Gregory J; Wallenborn, Jordyn T; Ferrance, Jacquelyn L
Age at sexual debut and age gap between partners at debut are modifiable characteristics that may be related to risky sexual behaviors. Understanding any such relationships is a necessary first step toward strengthening risk interventions. Age at sexual debut and partner age gap were examined for 3,154 female and 2,713 male respondents to the 2011-2013 National Survey of Family Growth who first had intercourse before age 18. Multivariable logistic regression was used to assess associations between these measures and teenage parenthood and reporting a high lifetime number of partners (i.e., a number above the sample median). Females' odds of teenage parenthood were elevated if sexual debut occurred at ages 15-17 and involved a partner age gap of 3-4 years (odds ratio, 1.8) or more (2.0); they were reduced if debut occurred before age 15 and the gap was 3-4 years (0.8). Females' likelihood of reporting a high lifetime number of partners was negatively associated with age gap (0.4-0.7, depending on age at debut and length of age gap). Males' likelihood of reporting a large number of partners was positively associated with age gap if sexual debut was before age 15 and the gap was five or more years (1.7) or if debut was at ages 15-17 and involved a 3-4-year gap (2.0). Identifying the mechanisms underlying these associations could inform program design and implementation. Copyright © 2017 by the Guttmacher Institute.
Japan Nuclear Fuel Industries and local governments signed the safety agreement, and the work began to initiate the operation of a uranium enrichment plant. In this way, the national Rokkashomura project to be constructed with the total cost of 1.2 trillion yen marked the debut of nuclear fuel cycle business in Japan. The public hearing concerning the low level radioactive waste storage facility was finished. However, a fuel reprocessing plant has not advanced since the national government did not clarify the policy for the management of high level rad-waste from the plant. Gubernatorial election was the best thing to happen for the public acceptance, and the local opposition movement lost steam. The operation of the uranium enrichment plant is to begin next January, and the construction of the low level waste storage facility proceeds on schedule. Regarding the fuel reprocessing plant, the public hearing is to be held in autumn, but it faces difficulties. The siting of nuclear fuel cycle facilities has already produced benefits for the local economy. 18 business establishments representing 15 firms have so far decided to open in Aomori Prefecture. JNFI and JNFS began the specific study for merger. (K.I.)
Francisco Infante Barrera
Full Text Available La evolución etiológica de la medicina la podemos dividir en dos grandes períodos: período de la sífilis y período de la tuberculosis. El período de la sífilis, gracias a las armas de combate de que hoy disponemos, ocupa un lugar secundario. El período de la tuberculosis y que no es sino el paralelo de la vida moderna, ocupa en vigencia el primer lugar. Es el período presente. Hasta hace poco tiempo el médico en general, iniciaba la exploración de su paciente con un interrogatorio, una inspección, un tacto y una serología con una obsesión sifilítica. En la época actual el médico y en especial el oftalmólogo debe tener una obsesión tuberculosa en la investigación etiológica. Cuántas veces en una afección ocular que de una manera lenta pero progresiva produce profundas alteraciones oculares, lleva el sello soterrado de una tuberculosis? Cuántos enfermos de una constitución en apariencia envidiable hacen precisamente por un exceso de sus defensas una alergia tuberculosa? Tan traicionera como la sífilis es la tuberculosis. La sífilis quema sus etapas y estalla con una hemorragia cerebral, una locura, una parálisis general, una ataxia locomotriz progresiva, una goma o una meningitis sifilítica. La tuberculosis hace su presentación con una afección ocular, una goma, una granulia, una artritis, una osteítis, o una meningitis óptico-quiasmática. Siendo esto así, es necesario, en la mayoría de las afecciones oculares, tratar de identificarla por los medios de diagnóstico de que hoy disponemos.
Peltzer, K; Pengpid, S
This report examines early sexual debut (age 15 years) among 15-year old in-school adolescents in six Caribbean countries. The total sample included 9948 school children aged primarily 13-16 years from nationally representative samples from six Caribbean countries. Univariate and multivariate analyses were conducted to assess the relationship between early sexual debut and substance use, unintentional injuries and violence, mental distress, physical activity, protective factors and socio-economic status variables. Approximately one-fourth of the sample (26.9%) had experienced sexual debut before age 15 years, 37.2% among boys and 16.9% among girls. In multivariate logistic regression analysis, it was found that male gender, substance use (smoking and alcohol use), having been in a physical fight in the past 12 months, sedentary behaviour, truancy and lack of parental or guardian attachment were associated with early sexual debut. This study found a high prevalence of early sexual debut. The risk factors identified were consistent with the Problem Behaviour Theory, which can be incorporated into broader sexual health promotion programmes.
Parkes, Alison; Wight, Daniel; Henderson, Marion; West, Patrick
Negative effects of early sexual debut on academic outcomes can extend beyond secondary school, although concurrent changes in other psychosocial risk factors have not been investigated. Data from three waves of a longitudinal survey of Scottish teenagers were used to examine associations between early sexual debut (first heterosexual intercourse) and both expectations for (N=5,061) and participation in (N=2,130) tertiary education at college or university. Early debut was associated with reduced tertiary education, after adjusting for academic performance and wave 1 confounders relating to social background, attitudes and behaviours. Pregnancy/partner pregnancy did not explain all of this finding, as many sexually experienced teenagers opted out of tertiary education after leaving school early for other reasons. Changes in other psychosocial risk factors between waves 1 and 2 mediated much of the association found. Early sexual experience may predict disengagement from tertiary education, although further research is needed to explore causal pathways.
Thin Zaw, Phyu Phyu; Liabsuetrakul, Tippawan; McNeil, Edward; Htay, Thien Thien
Globally, the proportion of youths has been steadily increasing, especially in Asia. This vulnerable population has limited exposure to sexual and reproductive health (SRH) information leading to various reproductive health (RH) problems including risky sexual debut, unwanted pregnancy, unsafe abortion as well as STI/HIV infections. Among known social variations which influence youth's RH, gender differences are critical for planning necessary gender appropriate interventions. This study aimed to identify gender differences in exposure to SRH information and risky sexual debut as well as associated factors among Myanmar youths in poor suburban communities of Mandalay City. A total of 444 randomly selected youths (aged 15-24 years) from all poor, suburban communities in Mandalay City took part in our survey. Gender differences in exposure to SRH information and risky sexual debut were assessed by bivariate analysis. Multivariate logistic regression was used to confirm gender differences and identify independent factors associated with main outcomes separately for males and females as well as for both. Of 444 youths interviewed, 215 were males and 229 were females. Gender differences were seen in both exposures to SRH information (p = 0.013) and risky sexual debut (p = 0.003). These gender differences were confirmed by multivariate analysis even after adjusting for other risk factors. For exposure to SRH information, only age group and schooling status were significant factors for females. As well as those two factors, media exposure and parental guardianship were significant factors among males. Only positive norm of premarital sex increased the likelihood of risky sexual debut among males. In contrast, unwillingness at sexual debut was a risk factor and a higher education level was a protective factor for risky sexual debut among females. Limited exposure to SRH information and high risky sexual debut among poor youths were found. There were different influential
Mårdh, P A; Creatsas, G; Guaschino, S; Hellberg, D; Henry-Suchet, J
To investigate whether women who made an early sexual debut differ from those with a later debut regarding genital signs and symptoms. The study included women who considered themselves gynecologically healthy and who attended 17 family planning centers in 13 European countries for contraceptive advice. There were 629 women who made their sexual debut at the age of 16 years or earlier (study population) and 927 women who had their first sexual intercourse at the age of 19 years or later (comparison group). Genital symptoms and signs, contraceptive use, smoking, and genital hygiene habits and previous genital infections were recorded on a structured patient record form. Detection of Chlamydia trachomatis was made by means of a polymerase chain reaction on first-void urine. The study was made, on average, 7-10 years after the women's sexual debut. The mean age of first intercourse was 15.3 years for the study group versus 20.7 years for the control group (p hygiene. The prevalence of C. trachomatis infection did not differ between the two groups (p = 0.22). Age at first intercourse is not only a predictor of sexual risk behavior, but also a predictor, regarding both signs and symptoms, of future gynecological problems.
T. Rubio; M. T. Gaztelu; A. Calvo; M. Repiso; H. Sarasíbar; F. Jiménez Bermejo; A. Martínez Echeverría
La tuberculosis abdominal cursa con un cuadro inespecífico, con difícil diagnóstico diferencial respecto a otras entidades de similar semiología. Presentamos el caso de un varón que ingresa por presentar dolor abdominal, pérdida progresiva y notoria de peso corporal y fiebre de dos meses de evolución. El cultivo de la biopsia de colon mostró presencia de bacilo de Koch.Abdominal tuberculosis develops according to a non-specific clinical picture, with a difficult differential diagnosis with re...
José A. Varón Rico
Full Text Available La tuberculosis se puede evitar en el niño en varias formas: en primer lugar se puede hacer una profilaxis que se llama de disposición, o sea, como la consideran los autores alemanes, mediante las prácticas de una puericultura bien realizada, ojalá en todas las clases sociales, su nutrición, sus hábitos higiénicos y dietéticos correctos, se va levantando por medio de ello resistencia no sólo a la tuberculosis sino a todas las enfermedades.
Follow-up though Dec 31, 2002 has been completed for a study of site-specific cancer mortality among tuberculosis patients treated with artificial lung collapse therapy in Massachusetts tuberculosis sanatoria (1930-1950).
Tuberculosis (TB) in animals and humans may result from exposure to bacilli within the Mycobacterium tuberculosis complex (i.e., M. tuberculosis, M. bovis, M. africanum, M. pinnipedii, M. microti, M. caprae, or M. canetti) . Mycobacterium bovis is the species most often isolated from tuberculous cat...
Jun 20, 2012 ... Key words: Congenital tuberculo- sis, case report, miliary tuberculosis. Introduction. Congenital tuberculosis defines tuberculosis in infants of .... tary TB and otitis media, resulting in seizures, deafness, and death. It is therefore not surprising that the index case who presented at twelve weeks of age, had ...
Doença pulmonar por Mycobacterium tuberculosis e micobactérias não-tuberculosas entre pacientes recém-diagnosticados como HIV positivos em Moçambique, África Mycobacterium tuberculosis and nontuberculous mycobacterial isolates among patients with recent HIV infection in Mozambique
Elizabete Abrantes Nunes
Full Text Available OBJETIVO: A micobacteriose é frequentemente diagnosticada entre pacientes infectados pelo HIV. Em Moçambique, onde apenas um pequeno número de pacientes encontra-se sob tratamento anti-retroviral, e a tuberculose tem alta prevalência, existe a necessidade de melhor caracterização destes agentes bacterianos, em nível de espécie, bem como de se caracterizar os padrões de resistência às drogas antituberculosas. MÉTODOS: Em uma coorte de 503 indivíduos HIV positivos suspeitos de tuberculose pulmonar, 320 apresentaram positividade para baciloscopia ou cultura no escarro e no lavado brônquico. RESULTADOS: Bacilos álcool-ácido resistentes foram detectados no escarro em 73% dos casos com cultura positiva. De 277 isolados em cultura, apenas 3 mostraram-se tratar de micobactérias não-tuberculosas: 2 Mycobacterium avium e uma M. simiae. Todos os isolados de M. tuberculosis inicialmente caracterizados através de reação em cadeia de polimerase (RCP do gene hsp65 foram posteriormente caracterizados como tal através de RCP do gene gyrB. Resistência à isoniazida foi encontrada em 14% dos casos; à rifampicina em 6%; e multirresistência em 5%. Pacientes previamente tratados para tuberculose mostraram tendência a taxas maiores de resistência às drogas de primeira linha. O padrão radiológico mais freqüente encontrado foi o infiltrado intersticial (67%, seguido da presença de linfonodos mediastinais (30%, bronquiectasias (28%, padrão miliar (18% e cavidades (12%. Os pacientes infectados por micobactérias não-tuberculosas não apresentaram manifestações clínicas distintas das apresentadas pelos outros pacientes. A mediana de linfócitos CD4 entre todos os pacientes foi de 134 células/mm³. CONCLUSÕES: Tuberculose e AIDS em Moçambique estão fortemente associadas, como é de se esperar em países com alta prevalência de tuberculose. Embora as taxas de resistência a drogas sejam altas, o esquema isoniazida
Nicolás Drolett SF.; Nicolás Drolett SF.; Nakita Reyes J.; Dr. Marcelo Zamorano D.
RESUMEN INTRODUCCIÓN: El absceso del psoas (AP) es una patología infrecuente de difícil diagnóstico. Se clasifica en primario o secundario teniendo como factor de riesgo común la inmunodeficiencia. PRESENTACIÓN DEL CASO: Paciente masculino de 40 años sin antecedentes mórbidos. Consulta por cuadro de un mes de evolución caracterizado por dolor lumbar derecho que aumenta al flexionar el muslo ipsilateral. Se asocia compromiso del estado general, dolor abdominal, sensació...
Nagi, B.; Kochhar, R.; Bhasin, D.K.; Singh, K.
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.)
O'Hara, Ross E; Gibbons, Frederick X; Gerrard, Meg; Li, Zhigang; Sargent, James D
Early sexual debut is associated with risky sexual behavior and an increased risk of unplanned pregnancy and sexually transmitted infections later in life. The relations among early movie sexual exposure (MSE), sexual debut, and risky sexual behavior in adulthood (i.e., multiple sexual partners and inconsistent condom use) were examined in a longitudinal study of U.S. adolescents. MSE was measured using the Beach method, a comprehensive procedure for media content coding. Controlling for characteristics of adolescents and their families, analyses showed that MSE predicted age of sexual debut, both directly and indirectly through changes in sensation seeking. MSE also predicted engagement in risky sexual behaviors both directly and indirectly via early sexual debut. These results suggest that MSE may promote sexual risk taking both by modifying sexual behavior and by accelerating the normal rise in sensation seeking during adolescence.
... Education & Training Home Conditions Tuberculosis (TB) Tuberculosis: Treatment Tuberculosis: Treatment Make an Appointment Refer a Patient Ask ... or bones is treated longer. NEXT: Preventive Treatment Tuberculosis: Diagnosis Tuberculosis: History Clinical Trials For more than ...
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Full Text Available Abstract Background Experiences at sexual debut may be linked to reproductive health later in life. Additionally, young women with older sexual partners may be at greater risk for HIV and sexually transmitted infections. This study examines sexual debut with an older partner and subsequent reproductive health outcomes among 599 sexually experienced women aged 15–24 who utilized voluntary counseling and testing or reproductive health services in Port-au-Prince, Haiti. Methods Logistic regression models, controlling for socioeconomic and demographic factors, examined whether age differences at first sex were significantly associated with STI diagnosis in the previous 12 months and family planning method use at last intercourse. Results Sixty-five percent of women reported sexual initiation with a partner younger or less than 5 years older, 28% with a partner 5 to 10 years older, and 7% with a partner 10 or more years older. There was a trend towards decreased likelihood of recent use of family planning methods in women who had first sexual intercourse with a partner 5 to 9 years older compared to women with partners who were younger or less than 5 years older. Age differences were not linked to recent STI diagnosis. Conclusion Programs focusing on delaying sexual debut should consider age and gender-based power differentials between younger women and older men. Future research should examine whether wide age differences at sexual debut are predictive of continued involvement in cross-generational relationships and risky sexual behaviors and explore the mechanisms by which cross-generational first sex and subsequent reproductive health may be connected.
Full Text Available Tuberculosis is still a significant health problem in the world, mostly in developing countries. The special significance lies in immunocompromised patients, particularly those suffering from the HIV. Urogenital tuberculosis is one of the most common forms of extrapulmonary tuberculosis, while the most commonly involved organ is the kidney. Renal tuberculosis occurs by hematogenous dissemination of mycobacterium tuberculosis from a primary tuberculosis foci in the body. Tuberculosis is characterized by the formation of pathognomonic lesions in the tissues - granulomata. These granulomata may heal spontaneously or remain stable for years. In certain circumstances in the body associated with immunosuppression, the disease may be activated. Central caseous necrosis occurs within tuberculoma, leading to formation of cavities that destroy renal parenchyma. The process may gain access to the collecting system, forming the caverns. In this way, infection can be spread distally to renal pelvis, ureter and bladder. Scaring of tissue by tuberculosis process may lead to development of strictures of the urinary tract. The clinical manifestations are presented by nonspecific symptoms and signs, so tuberculosis can often be overlooked. Sterile pyuria is characteristic for urinary tuberculosis. Dysuric complaints, flank pain or hematuria may be presented in patients. Constitutional symptoms of fever, weight loss and night sweats are presented in some severe cases. Diagnosis is made by isolation of mycobacterium tuberculosis in urine samples, by cultures carried out on standard solid media optimized for mycobacterial growth. Different imaging studies are used in diagnostics - IVU, CT and NMR are the most important. Medical therapy is the main modality of tuberculosis treatment. The first line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide and ethambutol. Surgical treatment is required in some cases, to remove severely damaged kidney, if
Brown, Monique J.; Masho, Saba W.; Perera, Robert A.; Mezuk, Briana; Cohen, Steven A.
Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the associatio...
Pastor Durán, Xavier
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..
Shoko, Mercy; Ibisomi, Latifat; Levin, Jonathan; Ginsburg, Carren
SummaryThis study examined the relationship between orphanhood status, living arrangements and sexual debut. The study is important in the context of southern Africa, where a substantial number of children live apart from their parents because the parent is dead or living elsewhere, and where female adolescents face disproportionate sexual and reproductive health risks. Data for female adolescents were taken from Demographic and Health Surveys conducted in seven southern African countries. Unadjusted and adjusted hazard ratios of sexual debut were estimated using Cox Proportional Hazard models. The results from multivariate analyses showed that non-co-residence with biological parents was significantly associated with higher risk of sexual debut in five of the seven countries. Using pooled data, the results showed that father absence was associated with higher risk of sexual debut - whether the father was deceased or living elsewhere. Interventions to delay sexual debut among female adolescents should seek to promote father-adolescent co-residence and improve access to education.
Huneeus, Andrea; Deardorff, Julianna; Lahiff, Maureen; Guendelman, Sylvia
Although condom use in adolescence is related to higher lifetime educational attainment, the association between primary education (from kindergarten to eighth grade) and adolescent sexual behavior is not well understood. This study examined the association between type of school in which primary education was completed-public, charter, or private-and condom use at sexual debut among Chilean adolescents. Drawing on the 2009 Chilean National Youth Survey, a population-based sample of general community youth aged 15 to 29 years, we conducted a study of the 4217 participants who reported onset of sexual activity during adolescence. Bivariate and multple logistic regression was used to examine the relationship between type of primary school attended (60.1% public, 30.3% charter, and 9.6% private) and condom use at sexual debut while controlling for sociodemographic characteristics and sexual behavior. Compared with students who completed their primary education in private or charter schools, students who completed their primary education in public schools had 1.85 (95% confidence interval, 1.12-3.04) and 1.67 (95% confidence interval, 1.26-2.23) higher odds, respectively, of not using condoms at sexual debut. Odds were similar for students living in urban settings, whereas there were too few students attending private schools in rural areas to allow meaningful estimates. Independent of household income, primary schooling is associated with sexual health behaviors among Chilean adolescents living in urban areas and can serve as a target for public health interventions designed to prevent sexually transmitted infections in adolescence.
enfermedades resultantes. CONCLUSIONES: En conjunto, la evidencia sugiere que el tabaquismo (tanto en la actualidad como en sus inicios se asocia con lo siguiente: el riesgo a infectarse con Mycobacterium tuberculosis, el riesgo de desarrollar tuberculosis, de formas más severas de la misma, y con el riesgo de morir a causa de ella. En muchos casos, hay una fuerte relación dosis-respuesta, tanto en términos de cantidad como de duración del tabaquismo. Estas relaciones incluso se explican mediante el control de variables potencialmente confusoras como la edad, el género, el consumo de alcohol y la enfermedad del VIH.
... Diseases > Lung Disease Lookup > Tuberculosis (TB) Learn About Tuberculosis Tuberculosis (TB) is an airborne bacterial infection caused by the organism Mycobacterium tuberculosis that primarily affects the lungs, although other organs ...
Rabahi, Marcelo Fouad; da Silva, José Laerte Rodrigues; Ferreira, Anna Carolina Galvão; Tannus-Silva, Daniela Graner Schuwartz; Conde, Marcus Barreto
ABSTRACT Tuberculosis treatment remains a challenge due to the need to consider, when approaching it, the context of individual and collective health. In addition, social and economic issues have been shown to be variables that need to be considered when it comes to treatment effectiveness. We conducted a critical review of the national and international literature on the treatment of tuberculosis in recent years with the aims of presenting health care workers with recommendations based on the situation in Brazil and better informing decision-making regarding tuberculosis patients so as to minimize morbidity and interrupt disease transmission. PMID:29340497
Lanier, Yzette; Stewart, Jennifer M; Schensul, Jean J; Guthrie, Barbara J
African American youth continue to be disproportionately affected by HIV. Early sexual debut has been identified as a major determinant of HIV risk. However, emerging research suggests that the overarching context in which first sex occurs may have greater implications for sexual health than simply age alone. The purpose of this exploratory, qualitative study was to better understand the broader context of African Americans' sexual debut. In-depth, semi-structured interviews were conducted with 10 African American men and women aged 18-24 years. Thematic analysis was used to analyze the data. The mean age at sexual debut for the sample was 15.4 (SD = 3.3), and youth framed their sexual debut as positive (50%), negative (30%), and both positive and negative (20%). The majority of youth initiated pre-sex conversations with their partners to gauge potential interest in engaging in sexual activity, and all youth utilized at least one HIV/sexually transmitted infection and pregnancy prevention method. However, most youth failed to talk to their partners prior to sex about their past sexual histories and what the experience meant for their relationship. Key differences emerged between youth who framed the experience as positive and those who framed the experience as negative or both positive and negative in terms of their motivations for initiating sex (i.e., readiness to initiate sex, pressure, and emotionally safety) and post-sex emotions (i.e., remorse and contentment). Findings provide further support for examining the broader sexual context of African American's sexual debut. A more comprehensive understanding of sexual debut will aid in the development and tailoring of sexual risk reduction programs targeting African American youth.
Valencia Molina, Claudia Patricia; Canaval Erazo, Gladys Eugenia; Sevilla Peñuela, Teresita María; Orcasita Pineda, Linda Teresa
This work sought to understand sexual debut as a transitional process in the lives of a group of young adults and to interpret the meaning of this transition for them. This was a qualitative research with 18 life stories of students from different socio-economic backgrounds and with diverse sexual orientations. According to the middle-range theory of transitions, sexual debut can be considered a developmental transition. The initiative can be their own, motivated by desire, or coerced by pressure from a partner or peers in which case underlay power relations either by age or hierarchy. Its features are shaped by the individual's abilities, knowledge, and uncertainties, as much as by the circumstances surrounding the event and the socio-cultural precepts towards the topic. It is valued as a healthy transitional process when it is agreed upon by both members of the couple, planned and flows into symmetrical relations. The theory of transitions and analysis of the context are useful in understanding the phenomenon because the subjective experience is framed within normative, appreciative, and socio-cultural constructions. Nursing, as discipline, requires elements like those provided by this research to interpret the dynamics, meanings, as well as subjective and social processes in the sexual evolution of people in different contexts and historical moments.
Mirza, M.R.; Sarwar, M.
Tuberculosis is a world wide communicable disease caused by tubercle bacilli discovered by Robert Kock in 1882. In 1993 WHO declared TB as a global emergency due to its world wide resurgence. It can involve any organ of the body. Abdomen is the fourth commonest site of involvement in the extra pulmonary tuberculosis after the lymph-nodes, skeletal and Genito urinary variants. In the gastro intestinal tract tuberculosis can affect any part from the mouth to the anus but ileocaecal area is a favourite location. Duodenal involvement is uncommon and accounts for only 2.5% of tuberculous enteritis. Major pathogens are Mycobacterium Tuberculosis and bovis and the usual route of entry is by direct penetration of the intestinal mucosa by swallowed organisms. (author)
... Increase in HIV infections Increase in number of homeless people (poor environment and nutrition) Drug-resistant strains ... Disease Control and Prevention/Infectious Diseases Society of America ... guidelines: treatment of drug-susceptible tuberculosis. ...
Sáenz-Gómez, Jessica; Karam Bechara, José; Jamaica Balderas, Lourdes
Perinatal tuberculosis is acquired during birth or during the early neonatal period. Although its incidence is unknown, a search was conducted in Medline and 28 cases were found of perinatal tuberculosis reported from 1983 to 2011. Diagnosis of this disease is important due to having nonspecific symptoms that are mistaken for other infectious diseases. The disease has a high mortality rate (60%); therefore, it requires prompt diagnostic suspicion by the medical staff to prevent a fatal outcome. We describe the case of a 3-month-old male whose 29-year-old mother died of septic shock at 15 days of delivery. The infant's condition began within 30 days of age with cough and difficulty breathing with a diagnosis of multiple foci pneumonia. The infant presented respiratory impairment, meriting change of antibiotics twice, without improvement. The autopsy report of the mother revealed peritoneal tuberculosis. PCR was carried out using tracheal aspirate and pleural fluid of the patient, which were positive for Mycobacterium tuberculosis. Perinatal diagnosis of tuberculosis was established. No hepatic granuloma was found. Perinatal infection should be suspected in children with sepsis and/or pneumonia unresponsive to antibiotics. In this care, the history of tuberculosis in the mother should have oriented the diagnosis. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.
Sara Malou Strandvad
Full Text Available AbstractIn this article, the question of the auteur is transferred from film criticism to filmmaking processes in order to analyze how production practices are organized. By doing so, the article shifts the focus from understanding the concept of the auteur from a textual perspective to a sociological analysis, where the concept is understood as a social resource that enables and structures certain kinds of interactions. Accordingly, the article investigates how the ideal of the auteur is invoked in a dual case study of the making of two Danish debut films. In both projects, the directors embody the motif of the project and the auteur notion thereby comes to be activated as an organizing device. The analysis shows that putting the auteur notion to use to organize the making of films has various consequences, not all of which are intended and beneficial.
Sara Malou Strandvad
Full Text Available Abstract In this article, the question of the auteur is transferred from film criticism to filmmaking processes in order to analyze how production practices are organized. By doing so, the article shifts the focus from understanding the concept of the auteur from a textual perspective to a sociological analysis, where the concept is understood as a social resource that enables and structures certain kinds of interactions. Accordingly, the article investigates how the ideal of the auteur is invoked in a dual case study of the making of two Danish debut films. In both projects, the directors embody the motif of the project and the auteur notion thereby comes to be activated as an organizing device. The analysis shows that putting the auteur notion to use to organize the making of films has various consequences, not all of which are intended and beneficial.
Koch, Anastasia; Mizrahi, Valerie
In this infographic, the genetics, phylogeny, physiology, and pathogenesis mechanisms of Mycobacterium tuberculosis are shown. Mycobacterium tuberculosis is the etiological agent of tuberculosis (TB), the leading cause of death due to a single infectious agent, claiming 1.7 million lives in 2016. Of the deaths attributable to TB in 2016, 22% occurred in people coinfected with HIV, and close to 5% of the 10.4 million incident cases of this disease were resistant to at least two of the first-line TB drugs. In this infographic, we describe the fundamental features of the genetics, phylogeny, and physiology of this member of the phylum Actinobacteria, which is associated increasingly with drug resistance mediated by mutations and rearrangements in its single, circular chromosome. We also highlight the key pathogenesis mechanisms employed by this slow-growing, facultative intracellular bacterium, which include avoidance of host cell clearance by arrest of the normal macrophage maturation process. Copyright © 2018 Elsevier Ltd. All rights reserved.
Oliveira, E; Oliveira, A; Costa, A; Sa, L; Vieira, A; Oliveira, A
A 37 year old woman with duodenal ulcer not responsive to medical treatment was operated. Antrectomy, truncal vagotomy and Bilroth II gastrojejunostomy were performed. The histopathology revealed epithelioid cell granulomas with multinucleated cells and central ceseation, in the gastric side of the pylorus and in three isolated lymph nodes. With Ziehl-Neelsen staining there were multiple acid-fast bacilli. There was no evidence or previous history, personal or familial, or tuberculosis in an other localization. Epidemiology, pathology, diagnosis, and treatment of gastric tuberculosis are discussed according to the literature.
Durowade, Kabir Adekunle; Babatunde, Oluwole Adeyemi; Omokanye, Lukman Omotayo; Elegbede, Olusegun Elijah; Ayodele, Lawrence Majekodunmi; Adewoye, Kayode Razaq; Adetokunbo, Stella; Olomofe, Charles O; Fawole, Adegboyega A; Adebola, Oyebola Eyitayo; Olaniyan, Temitope O
Early adolescent sexual activity remains a recurring problem with negative psychosocial and health outcomes. The age at sexual debut varies from place to place and among different individuals and is associated with varying factors. The aim was to determine the prevalence and risk factors of early sexual debut among secondary school students in Ido-Ekiti, South-West Nigeria. This was a cross-sectional study. The respondents were selected using multi-stage sampling technique. Pre-tested, semi-structured, self-administered questionnaire was used to collect data. Data was analyzed using SPSS version 15. More than two-thirds, 40(67.8%), had early sexual debut. The prevalence of early sexual debut was about 11%. The mean age of sexual debut was 13.10±2.82; the mean age for early sexual debutants was 11.68±1.98. The mean number of sexual partners was 2.44±1.99. Male gender, having friends who engaged in sexual activities had association with early sexual exposure (p<0.05). Alcohol intake had the strongest strength of association for early sexual debut among the students. The high prevalence of early sexual exposure among the students calls for urgent interventions to stem the trend. This will help to reduce the devastating negative psycho-social and health sequels.
Conclusiones: La infección perinatal debe sospecharse en niños con sepsis o neumonía sin respuesta a antibióticos. En este caso, el antecedente de la madre con tuberculosis orientó al diagnóstico.
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
Method: Through an internet search and review of current literature on tuberculosis and its ocular complications, the information relevant to the objectives was obtained. ' Conclusions: TB can affect any structure in the eye and adnexae. Ocular TB is not easy to diagnose because most times there is no concurrent active ...
Zhang, Susan; Burns-Huang, Kristin E; Janssen, Guido V; Li, Huilin; Ovaa, Huib; Hedstrom, Lizbeth; Darwin, K Heran
The protein degradation machinery of Mycobacterium tuberculosis includes a proteasome and a ubiquitin-like protein (Pup). Proteasome accessory factor A (PafA) attaches Pup to proteins to target them for degradation by the proteasome. Free Pup is unstable and never observed in extracts of M. tuberculosis , an observation that led us to hypothesize that PafA may need alternative sources of Pup. Here, we show that PafA can move Pup from one proteasome substrate, inositol 1-phosphate synthetase (Ino1), to two different proteins, malonyl coenzyme A (CoA)-acyl carrier protein transacylase (FabD) and lonely guy (Log). This apparent "transpupylation" reaction required a previously unrecognized depupylase activity in PafA, and, surprisingly, this depupylase activity was much more efficient than the activity of the dedicated depupylase Dop (deamidase of Pup). Thus, PafA can potentially use both newly synthesized Pup and recycled Pup to doom proteins for degradation. IMPORTANCE Unlike eukaryotes, which contain hundreds of ubiquitin ligases, Pup-containing bacteria appear to have a single ligase to pupylate dozens if not hundreds of different proteins. The observation that PafA can depupylate and transpupylate in vitro offers new insight into how protein stability is regulated in proteasome-bearing bacteria. Importantly, PafA and the dedicated depupylase Dop are each required for the full virulence of Mycobacterium tuberculosis Thus, inhibition of both enzymes may be extremely attractive for the development of therapeutics against tuberculosis. Copyright © 2017 Zhang et al.
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 ...
... Alt+0 Navigation Alt+1 Content Alt+2 Tuberculosis (TB) Menu Tuberculosis The End TB Strategy Areas ... data News, events and features About us Global tuberculosis report 2017 WHO has published a global TB ...
Fatores associados ao início da vida sexual de adolescentes matriculados em uma unidade de saúde da família da zona leste do Município de São Paulo, Brasil Factors associated with sexual debut among adolescents enrolled in a family health unit in East Side São Paulo, Brazil
Ana Luiza Vilela Borges
Full Text Available Com o objetivo de analisar os aspectos individuais e familiares associados ao início da vida sexual, foram entrevistados, entre junho e dezembro de 2002, 383 adolescentes solteiros entre 15 e 19 anos de idade, residentes na área de abrangência de uma unidade de saúde da família da zona leste do Município de São Paulo, Brasil. Os dados foram analisados por meio de regressão logística múltipla separadamente para homens e mulheres. Os resultados mostraram que o namoro e a idade foram associados ao início da vida sexual dos adolescentes. No entanto, somente entre os homens, observou-se como fatores associados variáveis relacionadas aos pais e mães e, apenas entre as mulheres, variáveis relacionadas à propriedade do domicílio e aos irmãos. Dessa forma, o namoro e as questões familiares, tais como os valores parentais no tocante às práticas sexuais de adolescentes e a presença de irmão(ã que já passou por gravidez antes de uma união, são aspectos que necessitam ser incorporados na formulação de políticas de saúde reprodutiva e sexual voltadas aos adolescentes, pois mostraram ser determinantes na iniciação sexual dos jovens entrevistados.This study aimed to analyze the individual and family factors associated with sexual debut among adolescents. From June to December 2002, a cross-sectional study was conducted with 383 15-19-year-old single adolescents enrolled in a family health unit on the East Side of the city of São Paulo, Brazil. Multiple logistic regression analysis was conducted separately for males and females. Dating and age were positively associated with sexual debut for both boys and girls. Parental factors were only associated with male sexual debut, while factors related to siblings and housing were only associated with female sexual debut. Thus, dating and family factors like parents' opinions on sexual practices in adolescence and having a sibling with a history of teenage pregnancy are aspects that need
Infante Barrera, Francisco
La evolución etiológica de la medicina la podemos dividir en dos grandes períodos: período de la sífilis y período de la tuberculosis. El período de la sífilis, gracias a las armas de combate de que hoy disponemos, ocupa un lugar secundario. El período de la tuberculosis y que no es sino el paralelo de la vida moderna, ocupa en vigencia el primer lugar. Es el período presente. Hasta hace poco tiempo el médico en general, iniciaba la exploración de su paciente con un interrogatorio, una inspec...
Cox, Mary F
Parenting style may be a determinant in reducing adolescent risk behavior. Previous studies have relied on a typological parenting approach, with classification into four groups: authoritative, authoritarian, permissive, and neglectful. In this study, two distinct parenting dimensions, demandingness and responsiveness, were examined as independent predictors of adolescent condom use. This study used a subsample of the National Longitudinal Study of Adolescent Health (Add Health) that included 153 adolescent-mother pairs. Maternal demandingness and responsiveness were measured using Wave I mother interviews. Logistic regression analyses were used to predict adolescent condom use at sexual debut at Wave II and to assess moderation by gender and race. (1) Maternal demandingness predicted increased likelihood of condom use in African American adolescents but decreased likelihood of condom use in White adolescents; (2) maternal responsiveness did not predict condom use; and (3) gender moderation was not present. To provide appropriate family counseling, public health nurses need to consider racial differences in contraceptive practices. Education regarding parental supervision practices should be considered as part of nursing interventions intended to increase condom use in African American adolescents.
HIV-associated tuberculous lymphadenitis: the importance of polymerase chain reaction (PCR as a complementary tool for the diagnosis of tuberculosis - a study of 104 patients Linfadenite tuberculosa associada ao HIV: a importância da reação em cadeia de polimerase (PCR como ferramenta complementar para o diagnóstico da tuberculose - estudo de 104 pacientes
Marcio Valle Cortez
ções associadas a essa condição é complexo, especialmente em relação à tuberculose. A detecção rápida e específica do Mycobacterium tuberculosis (M. tuberculosis é essencial para o tratamento adequado. Além disso, frequentes causas de linfadenites tais como as relacionadas a linfoma, histoplasmose, e outras, devem ser afastadas. OBJETIVOS: Avaliar a importância da biópsia cirúrgica excisional das linfadenites e realização dos exames histopatológicos, exames baciloscópicos (Ziehl-Neelsen, cultura (Lowenstein-Jensen e reação em cadeia da polimerase (PCR com finalidade diagnostica MÉTODOS: Desenvolveu-se um protocolo para biópsias excisionais de linfonodos, adotando-se os seguintes procedimentos: exame direto de esfregaços corados pelo método de Ziehl-Neelsen, cultura em meio de Lowenstein-Jensen, exame anátomo-patológico e PCR. RESULTADOS: Ao todo foram incluídos 104 pacientes, e o exame histopatológico evidenciou 36% (n = 38 pacientes de casos de linfadenite crônica inespecífica, 26% (n = 27 de linfadenite tuberculosa, 10,5% (n =11 de linfoma e 8,7% (n = 9 de histoplasmose. Através da cultura no meio de Lowenstein-Jensen, os casos positivos para linfadenite tuberculosa aumentaram para 30%. A PCR detectou M. tuberculosis em 6 das 38 amostras de linfadenite crônica inespecífica. Três desses pacientes foram acompanhados, exibiram sintomas de tuberculose e foram curados após tratamento específico. CONCLUSÃO: Os dados obtidos neste trabalho sugerem que em todos os casos de linfadenopatia deve-se realizar exame histopatológico, cultura em Lowenstein-Jensen ou Ogawa e reação em cadeia da polimerase. A reação em cadeia da polimerase pode ser útil na detecção precoce e acurada de casos de TB extrapulmonar nos pacientes HIV-positivos com linfadenopatias, evitando-se o uso de tratamentos empíricos e o eventual desenvolvimento de cepas resistentes.
Tuberculose como doença definidora de síndrome da imunodeficiência adquirida: dez anos de evolução na Cidade do Rio de Janeiro Tuberculosis as a disease defining acquired immunodeficiency syndrome: ten years of surveillance in Rio de Janeiro, Brazil
Elizabeth Cristina Coelho Soares
Full Text Available OBJETIVO: Analisar a freqüência da tuberculose e das outras principais doenças oportunistas definidoras de síndrome da imunodeficiência adquirida, no momento em que estes casos são notificados, no Município do Rio de Janeiro. MÉTODOS: Análise do banco de dados do Sistema de Vigilância Epidemiológica do Programa de Doenças Sexualmente Transmissíveis e Síndrome da Imunodeficiência Adquirida da Cidade do Rio de Janeiro, no período de 1993 a 2002. RESULTADOS: A expansão da definição de casos de síndrome da imunodeficiência adquirida ocorrida em 1998 criou um aumento substancial no número de casos notificados de síndrome da imunodeficiência adquirida, principalmente por aqueles que passaram a ser definidos pelo critério imunológico. Dentre os casos de síndrome da imunodeficiência adquirida que foram definidos apenas por doença, a candidíase em suas diversas formas manteve-se como a doença oportunista de maior freqüência no momento da notificação. Embora a pneumonia por Pneumocystis carinii se apresentasse como a segunda doença mais freqüente na maioria dos anos observados, a partir de 2001, a tuberculose ultrapassou-a em freqüência, tornando-se a segunda doença mais freqüente no momento da notificação dos casos de síndrome da imunodeficiência adquirida. CONCLUSÃO: Apesar da diminuição do número de casos de síndrome da imunodeficiência adquirida definidos por doença, a tuberculose manteve-se como um importante evento definidor dessa síndrome, sendo atualmente de ocorrência mais freqüente do que a pneumonia por Pneumocystis carinii e a toxoplasmose, provavelmente por sua alta taxa de prevalência na cidade.OBJECTIVE: To analyze the frequency of tuberculosis and of the other principal opportunistic infections defining acquired immunodeficiency syndrome at the time such cases were reported in the city of Rio de Janeiro, Brazil. METHODS: Analysis of the data compiled in the Rio de Janeiro Municipal
Suarez, Tatiana; Garcia, Vanessa; Tamara, Estrada; Acosta, Federico
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
Namugenyi, Sarah B; Aagesen, Alisha M; Elliott, Sarah R; Tischler, Anna D
The Mycobacterium tuberculosis phosphate-specific transport (Pst) system controls gene expression in response to phosphate availability by inhibiting the activation of the SenX3-RegX3 two-component system under phosphate-rich conditions, but the mechanism of communication between these systems is unknown. In Escherichia coli , inhibition of the two-component system PhoR-PhoB under phosphate-rich conditions requires both the Pst system and PhoU, a putative adaptor protein. E. coli PhoU is also involved in the formation of persisters, a subpopulation of phenotypically antibiotic-tolerant bacteria. M. tuberculosis encodes two PhoU orthologs, PhoY1 and PhoY2. We generated phoY single- and double-deletion mutants and examined the expression of RegX3-regulated genes by quantitative reverse transcription-PCR (qRT-PCR). Gene expression was increased only in the Δ phoY1 Δ phoY2 double mutant and could be restored to the wild-type level by complementation with either phoY1 or phoY2 or by deletion of regX3 These data suggest that the PhoY proteins function redundantly to inhibit SenX3-RegX3 activation. We analyzed the frequencies of antibiotic-tolerant persister variants in the phoY mutants using several antibiotic combinations. Persister frequency was decreased at least 40-fold in the Δ phoY1 Δ phoY2 mutant compared to the frequency in the wild type, and this phenotype was RegX3 dependent. A Δ pstA1 mutant lacking a Pst system transmembrane component exhibited a similar RegX3-dependent decrease in persister frequency. In aerosol-infected mice, the Δ phoY1 Δ phoY2 and Δ pstA1 mutants were more susceptible to treatment with rifampin but not isoniazid. Our data demonstrate that disrupting phosphate sensing mediated by the PhoY proteins and the Pst system enhances the susceptibility of M. tuberculosis to antibiotics both in vitro and during infection. IMPORTANCE Persister variants, subpopulations of bacteria that are phenotypically antibiotic tolerant, contribute to
Bhatti, M.; Hussain, M.; Kumar, D.; Samo, K.A.
Duodenal tuberculosis is an uncommon disease. It may be either extrinsic or intrinsic or both. In the extrinsic type there can either be primary duodenal involvement or compression due to enlarged para duodenal lymph nodes. The clinical presentation can be dyspeptic or obstructive symptoms. The dyspeptic symptoms include epigastric pain, nausea, and occasional vomiting and obstructive symptoms include bilious vomiting frequently after meals, epigastric pain, and generalized abdominal pain. This report describes a young lady presenting with gastric outlet obstruction symptoms due to tuberculous adhesion involving the proximal duodenum. (author)
Dunn, R N; Ben Husien, M
Tuberculosis (TB) remains endemic in many parts of the developing world and is increasingly seen in the developed world due to migration. A total of 1.3 million people die annually from the disease. Spinal TB is the most common musculoskeletal manifestation, affecting about 1 to 2% of all cases of TB. The coexistence of HIV, which is endemic in some regions, adds to the burden and the complexity of management. This review discusses the epidemiology, clinical presentation, diagnosis, impact of HIV and both the medical and surgical options in the management of spinal TB. Cite this article: Bone Joint J 2018;100-B:425-31.
Sánchez-Alemán, Miguel Angel; Uribe-Salas, Felipe Javier; Lazcano-Ponce, Eduardo Cesar; García-Cisneros, Santa; Eguiza-Fano, Sergio; Conde-Glez, Carlos Jesús
Early sexual debut is a behaviour that has been associated with acquiring sexually transmitted infections. Higher schooling may delay sexual debut, thus the university population is categorised with low-risk sexual behaviours. The rate ratio of herpes simplex virus type 2 (HSV-2) seroincidence according to demographic characteristics and sexual behaviour was estimated for a cohort of university students. A dynamic cohort of university students was followed at the Autonomous University of Morelos, in central Mexico, during the years 2001-5. After obtaining informed consent, information was gathered annually regarding demographic characteristics and sexual behaviour and blood samples were obtained to determine HSV-2 antibodies. Seroincidence was estimated and the incidence rate ratio was evaluated using the Poisson regression model. A total of 404 students participated, with 669.2 person-years of follow-up. An incidence of 4.2 cases per 100 person-years was estimated. The variables delayed sexual debut (≥18 years) and multiple sexual partners (two or more sexual partners during the past year) had a rate ratio of 4.1 (95% CI 1.2 to 14.3) and 2.5 (95% CI 1.1 to 5.6), respectively. Incidence for students with delayed sexual debut and multiple partners is estimated to be 10.3 cases per 100 person-years. Delayed sexual debut was a risk factor for acquiring HSV-2, due to a subgroup with sexual debut at 18 years of age or older that had multiple sexual partners; therefore, in the university population that tends to delay sexual debut, it is necessary to implement prevention programmes to promote the decrease of other risky sexual behaviours, as well as the promotion of the consistent use of condoms.
Brown, Monique J.; Masho, Saba W.; Perera, Robert A.; Mezuk, Briana; Cohen, Steven A.
Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the association between ACEs and age at sexual debut. Data were obtained from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic and linear regression model were used to obtain crude and adjusted estimates and 95% confidence intervals adjusting for age, race/ethnicity, income, education, insurance and marital status for the association between ACEs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration and psychopathology) and early sexual debut. Analyses were stratified by sex and sexual orientation. Larger effect estimates depicting the association between ACEs and sexual debut were seen for women compared to men, and among sexual minorities, particularly among men who have sex with men (MSM) and women who have sex with women (WSW), compared to heterosexuals. Sexual health education programs with a focus on delaying sexual debut among children and adolescents should also consider addressing ACEs, such as neglect, physical, psychological and sexual abuse, witnessing parental violence, and parental incarceration and psychopathology. Public health practitioners, researchers and sexual health education curriculum coordinators should consider these differences by sex and sexual orientation when designing these programs. PMID:25804435
Brown, Monique J; Masho, Saba W; Perera, Robert A; Mezuk, Briana; Cohen, Steven A
Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the association between ACEs and age at sexual debut. Data were obtained from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic and linear regression models were used to obtain crude and adjusted estimates and 95% confidence intervals adjusting for age, race/ethnicity, income, education, insurance and marital status for the association between ACEs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration and psychopathology) and early sexual debut. Analyses were stratified by sex and sexual orientation. Larger effect estimates depicting the association between ACEs and sexual debut were seen for women compared to men, and among sexual minorities, particularly among men who have sex with men (MSM) and women who have sex with women (WSW), compared to heterosexuals. Sexual health education programs with a focus on delaying sexual debut among children and adolescents should also consider addressing ACEs, such as neglect, physical, psychological and sexual abuse, witnessing parental violence, and parental incarceration and psychopathology. Public health practitioners, researchers and sexual health education curriculum coordinators should consider these differences by sex and sexual orientation when designing these programs. Copyright © 2015 Elsevier Ltd. All rights reserved.
Full Text Available We report a case of 23-year-old male patient with tuberculosis verrucous cutis on the foot for a duration of six months without responding to routine treatment. Tuberculosis is a common disease worldwide. Extrapulmonary tuberculosis contributes to 10% of cases. Cutaneous tuberculosis occupies a small spectrum of extrapulmonary tuberculosis. Tuberculosis verrucosa cutis is an exogenous infection occurring in a previously sensitized patient by direct inoculation of the organism. It occurs in sensitized patients with a moderate to high immune response. The diagnosis in our patient was confirmed by history, clinical examination, histopathological examination and the patient’s response to anti-tuberculous therapy.
Hallett, T B; Gregson, S; Lewis, J J C; Lopman, B A; Garnett, G P
Sexual behavioural change is essential to prevent HIV infections in Africa and statistical analysis of risk factors at the individual-level may be used to design interventions. The importance of reducing cross-generational sex (young women having sex with older men) and delaying age at first sex on the spread of HIV at the population-level has been presumed but not scientifically investigated and quantified. A mathematical model of heterosexual spread of HIV was developed to predict the population-level impact of reducing cross-generational sex and delaying sexual debut. The impact of behaviour change on the spread of HIV is sensitive to the structure and reaction of the sexual network. Reducing cross-generational sex could have little impact on the risk of infection unless it is accompanied by a reduction in the number of risky sexual contacts. Even peer-to-peer sexual mixing can support high endemic levels of HIV. The benefit of delaying sexual debut is comparatively small and is reduced if males continue to prefer young partners or if young women spend more time unmarried. In Manicaland, Zimbabwe, if older men were to use condoms as frequently as young men, the reduction in risk of infection could exceed that generated by a two-year delay in first sex. At the individual-level avoiding sex with older partners and delaying sexual debut can decrease the risk of infection but at the population-level these interventions may do little to limit the spread of HIV without wider-ranging behavioural changes throughout the sexual network.
- associated tuberculosis, particularly related to national and international evidence- based policy. She is the author of several scientific papers and international policy documents, and serves on various interna- tional tuberculosis expert ...
TUBERCULOSIS www.who.int/tb & DIABETES THE DUAL EPIDEMIC OF TB AND DIABETES DEADLY LINKAGES People with ... higher risk of progressing from latent to active tuberculosis. Diabetes triples a person’s risk of developing TB. ...
Gangopadhyay Asok Kumar
Full Text Available Lymphoedema following cutaneous tuberculosis is a rare occurrence. A case of elephantiasis of leg following lupus vulgaris is presented. It can still be seen in rural India in untreated advanced cutaneous tuberculosis.
and National Tuberculosis and Leprosy Control Program manual. RESULTS: A total of 112 extra pulmonary ... Key words: Clinical audit; extra pulmonary Tuberculosis; National Tuberculosis and. Leprosy Control manual. "Addis Ababa ..... intern influence drug regimen selection. Compliance to the 1997 NTLCP inanual is.
Heda Melinda Nataprawira
supported the diagnosis. There was no positive results of acid fast bacilli and culture done for Mycobacterium tuberculosis in gastric aspirate as well as ascitic fuid. Peritonitis tuberculosis was most commonly diagnosed (80.0%, followed by mesenterial/nodal tuberculosis (20.0%. All of the children followed (60.0% responded well to the drugs therapy.
This hospital based study was done to estimate the magnitude of pulmonary and extra-pulmonary tuberculosis and to determine predictors of tuberculosis ..... Patient`s risk factors associated with increased risk of tuberculosis includes chronic cough, wasting, advanced age, HIV status, Diabetes Mellitus, Malnutrition etc ...
Aug 18, 2009 ... Recombinant and synthetic peptides to identify. Mycobacterium tuberculosis antigens and epitopes of diagnostic and vaccine relevance. Tuberculosis. 85: 367–376. Okkels LM, Andersen P (2004). Protein-protein interactions of proteins from the ESAT-6 family of Mycobacterium tuberculosis. J. Bacteriol.
Full Text Available We conducted a molecular epidemiology study of Mycobacterium tuberculosis strains isolated from patients in Lisbon hospitals. We used restriction fragment length polymorphism (RFLP to detect Lisbon family strains and to determine the genetic diversity of Mycobacterium tuberculosis strains isolated in Lisbon, through identification of the most important risk factors of tuberculosis transmission analysis, with the insertion sequence IS6110 as a probe to fingerprint isolates of Mycobacterium tuberculosis. 64.8% of the 290 Mycobacterium tuberculosis isolates were grouped in clusters. This figure was 60.7% if we excluded strains with five or fewer IS6110 copies. Multidrug-resistance was observed in 4.1% of the strains and they were all in clusters. Forty-five (18.2% strains were included in the Lisbon family. Considering the relatively high percentage of strains in cluster detected in this study, we believe that active transmission is still taking place in Lisbon. Moreover, clusters of Lisbon strains represent the predominant strains circulating in Lisbon and are still related to drug resistance although presenting a lower percentage than that observed in previous studies. Resumo: Foi realizado um estudo de epidemiologia molecular a estirpes de Mycobacterium tuberculosis isoladas em hospitais de Lisboa. Analisaram-se geneticamente os isolados de Mycobacterium tuberculosis com o método restriction fragment length polymorphism (RFLP utilizando a sequência de inserção IS6110 como sonda, com o objectivo de detectar as estirpes da família Lisboa e determinar a diversidade genética das estirpes de Mycobacterium tuberculosis isoladas em Lisboa, identificando os mais importantes factores de risco de transmissão da tuberculose.Foram analisados 290 isolados de Mycobacterium tuberculosis, dos quais 64,8% se encontraram agrupados em clusters; mesmo excluindo as estirpes que apresentaram mais de 5 cópias de IS6110, a percentagem de agrupamento foi de 60
Valenzuela-Jiménez, Hiram; Manrique-Hernández, Edgar Fabian; Idrovo, Alvaro Javier
The combination of tuberculosis with other diseases can affect tuberculosis treatment within populations. In the present study, social network analysis of data retrieved from the Mexican National Epidemiological Surveillance System was used in order to explore associations between the number of contacts and multimorbidity. The node degree was calculated for each individual with tuberculosis and included information from 242 contacts without tuberculosis. Multimorbidity was identified in 49.89% of individuals. The node degrees were highest for individuals with tuberculosis + HIV infection (p edema (p edema pulmonar (p < 0,07). A análise de redes sociais deve ser usada como método-padrão para monitorar a tuberculose e a sindemia relacionada com a tuberculose.
Mendez Rojas, Bomar; Beogo, Idrissa; Owili, Patrick Opiyo; Adesanya, Oluwafunmilade; Chen, Chuan-Yu
Community attributes have been gradually recognized as critical determinants shaping sexual behaviors in young population; nevertheless, most of the published studies were conducted in high income countries. The study aims to examine the association between community social capital with the time to sexual onset and to first birth in Central America. Building upon the 2011/12 Demographic and Health Survey conducted in Nicaragua, we identified a sample of 2766 community-dwelling female adolescents aged 15 to 19 years. Multilevel survival analyses were performed to estimate the risks linked with three domains of community social capital (i.e., norms, resource and social network). Higher prevalence of female sexual debut (norms) and higher proportion of secondary school or higher education (resource) in the community are associated with an earlier age of sexual debut by 47 % (p teen birth (p teen childbearing (p teen-onset sex and birth. The norm and resource aspects of social capital appeared differentially associated with adolescent sexual and reproductive behaviors. Interventions aiming to tackle unfavorable sexual and reproductive outcomes in young people should be devised and implemented with integration of social process.
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.
Lamb, Gabriella S; Starke, Jeffrey R
One million children develop tuberculosis disease each year, and 210,000 die from complications of tuberculosis. Childhood tuberculosis is very different from adult tuberculosis in epidemiology, clinical and radiographic presentation, and treatment. This review highlights the many unique features of childhood tuberculosis, with special emphasis on very young children and adolescents, who are most likely to develop disease after infection has occurred.
Mathema, Barun; Andrews, Jason R; Cohen, Ted; Borgdorff, Martien W; Behr, Marcel; Glynn, Judith R; Rustomjee, Roxana; Silk, Benjamin J; Wood, Robin
Measuring tuberculosis transmission is exceedingly difficult, given the remarkable variability in the timing of clinical disease after Mycobacterium tuberculosis infection; incident disease can result from either a recent (ie, weeks to months) or a remote (ie, several years to decades) infection event. Although we cannot identify with certainty the timing and location of tuberculosis transmission for individuals, approaches for estimating the individual probability of recent transmission and for estimating the fraction of tuberculosis cases due to recent transmission in populations have been developed. Data used to estimate the probable burden of recent transmission include tuberculosis case notifications in young children and trends in tuberculin skin test and interferon γ-release assays. More recently, M. tuberculosis whole-genome sequencing has been used to estimate population levels of recent transmission, identify the distribution of specific strains within communities, and decipher chains of transmission among culture-positive tuberculosis cases. The factors that drive the transmission of tuberculosis in communities depend on the burden of prevalent tuberculosis; the ways in which individuals live, work, and interact (eg, congregate settings); and the capacity of healthcare and public health systems to identify and effectively treat individuals with infectious forms of tuberculosis. Here we provide an overview of these factors, describe tools for measurement of ongoing transmission, and highlight knowledge gaps that must be addressed. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.
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, ...
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
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
Ana Luiza Vilela Borges
Full Text Available Buscou-se descrever a trajetória afetivo-amorosa e razões para o início ou adiamento da vida sexual de adolescentes do sexo masculino, por meio de entrevistas com 184 homens de 15 a 19 anos de idade, residentes no Município de São Paulo, Brasil, em 2002. O início da vida sexual ocorreu, entre outros, por conta da atração física, da curiosidade e do desejo de perder a virgindade, sugerindo um caráter mais próximo do papel social masculino. Por outro lado, a maior parte dos adolescentes virgens justificou sua opção por questões de ordem romântica, como não ter encontrado a pessoa certa ou porque gostaria de casar-se virgem. Os resultados revelaram um duplo padrão social em que há a valorização do sentimento de amor e entrega à pessoa amada simultaneamente à premência física e instintiva para o sexo. Padrões tradicionais de masculinidade, como a dissociação entre sexo e amor, parecem estar sendo transpostos no tocante à iniciação sexual, revelando diversidade nos modos de viver a sexualidade na adolescência que, por sua vez, estão relacionados à saúde sexual e reprodutiva dos homens e suas parcerias.This article describes male adolescents' affective history and reasons for initiating or postponing sexual activity, using interviews with 184 males ages 15 to 19 and residing in the city of São Paulo, Brazil, in 2002. Factors for sexual debut included physical attraction, curiosity, and the desire to lose their virginity, suggesting a profile similar to the male social role. Most of the virgin adolescent males justified their choice based on issues of a romantic order, such as not having found the right person or because they preferred to remain virgin until marrying. The results showed a dual social pattern, valuing the feeling of love and deliverance to the loved one, simultaneously with the pressing physical and instinctive desire for sex. Traditional patterns of masculinity, like the dissociation between sex and
Pittet, Florent; Johnson, Crystal; Hinde, Katie
The age at which females initiate their reproductive career is a critical life-history parameter with potential consequences on their residual reproductive value and lifetime fitness. The age at reproductive debut may be intimately tied to the somatic capacity of the mother to rear her young, but relatively little is known about the influence of age of first birth on milk synthesis within a broader framework of reproductive scheduling, infant outcomes, and other life-history tradeoffs. Our study investigated the predictors of age at first reproduction among 108 captive rhesus macaque (Macaca mulatta) females, and associations with their milk synthesis at peak lactation, infant mass, and ability to subsequently conceive and reproduce. The majority of females reproduced in their fourth year (typical breeders); far fewer initiated their reproductive career one year earlier or one year later (respectively early and late breeders). Early breeders (3-year-old) benefited from highly favorable early life development (better juvenile growth, high dominance rank) to accelerate reproduction, but were impaired in milk synthesis due to lower somatic resources and their own continued growth. Comparatively, late breeders suffered from poor developmental conditions, only partially compensated by their delayed reproduction, and evinced compromised milk synthesis. Typical breeders not only produced higher available milk energy but also had best reproductive performance during the breeding and birth seasons following primiparity. Here, we refine and extend our understanding of how life-history tradeoffs manifest in the magnitude, sources, and consequences of variation in age of reproductive debut. These findings provide insight into primate reproductive flexibility in the context of constraints and opportunities. © 2017 Wiley Periodicals, Inc.
Bomar Mendez Rojas
Full Text Available Abstract Background Community attributes have been gradually recognized as critical determinants shaping sexual behaviors in young population; nevertheless, most of the published studies were conducted in high income countries. The study aims to examine the association between community social capital with the time to sexual onset and to first birth in Central America. Methods Building upon the 2011/12 Demographic and Health Survey conducted in Nicaragua, we identified a sample of 2766 community-dwelling female adolescents aged 15 to 19 years. Multilevel survival analyses were performed to estimate the risks linked with three domains of community social capital (i.e., norms, resource and social network. Results Higher prevalence of female sexual debut (norms and higher proportion of secondary school or higher education (resource in the community are associated with an earlier age of sexual debut by 47 % (p < 0.05 and 16 %, respectively (p < 0.001. Living in a community with a high proportion of females having a child increases the hazard of teen birth (p < 0.001 and resource is negatively associated with teen childbearing (p < 0.05. Residential stability and community religious composition (social network were not linked with teen-onset sex and birth. Conclusions The norm and resource aspects of social capital appeared differentially associated with adolescent sexual and reproductive behaviors. Interventions aiming to tackle unfavorable sexual and reproductive outcomes in young people should be devised and implemented with integration of social process.
Gupta, Vishali; Shoughy, Samir S; Mahajan, Sarakshi; Khairallah, Moncef; Rosenbaum, James T; Curi, Andre; Tabbara, Khalid F
Ocular tuberculosis is an extrapulmonary tuberculous condition and has variable manifestations. The purpose of this review is to describe the clinical manifestations of ocular tuberculosis affecting the anterior and posterior segments of the eye in both immunocompetent and immunocompromised patients. Review of literature using Pubmed database. Mycobacterium tuberculosis may lead to formation of conjunctival granuloma, nodular scleritis, and interstitial keratitis. Lacrimal gland and orbital caseating granulomas are rare but may occur. The intraocular structures are also a target of insult by M. tuberculosis and may cause anterior granulomatous uveitis, anterior and posterior synechiae, secondary glaucoma, and cataract. The bacillus may involve the ciliary body, resulting in the formation of a localized caseating granuloma. Posterior segment manifestations include vitritis, retinal vasculitis, optic neuritis, serpiginous-like choroiditis, choroidal tubercules, subretinal neovascularization, and, rarely, endophthalmitis. The recognition of clinical signs of ocular tuberculosis is of utmost importance as it can provide clinical pathway toward tailored investigations and decision making for initiating anti-tuberculosis therapy.
Janković Slavko M.
Full Text Available The perplexing and tantalizing disease of rapid eye movement (REM sleep behavior disorder (RBD is characterized by peculiar, potentially dangerous behavior during REM sleep. It was described both in animals and humans. RBD in mammals was first described by Jouvet and Delorme in 1965, based on an experimental model induced by lesion in pontine region of cats . In 1972, Passouant et al. described sleep with eye movements and persistent tonic muscle activity induced by tricyclic antidepressant medication , and Tachibana et al., in 1975, the preservation of muscle tone during REM sleep in the acute psychosis induced by alcohol and meprobamate abuse . However, the first formal description of RBD in humans as new parasomnia was made by Schenck et al in 1986 [4-7]. Subsequently, in 1990, the International Classification of Sleep Disorders definitely recognized RBD as new parasomnia . To our knowledge, arts and literature do not mention RBD. Except for the quotation, made by Schenck et al  in 2002, of Don Quixote de la Mancha whose behavior in sleep strongly suggested that Miguel de Servantes actually described RBD, no other artistic work has portrayed this disorder. Only recently we become aware of the cinematic presentation of RBD which by decades precedes the first scientific description. The first presentation of RBD on film was made prior to the era of advanced electroencephalography and polysomnography, and even before the discovery of REM sleep by Aserinsky and Kleitman in 1953. . The artistic and intuitive presentation of RBD was produced in Technicolor in a famous film "Cinderella" created by Walt Disney in 1950, some 35 years prior to its original publication in the journal "Sleep" . Since there is an earlier version of the film initially produced in 1920, presumably containing this similar scene, we can only speculate that the first cinematic presentation of RBD might precede its scientific debut by 65 years. In a scene
Janković, Slavko M; Sokić, Dragoslav V; Vojvodić, Nikola M; Ristić, Aleksandar J
The perplexing and tantalizing disease of rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by peculiar, potentially dangerous behavior during REM sleep. It was described both in animals and humans. RBD in mammals was first described by Jouvet and Delorme in 1965, based on an experimental model induced by lesion in pontine region of cats. In 1972, Passouant et al. described sleep with eye movements and persistent tonic muscle activity induced by tricyclic antidepressant medication, and Tachibana et al., in 1975, the preservation of muscle tone during REM sleep in the acute psychosis induced by alcohol and meprobamate abuse. wever, the first formal description of RBD in humans as new parasomnia was made by Schenck et al in 1986. Subsequently, in 1990, the International Classification of Sleep Disorders definitely recognized RBD as new parasomnia. To our knowledge, arts and literature do not mention RBD. Except for the quotation, made by Schenck et al [n 2002, of Don Quixote de la Mancha whose behavior in sleep strongly suggested that Miguel de Servantes actually described RBD, no other artistic work has portrayed this disorder. Only recently we become aware of the cinematic presentation of RBD which by decades precedes the first scientific description. The first presentation of RBD on film was made prior to the era of advanced electroencephalography and polysomnography, and even before the discovery of REM sleep by Aserinsky and Kleitman in 1953. The artistic and intuitive presentation of RBD was produced in Technicolor in a famous film "Cinderella" created by Walt Disney in 1950, some 35 years prior to its original publication in the journal "Sleep". Since there is an earlier version of the film initially produced in 1920, presumably containing this similar scene, we can only speculate that the first cinematic presentation of RBD might precede its scientific debut by 65 years. In a scene in a barn, clumsy and goofy dog Bruno is, as dogs
S. Rodríguez-Rodríguez; S.J.A. Ruy-Díaz-Reynoso; R. Vázquez-López
The resurgence of tuberculosis and the appearance of multidrug-resistant strains of Mycobacterium tuberculosis are due to several different factors. Principal among these is the worldwide prevalence of autoimmune deficiency syndrome (AIDS), coupled with misdirected therapeutic practices and patient non-compliance, the latter being derived from the undesirable side effects of anti-tuberculosis drugs. Aside from AIDS, other diseases or immunosuppressive disorders have been associated with this ...
Rodrigues, Luis Vaz; Gandara, Judit; Pires, João; Duarte, Raquel; Calvário, Fernando; Dominguez, Miguel; Carvalho, Aurora; Seca, Rui
We report on a patient diagnosed with disseminated (hepatic and pulmonary) tuberculosis in the context of immunosuppression following liver transplant. During the administration of anti-tuberculosis drugs an abrupt elevation of liver enzymes was detected leading us to suspect drug toxicity rather than graft rejection. Nevertheless, careful surveillance and adjustment of serum levels of immunosuppressant drugs permitted continuance of tuberculosis treatment with no further side effects.
Louise Cilliers; François Retief
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...
Munir, M.K.; Iqbal, R.; Shabbir, I.; Chaudhry, K
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)
Mansour, Ahmad M.; Tabbara, Khalid F.; Tabbarah, Zuhair
We present a healthy male subject who developed progressive visual loss in the left eye initially diagnosed as optic neuritis. Upon suspicion of infectious etiology, testing was positive for tuberculosis. There were no signs or symptoms of active systemic tuberculosis infection. The patient responded swiftly to antimycobacterial therapy with return of vision and resolution of disc swelling. Positive purified protein derivative skin test, negative chest radiograph, negative systemic workup, negative workup for other causes of unilateral optic neuritis and quick response to mycobacterial therapy reaffirm the entity of isolated optic disc tuberculosis similar to isolated choroidal tuberculosis without systemic manifestation. PMID:26483675
Ahmad M. Mansour
Full Text Available We present a healthy male subject who developed progressive visual loss in the left eye initially diagnosed as optic neuritis. Upon suspicion of infectious etiology, testing was positive for tuberculosis. There were no signs or symptoms of active systemic tuberculosis infection. The patient responded swiftly to antimycobacterial therapy with return of vision and resolution of disc swelling. Positive purified protein derivative skin test, negative chest radiograph, negative systemic workup, negative workup for other causes of unilateral optic neuritis and quick response to mycobacterial therapy reaffirm the entity of isolated optic disc tuberculosis similar to isolated choroidal tuberculosis without systemic manifestation.
Ablin, D.S.; Jain, K.A.; Azouz, E.M.
Four boys with abdominal tuberculosis, one of whom had acquired immunodeficiency syndrome, are presented. Abdominal imaging findings on plain radiography, ultrasonography, computer tomography, and gastrointestinal contrast studies included tuberculous peritonitis and ascites in all patients, tuberculous adenopathy in two, gastrointestinal tuberculosis in two, and omental tuberculosis in two. The radiographic features particularly characteristic of abdominal tuberculosis were: (1) Low attenuating adenopathy with rim enhancement, (2) omental or ileocecal inflammatory mass, (3) high density ascites, and (4) gastrointestinal enteritis involving the ileocecal region. (orig./MG)
Full Text Available Hasta en un 25% de los casos de tuberculosis existe afectación extrapulmonar. Esta afectación es producida por la diseminación hematógena y linfática del bacilo de M. tuberculosis hacia otros órganos. Las localizaciones más frecuentes son la ganglionar, pleural y osteo-articular. El problema de estas formas de tuberculosis radica en la dificultad para llegar a su diagnóstico definitivo, ya que tanto los síntomas clínicos, como las pruebas de imagen pueden ser inespecíficos. La mayoría de las veces es necesario recurrir a pruebas diagnósticas invasivas como PAAF guiada con ecografía o TAC, para la recolección de muestras biológicas para su diagnóstico. A pesar del auge y el avance, en los últimos años, de los métodos moleculares para la detección precoz de ADN de la micobacteria, el cultivo sigue siendo el gold estándar que permite el diagnóstico microbiológico definitivo. El tratamiento de estas formas de tuberculosis, no va diferir de las pautas de tratamiento de las formas pulmonares. Se recomienda utilizar los mismos regímenes de antibióticos con una duración de 6 meses y únicamente prolongar la duración en las tuberculosis con afectación del sistema nervioso y en la espondilitis tuberculosa con afectación neurológica.
Nakbanpot, Sudarat; Rattanawong, Pattara
We report the death of an infant due to severe sepsis caused by congenital tuberculosis following treatment with antituberculous drugs and antibiotics, who was born to a mother with misdiagnosed symptomatic pulmonary tuberculosis during pregnancy. Therefore, pregnant women with chronic cough and constitutional symptoms must be examined for pulmonary tuberculosis, particularly in tuberculosis endemic areas.
Citocinas e proteínas de fase aguda do soro como marcadores de regressão da resposta inflamatória ao tratamento da tuberculose pulmonar Cytokines and acute phase serum proteins as markers of inflammatory regression during the treatment of pulmonary tuberculosis
Full Text Available OBJETIVO: Analisar o padrão de citocinas pró- e antiinflamatórias e da resposta de fase aguda (RFA como marcadores de resposta ao tratamento da tuberculose pulmonar. MÉTODOS: Determinação dos níveis de interferon-gama (IFN-γ, tumor necrosis factor-alpha (TNF-α, fator de necrose tumoral-alfa, interleucina-10 (IL-10 e transforming growth factor-beta (TGF-β, fator transformador de crescimento-beta, pelo método ELISA, em sobrenadante de cultura de células mononucleares do sangue periférico e monócitos, assim como dos níveis de proteínas totais, albumina, globulinas, alfa-1-glicoproteína ácida (AGA, proteína C reativa (PCR e velocidade de hemossedimentação (VHS em 28 doentes com tuberculose pulmonar, em três tempos: antes (T0, aos três meses (T3 e aos seis meses (T6 de tratamento, em relação aos controles saudáveis, em um único tempo. RESULTADOS: Os pacientes apresentaram valores maiores de citocinas e RFA que os controles em T0, com diminuição em T3 e diminuição (TNF-α, IL-10, TGF-β, AGA e VHS ou normalização (IFN-γ e PCR em T6. CONCLUSÕES: PCR, AGA e VHS são possíveis marcadores para auxiliar no diagnóstico de tuberculose pulmonar e na indicação de tratamento de indivíduos com baciloscopia negativa; PCR (T0 > T3 > T6 = referência pode também ser marcador de resposta ao tratamento. Antes do tratamento, o perfil Th0 (IFN-γ, IL-10, TNF-α e TGF-β, indutor de e protetor contra inflamação, prevaleceu nos pacientes; em T6, prevaleceu o perfil Th2 (IL-10, TNF-α e TGF-β, protetor contra efeito nocivo pró-inflamatório do TNF-α ainda presente. O comportamento do IFN-γ (T0 > T3 > T6 = controle sugere sua utilização como marcador de resposta ao tratamento.OBJECTIVE: To evaluate the pattern of pro-inflammatory cytokines, anti-inflammatory cytokines and the acute phase response (APR as markers of the response to treatment of pulmonary tuberculosis. METHODS: Twenty-eight patients with pulmonary tuberculosis
Patel, Sonal; DeSantis, Evelyn R Hermes
The diagnosis and treatment of congenital tuberculosis are discussed. Congenital tuberculosis is rare and fatal if left untreated. If a pregnant woman with tuberculosis is not treated, infection of the fetus can occur by hematogenous spread through the umbilical cord or by aspiration or ingestion of amniotic fluid. Signs and symptoms of congenital tuberculosis may be nonspecific, which may preclude early diagnosis and treatment. Criteria for the diagnosis of congenital tuberculosis require the infant to have a tuberculous lesion, as indicated by chest radiography or granulomas, and at least one of the following should be confirmed: (1) onset during the first week of life, (2) primary hepatic tuberculosis complex or caseating hepatic granulomas, (3) infection of the placenta or maternal genital tract, or (4) exclusion of postnatal transmission by a contact investigation. Since 2001, 21 cases of congenital tuberculosis have been reported in English-language medical journals, with the age of presentation ranging from day 1 to 90. Based on findings from published case reports, congenital tuberculosis should be considered in the differential diagnosis of newborns who have (1) nonresponsive, worsening pneumonia, especially in regions with high rates of tuberculosis, (2) nonspecific symptoms but have a mother diagnosed with tuberculosis, (3) high lymphocyte counts in the cerebrospinal fluid without an identified bacterial pathogen, or (4) fever and hepatosplenomegaly. Once diagnosed, it is essential to promptly begin treatment with isoniazid, rifampin, pyrazinamide, and streptomycin in order to decrease the mortality associated with the infection. Early diagnosis and treatment during the neonatal period are crucial in minimizing the fatality associated with congenital tuberculosis.
Valentin Malagón Castro
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Con ocasión de un estudio de revisión que hemos llevado a cabo recientemente sobre la tuberculosis osteoarticular, *** se ha apreciado un cambio notable en las características y manifestaciones de esta enfermedad.
Hemos sido testigos del comportamiento de la tuberculosis en los últimos 40 años. Realizamos la tesis profesional en el Hospital de niños de la Misericordia de Bogotá en el año 1950 (86, basada en el análisis de más de 300 enfermos de Mal de Pott tratados con pobres resultados en esa institución en la época prequimioterápica. Efectuamos estudios de control del tratamiento quirúrgico de esa afección en el Hospital Infantil Lorencita Villegas de Santos y publicamos sus resultados en los años 1975,1980 Y1987 (85-87-88. Los pacientes correspondientes a estas nuevas series, ya en la época de la quimioterapia moderna, presentaban un mejor pronóstico vital y funcional. Cuadro 1A.
En el decenio 1978-1988 asistimos al descenso espectacular de la frecuencia de tuberculosis osteoarticular en las salas de nuestros hospitales. Posteriormente hemos sido igualmente testigos de su lenta y progresiva reaparición.
El estudio actual nos ha mostrado profundos cambios, como ya se ha dicho, en el comportamiento de la entidad, por lo que estamos de acuerdo en denominarla: La tuberculosis, una enfermedad modificada, diferente a la que hasta hace un década parecía derrotada, vencida por las nuevas drogas y las recientes técnicas quirúrgicas.
La actual es una enfermedad diferente que ha tomado una fuerza avasalladora que amenaza con volverse resistente al tratamiento específico y dar lugar a una pandemia de incalculables proporciones y de terribles consecuencias para la humanidad.
El objeto de publicar este estudio es recordar a nuestros colegas, en especial a aquellos de las nuevas promociones que quizás no han tenido la oportunidad de estar en contacto con pacientes de tuberculosis osteoarticular, de
Rezgui, Amel; Fredj, Fatma Ben; Mzabi, Anis; Karmani, Monia; Laouani, Chadia
Multifocal tuberculosis is defined as the presence of lesions affecting at least two extrapulmonary sites, with or without pulmonary involvement. This retrospective study of 10 cases aims to investigate the clinical and evolutionary characteristics of multifocal tuberculosis. It included 41 cases with tuberculosis collected between 1999 and 2013. Ten patients had multifocal tuberculosis (24%): 9 women and 1 man, the average age was 50 years (30-68 years). Our patients were correctly BCG vaccinated. The evaluation of immunodepression was negative in all patients. 7 cases had lymph node tuberculosis, 3 cases digestive tuberculosis, 2 cases pericardial tuberculosis, 2 cases osteoarticular tuberculosis, 1 case brain tuberculosis, 2 cases urinary tuberculosis, 4 cases urogenital tuberculosis, 1 case adrenal tuberculosis, 1 case cutaneous and 1 case muscle tuberculosis. All patients received anti-tuberculosis treatment for a mean duration of 10 months, with good evolution. Multifocal tuberculosis is difficult to diagnose. It can affect immunocompetent patients but often has good prognosis. Anti-tuberculosis therapy must be initiated as soon as possible to avoid sequelae.
The epidemic of drug-resistant tuberculosis. (DR-TB) is a public health emergency that threatens to destabilise global TB control. Although TB incidence and mortality are decreasing in several parts of the world, the overall prevalence of multidrug-resistant tuberculosis (MDR-TB) is increasing in many high-burden countries, ...
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.
Mathema, Barun; Andrews, Jason R.; Cohen, Ted; Borgdorff, Martien W.; Behr, Marcel; Glynn, Judith R.; Rustomjee, Roxana; Silk, Benjamin J.; Wood, Robin
Measuring tuberculosis transmission is exceedingly difficult, given the remarkable variability in the timing of clinical disease after Mycobacterium tuberculosis infection; incident disease can result from either a recent (ie, weeks to months) or a remote (ie, several years to decades) infection
... infection . Signs and Symptoms In older infants and children, latent tuberculosis infection (LTBI), which is the first infection with ... out if someone has been infected by the tuberculosis bacteria) is positive, indicating that the child has been infected. Children with a positive tuberculin ...
Luis Fernando García
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Las citoquinas desempeñan un papel fundamental en la respuesta
inmune antimicobacteriana, en el desarrollo de la enfermedad, el daño tisular, el tipo de enfermedad y los defectos inmunológicos asociados a la tuberculosis (TB. El IFNγ y el TNFα están asociados con la activación del macrófago y por lo tanto con aumento de la capacidad antimicobacteriana, mientras la IL-10 y el TGFβ tienen efectos opuestos, como citoquinas desactivadoras de los macrófagos. En pacientes con TB hay disminución de la producción de IFNγ por parte de los linfocitos en respuesta a antígenos icobacterianos e incremento en la producción de TGFβ e IL-10. Por muchos años se ha sospechado la influencia de factores genéticos en la resistencia/susceptibilidad a la tuberculosis (TB. Estudios recientes muestran que la producción de citoquinas está regulada genéticamente; polimorfismos, muchos de ellos localizados en las
regiones promotoras, han sido reportados para TNFα, IFNγ, IL-10, IL-1βy TGFβ y se correlacionan con los niveles de producción de estas citoquinas. Por lo tanto esas variaciones genéticas podrían tener consecuencias funcionales y clínicas.
Con este trabajo se pretende estudiar la asociación de polimorfismos
en los genes que codifican para citoquinas y la resistencia/susceptibilidad a la tuberculosis, y así mismo con las diferentes formas clínicas de la enfermedad.
Pereira, Jose M.; Madureira, Antonio J.; Vieira, Alberto; Ramos, Isabel
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
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.; Hermier, M.
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)
Pereira, Jose M. [Department of Radiology, Hospital de S. Joao, Porto (Portugal)]. E-mail: email@example.com; Madureira, Antonio J. [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Vieira, Alberto [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Ramos, Isabel [Department of Radiology, Hospital de S. Joao, Porto (Portugal)
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.
Kim, Soon Yong
It was known that some of the abdominal tuberculosis can produce tumor-like appearance clinically and radiologically. But these were mainly masses formed in mesenteric and retroperitoneal lymph nodes. The author has experienced the gastrointestinal tuberculosis resembling to a neoplastic process. In the gastric tuberculosis, irregular narrowing and filling defect with mucosal distortion and occasional shoulder effect could be seen in pyloric antrum. Deformity of proximal portion of duodenum was noted in most cases. Difficulty in differential diagnosis from the gastric cancer might be encountered. If duodenum was not involved. No definite sign of mucosal destruction involved area and associated deformity of duodenum was suggestive of an inflammatory lesion. If there is any tuberculous changes in small bowel, than gastric tuberculosis is more likely. There was the tuberculosis of descending duodenum or pancreaticoduodenal group of lymph nodes revealed cancer-like appearance. Long irregular narrowing with nodular filling defect and mucosal distortion or inverted 3 sign was evident. Differential diagnosis from cancer in duodenum or pancreas could not be made radiographically. Short annular stenosis and nodular filling defect with shoulder effect in both ends of stenosis was noted in some of small bowel tuberculosis. The findings were very resemble to malignancy. There was a case of huge hepatoma-like tuberculosis formed a large irregular mass by lymph nodes and adjacent organs. Chest film was not much help in the differential diagnosis. In many cases of the gastrointestinal tuberculosis, radiological findings were resembled to a neoplastic process. Since none of radiologic findings are specific enough to allow one to make a definitive diagnosis of the gastrointestinal tuberculosis and since type of the gastrointestinal tuberculosis could be cured by chemotherapy, careful analyzation of clinical features is emphasized before surgery.
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
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 (M. tuberculosis). Mycobacterium bovis (M. bovis) is ...
Noemí Martínez Caraballo
Full Text Available Objeto: Zara abrió en España, Francia, Alemania, Reino Unido, Italia y Portugal su tienda online en la campaña otoño/invierno 2010. Se trata de un paso estratégico importante, encuadrado en la búsqueda que el Grupo Inditex realiza diariamente para ofrecer el mejor servicio a los clientes en todo el mundo. El presente trabajo analiza la notoriedad de marca de Zara y las posibilidades que plantea Internet como herramienta de comunicación y como canal de distribución.Diseño/metodología: Se presenta un análisis descriptivo de la experiencia de Zara desde el lanzamiento de zara.com desde septiembre de 2010. Se muestra, además, un análisis comparativo respecto a dos de sus competidores: H&M y Mango.Resultados: Se observa cómo Zara parece estar superando en alcance y en número de páginas vistas a Mango, pero todavía no alcanza los niveles de H&M, a nivel internacional.Limitaciones: Se trata de un artículo descriptivo; no se han podido analizar con detalle los resultados de la venta online de Zara debido a su reciente incorporación en este canal de distribución y a que la política del Grupo Inditex es esperar a que transcurran doce meses de funcionamiento de la tienda virtual para ofrecer los primeros resultados.Implicaciones prácticas: Conocer la estrategia emprendida por Zara y sus competidores para, a través del comercio electrónico, lograr consolidar su imagen de marca internacional. Ello permite perfilar recomendaciones para los gestores y que la incursión en el canal de venta online sea un éxito.Valor añadido: Dada la situación de recesión económica en que nos encontramos y debido al papel protagonista que está tomando el sector textil en la comercialización y venta online en España en los últimos meses, el comercio electrónico en el sector textil resulta un tema de gran actualidad. Además, se centra en una de las empresas españolas que más estudios ha acaparado gracias a su indudable éxito.
Van Dyck, P.; De Schepper, A.M.; Vanhoenacker, F.M.; Van den Brande, P.
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.)
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.
Galagan, James E
Prevalent since pre-history, human tuberculosis - caused by the pathogen Mycobacterium tuberculosis - remains a major source of death worldwide. Moreover, increasing drug resistance poses the threat of disease resurgence. However, the expanding application of genomic techniques is providing new avenues for combating this old foe. Whole-genome sequencing, comparative genomics and systems biology are generating new insights into the origins and ongoing evolution of M. tuberculosis, as well as the molecular basis for its pathogenicity. These have important implications for our perspective of the disease, development of new drugs and vaccines, and treatment of patients using existing therapeutics.
Lee, Regina Lai Tong; Yuen Loke, Alice; Hung, Tommy Tsz Man; Sobel, Howard
To review literature on identifying the risk factors associated with early sexual coerced debut with the aim to facilitate the healthcare workers' planning of relevant health services to improve intervention strategies for delaying of early coerced sexual debut or forced sexual debut (CSD/FSD) in the communities. Identifying the risk factors associated with coercion at first sex is crucial for developing appropriate sexual and reproductive health information and health promotion in response. However, current knowledge about the risk factors associated with coercion, sexual debut (SD) and delayed SD among young people is limited. Health information programmes are important during adolescence, when young people are developing their values and beliefs about sexual activity and sexual norms. However, little is known about those risk factors on initiation of early sexual debut to plan relevant interventions that can delay SD and prevent CSD/FSD in this population. A systematic review. An extensive literature search using MEDLINE (PubMed), Nursing Journals (PubMed), Web of Science, PsychINFO and CINAHL. The search generated 39 published studies that met our inclusion and exclusion criteria. Thirty-two articles passed the quality appraisal and were selected. This review identified six domains of risk factors, categorised as: (1) the individual domain, (2) the family domain, (3) the partner/peer domain, (4) the school domain, (5) the community domain and (6) the cultural domain. These factors highlight the influences on sexual decision-making among adolescents and young people and the timing of their first sexual intercourse. It is important to use the outcome of this review's categorisation of identified risk factors to facilitate the healthcare workers and plan relevant sexual and reproductive health programmes more accessible to adolescents, especially young females and their parents. There is a need to evaluate the impact of these programmes that can delay SD and
The aim of this study is to analyse the different factors involved in this phenomenon and to give a clear, comprehensive picture of the problem of tuberculosis resurgence and its correlation with diabetes and metabolic syndrome.
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...
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...
U.S. Department of Health & Human Services — NNDSS - Table III. Tuberculosis - 2017.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...
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...
... AIDS Drugs Clinical Trials Apps skip to content HIV and Opportunistic Infections, Coinfections, and Conditions Home Understanding ... 4 p.m. ET) Send us an email HIV and Tuberculosis (TB) Last Reviewed: July 26, 2017 ...
Warner, Digby F.
Metabolism underpins the physiology and pathogenesis of Mycobacterium tuberculosis. However, although experimental mycobacteriology has provided key insights into the metabolic pathways that are essential for survival and pathogenesis, determining the metabolic status of bacilli during different stages of infection and in different cellular compartments remains challenging. Recent advances—in particular, the development of systems biology tools such as metabolomics—have enabled key insights into the biochemical state of M. tuberculosis in experimental models of infection. In addition, their use to elucidate mechanisms of action of new and existing antituberculosis drugs is critical for the development of improved interventions to counter tuberculosis. This review provides a broad summary of mycobacterial metabolism, highlighting the adaptation of M. tuberculosis as specialist human pathogen, and discusses recent insights into the strategies used by the host and infecting bacillus to influence the outcomes of the host–pathogen interaction through modulation of metabolic functions. PMID:25502746
Barbouch, Samia; Hajji, Meriam; Helal, Imed; Ounissi, Mondher; Bacha, Mohammed Mongi; Ben Hamida, Fathi; Abderrahim, Ezzedine; Ben Abdallah, Taieb
Tuberculosis is one of the leading infections after renal transplant, particularly in developing countries where the incidence and prevalence in the general population are high. Diagnosis requires bacteriologic and histologic confirmation. Interactions among the antitubercular drugs and the immunosuppressive agents have to be considered while prescribing, and surveillance for adverse effects is required. Although rare, case reports are available on extrapulmonary tuberculosis in allograft recipients. Here, we present a 25-year-old kidney transplant recipient who was diagnosed with lymph node tuberculosis under uncommon circumstances but who had a good outcome. This case report illustrates the difficulties in diagnosis of tuberculosis, changes in therapeutic protocols, and prognostic factors and highlights the effects of infectious complications with immunosuppressive therapy in this particular patient population.
A K Bajaj
Full Text Available A patient with chronic miliary tuberculosis is being reported. The patient had miliary mottling of the lung, tubercular lymphadenitis, cervicitis and disseminated lupus vulgaris of skin lesions.
Full Text Available Resumo: Foi realizado um estudo de epidemiologia molecular a estirpes de Mycobacterium tuberculosis isoladas em hospitais de Lisboa. Analisaram-se geneticamente os isolados de Mycobacterium tuberculosis com o método restriction fragment length polymorphism (RFLP utilizando a sequência de inserção IS6110 como sonda, com o objectivo de detectar as estirpes da família Lisboa e determinar a diversidade genética das estirpes de Mycobacterium tuberculosis isoladas em Lisboa, identificando os mais importantes factores de risco de transmissão da tuberculose.Foram analisados 290 isolados de Mycobacterium tuberculosis, dos quais 64,8% se encontraram agrupados em clusters; mesmo excluindo as estirpes que apresentaram mais de 5 cópias de IS6110, a percentagem de agrupamento foi de 60,7%. A multirresistência foi observada em 4,1% das estirpes e encontraram-se todas em clusters. Quarenta e cinco isolados (18,2% pertenciam à família Lisboa. Considerando a percentagem relativamente alta de estirpes em cluster detectada neste estudo, cremos que a transmissão activa continua a ser uma realidade em Lisboa. Para além disso, as estirpes dos clusters Lisboa representam as estirpes predominantes que circulam em Lisboa. continuando muito relacionadas com a resistência aos antibacilares, embora correspondam a uma percentagem inferior à verificada em estudos anteriores.Rev Port Pneumol 2007; XIV (2: 239-259 Abstract: We conducted a molecular epidemiology study of Mycobacterium tuberculosis strains isolated from patients in Lisbon hospitals. We used restriction fragment length polymorphism (RFLP to detect Lisbon family strains and to determine the genetic diversity of Mycobacterium tuberculosis strains isolated in Lisbon, through identification of the most important risk factors of tuberculosis transmission analysis, with the insertion sequence IS6110 as a probe to fingerprint isolates of Mycobacterium tuberculosis. 64.8% of the 290 Mycobacterium
A J Kanwar
Full Text Available Analysis of the clinical and laboratory data from 21 patents of cutaneous tuberculosis seen over a period of 10 years revealed that it is rare in eastern Libya. There were 15 males and 6 females. Lupus vulgaris was seen in 11, scrofuloderma in 4. Three patients each had tuberculosis verrucosa cutis and papulonecrotic tuberculid. The diagnosis in each case was confirmed histopathologically.
Kim, Do Un; Kim, Seok Won; Ju, Chang IL
Isolated tuberculosis of the coccyx is extremely rare. A 35-year-old man presented with a 3-month history of coccygeal and gluteal pain. Computed tomography and magnetic resonance imaging revealed osseous destruction and a large enhancing mass involving the coccyx with anterior and posterior extension. Pathologic examination of the surgical specimen revealed necrosis, chronic granulomatous inflammation, and multinucleated giant cells consistent with tuberculosis. This case highlights the impo...
Martin, Carlos; Aguilo, Nacho; Gonzalo-Asensio, Jesús
BCG (Bacille Calmette-Guérin) vaccination is included in the immunization schedule for tuberculosis endemic countries with a global coverage at birth close to 90% worldwide. BCG was attenuated from Mycobacterium bovis almost a century ago, and provides a strong protection against disseminated forms of the disease, though very limited against pulmonary forms of tuberculosis, responsible for transmission. Novel prophylactic tuberculosis vaccines are in clinical development either to replace BCG or to improve its protection against respiratory forms of the disease. There are limitations understanding the immunological responses involved and the precise type of long-lived immunity that new vaccines need to induce. MTBVAC is the first and only tuberculosis vaccine candidate based on live-attenuated Mycobacterium tuberculosis in clinical evaluation. MTBVAC clinical development plans to target tuberculosis prevention in newborns, as a BCG replacement strategy, and as secondary objective to be tested in adolescents and adults previous vaccinated with BCG. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.
Rivera-Rivera, Leonor; Leyva-López, Ahidée; García-Guerra, Armando; de Castro, Filipa; González-Hernández, Dolores; de Los Santos, Lilia Margarita
To estimate the mean age of sexual intercourse debut (SID) and associated family and individual factors in 14-19-year-olds of both sexes in the 32 states of Mexico in 2007. A cross-sectional study was conducted of a representative sample of 9,893 students aged between 14 and 19 years old. The data were collected through a self-administered, anonymous and voluntary questionnaire. Logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (95%CI) by category: no SID, SID at 10-15 years and SID at 16-19 years. The national mean age of SID was 16 years, being 15 years for boys (95%CI: 15.88-16.11) and 16 years for girls (95%CI: 15.26-15.42). Factors associated with SID in boys were disadvantaged socioeconomic level (OR=0.66; 95%CI: 0.46-0.94), living with parents (OR=0.65; 95%CI: 0.56-0.75), less offensive communication between parents and boys/girls (OR=0.66; 95%CI: 0.57-0.77), and high social self-esteem (OR=1.68; 95%CI: 1.35-1.77). Factors associated with SID in girls were traditional gender beliefs (OR=0.49; 95%CI: 0.32-0.74), high depressive symptoms (OR=1.88; 95%CI: 1.19-2.99), and high family self-esteem (OR= 0.50; 95%CI: 0.38-0.65). In Mexico, SID occurred early in boys. In addition, the findings of this study show that in Mexico, the age of SID and associated factors differ in boys and girls. The age of SID is strongly influenced by gender and cultural beliefs. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.
Ramchandani, Kanika; Morrison, Penelope; Gold, Melanie A; Akers, Aletha Y
Little is known about the information shared during family discussions about sexuality. From a public health perspective, abstinence is one of the most important sexuality topics parents can talk about with adolescents. We sought to characterize the messages mothers communicate to young adolescents regarding abstinence. Content analysis of dyadic discussions that occurred between June 2011-December 2012 between mothers and their 10- to 14-year-old adolescent sons and daughters. Discussions were audio-recorded, transcribed, and a grounded theory approach to content analysis performed. Urban city in Western Pennsylvania. Twenty-one dyads; 15 mother-daughter dyads and 6 mother-son dyads. None. None. Four key themes emerged reflecting the high priority mothers placed on abstinence, delaying their adolescent's sexual debut, and nurturing sexual decision-making skills. Theme 1 focused on ensuring that adolescents understand what abstinence means. In defining abstinence, only 1 mother explained what sex is. The 3 remaining themes emphasized sexual decision-making and emphasized when it is acceptable to stop being abstinent (theme 2), why abstinence is important (theme 3), and mothers' desire to engage in ongoing discussions, particularly when an adolescent was considering becoming sexually active (theme 4). Messages did not vary according to mothers' age or according to adolescent age, gender, or race. Mothers convey complex information about abstinence and sexual decision-making to young, non-sexually active adolescents. Message tailoring on the basis of the adolescents' age or sex was not observed. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Tuberculosis - medicines; DOT; Directly observed therapy; TB - medicines ... Ellner JJ. Tuberculosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 324. ...
Gilberto Rueda Pérez
Full Text Available
Qué es actualizar en tuberculosis? Infortunadamente nuestro modelo de educación médica, aún otorga una exagerada prioridad a los aspectos técnicos, biológicos y científicos, lo que se traduce en una incoherencia entre lo que se enseña y lo que nuestra situación de salud necesita.
Este modelo nos induce inmediatamente a pensar que la actualización en tuberculosis, es profundizar en esos aspectos y desarrollar con mayor énfasis los avances en inmunogenética del bacilo tuberculoso y del huésped y en las nuevas drogas. Sabemos sin embargo, que los métodos bacteriológicos e histopatológicos actualmente disponibles, si bien no son óptimos, permiten el diagnóstico en más del 95% de los pacientes. El tratamiento bien conducido produce la curación de cerca del 99% de esos mismos pacientes. Una situación como ésta, difícilmente se da para otra enfermedad.
Pero el hecho innegable que la tuberculosis continúa siendo un problema de salud pública especialmente en países en vía de desarrollo, nos lleva a unirnos a la siguiente aseveración: “La historia contemporánea de la tuberculosis se enmarca en grandes triunfos y profundas derrotas: el triunfo de disponer de métodos diagnósticos y tratamientos altamente efectivos y la gran derrota de ser incapaces de utilizar este avance”.
Las anteriores anotaciones, confirmadas por la mayoría de los programas nacionales de tuberculosis, demuestran que en esta enfermedad las bases epidemiológicas administrativas, operativas y sociológicas son, por lejos, más importantes que los aspectos técnico-científicos en la solución del problema.
Por lo tanto, las actualizaciones en tuberculosis, en países como el nuestro, deben encaminarse a dar nuevos elementos administrativos, operativos y sociales que le permitan al personal de salud utilizar la tecnología disponible.
Conociendo de cerca la metodología de enseñanza de la enfermedad en nuestras
Edna Lúcia S. de Souza
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.
Margarita González Tapia
Full Text Available Sr. Editor: La tuberculosis es una de las enfermedades remergentes en Cuba; por ello en todas las provincias cubanas se trabaja con mucha fuerza, dedicación y profesionalidad con respecto a esta problemática. En este contexto, resulta muy acertada la publicación del artículo “Algunas variables clínico-epidemiológicas de la tuberculosis pulmonar. Puerto Padre, 2008-2012”, que salió en el Vol.38 No.6.01 del mes de junio de 2013 de la Revista Electrónica Dr. Zoilo E. Marinello Vidaurreta; tanto por el significado social que reviste la divulgación de este tema, como por el propio resultado de la investigación realizada. La historia de la tuberculosis es un tema apasionante. En pocas enfermedades es posible documentar su estrecha relación con la historia de la propia humanidad como en la que nos ocupa. Existen evidencias paleológicas de tuberculosis vertebral en momias egipcias que datan aproximadamente del año 2400 a.C. La tuberculosis se ha conocido a través de la historia, con los nombres de: tisis, consunción, escrófula, mal de Pott, plaga blanca y mal del rey.1 En el artículo se plantea como conclusión que la tendencia de la tuberculosis en el quinquenio de estudio es estacionaria, pero en los últimos cuatro años tiende al ascenso. En los casos diagnosticados de tuberculosis en este quinquenio más de dos tercios correspondieron al sexo masculino y mayores de 45 años, las ocupaciones que más prevalecieron fueron recluso, desocupado, ama de casa y jubilado. Los factores de riesgo que más se relacionaron fueron el albergamiento prolongado en instituciones cerradas, el alcoholismo, y la edad mayor de 65 años; la forma clínica de mayor incidencia en casi la totalidad de los pacientes fue la pulmonar y, dentro de ella, los casos con baciloscopia positiva. Hubo fallas en el diagnóstico, ya que alrededor de la mitad de los casos se diagnosticaron en la atención secundaria y con un tiempo de demora de más de dos meses de
Nagi, B.; Kochhar, R.; Bhasin, D.K.; Singh, K. [PGIMER, Chandigarh (India). Dept. of Gastroenterology; Lal, A.; Gulati, M.; Suri, S. [PGIMER, Chandigarh (India). Dept. of Radiodiagnosis
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.
Nagi, B.; Kochhar, R.; Bhasin, D.K.; Singh, K.; Lal, A.; Gulati, M.; Suri, S.
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
Tuberculosis of the cervical spine is rare, comprising 3 -. 5% of cases of tuberculosis of the spine. Eight patients with tuberculosis of the cervicaJ spine seen during 1989 -. 1992 were reviewed. They all presented with neck pain. The 4 children presented with a kyphotic deformity. In all the children the disease was extensive, ...
Lifeguards run the risk of workplace infection by tuberculosis-carrying swimmers. Even if they work in ventilated, sunlit areas (which reduces risk), they can contract tuberculosis when performing respiratory resuscitation. Without appropriate precautions, lifeguards may be unnecessarily exposed. A tuberculosis infection control plan is needed in…
Gessner, Bradford D.
The incidence of tuberculosis among Alaskan children under 15 was more than twice the national rate, with Alaska Native children showing a much higher incidence. Children with household exposure to adults with active tuberculosis had a high risk of infection. About 22 percent of pediatric tuberculosis cases were identified through school…
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
Full Text Available Convencionalmente se asume que la defensa del hospedero contra Mycobacterium tuberculosis se basa en los mecanismos de inmunidad celular exclusivamente y se descarta el papel de los anticuerpos en la protección. En este trabajo se analizan evidencias recientes que retan este dogma y sugieren la importancia de considerar la manipulación de la respuesta inmune humoral como una alternativa en la investigación de vacunas contra la tuberculosis.
Annette León; Armando Acosta; María Elena Sarmiento; Pedro Estévez; Máximo Martínez; María Elena Pérez; Gustavo Falero; Mildrey Fariñas; Juan Francisco Infante; Juraj Ivanyi; Gustavo Sierra
Poco se ha estudiado acerca del papel de los anticuerpos específicos, presentes en las secreciones del aparato respiratorio, en la defensa contra patógenos intracelulares, como es el caso de las micobacterias causantes de la tuberculosis en el hombre: Micobacterium tuberculosis, bovis y africanum. Con el objetivo de desarrollar modelos adecuados para evaluar el posible papel de la inmunidad secretoria en la defensa contra la tuberculosis, se desarrollaron dos modelos animales con la utilizaci...
Eisenhuber, E.; Mostbeck, G.; Bankier, A.; Stadler, A.; Rumetshofer, R.
The radiologic knowledge of tuberculosis-associated lung disease is an essential tool in the clinical diagnosis of tuberculosis. Chest radiography is the primary imaging method, but the importance of CT is still increasing, as CT is more sensitive in the detection of cavitation, of hilar and mediastinal lymphadenopathie, of endobronchial spread and of complications in the course of the disease. In addition, CT has been proven as a valuable technique in the assessment of tuberculosis activity, especially in patients where M. tuberculosis has not been detected in the sputum or in patients with multidrug-resistant tuberculosis. Depending on the immune status of the patient, the morphologic spectrum of tuberculosis is quite variable. Early diagnosis of tuberculosis is essential to prevent further spread of the disease. (orig.) [de
Rudolf, Frauke; Joaquim, Luis Carlos; Vieira, Cesaltina
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...
Aftab, Huma; Christensen, Dirk L.; Ambreen, Atiqa
Individuals with newly diagnosed tuberculosis (TB) were screened for diabetes (DM) with fasting plasma glucose (FPG) in Pakistan. A significant decrease in FPG was observed when TB was treated. Of those with newly diagnosed DM, 46% and 62% no longer had hyperglycemia after 3 and 6 months, respect......Individuals with newly diagnosed tuberculosis (TB) were screened for diabetes (DM) with fasting plasma glucose (FPG) in Pakistan. A significant decrease in FPG was observed when TB was treated. Of those with newly diagnosed DM, 46% and 62% no longer had hyperglycemia after 3 and 6 months...
Thomas, Tania A
Mycobacterium tuberculosis is the leading cause of death worldwide from a single bacterial pathogen. The World Health Organization estimates that annually 1 million children have tuberculosis (TB) disease and many more harbor a latent form. Accurate estimates are hindered by under-recognition and challenges in diagnosis. To date, an accurate diagnostic test to confirm TB in children does not exist. Treatment is lengthy but outcomes are generally favorable with timely initiation. With the End TB Strategy, there is an urgent need for improved diagnostics and treatment to prevent the unnecessary morbidity and mortality from TB in children. Copyright © 2017 Elsevier Inc. All rights reserved.
Nagai, Hideaki; Inagaki, Tomokazu; Toyoda, Emiko; Kawabe, Yoshiko; Fujiwara, Keiko; Masuyama, Hidenori; Takahashi, Shigeru
Tuberculosis (TB) patients must be hospitalized while the smear of sputum is positive because TB spreads through air. Cooperation of a patient is important in order to complete the treatment of TB. However, a small number of patients are noncooperative for the treatment and may sometimes refuse it. At this symposium, we discussed about whether we could restrict the human rights of noncooperative TB patients. Although the patients' human rights must be protected, we also have to protect the human rights of people who may receive TB infection. The balance of the both people's rights is fully considered in the TB control policy. It is epoch-making that the TB society took up the theme about the human rights' restriction of TB patients. Five speakers presented their papers from each position. There were presentations about the scientific evidence of isolation, the actual cases, the situation of the United States, and the legal view on the human rights' restriction of TB patients. The present situation and the legal problems in Japan became clear at this symposium. We need further discussion about the human rights' restriction of TB patients for the revision of the Tuberculosis Protection Act and have to obtain the national consensus on it. 1. The evidence for isolation: Emiko TOYODA (International Medical Center of Japan) To determine appropriate periods of respiratory isolation, available biological, clinical, and epidemiological issues and data were studied. Although absolute lack of infectiousness requires consecutive culture negative and it takes too long and impractical periods. There seems to be no established evidence for noncontagiousness after 2 to 3 weeks effective treatment. Practically conversion to 3 negative consecutive smear results may used as a surrogate for noninfectiousness, even though a small risk of transmission still be present. Chemical isolation has been more important and administration with DOT should be indicated to keep compliance. 2
Martín Monjas, Jesús Enrique
El presente trabajo aborda, mediante una revisión bibliográfica, los cuidados destinados a un paciente pediátrico con un debut diabético y su posterior educación diabetológica. La diabetes mellitus es uno de los grandes problemas mundiales de salud y constituye una de las enfermedades crónicas más frecuentes en la infancia. En concreto la de tipo 1 es la causante de estos debuts diabéticos en niños. La estabilización del niño con un debut diabético en el servicio de urgencias o planta p...
Winther, Christian Dahl
-of-mouth communication influences popularity in the two periods of competition by increasing the likelihood of the late consumer having an affinity towards the brand adopted at the first stage. In this environment firms strategically choose their timing of product introduction knowing that fast introduction is costly. I......-mover advantages, alleviating incentives to enter a costly product development race....
Because of signs of tuberculous lesions in old skeletons it can be stated with certainty that tuberculosis has occurred in the country shortly after the settlement. From that time and up to the seventeenth century, little or nothing is known about the occurrence of the disease. A few preserved descriptions of diseases and deaths indicate that tuberculosis has existed in the country before the advent of qualified physicians in 1760. On the basis of papers and reports from the first physicians and the first tuberculosis registers the opinions is set forth that the disease has been rare up to the latter part of the nineteenth century. During the two last decades of that century the disease began to spread more rapidly and increased steadily up to the turn of the century. Although reporting of the disease was started in the last decade of the nineteenth century the reporting was first ordered by law with the passage of the first tuberculosis Act in the year 1903. With this legislation official measures for tuberculosis control work really started in the country. The first sanatorium was built in 1910. In 1921 the tuberculosis Act was revised and since then practically all the expenses for the hospitalization and treatment of tuberculous cases has been defrayed by the state. In the year 1935 organized tuberculosis control work was begun and a special physician appointed to direct it. From then on systematic surveys were made, partly in health centers i.e. tuberculosis clinics, which were established in the main towns, and partly by means of transportable X ray units in outlying rural areas of the country. In 1939 the tuberculosis Act was again revised with special reference to the surveys and the activities of the tuberculosis clinics. This act is still in force. Some items of it are described. The procedure of the surveys and the methods of examination are described. The great majority of subjects were tuberculin tested and all positive reactors X rayed. Furthermore, X
Wand, Handan; Bryant, Joanne; Worth, Heather; Pitts, Marian; Kaldor, John M; Delaney-Thiele, Dea; Ward, James
Background Earlier age at sexual debut is associated with drug and alcohol use, risky sexual behaviours and sexually transmissible infections (STI). In the present study, 2320 young Indigenous Australians were surveyed. Most study participants had sex for the first time when they were 14 years or younger (79% and 67% for males and females respectively). More than 80% of participants were categorised as being in the high-risk category for the combined sexual risk factors (i.e. not using condoms, drunk or high at last sexual act, or three or more sexual partners in the past year). There was a linear decreasing trend between the proportion of males and females who had less than high school education and age at first sex (Ptrendsex education and STI prevention should start early when targeting Indigenous young people, with age-appropriate messages. Sex education should be comprehensive and address individual risk behaviours, sexual agency and societal vulnerability to not only delay sexual debut, but also to emphasise the importance of STI prevention through condom use, which clearly already works to a certain extent with this group.
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.
Suñé Ysamat, Bertila
La tuberculosis pulmonar todavía no es una enfermedad erradicada, aunque su incidencia ha disminuido considerablemente. El tratamiento y el pronóstico de esta enfermedad han dado un cambio profundo durante estos últimos 30 años con el descubrimiento de nuevos medicamentos antituberculosos.
Abdelmalek, R; Mebazaa, A; Berriche, A; Kilani, B; Ben Osman, A; Mokni, M; Tiouiri Benaissa, H
Tuberculosis is endemic in Tunisia. Pulmonary tuberculosis is the most common presentation in our country. Cutaneous presentations are rare (1-2% of cases). The diagnosis of cutaneous tuberculosis (CT) is difficult. Histological and clinical presentations are polymorphous, many differential diagnoses are available, and it is difficult to isolate Mycobacterium. We had for aim to study the epidemiological and clinical features of CT in Tunisia, and to compare presentations before and after 1990. We conducted a retrospective study between January 1991 and December 2011, in which we included all cases of CT observed at the Infectious Diseases and Dermatology Units of the Tunis la Rabta Hospital. Hundred and thirty-seven patients were included, with a mean age of 43.8years; 72.3% were female patients. Hundred and fifty locations were observed, most of which on the head and neck. Scrofuloderma was the most frequent presentation, observed in 65% of cases. The diagnosis was confirmed by histology and/or microbiology in 75.8% of cases. The treatment was prescribed for a mean 11.3months, leading to full recovery in most cases. CT is still reported in Tunisia. The diagnosis relies mainly on histology. Controlling this mutilating tuberculosis requires a global control of this disease, and especially lymph node location, given the high rate of scrofuloderma. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Lions (Panthera leo) are susceptible to Mycobacterium bovis (M. bovis) infection, resulting in bovine tuberculosis (BTB). This chronic, debilitating disease can affect multiple organs, particularly the lungs, and may ultimately lead to death of the infected animal. Cases of lion BTB have been
recently our experience in the Eating Disorders Unit at Tara, where three patients with pulmonary tuberculosis were only diagnosed after admission for treatment of anorexia nervosa.· It appears that despite the presence of a persistent dry cough in each case, no investigation was undertaken. Did demographic stereotyping ...
D.M. Kamau, MBChB, MMed (Orth. Surg), UON,. Menelik Medical Centre, P.O. Box 55164-00200,. Nairobi, Kenya. Email: firstname.lastname@example.org. REFERENCES. 1. Spiegel, D.A., Singh, G.K. and Banskota, A.K.. Tuberculosis of the musculoskeletal system. Tech. Orthopaed. 2005; 20:167-178. 2. WHO. Fact Sheet 104.
Hudrisier, Denis; Neyrolles, Olivier
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. Copyright © 2014 Elsevier Inc. All rights reserved.
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 ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination
. Safety assessment in primary Mycobacterium tuberculosis smear microscopy centres in Blantyre. Malawi: a facility based cross sectional survey. ABSTRACT. Introduction. Tuberculosis (TB) is caused by Mycobacterium tuberculosis and is.
Tarver, R.D.; Pearcy, E.A.; Conces, D.J. Jr.; Mathur, P.N.
The chest radiographs of 95 patients with the new diagnosis of atypical turberculosis were reviewed to determine if any significant differences between atypical tuberculosis and that caused by Mycobacterium tuberculosis could be discerned. Findings included upper lobe involvement in B4 of the 95 patients and cavities in 76, with nearly equal groups having no, moderate, or extensive surrounding alveolar disease. Nodules were common; in six patients a nodule was the sole manifestation of disease. Adenopathy was seen in 12 of the 95 patients, atlectasis in 45, pleural thickening in 90, and effusions in three. These radiographic findings did not allow the radiographic differentiation of atypical tuberculosis from Mycobacterium tuberculosis infection
Ernesto Cortés Ahumada
Full Text Available ¡Don Juan! ¡Como un estudiante! ¡Como un infante! ¡Como un pirata! Se trata, por tanto, de pensar sobre el donjuanismo. Pero no bien acabo de escribir esta palabra, o mejor todavía, de balbucir una meditación acerca de esta perspectiva dinámica y en extremo viviente, porque aún sin saber nada de él algo de nosotros se dispara en emotivas tensiones y sensuales distensiones, cuando caigo en la cuenta de que el tema es sumamente complejo.
Roberto José Vernengo
Para el historiador, antiguamente, y para el sociólogo, en nuestros días, el derecho es un fenómeno empírico. El derecho de una sociedad es un dato de su realidad: historiador o sociólogo tienen que buscar el derecho en alguna experiencia empírica accesible. Sin embargo, no es fácil toparse con el derecho de una sociedad, como, por caso, con el derecho argentino actual, pues no sabemos muy bien a qué datos de la realidad apuntar. Aquéllos que discernimos aparecen teñidos por alguna concepción...
Tytle, T.L.; Johnson, T.H.
The authors reviewed the initial chest roentgenograms of 182 consecutive adult patients with proven active tuberculosis. Less than 50% of all cases were known or suspected at the time of initial presentation. There is a low degree of correlation between radiologically discernible active pulmonary tuberculosis and extrapulmonary tuberculosis. A high percentage of cases represent uncommon pulmonary locations. The frequency of occurrence of four common pulmonary patterns is presented. 21 references, 4 figures, 5 tables
The treatment of drug-sensitive tuberculosis consists of 2 months of isoniazid, rifampin, pyrazinamide and ethambutol, followed by 4 months of isoniazid and rifampin. These drugs are well tolerated and cure rate are above 95 %. In contrast the treatment of drug-resistent tuberculosis is difficult, mostly due to side effects of the drugs used under these circumstances. Therefore, any treatment of drug-resistant tuberculosis has to be done by experts.
My Youssef Alaoui Lamrani
Full Text Available Tuberculosis has been reported in almost all bones of body. The great trochanter tuberculosis (GTT installation is insidious and clinical symptoms are often vague with moderate painful swelling and stiffness. GTT is about 0,2 to 2% of all osteo-articular tuberculosis, occurring most commonly by hematogenous seeding secondary to primary focus elsewhere, more commonly in the lungs. Isolated GTT is unusual and thus its awareness is slow and diagnosis is often delayed.
Rhanim Aziza; Hammi Sanae; Kouismi Hatim; Jamal Eddine Bourkadi
Background: Smoking and tuberculosis are two major challenges in public health system. The aim of our study is to identify the impact of smoking on clinical, radiological manifestations and evolutive pulmonary tuberculosis. Methods: This retrospective case–control study examined the files of 104 patients. The patients monitored for pulmonary tuberculosis were divided into 2 groups. We studied the clinical and radiological profile, and evolution in both groups. Results: 104 patients were...
Gilberto Rueda Pérez
Full Text Available
La tuberculosis ha acompañado al hombre desde sus orígenes. Debido a su enorme contagiosidad se convirtió con el pasar de los años en un proceso endémico a nivel mundial que, por no tener causa conocida llevó al hombre a atribuirla a procesos sobrenaturales que incluían a partir del Levítico (Cuadro 1 el castigo de Dios.
Fue solamente hasta 1882, cuando Roberto Koch tras completa investigación bacteriológica presentó sus estudios ante la Sociedad de Fisiología de Berlín en los cuales demostró, sin lugar a dudas, que la tuberculosis era producida por contaminación del hombre por el Micobacterium tuberculosis aclarando de una vez por todas la etiología y la forma de transmisión de la enfermedad.
Este descubrimiento científico se puede considerar el más grande en la historia de la tuberculosis y después del descubrimiento de las bacterias por Pasteur, el más destacado en la historia de la Bacteriología. Este llevó a los científicos del mundo entero a la máxima exultación pues, al conocerse su causa etiológica bacteriana, era de suponer que la curación del proceso estaba al alcance de la ciencia pues las investigaciones deberían dirigirse hacia el producto farmacéutico o biológico que pudiera atacar y destruir el bacilo; el mismo Koch produjo la tuberculina, derivada de las proteínas del bacilo y consideró erróneamente que ésta constituiría el elemento necesario para la curación de la TBC. Pero esto no fue así, la tuberculina no conducía a la curación y en la actualidad se utiliza como método de detección de infección tuberculosa únicamente.
Koch defendió hasta su muerte el efecto curativo de la tuberculina.
La tuberculosis continuó atacando al hombre a través de los años y aunque en las últimas décadas la incidencia disminuía en forma persistente entre un 2 y un 5% anual a consecuencia de los métodos de control establecidos, vino a observarse que esta tendencia
José Antonio Román
Full Text Available El artículo aborda la solidaridad como un vocablo de importante protagonismo cultural en nuestro país, tal que es empleado cotidiana - mente para resolver gran variedad de situaciones en que es necesario concitar la ayuda, como re - ferente para la evaluación de la calidad moral de una acción, persona o colectivo, y hasta ha lle - gado a establecerse un mes de la solidaridad. Sin embargo, esta relevancia no ha sido acompañada de una línea correlativa en investigación social. En este contexto, el artículo se propone proble - matizar la noción de solidaridad, de tal forma de dejar de pensarla como dato, y poder comenzar su reflexión como un problema de estudio en la investigación social nacional.
Full Text Available Resumo: Os testes utilizados no diagnóstico de infecção latente pelo Mycobacterium tuberculosis, o teste tuberculínico e o doseamento do interferão gama (IGRA identificam a existência de uma resposta imunológica adaptativa de memória contra os antigénios micobacterianos. Considerando as limitações dos dois testes, a melhor solução passa por tirar proveito das melhores características de cada um. A maior parte dos autores concorda com a utilização dos dois testes, utilizando os IGRA sobretudo na confirmação da positividade do teste tuberculínico (tirando proveito da sua maior especificidade.As características operativas do teste tuberculínico dependem da prevalência da doença na comunidade e dos objectivos da sua realização (as suas características são superiores quando utilizada no âmbito de rastreio ou como teste diagnóstico. Para interpretar correctamente um teste tuberculínico, o clínico deve conhecer a epidemiologia da tuberculose na comunidade e definir correctamente as indicações para a sua realização. Abstract: The tests used in the diagnosis of tuberculosis latent infection, the tuberculin skin test (TST and the interferon-gamma assays (IGRA, identify the existence of an adaptive immune response towards mycobacterial antigens. Considering the limitations of the two tests, the best solution is to take advantage of the best characteristics of each one. Most of the authors agree to the use of the two tests, using the IGRAS in the confirmation of a positive TST (because of its higher specificity. The operative characteristics of TST depend on the prevalence of the illness in the community and the aim of its use (its operative characteristics are higher when used in the tracing scope or as a diagnostic test. To interpret correctly a TST, the physician must know the epidemiology of tuberculosis in the community and correctly define the indications for its use. Palavras-chave: Tuberculose, teste tubercul
Kritsaneepaiboon, Supika; Andres, Mariaem M; Tatco, Vincent R; Lim, Cielo Consuelo Q; Concepcion, Nathan David P
Tuberculosis in childhood is clinically challenging, but it is a preventable and treatable disease. Risk factors depend on age and immunity status. The most common form of pediatric tuberculosis is pulmonary disease, which comprises more than half of the cases. Other forms make up the extrapulmonary tuberculosis that involves infection of the lymph nodes, central nervous system, gastrointestinal system, hepatobiliary tree, and renal and musculoskeletal systems. Knowledge of the imaging characteristics of pediatric tuberculosis provides clues to diagnosis. This article aims to review the imaging characteristics of common sites for extrapulmonary tuberculous involvement in children.
Wernery, U; Kinne, J
Tuberculosis is a chronic, contagious, granulomatous disease caused by mycobacterial species belonging to the Mycobacterium tuberculosis complex. Camelids were not considered highly susceptible to tuberculosis, but in recent years increased numbers of cases have been experienced in some countries. In most of the cases, transmission probably occurs through contact with infected cattle or wildlife. None of the ante-mortem tests currently available can consistently provide accurate diagnosis of the infection in live camelids. Recently developed serological assays have the potential for rapid and accurate diagnosis of tuberculosis but still need to be validated.
Mnyani, C N; McIntyre, J A
Tuberculosis (TB) remains an important infection in women globally. It is responsible for 700 000 deaths annually and is a major contributor to maternal mortality. Mycobacterium tuberculosis/HIV co-infection is common in areas of high HIV prevalence, and may be associated with significant perinatal and maternal morbidity. Improved diagnosis and treatment of TB in pregnant women are important interventions for both maternal and child health. Controlling TB in pregnancy in high-prevalence areas requires a range of interventions, including active TB screening in pregnant women, TB preventative therapy for HIV-infected pregnant women, treatment of active TB and linking mothers and children to TB care services. © 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology.
Osmany Leonel Mendoza Cruz
Full Text Available La tuberculosis es una enfermedad reemergente en la actual sociedad globalizada y puede presentarse prácticamente ante cualquier especialista. Las formas extrapulmonares pueden representar hasta la cuarta parte de los casos, y entre ellos la afectación ganglionar se ubica entre las más frecuentes. Se reportan dos pacientes estudiados y tratados en el Servicio de Otorrinolaringología del Hospital General de Bata, Litoral de Guinea Ecuatorial, África Central, afectados por tumoraciones laterocervicales subagudas, con escasos síntomas y excelente evolución, tras su diagnóstico de tuberculosis ganglionar cervical y terapéutica antibiótica. Aunque la punción y aspiración con aguja fina no fue concluyente, ambos casos resultaron positivos por medio de la tinción de Ziehl-Neelsen
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.
Roberto José Vernengo
Full Text Available Para el historiador, antiguamente, y para el sociólogo, en nuestros días, el derecho es un fenómeno empírico. El derecho de una sociedad es un dato de su realidad: historiador o sociólogo tienen que buscar el derecho en alguna experiencia empírica accesible. Sin embargo, no es fácil toparse con el derecho de una sociedad, como, por caso, con el derecho argentino actual, pues no sabemos muy bien a qué datos de la realidad apuntar. Aquéllos que discernimos aparecen teñidos por alguna concepción previa que tengamos sobre qué haya de entenderse por derecho. (...
HOSTED BY. Pan African Urological Surgeons' Association. African Journal of Urology www.ees.elsevier.com/afju · www.sciencedirect.com. Case report. Primary prostatic tuberculosis: A rare form of genitourinary tuberculosis. J.M. Ratkal. KIMS, Hubli, India. Received 6 August 2014; received in revised form 28 August 2014 ...
Michelsen, Sascha Wilk; Soborg, Bolette; Agger, Else-Marie
BACKGROUND: Human immune responses to latent Mycobacterium tuberculosis (Mtb) infection (LTBI) may enable individuals to control Mtb infection and halt progression to tuberculosis (TB), a hypothesis applied in several novel TB vaccines. We aimed to evaluate whether immune responses to selected LTBI...
Gold, Ben; Nathan, Carl
While the immune system is credited with averting tuberculosis in billions of individuals exposed to Mycobacterium tuberculosis, the immune system is also culpable for tempering the ability of antibiotics to deliver swift and durable cure of disease. In individuals afflicted with tuberculosis, host immunity produces diverse microenvironmental niches that support suboptimal growth, or complete growth arrest, of M. tuberculosis. The physiological state of nonreplication in bacteria is associated with phenotypic drug tolerance. Many of these host microenvironments, when modeled in vitro by carbon starvation, complete nutrient starvation, stationary phase, acidic pH, reactive nitrogen intermediates, hypoxia, biofilms, and withholding streptomycin from the streptomycin-addicted strain SS18b, render M. tuberculosis profoundly tolerant to many of the antibiotics that are given to tuberculosis patients in a clinical setting. Targeting nonreplicating persisters is anticipated to reduce the duration of antibiotic treatment and rate of post-treatment relapse. Some promising drugs to treat tuberculosis, such as rifampicin and bedaquiline, only kill nonreplicating M. tuberculosis in vitro at concentrations far greater than their minimal inhibitory concentrations against replicating bacilli. There is an urgent demand to identify which of the currently used antibiotics, and which of the molecules in academic and corporate screening collections, have potent bactericidal action on nonreplicating M. tuberculosis. With this goal, we review methods of high throughput screening to target nonreplicating M. tuberculosis and methods to progress candidate molecules. A classification based on structures and putative targets of molecules that have been reported to kill nonreplicating M. tuberculosis revealed a rich diversity in pharmacophores. However, few of these compounds were tested under conditions that would exclude the impact of adsorbed compound acting during the recovery phase of
Salas-Coronas, Joaquín; Rogado-González, M Cruz; Lozano-Serrano, Ana Belén; Cabezas-Fernández, M Teresa
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. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.
Cleaveland, S; Mlengeya, T; Kazwala, R R; Michel, A; Kaare, M T; Jones, S L; Eblate, E; Shirima, G M; Packer, C
Bovine tuberculosis, caused by Mycobacterium bovis, is a pathogen of growing concern in free-ranging wildlife in Africa, but little is known about the disease in Tanzanian wildlife. Here, we report the infection status of Mycobacterium bovis in a range of wildlife species sampled from protected areas in northern Tanzania. M. bovis was isolated from 11.1% (2/18) migratory wildebeest (Connochaetes taurinus) and 11.1% (1/9) topi (Damaliscus lunatus) sampled systematically in 2000 during a meat cropping program in the Serengeti ecosystem, and from one wildebeest and one lesser kudu (Tragelaphus imberbis) killed by sport hunters adjacent to Tarangire National Park. A tuberculosis antibody enzyme immunoassay (EIA) was used to screen serum samples collected from 184 Serengeti lions (Panthera leo) and 19 lions from Ngorongoro Crater sampled between 1985 and 2000. Samples from 212 ungulates collected throughout the protected area network between 1998 and 2001 also were tested by EIA. Serological assays detected antibodies to M. bovis in 4% of Serengeti lions; one positive lion was sampled in 1984. Antibodies were detected in one of 17 (6%) buffalo (Syncerus caffer) in Tarangire and one of 41 (2%) wildebeest in the Serengeti. This study confirms for the first time the presence of bovine tuberculosis in wildlife of northern Tanzania, but further investigation is required to assess the impact on wildlife populations and the role of different wildlife species in maintenance and transmission.
Full Text Available A 37-year old man presented at our institution with back pain, low-grade fever and weight-loss. X-ray of chest (postero-anterior view showed multiple opacities with erosion of right 2nd and left 6th ribs. CT-scan of thorax and CT-guided FNAC con-firmed the diagnosis of tuberculosis of ribs. Even after 5-months of treatment with four first line drugs, the patient developed a cold abscess at the back. Mycobacterial culture and drug sensitivity of material aspirated by Radiometric method from the cold abscess showed growth of Mycobacterium tuberculosis, and those bacilli were resistant to both isoniazide and rifampicin. The patient did not have anti-tubercu-lar medication in the past, and that established the diagnosis of primary multidrug resistant tuberculosis of ribs. Patient was treated successfully with 2nd line drugs at the cost of moderate degree of hearing loss. After one and half years of treatment X-ray of chest (PA view showed complete healing of rib erosions with new bone formation.
Full Text Available Objetivo general: Establecer la prevalencia y los factores asociados a la coinfección TBC/VIH-SIDA en adolescentes y adultos de la consulta externa y el servicio de hospitalización de las Instituciones Prestadoras de Servicios de Salud (IPS de Barranquilla de julio de 2003 a junio de 2004. Materiales y métodos: Estudio observacional descriptivo transversal realizado en 173 afiliados a las Empresas Promotoras de Salud (EPS, inscritos en los Programas de Control de VIH-SIDA. Fuente de información secundaria primordialmente, obtenida previa autorización de las instituciones y con el consentimiento informado de los pacientes. Variables estudiadas: demográficas, socioeconómicas, hábitos personales y clínicas (índice de masa corporal, Combe, enfermedades oportunistas, carga viral, recuento de CD4 y terapia antirretroviral. Para el análisis univariado y bivariado se utilizó el software Epi-Info versión 6.04d. Resultados: La mayoría de los pacientes fueron de sexo masculino y de estrato socioeconómico bajo (estratos 1 y 2. De los 173 pacientes VIH positivos estudiados, 19 fueron positivos para tuberculosis, con una prevalencia del 11%. La forma de tuberculosis predominante fue la pulmonar (17 casos. El análisis bivariado mostró asociación estadística significativa entre la presencia de tuberculosis y la concomitancia con enfermedades oportunistas previas o actuales (p=0.001, la fármacodependencia (p=0.026, el índice de masa corporal por debajo de 20 (p=0.042 y el bajo uso de terapia antirretroviral (p=0.0002. Aunque el recuento de linfocitos T-CD4 <200 u/L fue más común entre los pacientes con TBC y VIH que en los que solo estaban infectados por VIH, no se alcanzó a mostrar una relación estadísticamente significativa entre ellas. Conclusiones: La prevalencia de coinfección Tuberculosis-VIH/SIDA fue similar a la de varios países del Caribe y Centroamérica pero inferior a la de Jamaica. Se resaltó el predominio de la forma
Crosby, Richard; Geter, Angelica; Ricks, JaNelle; Jones, Jamal; Salazar, Laura F
Background The purpose of this study was to identify unmediated associations of early sexual debut (ESD) on the current safer sex practices of young Black men (YBM). A cross-sectional study of YBM (n=697) attending clinics treating sexually transmissible diseases (STIs) in three cities was conducted. ESD was dichotomised at the age of 13 years and under. A series of regression models were used to test the moderating effects of ESD and perceived parental monitoring (PPM). A regression model also tested the effect of years of sexual experience (YSE) on sexual risk behaviours, while controlling for ESD. Mean age of debut was 13.95 years. ESD results varied with significance for pregnancy (P<0.001), sexual partners (P<0.001), and ever having chlamydia (assessed by self report), but this final association was only found for older males (P=0.03). PPM held no moderating effect on any of the sexual risk outcomes. YSE was correlated with an increase in recent unprotected vaginal sex (AOR=1.19, 95%CI=1.10-1.27) and having a pregnant partner at the time of enrolment (AOR=1.30, 95%CI=1.17-1.43). The findings provide mixed evidence for unmediated associations of ESD among young Black males. The study strongly posits that ESD may actually be a mediating variable rather than a causal explanation for sexual risk. The findings also suggest that advancing YSE foster diminishing vigilance in safer sex practices. These outcomes should be utilised to inform intervention development.
Zaba, B; Isingo, R; Wringe, A; Marston, M; Slaymaker, E; Urassa, M
To evaluate quality of sexual debut and first marriage data, measure trends and study the association of risky sexual behaviour in youth with adult risk behaviour. Reports on age at first sex (AFS) and age at first marriage (AFM) from the Kisesa cohort study, 1994-2004, were evaluated for consistency and used to describe trends in median age-at-event and time spent single but sexually active in different birth cohorts. The association of these variables with marital stability and numbers of partners at later ages was explored using statistical regression techniques. AFS and AFM were inconsistently reported by 32% and 33% of respondents, respectively, but there was no general tendency to report lower or higher ages at a later report date. In 10-year birth cohorts born between 1950-9 and 1980-9, male median AFS declined from 18.1 to 17.0 years and female median AFM rose from 16.2 to 16.6 years. Young people of both sexes currently spend longer sexually active but unmarried than previously. Early marriage is statistically associated with remarriage and polygamy; longer time between sexual debut and marriage is associated with higher numbers of partners at later stages of life. Inconsistent reporting of age-at-event introduces noise but does not bias estimates of population level indicators. Lengthening time spent single and sexually active suggests that men and women entering first marriage will have been exposed to increased numbers of non-marital partners. Successful youth interventions may also influence adult behaviour.
Prison, tuberculosis, control, mortality. INTRODUCTION. Tuberculosis (TB) is an infectious disease caused by mainly. Mycobacterium tuberculosis in humans1. .... LA, Santos DS. The resumption of consumption -- a review on tuberculosis. Mem Inst Oswaldo. Cruz. 2006; 101(7):697-714. 6. World Health Organization (WHO).
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
Nakaoka, Hiroshi; Lawson, Lovett; Squire, S Bertel
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...
S19. Anaesthetics Supplement: Tuberculosis: the implications for anaesthesia. S Afr Fam Pract 2014. Vol 56 No 2 Supplement 1. Introduction. Tuberculosis is a common problem, especially in the developing world. In 2010, the World Health Organization estimated 8.8 million new cases worldwide.1 South Africa is one of the ...
Crevel, R. van; Ottenhoff, T.H.; Meer, J.W.M. van der
The different manifestations of infection with Mycobacterium tuberculosis reflect the balance between the bacillus and host defense mechanisms. Traditionally, protective immunity to tuberculosis has been ascribed to T-cell-mediated immunity, with CD4(+) T cells playing a crucial role. Recent
Pezzoli, Lorenzo; Gounder, Shakti; Tamani, Talatoka; Daulako, Mary Raori; Underwood, Frank; Mainawalala, Sakiusa; Nawadra-Taylor, Vasiti; Rafai, Eric; Gillini, Laura
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.
Gounder, Shakti; Tamani, Talatoka; Daulako, Mary Raori; Underwood, Frank; Mainawalala, Sakiusa; Nawadra-Taylor, Vasiti; Rafai, Eric; Gillini, Laura
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
Marcos V. Burgos
Full Text Available La reemergencia de la tuberculosis en el mundo ha despertado el interés en el entendimiento de la epidemiología y patogénesis de esta enfermedad. Un revolucionario avance en este campo de investigación ha sido el desarrollo de técnicas moleculares que permiten identificar y establecer la huella particular de cada cepa de M. tuberculosis. Con el uso de estas técnicas, y el establecimiento de la epidemilogia molecular como nueva disciplina se adicionó otra dimensión a la epidemiologia clásica de la tuberculosis y ha incrementado el conocimiento de la dinámica de la transmisión de M. tuberculosis dentro de una población. En el proceso han sido identificados problemas en los programas de control, lo cual ha ayudado a obtener recursos para su mejoramineto e implementación. Aún más, se ha resaltado la necesidad de continuar vigilando esta enfermedad. Otras metodologías genotípicas han sido desarrolladas a partir del conocimiento de la secuencia del genoma de M. tuberculosis. Estas metodologías genotípicas de fácil implementación y bajo costo se deben aplicar en países en vía de desarrollo, donde existe el 90% de la enfermedad, como apoyo a los programas de control de la tuberculosis. Estas herramientas permitirán conocer la dinámica de transmisión de la tuberculosis, la estructura de la población, la evolución y patogénesis de M. tuberculosis.
Ye. Yu. Zorkaltseva
Full Text Available Epidemiology situation and factors its determinates was analyzed. Reports of tuberculosis hospitals used and results of observed two hundred and sixty-three children with tuberculosis. It was determinate that reasons of increase children morbidity of tuberculosis: bad epidemiology situation in adults in region, not all adult patients with tuberculosis was hospitalized, defects of prophylactic of tuberculosis. Tuberculosis in children having contact with tuberculosis was determinates earlier and structure of clinical forms was better than in children which have no contact.
Gardiner, Jennifer L; Karp, Christopher L
The world is in need of more effective approaches to controlling tuberculosis. The development of improved control strategies has been hampered by deficiencies in the tools available for detecting Mycobacterium tuberculosis and defining the dynamic consequences of the interaction of M. tuberculosis with its human host. Key needs include a highly sensitive, specific nonsputum diagnostic; biomarkers predictive of responses to therapy; correlates of risk for disease development; and host response-independent markers of M. tuberculosis infection. Tools able to sensitively detect and quantify total body M. tuberculosis burden might well be transformative across many needed use cases. Here, we review the current state of the field, paying particular attention to needed changes in experimental paradigms that would facilitate the discovery, validation, and development of such tools. © 2015 Gardiner and Karp.
In spite of a decreasing number of new cases of silico-tuberculosis even today there still remains a serious complication of silicosis. The job of radiology is to recognise the disease, evaluate the course of the disease during therapy and classify the disease for compensation purposes. Due to the pathogenetic and pathomorphologic similarities of silicosis and tuberculosis, it is often difficult and sometimes even impossible to recognise the presence of tuberculosis in cases of silicoses or to identify and isolate the TB component in silico-tuberculosis. Careful consideration of all radiological and clinical parameters improves the accuracy of diagnosis. Since the radiographic examination provides the only method of evaluating the morphologic state of the disease, radiology will keep its central position in the diagnosis of silico-tuberculosis. (orig.) [de
Mack, U.; Migliori, G. B.; Sester, M.; Rieder, H. L.; Ehlers, S.; Goletti, D.; Bossink, A.; Magdorf, K.; Hölscher, C.; Kampmann, B.; Arend, S. M.; Detjen, A.; Bothamley, G.; Zellweger, J. P.; Milburn, H.; Diel, R.; Ravn, P.; Cobelens, F.; Cardona, P. J.; Kan, B.; Solovic, I.; Duarte, R.; Cirillo, D. M.
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
Alto a la tuberculosis en mi generaciÃ³n: Un llamado a un mundo libre de tuberculosis. Podcast del DÃa Mundial de la Tuberculosis del 2013 (Stop TB in My Lifetime: A Call for a World Free of TB World TB Day 2013)
En este podcast el doctor Kenneth Castro, Director de la DivisiÃ³n de EliminaciÃ³n de la Tuberculosis, habla sobre el DÃa Mundial de la Tuberculosis, asÃ como del tema y eslogan de este aÃ±o. Created: 3/12/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). Date Released: 3/13/2012.
Full Text Available Trata sobre la comunicación como herramienta estratégica en el sistema agrícola del ámbito rural. La propuesta consiste en armar la estrategia de comunicación para defender y promover la solución de los problemas partir de cada uno de los sectores.
Alice Ferry de Moraes
Full Text Available A terminologia empregada pelos pesquisadores para identificação dos temas de seus Grupos de Pesquisa, registrados junto ao Conselho Nacional de Desenvolvimento Científico e Tecnológico, foi também empregada como um instrumento na reordenação das Linhas de Pesquisa da Fundação Oswaldo Cruz, assim como indicador qualitativo para a avaliação da produção científica institucional. Esses dois processos foram desenvolvidos pelo Departamento de Estudos em Ciência e Tecnologia do Centro de Informação Científica e Tecnológica, em parceria com representantes de outras Unidades da Instituição. Uma análise comparativa apontou as divergências existentes entre a terminologia empregada pelos pesquisadores, a Tabela de Áreas do Conhecimento do Conselho Nacional de Desenvolvimento Científico e Tecnológico, os Descritores em Ciências da Saúde desenvolvidos pelo Centro Latino Americano e do Caribe de Informações em Ciências da Saúde e o Tesauro de Manguinhos. Os resultados desta análise levaram a uma conclusão sobre a validade do uso da análise terminológica como um dos instrumentos para a reordenação dos Grupos de Pesquisa dentro das linhas de pesquisa da Fundação Osvaldo Cruz, assim como do seu uso como instrumento de avaliação da produção científica, já que ambos estes processos visam proporcionar maior integração científica institucional, de maneira estratégica e econômica.
1. Philippines: The development, expansion and maintenance of pilot area activities: Cristina B. Giango (Technical Division, Cebu Provincial Health Office, the Philippines) In 1994, the Department of Health developed the new NTP policies based on WHO recommendations and started a pilot project in Cebu Province in collaboration with the Japan International Cooperation Agency. To test its feasibility and effectiveness, the new NTP policies were pre-tested in one city and one Rural Health Unit. The test showed a high rate of three sputum collection (90%), high positive rate (10%), and high cure rate (80%). Before the new guidelines were introduced, the new policy was briefed, a baseline survey of the facility was conducted, equipment was provided, and intensive training was given. Recording/Reporting forms and procedures were also developed to ensure accurate reporting. Supervision, an important activity to ensure effective performance, was institutionalized. Laboratory services were strengthened, and a quality-control system was introduced in 1995 to ensure the quality of the laboratory services. With the implementation of DOTS strategy, barangay health workers were trained as treatment partners. In partnership with the private sector, the TB Diagnostic Committee was organized to deliberate and assess sputum negative but X-ray positive cases. The implementation of the new NTP guidelines in Cebe Province has reached a satisfactory level, the cure rate and positive rate have increased, and laboratory services have improved. Because of its successful implementation, the new NTP guidelines are now being used nationwide. 2. Nepal: The DOTS Strategy in the area with hard geographic situation: Dirgh Singh Bam (National Tuberculosis Center, Nepal) Three groups of factors characterize the population of Nepal: 1) Socio-cultural factors, e.g. migration, poverty, language; 2) Environmental factors, e.g. geography and climate; and 3) Political factors, prisoners and refugee
William Alfredo Chapman Quevedo
Full Text Available En el presente artículo analizamos el papel de la tuberculosis en la ciudad de Barranquilla entre 1930 y 1960. En este sentido mostramos como esta enfermedad se convirtió en endémica debido a los altos índices de morbilidad y mortalidad, llamando la atención de los médicos y autoridades locales, quienes utilizaron los medios de comunicación para prevenir y difundir las formas de contagio. Para dicho análisis, entrelazamos las fuentes primarias (las actas de defunción, informes de los secretarios departamentales de higiene del departamento del Atlántico, la revista departamental de higiene y la prensa que reposan en el Archivo Histórico del Atlántico y la Biblioteca Nacional de Colombia con las fuentes secundarias (bibliografía escrita sobre la temática de la tuberculosis, higiene y salubridad a nivel global y en Colombia. Llegamos a la conclusión que, la tuberculosis pulmonar fue una enfermedad de suma importancia con la capacidad de alterar la vida cotidiana de los barranquilleros. Las autoridades locales lograron establecer espacios propicios para su tratamiento, como el dispensario, el hospital sanatorio infantil y la búsqueda del hospital de adultos, medidas que fueron insuficientes para combatir la enfermedad.
This paper presents an analysis of Tuberculosis (TB). Specifically addressed are the history of its development and treatment; its current resurgence; the global impact of this resurgence; the social issues responsible for the resurgence including poverty, homelessness, substance abuse, the HIV/AIDS epidemic, and increased immigration from TB endemic areas of the world; and the political, economic and ethical issues affecting its incidence today including inadequate funding, California's Proposition 187, pharmaceutical corporation profit motives, directly observed therapy and forced confinement of non-compliant patients.
Hamada, Tadao; Matsushita, Hiroshi.
Effects of atomic bomb on tuberculosis among atomic bomb survivors necropsied after 1956 when Atomic Bomb Hospital was opened were observed statistically and the following results were obtained. The morbidity of tuberculosis in the group exposed within 2 km from the hypocenter was higher than that of the control group, but there was not a significant difference between the both groups. The morbidity of all types of tuberculosis was significantly higher in the group exposed within 2 km from the hypocenter than in the control group. The morbidity of tuberculosis tended to decrease in both exposed and non-exposed groups with time. However, the morbidity of miliary or active tuberculosis has tended to rise in the exposed since 1975. The morbidity in young a-bomb survivors exposed within 2 km was higher than that in those of other groups, but there was not a difference in the morbidity among the aged. The higher the rate of complication of active tuberculosis with stomach cancer or acute myelocytic leukemia or liver cirrhosis, the nearer the places of exposure were to the hypocenter. Out of 26 patients with miliary tuberculosis, 6 were suspected to have leukemia while they were alive and were suggested to have leukemoid reaction by autopsy. They all were a-bomb survivors, and 4 of them were exposed within 2 km from the hypocenter. (Tsunoda, M.)
Im, Jae Hoon
Radiological findings of 87 cases of intestinal tuberculosis are analyzed and presented. The diagnosis was based on histopathology in 29 cases, and on clinical ground and radiological findings in 58 cases. The radio of male and female patients was 4:6, and peak incidence is between 10 and 30. Abdominal pain, diarrhea, weight loss, fever and general weakness are frequent symptoms, and tenderness of abdomen, ascites with abdominal distension, malnutrition and emaciation are frequent signs of the patients. Laboratory investigation reveal anemia, raised ESR, hypoalbuminaemia and positive occult blood reaction in the stool in most of the patients. Chest film show activity pulmonary tuberculosis in only 1/3 patients. There is no pathognomonic radiological findings in intestinal tuberculosis and their manifestations are protean, and differentiation from other inflammatory diseases and malignant tumors in gastrointestinal tract is very difficult on radiological ground alone. However, in patients with complaining vague abdominal symptoms and signs, the radiological diagnosis is most certain means in the decision of existence of organic lesion and suggestion of tuberculosis in the gastrointestinal tract and its extent as yet. Multiplicity of the lesion, involvement of adjacent organ such as peritoneum or mesenteric lymph nodes, typical nodularity or irregularity of mesenteric border and existence of active pulmonary tuberculosis are the suggestive findings of intestinal tuberculosis. In the diagnosis of inflammatory disease or malignant tumor of gastrointestinal tract, the possibility of tuberculosis should be borne in mind, and vice versa
Gabriela Capriogli Oliveira
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.
Renata Moreira Marquez
Full Text Available Este ensaio propõe uma reflexão crítica sobre o mapa como modelo privilegiado de representação do espaço. Partindo da iconografia historicamente verificada com a disseminação do imaginário do globo terrestre e buscando os possíveis estratos heterotópicos ou margens de desobediência cartográfica atuantes nos mapas existentes bem como na emergência de novos mapas, aborda algumas das suas transformações históricas na tensão constantemente experimentada entre inventário e invenção, através de um conjunto selecionado de reflexões e proposições de autores vindos não da geografia mas das artes visuais e da literatura tais como Joaquín Torres-García, Georges Perec, Joan Brossa, Julio Cortázar e outros. Frente à análise da aplicabilidade do mapa como relato subjetivo e da sua aproximação com uma experiência cartográfica múltipla e diversa capaz de inventariar, nos lugares estudados, a qualidade poética da vida, o mapa ressurge, assim, como ciência das qualidades em detrimento de campo das quantidades. Propõe-se, conclusivamente, repensar a cartografia como uma plataforma científica que, mesmo nas suas origens, já guardava uma potência mítica para relatos abertos e transversais à ciência e que, no contexto atual, pode tornar-se uma plataforma de ação criativa em prol de novas sensibilidades perceptivas, novos mundos estéticos e novos movimentos prospectivos de transformação imaginativa do espaço, ampliando e complexificando o esforço de conhecer as nossas relações geográficas.
GERGE C. HOMANS
Full Text Available En ¿Conducta Social como intercambio? : anotaciones a un texto clásico de un autor poco clásico (¿Social Behavior as Exchange? : Miguel Requena ofrece una introducción al español de la versión de Homans ?Social Behavior as Exchange? originariamente publicado en el American Journal of Sociology (1958, 63, May, 597-606.
Kaur, U; Katariya, S; Bhusnurmath, S R; Bambery, P; Dilawari, J B
A patient with cervical lymph node tuberculosis developed a tubercular ulcer in the oesophagus eight weeks after starting treatment. This was probably due to a drug related hypersensitivity reaction in an adjacent mediastinal lymph node and subsided with continued treatment.
G Angeline Grace
Full Text Available The morbidity and mortality due to tuberculosis (TB is high worldwide, and the burden of disease among women is significant, especially in developing countries. Mycobacterium tuberculosis bacilli reach the genital tract primarily by haematogenous spread and dissemination from foci outside the genitalia with lungs as the common primary focus. Genital TB in females is a chronic disease with low-grade symptoms. The fallopian tubes are affected in almost all cases of genital TB, and along with endometrial involvement, it causes infertility in patients. Many women present with atypical symptoms which mimic other gynaecological conditions. A combination of investigations is needed to establish the diagnosis of female genital TB (FGTB. Multidrug anti-TB treatment is the mainstay of management and surgery may be required in advanced cases. Conception rates are low among infertile women with genital TB even after multidrug therapy for TB, and the risk of complications such as ectopic pregnancy and miscarriage is high. More research is needed on the changing trends in the prevalence and on the appropriate methods for diagnosis of FGTB.
Full Text Available Tuberculosis (TB is a major public health concern worldwide: despite a regular, although slow, decline in incidence over the last decade, as many as 8.6 million new cases and 1.3 million deaths were estimated to have occurred in 2012. TB is by all means a poverty-related disease, mainly affecting the most vulnerable populations in the poorest countries. The presence of multidrug-resistant strains of M. tuberculosis in most countries, with some where prevalence is high, is among the major challenges for TB control, which may hinder recent achievements especially in some settings. Early TB case detection especially in resource-constrained settings and in marginalized groups remains a challenge, and about 3 million people are estimated to remain undiagnosed or not notified and untreated. The World Health Organization (WHO has recently launched the new global TB strategy for the “post-2015 era” aimed at “ending the global TB epidemic” by 2035, based on the three pillars that emphasize patient-centred TB care and prevention, bold policies and supportive systems, and intensified research and innovation. This paper aims to provide an overview of the global TB epidemiology as well as of the main challenges that must be faced to eliminate the disease as a public health problem everywhere.
Elma Z Tchilian
Full Text Available 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.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.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.
Full Text Available O corpo é foco de muitos estudos e intervenções. Alguns paradigmas o concebem apenas em seu aspecto sensório-motor, enquanto outros transitam prioritariamente por uma dimensão psicológica. Procurando contribuir para a formulação de outras perspectivas no campo, apresentam-se aspectos da concepção de corpo de Stanley Keleman em ressonância com os estudos de Regina Favre. A partir de cenas clínicas em grupos de seminários, podemos pensar o corpo como pulso, multimídia, multifacetado, que se (des constrói permanentemente nos encontros. Articulando experiências clínicas da autora como terapeuta ocupacional e docente da graduação e em grupos de estudos, essas concepções servem como guia para uma clínica pensada, construída e balizada pelo corpo mediante utilização de abordagens corporais para a promoção de encontros plasmados por afetos e acontecimentos, na tentativa de criar corpos que possam sustentar as intensidades vividas e permitam a observação de si, a aproximação com o outro e a produção de singularidades.
Full Text Available O corpo é foco de muitos estudos e intervenções. Alguns paradigmas o concebem apenas em seu aspecto sensório-motor, enquanto outros transitam prioritariamente por uma dimensão psicológica. Procurando contribuir para a formulação de outras perspectivas no campo, apresentam-se aspectos da concepção de corpo de Stanley Keleman em ressonância com os estudos de Regina Favre. A partir de cenas clínicas em grupos de seminários, podemos pensar o corpo como pulso, multimídia, multifacetado, que se (des constrói permanentemente nos encontros. Articulando experiências clínicas da autora como terapeuta ocupacional e docente da graduação e em grupos de estudos, essas concepções servem como guia para uma clínica pensada, construída e balizada pelo corpo mediante utilização de abordagens corporais para a promoção de encontros plasmados por afetos e acontecimentos, na tentativa de criar corpos que possam sustentar as intensidades vividas e permitam a observação de si, a aproximação com o outro e a produção de singularidades.
Full Text Available La tuberculosis es una enfermedad tan antigua como la humanidad. A pesar de los avances en el conocimiento de su fisiopatología y en el desarrollo de medicamentos antituberculosos, todavía es una enfermedad común que afecta a una gran proporción de la población mundial. En los últimos años han aumentado los problemas relacionados con la morbi-mortalidad, lo cual se refleja en el incremento de la coinfección con VIH, el aumento de casos de neurotuberculosis y la mayor mortalidad en pacientes con tuberculosis. En el presente artículo se presenta una revisión de aspectos microbiológicos, epidemiológicos y clínico-terapéuticos de la enfermedad.
Full Text Available El objetivo del presente trabajo fue abordar la problemática de la infección por tuberculosis (TB en Trabajadores de la Salud (TS a través de la experiencia en un programa de prevención y tratamiento de la TB en un Hospital General de Agudos de la Ciudad de Buenos Aires. Los objetivos del Programa fueron implementar acciones de educación para la salud, pesquisa periódica de TS, detección de casos de TB y efectuar acciones de control. Se definió infección TB como PPD 2 UT = 10 mm. Se realizaron dos estudios de prevalencia de infección. En 1998 fue de 31.7% (n = 533 y en 2008 de 35% (n = 670. Enfermería tuvo el mayor porcentaje de infectados. En 2008 se advirtió un aumento de la infección TB en los médicos (p = 0.02. Se estudiaron 45 TS en el grupo que repitió PPD a los tres meses del primer estudio de prevalencia. Se detectaron ochos virajes tuberculínicos (17%, todos en enfermeras. Se evaluaron 163 TS que estuvieron en contacto con 8 casos de TB diagnosticados en TS, 4 de los cuales eran enfermeras. El 39.9% presentó PPD positiva, no se detectaron casos nuevos de TB y se documentaron cinco conversiones tuberculínicas en enfermeras. Se evaluaron 127 TS de sectores con bajo riesgo, el 25.9% presentó PPD positiva (p = 0.01 comparando con el 39.9% en el grupo anterior. A pesar de las limitaciones en el recurso humano para realizar estudios de incidencia de TB, la protección personalizada, la educación en TB y la quimioprofilaxis podrían reducir los riesgos de TB en TS.The objective of this work was to address the problem of tuberculosis (TB infection among Health Care Workers (HCW, based on an experience in a TB Prevention and Treatment Programme at a General Acute Hospital in Buenos Aires City. The objectives of the programme were to provide health education and periodic screening of HCW, to detect TB cases and to implement control measures. TB infection was defined by a = 10 mm reaction to 2 UT PPD. Two prevalence studies of
Shin, Hyeong Cheol; Oh, Ki Keun
To evaluate the radiologic findings of breast tuberculosis. The authors evaluated the radiologic findings of five cases of surgically confirmed tuberculosis of the breast. Patients were examined with mammography (n=5), ultrasonography (n=3), and MRI (n=2). All patients were female. Four patients had unilateral lesion and the remaining one patient had bilateral breast tuberculosis. Mammographic findings were mainly radiopaque mass density without secondary signs. Two patients showed secondary signs such as skin thickening, parenchymal distortion, and nipple retraction. Ultrasonographic findings were variable but helpful in differentiating benign from malignant breast lesion, MRI findings were more helpful in differentiating abscess from malignant lesions. Radiologic findings were useful to diagnose tuberculosis of the breast, but fine needle aspiration biopsy and culture were needed for suspicious radiologic findings
Kim, S. W.; Ra, Y. W.; Kim, Y. J.
Radiographic findings of thirty eight cases of renal tuberculosis treated at this hospital during last 4 years were analysed with following results. The cases examined were 24 male and 14 female patients. Age distribution was broad and evenly distributed ranging from 2nd decades to 5th decades. Main symptoms complained were urinary frequency, hematuria, dysuria and flank pain. Findings of physical examination revealed tenderness of costovertebral angle, palpable mass on flank area and epididymal indutration. The simple chest films showed pulmonary tuberculosis in 22 cases including 6 cases of active military type. Thirty one cases showed increased ESR, 8 cases showed AFB positive in urine and 12 cases showed bilateral renal tuberculosis. Through urographic findings nonvisualization, cyceopelviectasis, motheaten appearance of minor calyx, contracted bladder, delayed visualization, ureteral stricture and beading were observed in order of frequency. Five cases with miliary tuberculosis showed advanced renal lesion on urogram
Full Text Available Current therapeutic management of tuberculosis is inadequate due to non-compliance, lengthy course of treatment and drug- related side effects. In order to address these setbacks, the authors are developing a nanotechnology drug delivery system...
Svendsen, Jesper Hastrup; Mikkelsen, A L; Siemssen, O J
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....
Conclusion: Our study raised the harmful impact of smoking on the clinical and radiological presentation of tuberculosis, and late bacteriological negativity, therefore we need to integrate smoking control into the national TB control program.
Svendsen, Jesper Hastrup; Mikkelsen, A L; Siemssen, O J
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....
Daniela Maria Alves Chaud
Full Text Available As informações sobre alimentação estão mais acessíveis e democráticas. As tendências alimentares são inspiradas por diversos fatores, mas sempre estão associados à moda, mídia e como forma de conjectura de um estilo de vida. Há pouco tempo, as grandes cidades brasileiras foram invadidas por uma nova mania: as paletas mexicanas, que, na verdade, não são “tão mexicanas”. Esses sorvetes apresentam qualidades organolépticas marcantes, em virtude, entre outros fatores, ao alto teor de açúcar e, em alguns casos, de gorduras. A concepção gourmetizada e natural dessa iguaria, seu custo e as propriedades nutricionais são peculiares e, aparentemente, um modismo. Esse trabalho teve como objetivo conhecer a composição desses produtos, a partir das informações nutricionais contidas nos sites das empresas produtoras, bem como as suas peculiaridades e concepções. Apesar da conotação natural e gastronômica, alto valor calórico, gorduras (especialmente na versão recheada sabor brigadeiro e elevadas quantidades de açúcares, foram encontrados, em média, por unidade: 207,2 Kcal; 38,4g de carboidratos; 3,9g de proteínas e 5,3g de gorduras. Uma rica ênfase na cultura mexicana, religiosidade e identidade visual marcante foram identificadas nos sites dos produtos pesquisados.
J. Hernando Ordoñez
Comentario sobre su origen endógeno y sus aplicaciones terapéuticas
Pocas drogas han sido más estudiadas que el grupo de los digitálicos, estrofantinas y ouabaina, cuyo estudio es objeto del presente trabajo.
La ouabaina empezó a ser estudiada desde el siglo pasado. La primera referencia conocida corresponde a Pelikan, 1865 (1), como veneno que empleaban para las flechas en Gabón (Africa). (.)
Caballero López, José Luis
Este trabajo se fundamenta en la investigación sobre el "terrorismo y los terroristas como agentes internacionales" en un contexto amplio aunque principalmente focalizado en la actualidad. Los tiempos en los que nos encontramos hoy en día requieren estudiar con exactitud los rasgos de la política internacional referentes al terror. Destaca sobremanera el concepto "yihadismo" y todo lo que le rodea, pues la dictadura de terror que se vive contemporáneamente en Oriente Próximo se encuentra r...
Mustafa Abu S
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.
Full Text Available Psoriasis is a chronic, relapsing and remitting inflammatory skin and joint disease that has a prevalence of 2-3% in the world’s population, whereas of 1–2% in Europe. The traditional concept of psoriasis as the “healthy people’s” disease has been recently revised because of ever-increasing reports of associations with various pathological conditions (hypertension, Crohn’s disease, type II diabetes mellitus, obesity, dyslipidemia, metabolic syndrome, infectious conditions. Particularly, advances in psoriasis therapies have introduced biologic agents. All the tumor necrosis factor-alpha inhibitors are associated with an increased risk of developing active disease in patients with latent tuberculosis infection, because of TNF-α key role against Mycobacterium tuberculosis. For this reason, exclusion of active tuberculosis and treatment of latent tuberculosis infection are clinical imperatives prior to starting this therapy. Moreover active surveillance for a history of untreated or partially treated tuberculosis or latent form has already been shown to be effective in reducing the number of incident tuberculosis cases.
Andreu, J. E-mail: email@example.com; Caceres, J.; Pallisa, E.; Martinez-Rodriguez, M
Pulmonary tuberculosis (TB) is a common worldwide lung infection. The radiological features show considerable variation, but in most cases they are characteristic enough to suggest the diagnosis. Classically, tuberculosis is divided into primary, common in childhood, and postprimary, usually presenting in adults. The most characteristic radiological feature in primary tuberculosis is lymphadenopathy. On enhanced CT, hilar and mediastinal nodes with a central hypodense area suggest the diagnosis. Cavitation is the hallmark of postprimary tuberculosis and appears in around half of patients. Patchy, poorly defined consolidation in the apical and posterior segments of the upper lobes, and in the superior segment of the lower lobe is also commonly observed. Several complications are associated with tuberculous infection, such as hematogenous dissemination (miliary tuberculosis) or extension to the pleura, resulting in pleural effusion. Late complications of tuberculosis comprise a heterogeneous group of processes including tuberculoma, bronchial stenosis bronchiectasis, broncholithiasis, aspergilloma, bronchoesophageal fistula and fibrosing mediastinitis. Radiology provides essential information for the management and follow up of these patients and is extremely valuable for monitoring complications.
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.
Tamine Jordán Severo
Full Text Available INTRODUCCIÓN: La detección de casos es la actividad fundamental de pesquisa que se realiza en Cuba y una de las estrategias fundamentales para lograr la eliminación de la tuberculosis como problema de salud pública. OBJETIVO: Describir algunas características encontradas en los casos de tuberculosis notificados en los municipios Boyeros, 10 de Octubre, Arroyo Naranjo y Cotorro, en el 2008. MÉTODOS: Se realizó un estudio descriptivo de los casos de tuberculosis notificados en el 2008, en cuatro municipios del sur de la capital del país. Estas personas fueron visitadas en sus hogares y se entrevistaron, utilizando un cuestionario adicional validado previamente. Se creó una base de datos y se procesó en Epi Info 2002. RESULTADOS: Se notificaron 59 casos de tuberculosis en estos cuatro municipios, los que mostraron tasas de incidencia de la enfermedad entre 6,2 y 10,1/100 000 habitantes. El 72,9 % de los casos se encontró entre 15 y 59 años y el 78 % fue del sexo masculino; el 86,4 % tuvo tuberculosis pulmonar y el 13,6 % falleció. El 91,5 % perteneció a grupos de riesgo, de estos fundamentalmente ancianos, alcohólicos y exreclusos. El 100 % de los fallecidos pertenecía a grupos de riesgo. CONCLUSIONES: Los cuatro municipios mostraron tasas de incidencia > 5/ 100 000 habitantes y todos excepto Arroyo Naranjo estuvieron por encima de la tasa nacional; predominó el grupo de edades de 15 a 59 años, el sexo masculino y la tuberculosis pulmonar con baciloscopia positiva, pertenecientes en su mayoría a grupos vulnerables importantes, en los cuales ocurrió la totalidad de los fallecidos.INTRODUCTION: The case detection is the fundamental activity of screening carried out in Cuba and one of the essential strategies to achieve the eradication of tuberculosis as a problem of public health. OBJECTIVE: To describe some characteristics found in the cases of tuberculosis reported in 2008 at the Boyeros, 10 de Octubre, Arroyo Naranjo and
de Jong, Bouke C.; Hill, Philip C.; Aiken, Alex; Awine, Timothy; Antonio, Martin; Adetifa, Ifedayo M.; Jackson-Sillah, Dolly J.; Fox, Annette; Deriemer, Kathryn; Gagneux, Sebastien; Borgdorff, Martien W.; McAdam, Keith P. W. J.; Corrah, Tumani; Small, Peter M.; Adegbola, Richard A.
BACKGROUND: There is considerable variability in the outcome of Mycobacterium tuberculosis infection. We hypothesized that Mycobacterium africanum was less likely than M. tuberculosis to transmit and progress to tuberculosis disease. METHODS: In a cohort study of patients with tuberculosis and their
Shewchuk, Jason R.; Reed, Martin H.
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.)
Kienzl-Palma, D.; Prosch, H.
Tuberculosis (TB) is a granulomatous disease caused by Mycobacterium tuberculosis and transmission is via an airborne route by droplet infection. In the majority of cases patients have thoracic TB, which most frequently presents with hilar lymphadenopathy and pulmonary manifestation. Due to the rise in incidence of TB in central Europe to be expected over the coming years, it is essential to be acquainted with the radiological manifestations of pulmonary TB, particularly to be able to discriminate active from inactive TB. Due to the use of molecular techniques entailing DNA fingerprinting, the traditional classification of TB in primary and postprimary TB is being challenged. These genetic studies have revealed that variations in the clinical and radiographic appearance of TB are mainly affected by the immune status of the patients. Due to the low prevalence of TB in central Europe and the wide variation of radiological presentations, the diagnosis and therapy of TB is often delayed. In this article, the radiographic manifestations of thoracic TB are summarized and discussed. Together with the medical history and bacteriological tests, chest X-ray imaging and computed tomography (CT) play a major role not only in the detection of TB but also in the follow-up during and after therapy. Chest X-radiographs should be the primary diagnostic method in patients with suspected TB in screening as well as for diagnosis and therapy monitoring. The use of CT is more sensitive than chest radiographs and is frequently performed after chest radiographs to obtain detailed information about subtle parenchymal changes or lymph node manifestation. When active TB is suspected CT should be performed. Tree in bud, lobular consolidations, centrilobular nodules, cavities and ground-glass opacification are typical changes in active TB. (orig.) [de
Toth, Anita; Fackelmann, Janice; Pigott, Wendy; Tolomeo, Ornella
Tuberculosis (TB) is one of the oldest known diseases and has claimed more lives than any other Today, about one-third of the world's population is infected with TB. In 2003, 1,379 cases of new, active and relapsed TB were reported in Canada. TB is caused by Mycobacterium tuberculosis. Only 10 per cent of infected individuals will develop active TB. Pulmonary TB can be spread by an infectious person through the aerosolization of droplets when coughing, talking, spitting, sneezing or singing. Symptoms of pulmonary TB are a cough with or without sputum production lasting at least three weeks, chest pain, hemoptysis, fever, night sweats, weight loss, lack of appetite, chills and weakness. Extrapulmonary TB is generally not associated with person-to-person spread. Common sites include the throat, lymph nodes, abdomen, intestines, long bones of the legs, spine, kidneys, bladder, skin, eyes and meninges. The risk factors for TB infection and disease include close contact with an active pulmonary TB case, HIV infection or AIDS, inactive disease not adequately treated, low income, underlying medical condition, homelessness, alcoholism, injection drug use, aboriginal background or occupation in health care. Risk settings include travel or residence in an endemic area or work or residence in a correctional facility, shelter, rooming house, residential facility, hospital or long-term care facility. Nurses need to advocate for the prompt diagnosis and isolation of suspected and confirmed TB cases. Knowing when to institute such measures as isolation in a negative pressure room, using respirator masks and limiting interpersonal contacts is vital to the nursing care of TB patients. In addition, the role of the public health department needs to be understood; for example, all jurisdictions have legislated requirements for reporting new positive TB skin tests to public health.
Zumla, Alimuddin; Maeurer, Markus; Chakaya, Jeremiah; Hoelscher, Michael; Ntoumi, Francine; Rustomjee, Roxana; Vilaplana, Cristina; Yeboah-Manu, Dorothy; Rasolof, Voahangy; Munderi, Paula; Singh, Nalini; Aklillu, Eleni; Padayatchi, Nesri; Macete, Eusebio; Kapata, Nathan; Mulenga, Modest; Kibiki, Gibson; Mfinanga, Sayoki; Nyirenda, Thomas; Maboko, Leonard; Garcia-Basteiro, Alberto; Rakotosamimanana, Niaina; Bates, Matthew; Mwaba, Peter; Reither, Klaus; Gagneux, Sebastien; Edwards, Sarah; Mfinanga, Elirehema; Abdulla, Salim; Cardona, Pere-Joan; Russell, James B. W.; Gant, Vanya; Noursadeghi, Mahdad; Elkington, Paul; Bonnet, Maryline; Menendez, Clara; Dieye, Tandakha N.; Diarra, Bassirou; Maiga, Almoustapha; Aseffa, Abraham; Parida, Shreemanta; Wejse, Christian; Petersen, Eskild; Kaleebu, Pontiano; Oliver, Matt; Craig, Gill; Corrah, Tumena; Tientcheu, Leopold; Antonio, Martin; Rao, Martin; McHugh, Timothy D.; Sheikh, Aziz; Ippolito, Giuseppe; Ramjee, Gita; Kaufmann, Stefan H. E.; Churchyard, Gavin; Steyn, Andrie; Grobusch, Martin; Sanne, Ian; Martinson, Neil; Madansein, Rajhmun; Wilkinson, Robert J.; Mayosi, Bongani; Schito, Marco; Wallis, Robert S.
The treatment of tuberculosis is based on combinations of drugs that directly target Mycobacterium tuberculosis. A new global initiative is now focusing on a complementary approach of developing adjunct host-directed therapies
Cobelens, Frank; van den Hof, Susan; Pai, Madhukar; Squire, S. Bertel; Ramsay, Andrew; Kimerling, Michael E.; Bhan, Anant; Chin, Daniel; Dewan, Puneet; Durovni, Betina; Dye, Chris; Goldhaber-Fiebert, Jeremy; Harper, Ian; Langley, Ivor; Leeflang, Mariska; Lienhardt, Christian; McCray, Eugene; Mukadi, Ya Diul; Nicol, Mark; O'Brien, Rick; Ridderhof, John; Schito, Marco; Small, Peter; Vassall, Anna; Zhao, Yanlin
Recently, new diagnostic tools for tuberculosis detection and resistance testing have become available. The World Health Organization endorses new tuberculosis diagnostics by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process. This endorsement process takes
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 ...
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...
C. Martín A Alvarado-Dulanto
Full Text Available En Latinoamérica la información del pronóstico de pacientes con enfermedad cerebrovascular (ECV es limitada. Por ello, se buscó determinar el pronóstico vital y funcional al año, de pacientes con debut de ECV. Se desarrolló un estudio de cohorte prospectivo, con seguimiento al año a pacientes con primer evento cerebrovascular reclutados en el servicio de medicina de un hospital nacional. Se recolectó datos sociodemográficos, antecedentes patológicos e información del evento. Se halló proporciones de mortalidad, diferencias entre subgrupos y se comparó la funcionalidad inicial y al año. Se incluyó 101 pacientes, 20,8% falleció durante el seguimiento, encontrándose mayor mortalidad en los mayores de 65 años y en aquellos severamente discapacitados tras el evento. La funcionalidad no mejoró al año. Se concluye que uno de cinco pacientes que debuta con ECV fallece al año, con mayor mortalidad en ancianos y en pacientes gravemente discapacitados. Es pertinente crear un sistema de seguimiento y soporte para prevenir evolución desfavorable en pacientes que sufren ECV
To evaluate the main features of TB epidemiology in 2012 in Poland and to compare with the corresponding EU data. Analysis of case- based clinical and demographic data on TB patients from Central TB Register, of data submitted by laboratories on anti-TB drug susceptibility testing results in cases notified in 2012, data from National Institute of Public Health - National Institute of Hygiene on cases of tuberculosis as AIDS-defining disease, from Central Statistical Office on deaths from tuberculosis based on death certificates, data from ECDC report "Tuberculosis Surveillance in Europe, 2014 (situation in 2012). 7 542 TB cases were reported in Poland in 2012. The incidence rate was 19.6 cases per 100 000, with large variability between voivodships from 10.6 to 30.2. The mean annual decrease of TB incidence in 2008-2012 was 2.4%. 6 665 cases had no history of previous treatment; 17.3 per 100 000. The number of all notified pulmonary tuberculosis cases was 7 018; 18.2 per 100 000. The proportion of extrapulmonary tuberculosis among all registered cases was 6.9% (524 cases). In 2012, 36 patients had fibrous-cavernous pulmonary tuberculosis (0.5% of all cases of pulmonary tuberculosis). TB was diagnosed in 95 children (1.3% of all cases, incidence 1.6). The incidence of tuberculosis increased progressively with age to 34.8 among patients 65 years old and older. The mean age of new TB cases was 53.1 years. The incidence among men (27.4) was more than two times higher than among women (12.2). The incidence rate in rural population was lower than in urban; 20.2 vs. 18.6. Bacteriologically confirmed pulmonary cases (4870) constituted 69,4% of all pulmonary TB cases. The number of smear positive pulmonary TB cases was 2 778 (39.6% of all pulmonary cases). In 2012 in the all group of TB patients in Poland there were 276 (3.7%) of homeless and 1 905 (25.3%) of unemployed. There were 48 foreigners registered among all cases of tuberculosis in Poland (0.6%) and 243 cases
Balkis A. Talip
Full Text Available Tuberculosis globally results in almost 2 million human deaths annually, with 1 in 4 deaths from tuberculosis being human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS-related. Primarily a pathogen of the respiratory system, aerobic Mycobacterium tuberculosis complex (MTBC infects the lungs via the inhalation of infected aerosol droplets generated by people with pulmonary disease through coughing. This review focuses on M. tuberculosis transmission, epidemiology, detection methods and technologies.
Full Text Available Giovanni Botero, en una célebre página de su Ragion di stato, se detuvo sobre el tema de la fuerza de la religión en los gobiernos. Esta función de la religión cristiana —para Botero, católica— es garante del orden público y se presenta también como opuesta a la generadora de desorden de Lutero y Calvino, quienes siembran por todo cizañas y revoluciones de estados y ruinas de los reinos. Estamos en los orígenes del esquema historiografía de la periodización de la Edad Moderna que confió precisamente a la Reforma el papel de nodriza de las revoluciones que nacieron en Europa.
Andrés Felipe Castelar
Full Text Available La presión social por constituir una forma indentitaria que sea acorde con el referente biológico es de origen histórico y se encuentra al servicio de prácticas de control y dominación social. Este artículo presenta una discusión sobre el lugar actual de la idea de identidad, especialmente en el plano de la sexualidad. Para esto recurre a la tesis de la filósofa Judith Butler, quien propone desde una visión deconstructivista y post-estructuralista una nueva definición de idenridad en términos de la iteración performativa. La identiclad es entendida entonces como una exigencia de inteligibiliclacl ante la sociedad, la cual limita las posibiliclades de expresión sexual.
Full Text Available O artigo tenta demonstrar que todos os textos, mesmo aqueles cuja natureza é teórica, têm alguma forma de narrativa. Nem sempre são personagens que os ocupam, podem ser ideias, mas mesmo assim há um enredo conceitual que se passa. Modernamente, a forma dessa narrativa foi sobretudo o sistema, com a pretensão totalizadora presente, por exemplo, na filosofia de Hegel. Contemporaneamente, porém, a forma do ensaio – surgida ainda na era moderna – ganha destaque por sua forma descontínua de narrar. O objetivo do artigo é apontar que, se o ensaio é uma forma, como explicitaram Lukács, Benjamin e Adorno, ele é também uma forma de narrar – ainda que de narrar conceitualmente objetos da cultura.
Full Text Available Se ofrece un amplio análisis sobre la industria electoral, recordando que un candidato a presidente es "un producto para la venta". Se Desmenuzan las estrategias utilizadas en el plebiscito chileno,las elecciones norteamericanas con el NO a BUSH. El Mercadeo Social es una nueva metodología utilizada en proyectos de desarrollo a nivel de campo por ello se hace un esclarecimiento y clarifica el vínculo con la comunicación. Se agrega temas como: Los modelos de recepción de mensajes cuyos marcos conceptuales y metodologías aún no se han adaptado al potencial de esta línea de trabajo.Se analiza la agonía de las radios mineras en Bolivia en la que 42 años de historia y heroísmo se desmoronan.
Tuberculosis can involve any part of the gastrointestinal tract from mouth to anus, the peritoneum and the pancreatobiliary system. Here we report a case of splenic tuberculosis in a 60-year-old man who presented with ascitis. Splenic tuberculosis is an unusual clinical presentation, especially in immunocompetent patients.
... 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, 1968...
BACKGROUND: In Burkina Faso, there is no recent data about the level of drug resistance in Mycobacterium tuberculosis strains among newly diagnosed tuberculosis cases. OBJECTIVE: To provide an update of the primary drug resistance of mycobacterium tuberculosis among patients in Burkina faso. METHODS: ...
... 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. ...
Early diagnosis of tuberculosis (TB) and prompt initiation of treatment are essential for an effective tuberculosis control programme. In many resource limited settings microscopic diagnosis is still the pivotal tool in the diagnosis of pulmonary TB. This study aimed at evaluating laboratory microscopic diagnosis of tuberculosis ...
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Tuberculosis. 311.2 Section 311.2... CERTIFICATION DISPOSAL OF DISEASED OR OTHERWISE ADULTERATED CARCASSES AND PARTS § 311.2 Tuberculosis. The... pathogenesis of tuberculosis in swine, cattle, sheep, goats, and equines. (a) Carcasses condemned. The entire...
Objectives. Drug resistance is a serious problem in the treatment of tuberculosis and a threat to successful tuberculosis control programmes. Local health workers have expressed concern that the increasing tuberculosis epidemic in the Western Cape is partly attributable to drug resistance. The aim of this study was to ...
Tuberculosis is a major public health problem in Nigeria. Drug resistant tuberculosis is now common place due to poor patient compliance and lack of detection of resistant strains. The occurrence of HIV has been responsible for an increased frequency of tuberculosis. Knowledge of the blood picture in pulmonary ...
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 ...
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 ...
Background: Tuberculosis is a major public health problem throughout the world. Nearly one third of the world's population is infected with Mycobacterium tuberculosis (MTB) and hence at risk of developing active disease. Tuberculosis is a major cause of morbidity and mortality in Ethiopia, and the country belongs to one of ...
Feb 3, 2005 ... Mycobacterium tuberculosis is superbly adapted to infect humans, and tuberculosis remains one of the most lethal infections to afflict our species. Tuberculosis has been described in the writings of many ancient civilisations and an estimated one-third of people alive today have latent infection. The global ...
Aug 1, 2005 ... February 2013 Downloaded from www.southsudanmedicaljournal.com. MaIN arTIClES. 10. Tuberculosis 2: Pathophysiology and microbiology of pulmonary tuberculosis. Robert L. Serafino Wania MBBS, MrCP, MSc (Trop Med). Pathophysiology. Inhalation of Mycobacterium tuberculosis leads to one of.
Talat, Najeeha; Perry, Sharon; Parsonnet, Julie; Dawood, Ghaffar; Hussain, Rabia
To assess the association between vitamin D deficiency and tuberculosis disease progression, we studied vitamin D levels in a cohort of tuberculosis patients and their contacts (N = 129) in Pakistan. Most (79%) persons showed deficiency. Low vitamin D levels were associated with a 5-fold increased risk for progression to tuberculosis.
With the completion of genome sequencing of Mycobacterium tuberculosis and upsurge in the incidence of M. tuberculosis infection worldwide partly as a result of HIV pandemic, there is need for rationale approach to vaccine and chemotherapy discoveries for M. tuberculosis. The homologue of mig gene of. Mycobacterium ...
Mapukata, A.; Andronikou, S.; Grobbelaar, M.; McCulloch, M.
Full text: Renal tuberculosis is relatively uncommon in children. Imaging of renal tuberculosis in children differs from adults in that intravenous urography is rarely performed for urinary symptoms in childhood because of radiation dose considerations. Modern imaging modalities include cross-sectional techniques such as ultrasound, CT and MRI, which successfully show renal, calyceal, ureteric and bladder pathology of renal tuberculosis in children
Vuyst, Dimitri De; Vanhoenacker, Filip; Bernaerts, Anja; Gielen, Jan; Schepper, Arthur M. de
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.)
The general X-ray-symptoms follow one another or appear at the same time: Swelling of soft tissues by fungus; toxic perifocal and sometimes parafocal osteoporosis; osteolysis by specific granulation tissues; destruction of adjacent discs and articulation cartilages; formation of sequesters; cold abscess and formation of fistulas because of perforation of the corticalis by liquified tuberculous tissue; bone compression and deformation; amorphous calcifications; perifocal osteosclerosis as a repairing process. The spondylitis tuberculosis is the most frequent form with about 50%; usually narrowing of the discspace is the earliest X-ray-finding. On the second and third place follow the tuberculosis of the hip- and the knee-joint, the rest shows up at other locations of red bone marrow. Very often the perifocal osteoporosis is the earliest X-ray-symptom of joint tuberculosis. All X-ray-findings, even the earliest, in reality are late symptoms, because at that time the disease exists at least some months. Radiologically only the differential diagnosis can be made, final diagnosis is established by histologic examination only. Because the course of untreated skeletal tuberculosis usually is chronic and destructive and, on the other hand early antituberculous chemotherapy as well as surgical treatment show excellent results early radiological suggestion of tuberculosis is of great importance for initiating other diagnostic procedures to establish the diagnosis. (orig./MG) [de
Vuyst, Dimitri De [Department of Radiology, AZ Sint-Maarten, Campus Duffel, Rooienberg 25, 2570 Duffel (Belgium); Vanhoenacker, Filip; Bernaerts, Anja [Department of Radiology, AZ Sint-Maarten, Campus Duffel, Rooienberg 25, 2570 Duffel (Belgium); Department of Radiology, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem (Belgium); Gielen, Jan; Schepper, Arthur M. de [Department of Radiology, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem (Belgium)
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.)
Elkard, I; Zaghba, N; Benjelloun, H; Bakhatar, A; Yassine, N
Tuberculosis is a major public health problem in Morocco. Tuberculosis of the lung bases is a rare and atypical form and raises real diagnostic problems. We report a retrospective study of 21 cases of basal pulmonary tuberculosis, collected at the service of respiratory diseases in Ibn Rushd hospital in Casablanca between 2004 and 2015 (11 years). From a total of 21 patients having basal pulmonary tuberculosis, 13 (62%) were women versus eight men (48%), the average age was 33 years. The average time of diagnosis was 25 days. The disease was unilateral in 20 cases (95%). The right lower lobe was the most frequently affected (71%). Inhomogeneous opacities (66%) and consolidation (28%) were the main radiological findings. Associated comorbidities were dominated by diabetes in six cases (28%). Bronchoscopy had recovered thickening spurs in eight cases, endobronchial granules in seven cases and bronchial inflammation in six cases. Bronchial biopsies had found a necrotizing granulomatous inflammation tuberculoide in seven cases (33%). The smear was positive in sputum in three cases (14%), in the bronchial aspirate in four cases (19%), in induced sputum in one case (4.7%) and in post-bronchoscopic sputum in six cases (28%). The antituberculous treatment was started in all patients with good clinical and radiological evolution. The basal localization of the pulmonary tuberculosis is misleading; source of diagnostic delay, hence the need to think about it especially in patients with comorbidities. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Full Text Available El artículo de Emmanuel Housset implica un esfuerzo de rehabilitación del concepto «persona» para la filosofía contemporánea y la fenomenología. Para ello el autor busca mostrar cómo poco a poco «persona» tomó otra significación que la de «personaje» o sujeto de derecho. Es en autores como san Agustín y santo Tomás de Aquino que se halla un acceso diferente que pone el énfasis más bien en su carácter relacional y responsivo de la persona, antes que en su dimensión autónoma y autotélica. Tal dimensión aparece, según Housset, junto con la idea de persona como creatura y en oposición a la de individuo racional dueño de sí. La dimensión afectiva, la personalidad despertada por las diversas figuras de la alteridad son algunas de las dimensiones de la persona que examina el autor a partir del examen de la carne, las pasiones, la memoria, la historicidad y el amor alteridad.Emmanuel Housset's paper is an effort to revitalize the concept of 'person' for contemporary philosophy and phenomenology To this end the author looks to show how little by little the understanding of 'person' took on a different meaning to that of 'character' or "right bearing individual". It is in authors such as St. Augustine and St. Thomas Aquinas that a different approach is found, one that puts emphasis on the relational and responsive character of a person, rather than on the autonomous and auto telic dimension. According to Housset, such a dimension appears together with the idea of the person as a creation, and in opposition to the idea of the rational individual, that is his own master. The emotional dimension and the personality that is awoken by the many figures of alterity are some of the dimensions of the person that the author analyzes, based on examining the flesh, passions, memory historicity and love.
Lucía Echevarría Lucas
Los linfocitos CD4+ T, leucocitos, macrófagos y granulocitos, con la producción de sus mediadores interferón gamma, IL-12 o TNF-α son fundamentales para controlar al Mycobacterium tuberculosis. Por ello, antes de introducir Interferón beta 1b, convendría realizar técnicas de screening, como la prueba de Mantoux o el interferon gamma release assay–(quantiferon-TB para detectar posibles tuberculosis latentes potencialmente activables.
Pasticci, Maria Bruna; Lupi, Carla; Mazzolla, Rosanna; Bragetti, Patrizia; Rubeca, Monica; Sfara, Claudio; Baldoni, Angelo; Fratini, Daniela; Baldelli, Franco
A case of miliary tuberculosis complicated by deciduitis and sub-chorionitis in a pregnant woman manifesting also influenza A/H1N1v infection and urinary tract infection is reported. Diagnosis of tuberculosis was obtained before delivery by examining amniotic fluid for Mycobacterium tuberculosis. Even though maternal symptoms did not suggest TB, diagnosis was early enough to start effective treatment in both the mother and the neonate and prevent in-hospital M.tuberculosis diffusion. A high index of suspicion by health professionals is required to detect and manage tuberculosis in pregnancy and newborns in both the developed and developing word.
Full Text Available Osteoarticular tuberculosis is one of the rare forms of extrapulmonary tuberculosis especially when it involve the foot bones. This article highlights rare case reports of 3 cases of osteoarticular tuberculosis, 2 affecting the bones of foot and the third, the distal femur. Out of three cases 2 were treated as category 3 of RNTCP (Revised national tuberculosis control programme and for the last case we added Inj. streptomycin during the first 2 months of treatment. It was found that the last case recovered quickly when compared to the other 2 cases. All three cases were very rare presentations amongst osteoarticular tuberculosis.
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.
René F. Espinosa Alvarez
Full Text Available Se conoce que la tuberculosis pulmonar constituye un serio problema de salud en la mayor parte de los países del mundo. En el nuestro existe un programa de control de dicha entidad y su conocimiento y objetivos son de vital importancia para el médico de la familia. Se analizó el comportamiento del programa nacional de tuberculosis pulmonar en el policlínico docente Lawton en el trienio 1995-1997, a cuyo efecto se revisaron desde el 1-1-95 al 31-12-97 los esputos indicados por los médicos de la familia de los 49 consultorios que existen en dicha unidad y se extrajeron los datos de las hojas de cargo de los médicos del departamento de estadísticas y del laboratorio clínico que controla esta actividad. Los resultados demuestran algunas dificultades que subsisten en el control de la enfermedad que pudieran solucionarse con una mayor dedicación a esta actividad por parte de los médicos de la familia como responsables directos de sus diferentes áreas de salud, así como de las autoridades sanitarias que tienen que ver con el problemaIt is known that pulmonary tuberculosis is a serious health problem in most of the countries. In our country, there is a tuberculosis control program whose knowledge and objectives are of vital importance for the family physician. The behavior of the national program to control pulmonary tuberculosis was analyzed at "Lawton" Teaching Polyclinic from 1995 to 1997. To this end the sputa ordered from 1-1-95 to 31-12-97 by the family physicians from the 49 physicians’ offices existing in this unit were reviewed. Data were given by the Statistics Department and by the Clinical Laboratory controlling this activity. The results show that there are still some difficulties to control this disease that may be solved through a greater dedication to this activity on the part of the family physicians as direct responsible of their different health areas, and of the health authorities having to do with this problem
Full Text Available Durante los últimos años el crecimiento mundial de catástrofes naturales ha ido en franco aumento. Sin embargo, desde un enfoque sistémico puede verificarse que la gran mayoría de los desastres se origina en los países en desarrollo (entre ellos los latinoamericanos, siendo las pérdidas en ellos significativamente más altas que en los países industrializados. Bajo esta postura los desastres no son sólo naturales sino socio- naturales, enfatizando la estrecha relación de causalidad entre modelos de desarrollo y urbanización y procesos de generación de riesgos, al incrementar la vulnerabilidad de los sectores más desprotegidos. El desastre pone en evidencia así una situación (la pobreza y segregación urbana ya existente, pero no considerada hasta el momento de la catástrofe. Frente a este panorama el desastre aparece como oportunidad que precipita tres catalizadores de políticas habitacionales: tierra, asistencia técnica y financiamiento, incrementando la celeridad y la creatividad de las respuestas. El interrogante que surge es por qué esperar el desastre para ponerlos en marcha, cuando ninguno de ellos es estrictamente dependiente de la situación de riesgo, sino sujeto de luchas de poder.
Full Text Available Atualmente, com a profissionalização das empresas e com a grande concorrência no mercado, observa-se uma demanda cada vez maior de gestores comprometidos com o bem-estar pessoal e profissional de seus colaboradores. E, com esse intuito, de apresentar algumas idéias básicas de gestão voltadas à aplicação nas mais diversas técnicas de Endomarketing. Demonstra assim, a importância da utilização de feedback, tanto por parte dos colaboradores quanto dos gestores, destacando a importância de trabalhos de motivação, do clima organizacional favorável e de uma comunicação interna eficaz e a necessidade ímpar de tratar o colaborador como o diferencial dentro de uma empresa. Desta forma, foi realizada uma pesquisa bibliográfica que auxiliará e dará subsídios que lhe permitam retribuir em ações e atitudes de sucesso e, também, fazer um confronto de idéias, onde os autores apresentam suas mais diversas opiniões. Contudo, valendo-se, muitas vezes, de narrativas de experiências de outros gestores e até mesmo de suas próprias, tirando cada um suas próprias conclusões.
Full Text Available Resumo A proposta deste artigo é pensar o lugar da testemunha como um lugar terceiro que o analista, na clínica do traumático, é capaz de sustentar. Nos sonhos traumáticos, segundo Ferenczi, já existe a convocação de um terceiro. Não se trata da testemunha da esfera do Direito, tampouco do lugar do pai ou da Lei simbólica. Trata-se de um terceiro espaço que pode ser chamado de potencial, espaço intersticial, indeterminado e informe no qual circula - e aos poucos ganha forma -, algo que a princípio seria incomunicável. Esse espaço permite e suporta a literalidade da narrativa testemunhal, seus titubeios, paradoxos e silêncios. Mais do que uma teoria do trauma, a noção de espaço potencial seria a grande contribuição da psicanálise às pesquisas teóricas e clínicas com sobreviventes de campos de extermínio, de situações de tortura e de violência.
Full Text Available The aim of this article is to study the signs and symbols that appear in the hispanic medieval documents and manuscripts. These signs and symbols have usually been considered simply as mere elements to validate the charters. However, these alements were useful as a mean of visual communication between the high classes, able to generate charters, and the rest of medieval society—the majority illiterate— who received those charters. Because of their inability of understand an alphabetical code, they needed the graphic help to comprehend the message. Besides this, the article deals with non diplomatic signs and their function.
Este artículo se centra en los signos o símbolos presentes en los documentos y manuscritos medievales hispanos, que habitualmente han sido tratados como meros elementos de validación de los diplomas. Pero estos elementos servían también de nexos de comunicación visual entre las clases poderosas, capaces de producir escritos, y los demás miembros de la sociedad medieval, receptores y destinatarios de tales escritos, en su mayoría analfabetos. Precisamente por esta razón, su incapacidad de descifrar un código alfabético, necesitan de auxilio gráfico para acercarse a la comprensión del mensaje. Asimismo, tratamos de los signos no diplomáticos y de su función.
Full Text Available Este artigo tem como ponto de partida o exemplo da relação espelhada entre um livro e uma pintura de mesmo nome: o retrato que Lucian Freud fez do crítico de arte Martin Gayford e o diário que esse crítico escreveu sobre seu retratista, ambas as obras chamadas Homem com cachecol azul. A partir do exemplo, discuto a metáfora do espelho para caracterizar a arte, recorrendo para isso à teoria da representação artísticas elaborada pelo filósofo norte-americano Arthur Danto no artigo “O mundo da arte”, de 1964, e no primeiro capítulo do livro A transfiguração do lugar-comum, de 1981. Recorro, por fim, a dois exemplos artísticos de espelhamento na representação analisados por Danto em O abuso da beleza, de 2003, um quadro holandês do século dezessete e um poema de Rainer Maria Rilke.
Vernon H Hoeppner
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.
Kienzl-Palma, D.; Prosch, H.
Besides the lungs, tuberculosis (TB) can affect any organ system. In most cases, extrathoracic TB occurs in immunosuppressed patients as part of a severe illness via hematogenous spread. Extrathoracic involvement most commonly involves abdominal organs, especially the urogenital tract and less commonly the central nervous system (CNS) and the musculoskeletal system. Most frequently, computed tomography (CT) is used for detecting extrathoracic TB manifestations, except for CNS and musculoskeletal manifestations, where contrast-enhanced magnetic resonance imaging (MRI) is the gold standard. Extrathoracic manifestations of TB may be indistinguishable from inflammatory or malignant causes. Due to unspecific symptoms the diagnosis is often delayed. This article summarizes and discusses the various radiological manifestations of extrathoracic manifestation of TB. Radiological modalities for screening extrathoracic TB are CT and MRI. Conventional X-radiographs do not play a role in the diagnosis of extrathoracic TB. The possibility of extrathoracic TB should be considered particularly in immunosuppressed patients, such as the homeless, alcoholics or drug addicts or in patients with an immigrant background from the endemic areas of TB. The most likely site of extrathoracic TB is the abdomen; however, infections of the CNS or musculoskeletal systems and multisystem infections can also occur. In patients with suspected extrathoracic TB, radiological modalities for screening are CT, especially for abdominal infections and lymphadenopathy and MRI with contrast media for the musculoskeletal system and the CNS. (orig.) [de
Gupta, R.K. (Dept. of Radiology, Sanjay Gandhi Postgraduate Inst. of Medical Sciences, Lucknow (India)); Gupta, S. (Dept. of Radiology, Sanjay Gandhi Postgraduate Inst. of Medical Sciences, Lucknow (India)); Kumar, S. (Dept. of Radiology, Sanjay Gandhi Postgraduate Inst. of Medical Sciences, Lucknow (India)); Kohli, A. (Dept. of Neurology, Sanjay Gandhi Postgraduate Inst. of Medical Sciences, Lucknow (India)); Misra, U.K. (Dept. of Neurology, Sanjay Gandhi Postgraduate Inst. of Medical Sciences, Lucknow (India)); Gujral, R.B. (Dept. of Radiology, Sanjay Gandhi Postgraduate Inst. of Medical Sciences, Lucknow (India))
We studied 20 patients with intraspinal tuberculosis (TB), to characterise the MRI features of tuberculous meningitis and myelitis. MRI leptomeningitis and intramedullary involvement in 11 patients, intramedullary lesions alone in 5, leptomeningitis alone in 2, and isolated extradural disease in 2. TB leptomeningitis was characterised by loculation of the cerebrospinal fluid (CSF), nerve root thickening and clumping (seen only in the lumbar region) or complete obliteration of the subarachnoid space on unenhanced images. Gd-DTPA-enhanced images proved useful in 6 cases, revealing linear enhancement of the surface of the spinal cord and nerve roots or plaque-like enhancement of the dura-arachnoid mater complex. Intramedullary lesions included tuberculomas (8), cord oedema (5) and cavitation (3). In seven cases of intramedullary tuberculoma multiple lesions with skip areas were seen, without significant cord swelling. One patient had an isolated lesion in the conus medullaris. The lesions were iso- or hypointense on T1-weighted images, iso-, hypo- or hyperintense on T2-weighted images and showed rim or nodular enhancement with contrast medium. (orig.)
Full Text Available Tuberculosis (TB in children is a neglected aspect of the TB epidemic despite it constituting 20% or more of all TB cases in many countries with high TB incidence. Childhood TB is a direct consequence of adult TB but remains overshadowed by adult TB because it is usually smear-negative. Infants and young children are more likely to develop life-threatening forms of TB than older children and adults due to their immature immune systems. Therefore, prompt diagnoses are extremely important although difficult since clinical and radiological signs of TB can be non-specific and variable in children. Despite undeniable advances in identifying definite, probable, or possible TB markers, pediatricians still face many problems when diagnosing TB diagnosis. Moreover, curing TB can be difficult when treatment is delayed and when multi-drug resistant (MDR pathogens are the cause of the disease. In these cases, the prognosis in children is particularly poor because MDR-TB treatment and treatment duration remain unclear. New studies of diagnostic tests and optimal treatment in children are urgently needed with the final goal of developing an effective anti-TB vaccine.
Full Text Available Tuberculosis (TB is one of the major health problems that our country is facing today. Despite active interventions by our government, control of TB still remains to be achieved. The emergence and exponential growth of the human immunodeficiency virus and drug-resistant strains threaten to further complicate the TB situation in our country. Even in this era of advanced chemotherapy, many lives are lost every day in our country. Tuberculosis of the urinary tract, despite being one of the commonest forms of extra-pulmonary TB, is generally overlooked. Most patients present with vague lower urinary symptoms typical of urinary tract infection. In this article, we shall highlight the various issues related to the surgical management of renal and ureteral tuberculosis.
Full Text Available About 39330, new patients were examined over a period of two years and it was revealed that 104 patients (0.26% had cutaneous tuberculosis. Most of the tuberculosis patients (61.52% were between the age of 5 to 25 years. Lupus vulgaris was the commonest variant (57.69%, followed by scrofuloderma (21.15%. Males suffered more than females (2.25:1 and all patients belonged to lower socio-economic class. 62 cases (59.61% showed evidence of BCG vaccination that failed to protect cutaneous tuberculosis. Mantoux test was positive in all cases except 4. Bacteriological examination was negative in all cases. Response to antitubercular therapy was very good except in two cases which required addition of an extra drug and also took more time.
Bowong, Samuel; Aziz Alaoui, A. M.
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.
Bjerrum, Stephanie Mia Katrine; Bonsu, Frank; Hanson-Nortey, Nii Nortey
BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...... May and October 2014, before and after a performance feedback intervention in August 2014. The outcomes of interest were overall tuberculosis suspicion rate during consultations and provider adherence to the International Standards for Tuberculosis Care and the World Health Organizations' guidelines...
Infection with M. tuberculosis remains one of the most common infections in the world. The outcome of the infection depends on host ability to mount effective protection and balance inflammatory responses. Neutrophils are innate immune cells implicated in both processes. Accordingly, during M. tuberculosis infection, they play a dual role. Particularly, they contribute to the generation of effector T cells, participate in the formation of granuloma, and are directly involved in tissue necrosis, destruction, and infection dissemination. Neutrophils have a high bactericidal potential. However, data on their ability to eliminate M. tuberculosis are controversial, and the results of neutrophil depletion experiments are not uniform. Thus, the overall roles of neutrophils during M. tuberculosis infection and factors that determine these roles are not fully understood. This review analyzes data on neutrophil defensive and pathological functions during tuberculosis and considers hypotheses explaining the dualism of neutrophils during M. tuberculosis infection and tuberculosis disease. PMID:28626346
J. Hernando Ordoñez
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Comentario sobre su origen endógeno y sus aplicaciones terapéuticas
Pocas drogas han sido más estudiadas que el grupo de los digitálicos, estrofantinas y ouabaina, cuyo estudio es objeto del presente trabajo.
La ouabaina empezó a ser estudiada desde el siglo pasado. La primera referencia conocida corresponde a Pelikan, 1865 (1, como veneno que empleaban para las flechas en Gabón (Africa. (.
(. Vinieron luego los trabajos de Fraser, 1869, (2, 3, 6, Polaillon, 1871 (4, Amaud, 1888 (5, Vaquez y Lutembacher, 1917 (7, Stoll, 1939 (8, Lapicque, 1929 (9, Wiggers, 1927 (10, Ytantos otros (11, 12, 13. En la obra de Kisch (14 aparecen más de 700 referencias bibliográficas sobre el particular.
Ouabaina de origen endógeno. Purificación
Durante muchos años se conoció la ouabaina como de origen vegetal, elaborada por las plantas Strophanthus Glaber(k-estrofantina,AcocantheraOuabaio(Ouabaina yStrophanthus Kombe (k-estrofantina y kestrofantósido. Una propiedad común a todos los digitálicos, estrofantina y ouabaina es que todos son inhibidores de la bomba de Na-K, encargada de regular la salida de Na y la entrada de K celular.
Estudiando los inhibido res de esta bomba han encontrado en años recientes resultados extraordinarios en relación con el origen endógeno de algunos de estos inhibidores, entre ellos la ouabaina. Por considerarlos de extrema importancia y actualidad científica me permito citar algunos de ellos. Hamlyn y Manunta (15, 16, 17, 18, Y 19 hicieron estudios sobre el particular y lograron identificar en el plasma humano un compuesto igual a la ouabaina. Estos hallazgos fueron confirmados después por otros autores (20, 21, 22, 23 Y24.
Ham bl yn (19 da varios argumentos que ponen en evidencia que el compuesto químico encontrado es ouabaina pura, y, lo que es más interesante, que tiene un origen endógeno. a Por espectroscopia de alta resoluci
Full Text Available We have examined one of the facets which Law presents to society, looking at the theme through a brief history of Law, in which Roman Law stands out, up to modem times, comparing current juridical systems such as the Continental System, Common Law, and Soviet Law. We have looked at Law from the viewpoint of society 's need to have basic mies for living together, with the juridical ruZe being one of the most important. We have highlighted the views of Hart and Kelsen on the foundations of the validity of Law. We have also considered the obligatoriness of Law; giving the point of view of tadbruch who, explaining his ''Theory of the Obligatoriness of Law ", concluded that the obligatoriness of Law can only be withdraw when there is a Clash between morals, law, use and social conventions. We have looked at the notion of the imperativeness of Law the central theme of the work -drawing on the views of Miguel Reale, for whom the juridical nonn cannot be reduced to a "command of a volitional nature", but rather the obligatory character of the juridical nonn arises from the pressure of social values. Del Vecchio, who is also quoted, recognized that imperativeness exists in the juridical norm, whether it is preceptive (a positive command or permissive. Also mentioned is the opinion of Tercio Sampaio Ferraz, for whom the juridical norm has imperativeness to the extent that the imposition of behaviour is unconditionally guaranteed. Foi feita a abordagem de uma das facetas com que o Direito se apresenta à sociedade, enfocando o tema a partir de um brevíssimo histórico do Direito, onde revela a fase romana, até os períodos modernos, com comparações dos sistemas jurídicos hodiernos, como o sistema continental, o da Commum Law e o soviético. Foi enfocado o Direito em face da necessidade sociedade em ter básicas de convivência, despontando a regra jurídica como das mais importantes. Foi dado destaque às posições de Hart e Kelsen, sobre os
Moon, Un Hyeon; Lee, Jeong Seok; Ko, Kang Seok; Park, Byung Ran; Yang, Dong Cheol; Im, Ju Hyeon; Kang, In Young
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
Moon, Un Hyeon; Lee, Jeong Seok; Ko, Kang Seok; Park, Byung Ran; Yang, Dong Cheol; Im, Ju Hyeon [Kwangju Christian Hospital, Kwangju (Korea, Republic of); Kang, In Young [Kwangju Green Cross Hospital, Kwangju (Korea, Republic of)
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.
Full Text Available Resumen OBJETIVO Describir los conocimientos y percepciones sobre tuberculosis en asistentes a los cursos de educación vial para operarios del transporte público en Lima, Perú. MÉTODOS Estudio transversal realizado entre junio y agosto del año 2014, en asistentes al Curso de Educación Vial en Lima (Perú, que son obligatorios para laborar como trabajador del transporte público en dicha ciudad. Se aplicó una encuesta anónima y voluntaria para recolectar datos incluyendo características sociodemográficas, antecedente de tuberculosis, conocimientos y actitudes sobre tuberculosis. Se evaluaron los factores asociados a la percepción de riesgo de contagio mediante la regresión de Poisson. RESULTADOS De un total de 309 asistentes, se analizaron 216 encuestas (69,9%. El 88,4% fue de sexo masculino, 3,2% había tenido antecedente de tuberculosis, el síntoma más reconocido fue la tos con flema (44,4%, la fuente de información más popular fue la televisión (39,8%, en tanto que sólo 9,7% recibió alguna capacitación sobre tuberculosis. El 41,2% percibió que ser conductor o cobrador de bus es de alto riesgo para contraer tuberculosis, lo cual no estuvo significativamente asociado a otras variables del estudio. CONCLUSIÓN En la población encuestada se observó escaso conocimiento sobre la sintomatología de la tuberculosis, escasa capacitación recibida sobre el tema y baja percepción de riesgo para contraer esta enfermedad. Urge implementar estrategias de educación dirigidas a dicha población.
Xue He, Guang; van den Hof, Susan; van der Werf, Marieke J.; Guo, Hui; Hu, Yuan Lian; Fan, Ji Huan; Zhang, Wei Min; Tostado, Christopher P.; Borgdorff, Martien W.
This investigation of tuberculosis (TB) treatment regimens in 6 TB hospitals in China showed that only 18% of patients with new cases and 9% of patients with retreatment cases were prescribed standard TB treatment regimens. Adherence to treatment guidelines needs to be improved in TB hospitals to
Bélard, Sabine; Heller, Tom; Orie, Viyanti; Heuvelings, Charlotte C.; Bateman, Lindy; Workman, Lesley; Grobusch, Martin P.; Zar, Heather J.
Ultrasound reports of 102 children with microbiologically confirmed or clinically diagnosed pulmonary tuberculosis (TB) showed that 23 of 37 (64%) and 23 of 65 (36%) had TB suggestive abdominal lymphadenopathy, and 16 of 37 (44%) and 8 of 65 (13%) had splenic microabscesses, respectively. Splenic
Jacqueline Hernandez Escolar
Full Text Available Objetivo: Evaluar los conocimientos sobre Tuberculosis (TB Infantil, que tienen las madres comunitarias de Cartagena. Método: Estudio descriptivo realizado con 49 madres comunitarias a las cuales se aplicó una encuesta para evaluar variables sociodemográficas y un cuestionario con 50 preguntas, para medir conocimientos sobre tuberculosis en los niños. Se evaluaron cinco grandes aspectos, (diez preguntas para cada uno así: características de la enfermedad, factores de riesgo, prácticas de prevención, manifestaciones clínicas e identificación de casos, y ruta de atención para los casos sospechosos. Los datos se almacenaron y analizaron en una base de datos del programa SPSSS versión 21, fueron calculadas medidas de frecuencias para las variables categóricas, medidas de tendencia central y desviaciones estándar para variables cuantitativas. Resultado: Del total de participantes, 91,6% (40 desconoce que un individuo con tuberculosis latente puede transmitir la enfermedad; 38,8% (19 no conoce el riesgo que tienen los menores de un año a contagiarse; 22,4% (11 no identifica como factor de riesgo para los niños el contacto estrecho con una persona enferma. Solo el 2% (1 reconoce como signo sugestivo de la enfermedad tuberculosa en los niños la presencia de tos por más de 21 días. Conclusión: Las madres comunitarias de éste estudio tienen poco conocimiento acerca de la TB infantil. Se considera necesario realizar intervenciones educativas a estos actores sociales para que tengan conocimientos amplios sobre este tema.
Full Text Available According to the World Health Organization (WHO, 10.4 million people died of tuberculosis (TB in 2015, and the disease is now the number one cause of death from a preventable infectious disease worldwide. A bold vision is needed from global leaders to end the TB epidemic and plans to this end have been proposed. However enthusiasm must be matched by tangible and achievable goals based on the science and available funding. In order to reach the target and goals set by the WHO End TB Strategy, the challenges for TB eradication need to be addressed. In order to achieve the targets, several areas need to be bolstered, including the requirement to better identify and treat existing drug-susceptible cases and diagnose all the drug-resistant forms of the disease. Although treatment is available for most TB patients, stock-outs and other delays are problematic in some settings, resulting in ongoing transmission, especially for the drug-resistant forms of the disease. Despite the fact that a majority of multidrug-resistant cases are linked to treatment, the cure rate is only 50%, which highlights the need for safer, shorter, and more efficacious drug regimens that are more tolerable to patients. Prospects for a more efficacious vaccine are limited, with no correlates of protection identified; thus the availability of a vaccine by 2025 is highly improbable. Support for instituting infection control methods should be prioritized to subvert transmission while patients seek treatment and care. Finally, more adequate financial mechanisms should be instituted to reduce patient expenditures and support national TB programs. Moreover, funding to support basic science, drug development, clinical trials, vaccine development, diagnostics, and implementation research needs to be secured in order to reduce global TB incidence in the future.
Rangaka, Molebogeng X.; Cavalcante, Solange C.; Marais, Ben J.; Thim, Sok; Martinson, Neil A.; Swaminathan, Soumya; Chaisson, Richard E.
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 critical opportunity to interrupt tuberculosis transmission and reduce the global burden of tuberculosis disease. Programs focusing on single strategies rather than comprehensive programs that deliver an integrated arsenal for tuberculosis control may continue to struggle. Tuberculosis preventive therapy is a poorly utilized tool that is essential for controlling the reservoirs of disease that drive the current 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. This paper outlines challenges to implementation of preventive therapy and provides pragmatic suggestions for overcoming them. It further advocates for tuberculosis preventive therapy as the core of a renewed global 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, community engagement, and enhance sustainable large scale implementation of preventive therapy programs. PMID:26515679
Suleiman, M M A; Sahal, N; Sodemann, Morten
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...
negative disease, they have only limited use in TB endemic settings, primarily because of their cost and complexity. 6. Chest radiography. While radiography is a commonly performed investigation, it must be remembered that patients with HIV co-infection may not have typical radiographic features of pulmonary tuberculosis ...
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.
calculi were seen. The gynaecology team ruled out pelvic inflammatory disease. The Surgery Unit requested a computed tomography (CT) scan of the abdomen and a sputum specimen for tuberculosis (TB) diagnosis (no record of the latter could, however, be found). The CT scan confirmed the mass in the region of the ileo-.
Kumar, Prawin; Kumar, Amber; Lodha, Rakesh; Kabra, S K
Tuberculosis (TB) in children is a common cause of morbidity. Diagnosis is difficult because of paucibacillary nature of illness and difficulty in obtaining appropriate samples. Children presenting with poor weight gain, fever with or without cough for more than two weeks or contact with an adult in family with pulmonary tuberculosis should be investigated for TB. In all suspected cases of tuberculosis initial investigations include radiograph of chest (CXR) and Mantoux test. If CXR is suggestive of TB, an ambulatory gastric aspirate and induced sputum for acid fast bacilli (AFB) smear may be carried out in two days. Children with AFB positive or abnormal CXR with positive Mantoux test should be started on Antitubercular therapy (ATT). Rest of the patients require more investigations and should be referred to a specialist. All children with newly diagnosed tuberculosis should be treated with 6 mo of ATT (two months with 4 drugs, followed by four months with 2 drugs). Children on ATT should be monitored for improvement in symptoms and weight gain along with side effects of medications. CXR should be done after completion of treatment.
While radiography is a commonly performed investigation, it must be remembered that patients with HIV co-infection may not have typical radiographic features of pulmonary tuberculosis. While patients with higher CD4 cells (>350 cells/mm3) have radiographic abnormalities similar to their. Soumya Swaminathan and G ...
Jamieson, D.H. [Dept. of Radiology, Red Cross War Memorial Children`s Hospital, Rondebosch (South Africa)
A morphologically based imaging review of intracranial tuberculosis in childhood is presented. The computed tomography and magnetic resonance features of parenchymal tuberculoma, tuberculous meningitis and meningeal/meniningocerebral tuberculoma are illustrated. Recent insight into the nature of tuberculoma necrosis and its magnetic resonance correlation is reviewed. Pathogenesis, relevant clinical background and the role of modern imaging is discussed. (orig.)
Dr Oboro VO
Also efforts should be made to ensure that all positive cases .... tuberculosis situation in some cities of the country such as Portharcourt .... countries were above the age of 50 (17, 25) . Of the 350 smear-positive patients, 235 were tested for HIV infection. 63 (26.8%) of these were positive. This agrees with the WHO estimate.
Oct 15, 2008 ... 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 ... The diagnosis of TB is based on sputum smear microscopy, a 100-year old technique and chest radiography, which has problems of specificity.
Petrović, Slobodanka; Pribić, Radmila Ljustina; Rodić, Branislavka Bjelica; Dautović, Gordana Vilotijević; Cegar, Svetlana
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. 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. 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. If the condition is recognised and treated according to existing tuberculosis protocols, the outcome is favourable.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mycobacterium tuberculosis immunofluorescent... § 866.3370 Mycobacterium tuberculosis immunofluorescent reagents. (a) Identification. Mycobacterium... used to identify Mycobacterium tuberculosis directly from clinical specimens. The identification aids...
Rooyackers, Johanna Hendrica
Inclusion criteria were study populations of patients with predominantly pulmonary tuberculosis, cervical tuberculous lymphadenitis, tuberculous meningitis, spinal tuberculosis and tuberculosis of the kidney and urinary tract. The diagnosis had been confirmed bacteriologically and/or
Full Text Available La transmisión nosocomial de la tuberculosis (TB es un problema vigente en el Perú, tanto por el riesgo de enfermar que corre el personal de salud y pacientes, como por la presencia cada vez más frecuente de cepas resistentes: TB MDR (multidrogo resistente, TB XDR (extensivamente resistente a drogas. Se describen los factores condicionantes de la transmisión de TB en los hospitales, así como las medidas de control recomendadas, incluyendo: 1 control administrativo, 2 control ambiental y 3 protección respiratoria personal. Además, se señala la importancia de los Planes de Control de Infecciones de Tuberculosis en los hospitales y la experiencia en su implementación en 19 centros hospitalarios del país.
Dra. María Elena Guarda
Full Text Available La tuberculosis sigue siendo una epidemia mundial. En Chile en los últimos años se ha mantenido la tasa de enfermos con tuberculosis. En niños el diagnóstico es un desafio, ya que los elementos considerados como gold estándar como la baciloscopía y cultivos suelen ser falsos negativos. La prueba de tuberculina (PPD e IGRAS son pruebas complementarias con una sensibilidad y especificidad variable. La imágenes son un elemento fundamental en el contexto de un paciente sospechoso. En esta revisión se abarca la epidemiología, proceso diagnóstico (historia clínica, metodos diagnósticos, tratamiento y prevención en el niño.
Bothamley, G.H.; Ditiu, L.; Migliori, G.B.
Tuberculosis control depends on successful case finding and treatment of individuals infected with Mycobacterium tuberculosis. Passive case finding is widely practised: the present study aims to ascertain the consensus and possible improvements in active case finding across Europe. Recommendations...
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.
Lauer Jeremy A; Williams Brian G; Roglic Gojka; Forouhi Nita G; Stevenson Catherine R; Dye Chirstopher; Unwin Nigel
Abstract Background Tuberculosis (TB) remains a major cause of mortality in developing countries, and in these countries diabetes prevalence is increasing rapidly. Diabetes increases the risk of TB. Our aim was to assess the potential impact of diabetes as a risk factor for incident pulmonary tuberculosis, using India as an example. Methods We constructed an epidemiological model using data on tuberculosis incidence, diabetes prevalence, population structure, and relative risk of tuberculosis...
Kirenga, Bruce J.; Ssengooba, Willy; Muwonge, Catherine; Nakiyingi, Lydia; Kyaligonza, Stephen; Kasozi, Samuel; Mugabe, Frank; Boeree, Martin; Joloba, Moses; Okwera, Alphonse
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
Kirenga, B.J.; Ssengooba, W.; Muwonge, C.; Nakiyingi, L.; Kyaligonza, S.; Kasozi, S.; Mugabe, F.; Boeree, M.J.; Joloba, M.; Okwera, A.
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
Jennifer Monguí Riaño; Hilda Clemencia Villamil Ramírez; Lina María Maestre Daza; Alba Idaly Muñoz Sánchez
Los trabajadores de la salud son considerados de alto riesgo para el contagio de enfermedades como la Tuberculosis (TB), siendo la exposición a pacientes infectados uno de los peligros a los que se enfrentan. Este estudio tiene como objetivo caracterizar a los trabajadores de la salud que han padecido de tuberculosis en Bogotá en el período comprendido entre el año 2009-2011. Estudio cuantitativo, exploratorio, retrospectivo se analizaron los datos extraídos de la base de datos del Sistema de...
Christian Mauricio Rojas
Conclusiones. El período tan amplio comprendido entre el inicio de los síntomas y el diagnóstico de la enfermedad, se ha identificado previamente como factor de riesgo para el abandono de terapia. Las características epidemiológicas son similares a las descritas para los pacientes con tuberculosis pulmonar. Los hallazgos radiográficos indicativos de tuberculosis son diversos y no corresponden en su mayoría a cavernas. La infección concomitante con VIH fue identificada como parte del abordaje de la enfermedad por micobacterias en todos los casos.
den Boon, S.; van Lill, S. W. P.; Borgdorff, M. W.; Verver, S.; Bateman, E. D.; Lombard, C. J.; Enarson, D. A.; Beyers, N.
Background: Associations between smoking and tuberculosis disease including death from tuberculosis have been reported, but there are few reports on the influence of smoking on the risk of developing Mycobacterium tuberculosis infection. The aim of this study was to determine the association between
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.
Getahun, Haileyesus; Matteelli, Alberto; Abubakar, Ibrahim; Aziz, Mohamed Abdel; Baddeley, Annabel; Barreira, Draurio; den Boon, Saskia; Borroto Gutierrez, Susana Marta; Bruchfeld, Judith; Burhan, Erlina; Cavalcante, Solange; Cedillos, Rolando; Chaisson, Richard; Chee, Cynthia Bin-Eng; Chesire, Lucy; Corbett, Elizabeth; Dara, Masoud; Denholm, Justin; de Vries, Gerard; Falzon, Dennis; Ford, Nathan; Gale-Rowe, Margaret; Gilpin, Chris; Girardi, Enrico; Go, Un-Yeong; Govindasamy, Darshini; D Grant, Alison; Grzemska, Malgorzata; Harris, Ross; Horsburgh, C. Robert; Ismayilov, Asker; Jaramillo, Ernesto; Kik, Sandra; Kranzer, Katharina; Lienhardt, Christian; LoBue, Philip; Lönnroth, Knut; Marks, Guy; Menzies, Dick; Migliori, Giovanni Battista; Mosca, Davide; Mukadi, Ya Diul; Mwinga, Alwyn; Nelson, Lisa; Nishikiori, Nobuyuki; Oordt-Speets, Anouk; Rangaka, Molebogeng Xheedha; Reis, Andreas; Rotz, Lisa; Sandgren, Andreas; Sañé Schepisi, Monica; Schünemann, Holger J.; Sharma, Surender Kumar; Sotgiu, Giovanni; Stagg, Helen R.; Sterling, Timothy R.; Tayeb, Tamara; Uplekar, Mukund; van der Werf, Marieke J.; Vandevelde, Wim; van Kessel, Femke; van't Hoog, Anna; Varma, Jay K.; Vezhnina, Natalia; Voniatis, Constantia; Vonk Noordegraaf-Schouten, Marije; Weil, Diana; Weyer, Karin; Wilkinson, Robert John; Yoshiyama, Takashi; Zellweger, Jean Pierre; Raviglione, Mario
Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health
S K Das
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.
Habibullah, S.; Sheikh, M.A.; Sadiq, A.; Anwar, T.
Objective: To find out the average duration from onset of symptoms to the diagnosis and treatment of tuberculosis, reasons for diagnostic delay, its consequences, association of variables and formulation of recommendations. Results: In this study it was found that average time from onset of initial symptoms to diagnosis and treatment of tuberculosis was 120 days. In 64% of the patients medical practitioners were responsible for delaying the diagnosis of tuberculosis. Loss of weight in 40% and haemoptysis is 21% were the consequences of diagnostic delay of tuberculosis. Delay in the diagnosis of tuberculosis was statistically significant in those patients who consulted private practitioners, and consequences of tuberculosis were severe in those patients who consulted late. (author)
Navarro, Pedro Daibert de; Almeida, Isabela Neves de; Kritski, Afrânio Lineu; Ceccato, Maria das Graças; Maciel, Mônica Maria Delgado; Carvalho, Wânia da Silva; Miranda, Silvana Spindola de
,05-2,18) e uso de drogas inaláveis (OR ajustada = 1,48; IC95%: 1,03-2,13). Foram identificados 131 pacientes sintomáticos respiratórios (11,7%). O teste anti-HIV foi realizado em 940 (83,9%) dos participantes, sendo positivo em 5 indivíduos (0,5%). Dois casos de tuberculose ativa foram identificados no período do estudo. A prevalência de ILTB dentro das penitenciárias estudadas foi alta. Além disso, a ILTB estava associada ao relato de contato com casos de tuberculose e ao uso de drogas inaláveis. Nossos achados demonstram que é necessária a melhoria das condições de encarceramento e a utilização de outras estratégias, como a triagem por radiografia de tórax, para a descoberta de casos de tuberculose e redução da infecção pelo M. tuberculosis no sistema penitenciário.
Venz, S.; Sander, B.; Benndorf, G.; Terstegge, K.; Podrabsky, P.; Cordes, M.; Felix, R.
We reported three cases of acute intracranial tuberculosis including miliary tuberculosis, basal meningitis, tuberculomas and neuritis of cranial nerves. All patients had native and contrast enhanced CT and MRI scans. MRI revealed more granulomas and a better imaging contrast in the detection of basal meningitis. Neuritis was diagnosed only with the MRI. MRI scans should be prefered as the imaging procedure in clinically presumed intracranial tuberculosis. (orig.) [de
B N Praveen
Full Text Available Tuberculosis is most common disease in developing countries because of lack of public health awareness, poverty, nutritional deficiencies, absence of medical facilities. Primary oral lesions in tuberculosis are still exceedingly rare. Oral involvement may be primary or secondary to systemic involvement. Involvement of oral cavity is rare accounting for 0.2-1.5% of cases. A rare case report of primary oral tuberculosis is presented.
Montejo, M; Alonso, M; Aguirrebengoa, K; Moreno, G; Goicoetxea, J; Petreñas, E; Bañuelos, S; Vergez, A
We report 11 patients with laryngeal tuberculosis seen in our hospital, January 1990 to July 2000. Eight were men and all cases presented with dysphonia and/or disphagia. In 8 pulmonary tuberculosis was associated. Mycobacterium tuberculosis was isolated from the sputum in 7 patients. Granulomatous laryngitis was demonstrated in the eight patients with laryngeal biopsy. The evolution with medical treatment was favourable in all patients.
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
Martino, M; Hubbard, G B; Schlabritz-Loutsevitch, N
Old World monkeys are considered more susceptible to tuberculosis (TB) than New World monkeys. Several cases of TB in baboons are described in the literature. The data regarding baboon reaction to the tuberculin skin test (TST) are controversial. Some authors described anergy in this species, while the others documented a positive reaction. An 8-year-old clinically healthy pregnant female baboon (Papio cynocephalus anubis) developed positive TST after 3 years of negative tests in captivity while not pregnant. Thoracic radiographs demonstrated three nodular densities in the lung. Histological examination of tracheobronchial lymph nodes revealed multiple coalescing pyogranulomas filled with caseonecrotic debris and mineralized foci with numerous large foreign body-type and Langhans-type multinucleated giant cells. The bacterial culture contained a slow growing Mycobacterium tuberculosis complex. We describe, to the best of our knowledge, the first case of a positive TST in a wild caught, pregnant baboon with latent infection after 3 years in captivity.
Everardo Valdés Pacheco
Full Text Available Se realiza una revisión bibliográfica sobre el tema de la Tuberculosis, con el objetivo de llamar la atención sobre su importancia hoy y para actualizar algunas concepciones modernas. Desde 1986, se comienza a detectar una elevación en la presentación de casos de Tuberculosis en todo el mundo, principalmente en los países en desarrollo. La infección respiratoria continúa siendo la forma principal, pero la presencia de la infección VIH/ SIDA, tiene una especial susceptibilidad a la infección tuberculosa, al estar afectados los linfocitos t4 presentándose en estos casos con frecuencia las formas extrapulmonares. Se necesitan técnicas de diagnóstico más efectivas, rápidas y sencillas. El tratamiento se recomienda que sea con 3 o más medicamentos simultáneamente y realizarse de forma completa, y es imprescindible el apoyo financiero gubernamental para este propósito. La prevención es vital en cualquier programa de control y debe ser dirigido tanto al individuo susceptible, como al personal de salud que trabaja en contacto con estos pacientes.A bibliographic review is made on the topic of tuberculosis aimed at calling the attention on its importance at present and at updating some modern conceptions. Since 1986, the number of cases with tuberculosis has increased all over the world, mainly in the developing countries. The respiratory infection is still the principal form, but the presence of HIV/AIDS infection has a special susceptibility to tuberculosis, since the 14 lymphocytes are affected. The extrapulmonary forms appear frequently in these cases. More effective, faster and easier diagnostic techniques are necessary. It is a recommended a complete treatment with 3 or more drugs used simultaneously. It is essential the governmental financial support fo this purpose. Prevention is vital in any program of control and it should be directed not only to the susceptible individual, but also to the health personnel working with these
Leonardo Conrado Barbosa de Sá
Full Text Available A apresentação faringolaríngea da tuberculose como forma isolada da doença é rara, entretanto, nos últimos anos, com o aumento progressivo do número de casos de tuberculose em geral, a possibilidade dessas localizações aumentou. OBJETIVO: Descrever caso de tuberculose faringolaríngea primária em paciente grávida e imunocompetente. RELATORIO DE CASO: Paciente do sexo feminino, 30 anos, com história de odinofagia há 10 meses, sem qualquer sintoma sistêmico ou outras queixas referentes às vias aéreas superiores. Apresentava lesão granulomatosa em orofaringe e laringe, e o resultado da biópsia revelou bacilos álcool-ácido resistentes. Exames clínico e radiológico do aparelho respiratório sem alterações. Realizado tratamento anti-tuberculose por nove meses com resolução completa do quadro. CONCLUSÃO: Autores realçam a importância epidemiológica da tuberculose e a necessidade de um alto grau de suspeição de lesões das vias aéreas superiores para o diagnóstico precoce da doença.Tuberculosis of the Larynx and pharynx only is rare. However, in the last few years, the number of tuberculosis cases in general have had a dramatic increase, thus increasing the possibility of isolated laryngo-pharyngeal lesions. AIM: To report a case of isolated laryngo-pharyngeal tuberculosis in a pregnant, immunocompetent host. CASE REPORT: A 30- year-old pregnant female had complained of odynophagia for the last ten months. There were no other respiratory or systemic symptoms. An oro-pharyngeal granulomatous lesion was found, and the biopsy revealed acid-fast bacilli. There were no clinical or radiologic pulmonary findings. She was submitted successfully to an tuberculosis treatment protocol for nine months. CONCLUSIONS: The authors point out the epidemiological importance of tuberculosis and the need for a higher degree of suspicion when dealing with uncommon upper airway lesions to make an early diagnosis.
Mahmoud, I; Gafsi, L; Saidane, O; Souayah, A; Tekaya, R; Sahli, H; Abdelmoula, L
Trochanteric tuberculosis is a very rare localization of musculo-skeletal tuberculosis. The diagnosis is difficult and is often made in a late stage. The authors describe five cases of trochanteric tuberculosis. The mean age of patients was 46.6 years. Time to diagnosis was long (7.6 months on average). The tuberculosis was plurifocal in all cases. Diagnosis was based on positive Lowenstein culture in one case, on the presence of caseum granuloma in one case and through a pathognommonic manifestation in one case. For the remaining two cases, diagnosis was established on clinical and paraclinical arguments. The patients recovered after medical treatment alone.
O texto trata de três dificuldades relativas à moral, a saber: como, entre diferentes significações para a palavra “moral”, podemos entender que com ela se queira referir a uma só coisa; como entender que possamos falar de uma moral se sobre ela se podem ter tão diferentes concepções; e, finalmente, em que bases podemos perguntar como devemos ou queremos entender o que é a moral, se ela nos parece algo já dado. As respostas a essas questões estão baseadas na explicaçã...
(otorrinolaringologia que contactaram com casos de tuberculose activa. Material e mÃ©todos: Procedeu-se Ã realizaÃ§Ã£o de rastreio de tuberculose a todos os funcionÃ¡rios (73 do serviÃ§o de Otorrinolaringologia do Hospital de SÃ£o JoÃ£o que contactaram com dois doentes internados com tuberculose activa. A todos aqueles que referiram sintomas foi realizada radiografia torÃ¡cica e exame micobacteriolÃ³gico de expectoraÃ§Ã£o. Resultados: Dos 73 profissionais de saÃºde submetidos ao rastreio, foi estabelecido o diagnÃ³stico de tuberculose em 9 (8 do sexo feminino; idade mediana: 30 anos; uma mÃ©dica, seis enfermeiros e dois auxiliares de acÃ§Ã£o mÃ©dica. Em 8 profissionais de saÃºde foi diagnosticada tuberculose pulmonar, tratando-se o outro caso de tuberculose extra-pulmonar. O diagnÃ³stico microbiolÃ³gico foi obtido em 7 casos pelos seguintes mÃ©todos: exame micobacteriolÃ³gico directo de expectoraÃ§Ã£o, nÂ =Â 2; exame cultural de lavado brÃ´nquico, nÂ =Â 4; exame histolÃ³gico de tecido pleural, nÂ =Â 1. Em 4 casos, o DNA do Mycobacterium tuberculosis foi extraÃdo das culturas, tendo sido efectuada tipagem molecular. Todos estes casos apresentaram tipagem idÃªntica, o que permite a identificaÃ§Ã£o de uma ligaÃ§Ã£o epidemiolÃ³gica. ConclusÃ£o: A tuberculose nosocomial Ã© relevante, sendo necessÃ¡rio efectuar um esforÃ§o para implementar, com sucesso, medidas de controlo de infecÃ§Ã£o nas instituiÃ§Ãµes de saÃºde, assim como um programa eficaz de rastreio de tuberculose entre os profissionais de saÃºde. A tipagem molecular do Mycobacterium tuberculosis facilita a identificaÃ§Ã£o de clusters de infecÃ§Ã£o. Key-words: Tuberculosis, health care workers, nosocomial, Palavras-chave: Tuberculose, profissionais de saÃºde, nosocomial
encuestas sobre pruebas de tuberculina y de los estudios de vigilancia llevados a cabo en mataderos entre 1972 y 2008 en varias zonas geográficas del país. En el Ecuador varios factores, como el crecimiento de la industria láctea (impulsado por la alta demanda de leche y sus derivados, los intensos esfuerzos para aumentar la población bovina, la presencia de M. bovis y la falta de controles de la tuberculosis bovina, han ocasionado un aumento de la prevalencia de esta y, en consecuencia, representan una motivación creciente para llevar a cabo un programa nacional de control de la tuberculosis bovina.
Goss Levi, B
The generation of antihydrogens by merging positrons and antiprotons at the CERN laboratory lasted only for 37 ns before they were destroyed by electrons in the detector. There was insufficient time for comparing the antimatter with hydrogen.
An experiment built from components recycled from other experiments has put new limits on the properties of particles that might be the "dark matter" that makes up about 25% of the universe. The CERN Axion Solar telescope (CAST) was built to search for exotic particles called axions that might be produced inside the sun (1 page)
Kronfol, N M; Mansour, Z
In the past decade, the number of new cases of tuberculosis worldwide has barely declined and national tuberculosis control and elimination programmes in many high-income countries worldwide are increasingly challenged to address the problem of disease in foreign-born residents and migrant workers. Routine immigration medical screening, either before or after arrival in the recipient country, is designed to avoid the admission of migrants who pose a public health threat. Screening measures, however, have changed with time largely based on respect for individuals' rights. This paper reviews the measures that are being used by countries to screen immigrants and improve their health well-being, and presents cases studies from two Eastern Mediterranean Region countries.
Báguena Cervellera, María José
La tuberculosis es el prototipo de enfermedad infecciosa crónica. El género de las micobacterias, al que pertenece el organismo causal de la enfermedad, parece que se asoció por vez primera a los vertebrados antes del paso de estos animales de la vida acuática a la terrestre, hace más de 300 millones de años. El M. tuberculosis vendría de una forma bovina de micobacteria y su aparición en el hombre data del Neolítico, estando ligada a la domesticación de los bóvidos, mientras otro...
Mizunuma, Kimiyoshi; Toyoda, Keiko; Tada, Shimpei; Kaneko, Kenji; Yamaguchi, Manabu [Jikei Univ., Tokyo (Japan). School of Medicine
We retrospectively studied the CT findings of rental tuberculosis in 27 cases (32 kidneys). As a characteristic CT findings, nodular lesions were recognized in 20 kidneys. Low density nodules were found in three kidneys, isodensity nodules in seven, and high density nodules in 10. In a case examined by follow-up five years later, the low and isodensity nodules changed to high density nodules with decreasing volume. Ultrasound demonstrated the high density nodules as low-echo mass lesions. These nodular lesions corresponded with the localized foci in the renal parenchyma and/or pyocalyx. We consider that the density differences in nodular lesions reflect the process of water absorption from the caseous necrotizing materials of tuberculosis. (author).
Rajaram, Murugesan V S; Ni, Bin; Dodd, Claire E; Schlesinger, Larry S
Macrophages, the major host cells harboring Mycobacterium tuberculosis (M.tb), are a heterogeneous cell type depending on their tissue of origin and host they are derived from. Significant discord in macrophage responses to M.tb exists due to differences in M.tb strains and the various types of macrophages used to study tuberculosis (TB). This review will summarize current concepts regarding macrophage responses to M.tb infection, while pointing out relevant differences in experimental outcomes due to the use of divergent model systems. A brief description of the lung environment is included since there is increasing evidence that the alveolar macrophage (AM) has immunoregulatory properties that can delay optimal protective host immune responses. In this context, this review focuses on selected macrophage immunoregulatory pattern recognition receptors (PRRs), cytokines, negative regulators of inflammation, lipid mediators and microRNAs (miRNAs). Copyright © 2014 Elsevier Ltd. All rights reserved.
Full Text Available Tuberculosis may affect almost every part of the body. However, it is very uncommon for tuberculosis to involve the sternoclavicular joint. Demonstration of acid-fast bacilli, which is the gold standard for diagnosis, is extremely rare in these lesions. Diagnosis is usually based on demonstration of granulomas on histopathology. Good radiographs and imaging studies are supportive for diagnosis. We report a case of 32-year-old male who presented with a tender swelling over the medial end of the clavicle with a sinus and signs of inflammation. The fine needle aspiration of the lesion demonstrated acid-fast bacilli on Ziehl–Neelsen staining. The patient was put on antitubercular chemotherapy for 1 year and made an uneventful recovery.
Nakaoka, Hiroshi; Lawson, Lovett; Squire, S Bertel
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......-y-based assay (QuantiFERON Gold in Tube [QFT-IT] test) for 207 children in Nigeria in 1 of 3 groups: contact with adults with smear-positive TB, contact with adults with smear-negative TB, and controls. For these 3 groups, respectively, TST results were >10 mm for 38 (49%) of 78, 13 (16%) of 83, and 6 (13...... for infection with TB in children....
Shi, Xiaoshan; Darwin, K Heran
Copper (Cu) is a trace element essential for the growth and development of almost all organisms, including bacteria. However, Cu overload in most systems is toxic. Studies show Cu accumulates in macrophage phagosomes infected with bacteria, suggesting Cu provides an innate immune mechanism to combat invading pathogens. To counteract the host-supplied Cu, increasing evidence suggests that bacteria have evolved Cu resistance mechanisms to facilitate their pathogenesis. In particular, Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis, has evolved multiple pathways to respond to Cu. Here, we summarize what is currently known about Cu homeostasis in Mtb and discuss potential sources of Cu encountered by this and other pathogens in a mammalian host.
The results of this study confirm that rapid radiometric diagnostic tests such as the NAP selective inhibition test for the M. tuberculosis complex followed by the radiometric drug susceptibility tests are extremely reliable and compare favourably with conventional methodologies. This study also shows that referred cultures growing on solid medium can be processed by radiometric procedures without prior subculture. This circumstance by itself shortens the time needed for reporting. (Auth.)
Hamade, Issam H; Tabbara, Khalid F
To determine the effect of steroid treatment on visual outcome and ocular complications in patients with presumed ocular tuberculosis. Retrospective review of patients with presumptive ocular tuberculosis. The clinical diagnosis was made based on ocular findings, positive purified protein derivative (PPD) testing of more than 15 mm induration, exclusion of other causes of uveitis and positive ocular response to anti-tuberculous therapy (ATT) within 4 weeks. Group 1 included patients who had received oral prednisone or subtenon injection of triamcinolone acetonide prior to ATT. Group 2 included patients who did not receive corticosteroid therapy prior to administration of ATT. Among 500 consecutive new cases of uveitis encountered in 1997-2007 there were 49 (10%) patients with presumed ocular tuberculosis. These comprised 28 (57%) male and 21 (43%) female patients with a mean age of 45 years (range 12-76 years). Four (20%) patients in group 1 had initial visual acuity of 20/40 or better, in comparison to eight (28%) patients in group 2. At 1-year follow-up, six (30%) patients in group 1 had a visual acuity of 20/40 or better compared with 20 (69%) patients in group 2 (p = 0.007). Of 20 eyes (26%) in group 1 that had visual acuity of < 20/50 at 1-year follow up, 14 (70%) eyes developed severe chorioretinal lesion (p = 0.019). Early administration of corticosteroids without anti-tuberculous therapy in presumed ocular tuberculosis may lead to poor visual outcome compared with patients who did not receive corticosteroids prior to presentation. Furthermore, the severity of chorioretinitis lesion in the group of patients given corticosteroid prior to ATT may account for the poor visual outcome. © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.
Mack, U; Migliori, G B; Sester, M
be 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......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...... with M. tuberculosis, the in vivo tuberculin skin test and the ex vivo interferon-gamma release assays (IGRAs), are designed to identify an adaptive immune response against, but not necessarily a latent infection with, M. tuberculosis. The proportion of individuals who truly remain infected with M...
Schieffelbein, C W; Snider, D E
The prevalence of tuberculosis infection and disease among homeless persons is high. Several recent outbreaks have been reported in shelters for the homeless. To address this problem, the Centers for Disease Control, Atlanta, convened a group of consultants who made the following recommendations: (1) Tuberculosis should be suspected and sputum samples should be collected from any homeless individual with a productive cough. (2) Diagnosed or suspected tuberculosis in a homeless individual should be immediately reported to the health department. (3) Therapy should be fully supervised by a responsible person, and an intensive multidrug, six-month regimen should be utilized whenever possible. (4) A contact investigation should be conducted around each infectious case, and preventive therapy should be prescribed for high-risk infected individuals. (5) Shelter staff should receive a tuberculin skin test when they start work and every six to 12 months thereafter. (6) Skin test reactors should be considered for preventive therapy according to current guidelines. (7) Installation of ultraviolet lights to reduce transmission should be considered in some situations.
Full Text Available Tuberculosis (TB is an important cause of mortality and morbidity all over the world and is particularly relevant in developing countries like India where the disease is endemic. Female reproductive system is very vulnerable to this infection and clinical presentation of this disease in female reproductive tract is protean in nature and in a large majority of patients could be completely silent. This disease is an important cause of infertility, menstrual irregularity, pregnancy loss, and in association with pregnancy, morbidity to both the mother and child increases. Some of the effects of TB infection on female genital tract could be remote in nature due to infection elsewhere. Medicines used to treat TB infection can also have adverse effects on contraception and other areas of female reproductive health. HIV coinfection and multidrug-resistant tuberculosis (MDR-TB and increased population migration from developed to developing countries have now added a whole new dimension to this infection. Though new, finer diagnostic tools of detection of TB are increasingly available in the form of bacterial cultures and polymerase chain reaction (PCR based diagnostics, suspicion by clinicians remains the main tool for diagnosis of the condition. Hence, doctors need to be properly trained to become "Tuberculosis Minded".
Loto, Olabisi M; Awowole, Ibraheem
Tuberculosis (TB) was declared a public health emergency by WHO in 2005. The disease is a significant contributor to maternal mortality and is among the three leading causes of death among women aged 15-45 years in high burden areas. The exact incidence of tuberculosis in pregnancy, though not readily available, is expected to be as high as in the general population. Diagnosis of tuberculosis in pregnancy may be challenging, as the symptoms may initially be ascribed to the pregnancy, and the normal weight gain in pregnancy may temporarily mask the associated weight loss. Obstetric complications of TB include spontaneous abortion, small for date uterus, preterm labour, low birth weight, and increased neonatal mortality. Congenital TB though rare, is associated with high perinatal mortality. Rifampicin, INH and Ethambutol are the first line drugs while Pyrazinamide use in pregnancy is gaining popularity. Isoniazid preventive therapy is a WHO innovation aimed at reducing the infection in HIV positive pregnant women. Babies born to this mother should be commenced on INH prophylaxis for six months, after which they are vaccinated with BCG if they test negative. Successful control of TB demands improved living conditions, public enlightenment, primary prevention of HIV/AIDS and BCG vaccination.
Quratulain Fatima Kizilbash
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.
Full Text Available Abstract Background Early diagnosis and immediate initiation of treatment are essential for an effective tuberculosis (TB control program. Delay in diagnosis is significant to both disease prognosis at the individual level and transmission within the community. Most transmissions occur between the onset of cough and initiation of treatment. Methods A systematic review of 58 studies addressing delay in diagnosis and treatment of TB was performed. We found different definitions of, for example, debut of symptoms, first appropriate health care provider, time to diagnosis, and start of treatment. Rather than excluding studies that failed to meet strict scientific criteria (like in a meta-analysis, we tried to extract the "solid findings" from all of them to arrive on a more global understanding of diagnostic delay in TB. Results The main factors associated with diagnostic delay included human immunodeficiency virus; coexistence of chronic cough and/or other lung diseases; negative sputum smear; extrapulmonary TB; rural residence; low access (geographical or sociopsychological barriers; initial visitation of a government low-level healthcare facility, private practitioner, or traditional healer; old age; poverty; female sex; alcoholism and substance abuse; history of immigration; low educational level; low awareness of TB; incomprehensive beliefs; self-treatment; and stigma. Conclusion The core problem in delay of diagnosis and treatment seemed to be a vicious cycle of repeated visits at the same healthcare level, resulting in nonspecific antibiotic treatment and failure to access specialized TB services. Once generation of a specific diagnosis was in reach, TB treatment was initiated within a reasonable period of time.
Mauro Tadeu Ajaj Saieg
Full Text Available Os tumores do mediastino anterior incluem várias entidades com diferentes manifestações radiológicas e clínicas, consistindo em um grupo heterogêneo de condições congênitas, inflamatórias ou neoplásicas. Entre essas lesões, o tumor primário mais comum do mediastino é o timoma, seguido de perto por tumores de células germinativas e linfomas. A tuberculose do timo é extremamente rara, embora o envolvimento dos linfonodos mediastinais por essa entidade seja comum. Apresentamos aqui achados patológicos, radiológicos e clínicos de um caso de tuberculose tímica em um paciente de 18 anos de idade, que apresentou dor torácica, dispnéia a pequenos esforços e piora contínua dos sintomas em uma semana. A radiografia torácica mostrou uma grande massa no mediastino e a tomografia computadorizada mostrou que a localização era anterior. O paciente foi operado, sendo feita a exérese da massa, com aspecto microscópico de uma reação inflamatória maciça e presença de granulomas no tecido tímico. A pesquisa de bacilos álcool ácido resistentes pelo método de Ziehl-Neelsen foi positiva e o diagnóstico de tuberculose foi fechado. Portanto, o cirurgião e o patologista devem estar alertas quanto à essa entidade, bem como incluí-la na lista de diagnósticos diferenciais de massas mediastinais.Tumors of the anterior mediastinum include several entities with different radiological and clinical manifestations, constituting a heterogeneous group of congenital, inflammatory, and neoplastic conditions. Among these lesions, the most common primary tumor of the mediastinum is thymoma, nearly followed by germ cell tumors and lymphomas. Tuberculosis of the thymus, an extremely rare condition, typically involves Qthe mediastinal lymph nodes. We present, in this study, pathological, radiological, and clinical findings of one case of tuberculosis of the thymus in an 18-year-old patient who presented thoracic pain, dyspnea upon minimal effort
Background: Tuberculosis is a common health problem in the world. Sudan is among the countries with the highest prevalence for tuberculosis andHBV, HCV infections. Co infection with viral hepatitis (HBV, HCV) among tuberculosis patients increases the risk of hepatotoxicity occurring during tuberculosis treatment, so itis ...
Conclusion: Pelvic tuberculosis should be taken into account, especially in premenopausal women who manifest with massive ascites and adnexal tumors. Tumor markers such as CA-125 give limited information for the differential diagnosis of pelvic tuberculosis and ovarian carcinoma. We suggest exploratory laparotomy and intraoperative frozen pathology for the diagnosis of pelvic tuberculosis. New insight needs to be applied to tuberculosis.
Tuberculosis is a chronic granulomatous disease affecting human and many other mammals. Most human diseases are caused by M.tuberculosis but some are due to M.bovis.(1). Tuberculosis of the tubes and endometrium is intimately bound to the problem of sterility. Despite the decline in frequency of genital tuberculosis ...
Tuberculosis of the breast is a rare entity. Etiologically it can be divided into Primary Breast Tuberculosis and Secondary Breast Tuberculosis. On ultrasound, three different appearances of breast tuberculosis have been described, depending upon the imaging morphology visualized on sonomammography. The most ...
Objective: To determine HIV seroprevalence among tuberculosis patients and the burden of HlV attributable tuberculosis among notified patients in Kenya. Design: A cross-sectional anonymous unlinked HlV seroprevalence survey. Setting: Tuberculosis diagnostic clinics of the National Leprosy Tuberculosis Programme in ...
reported figure, because the annual risk of tuberculosis and prevalence of acquired multi-drug resistant tuberculosis and tuberculosis with HIV is increasing in India (Narain and Lo 2004). One case of XDR- TB is recently reported from Tuberculosis Research Center, Chennai (Thomas et al. 2007). 7. XDR-TB with HIV/AIDS.
Verma, Ajay; Singh, Anubhuti; Kishore, Kislay; Kant, Surya
Involvement of the prostate by tuberculosis (TB) occurs rarely and tuberculosis prostate abscess is an even rarer occurrence. It has been reported in immunocompromised patients, mainly human immunodeficiency virus seropositive individuals. We are reporting a case of tuberculosis prostatic abscess in an immunocompetent patient with relapse of TB. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.
Nov 21, 2011 ... Pulmonary tuberculosis is caused by Mycobacterium tuberculosis, which usually affects the apices of the lungs. According to the World. Health Organization report on global tuberculosis control,1 8.8 million new cases of tuberculosis were reported in 2010. Although there has been a decrease of 3.4% per ...
May 2, 2007 ... Abstract: Pulmonary tuberculosis diagnosis commonly relies on the bacteriological examination of sputum. A cross-sectional ... the spot” improve the sensitivity of tuberculosis diagnosis among patients with a history of coughing of over three weeks. However .... supervision of a trained nurse in the open air.
These are primarily mediated through induction of the cytochrome P450 enzyme system by rifampicin. Guidelines for the prevention of tuberculosis in the theatre environment need to be followed to avoid placing staff and other patients in danger. Keywords: tuberculosis, antitubercular agents, drug interactions, transmission, ...
Although genitourinary tuberculosis is common, reports of isolated ovarian tuberculosis are rare. However, its presentation can mimick that of an ovarian tumour, leading to diagnostic difficulties. A woman of 17 years presented with chronic pelvic pain, weight loss, a right ovarian mass on ultrasound, and a significantly ...
Tuberculosis (TB) is caused by mycobacterium tuberculosis. It remains a public health concern especially in developing country. Pulmonary infection is the main presentation. However, genitourinary TB is common especially with the increase in Human Immunodeficiency virus (HIV) infection. Genitourinary TB is one of the ...
The primary aims of tuberculosis (TB) control programmes is early diagnosis and prompt treatment of infectious cases to limit transmission. Failure to diagnose and adequately treat TB could lead to premature death and unrecognized transmission of Mycobacterium tuberculosis. The proportion of missed TB cases has not ...
Gastrointestinal tuberculosis is common in Africa. Nonetheless, isolated duodenal involvement is rare, and is more likely to mimic other causes of duodenal obstruction. We report a patient who succumbed to an isolated mid duodenal tuberculosis, diagnosed at laparatomy, whose clinical presentation, endoscopy and ...
The World Health Organization's targets of eliminating Tuberculosis (TB) by 2050 is challenged by the emergence and spread of drug resistance TB. However, the traditional mechanism of resistance is that of acquired resistance, whereby the mycobacterium Tuberculosis (MTB) strain develops mutations under selective ...
R.A. Ahmad (Riris)
textabstractTuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. The most frequent clinical manifestation of the disease is pulmonary TB, but it can affect any part of the body (extra-pulmonary TB), including the skin, lymph nodes, spine, joints,
Smith, Noel H; Kremer, Kristin; Inwald, Jacqueline; Dale, James; Driscoll, Jeffrey R; Gordon, Stephen V; Soolingen, Dick van; Hewinson, R Glyn; Smith, John Maynard
A phylogeny of the Mycobacterium tuberculosis complex has recently shown that the animal-adapted strains are found in a single lineage marked by the deletion of chromosomal region 9 (RD9) [Brosch et al., 2002. A new evolutionary scenario for the Mycobacterium tuberculosis complex. Proc. Natl Acad.
In conclusion, M. tuberculosis isolates from pulmonary tuberculosis cases in Tanzania were classified mostly within the CAS, LAM, and EAI and T families. Consistently good treatment outcomes were recorded across the spoligotype families. The proportion of drug resistance strains was low. The findings also suggest ...
Endobroncheal tuberculosis is defined as tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence. The disease is usually mistaken for other lung diseases including lung cancer. Bronchial stenosis is a common complication of this type of tuberculosis despite the use of effective ...
Introduction Tuberculosis (TB) is caused by Mycobacterium tuberculosis and is transmitted mainly through aerosolization of infected sputum which puts laboratory workers at risk in spite of the laboratory workersf risk of infection being at 3 to 9 times higher than the general public. Laboratory safety should therefore be ...
One of the complications of abdominal tuberculosis is intestinal obstruction, which can be acute, chronic or acute on chronic. Other complications include intestinal haemorrhage, perforation of the intestine (rare), faecal fistula, cold abscess formation, mal-absorption syndrome and dissemination of the tuberculosis to other ...
Key Words: tuberculosis, hip, treatment. Between September 1986 and December 1993,. 57 patients were seen with tuberculosis of the hip at Kenyatta National Hospital. The diagnosis was proven by ... LA 7cetahtiltdm and femoral head with early subluxation. FIG 2 Radiograph showing stabltciation of a ttihercltlolu hip.
Nov 6, 2013 ... Mycobacterium tuberculosis RRF does not complement E. coli for its deficiency of RRF (in the ... [Selvaraj M, Govindan A, Seshadri A, Dubey B, Varshney U and Vijayan M 2013 Molecular flexibility of Mycobacterium tuberculosis ribosome ...... Janosi L, Mottagui-Tabar S, Isaksson LA, Sekine Y, Ohtsubo E,.
l'infection à Mycobacteriumtuberculosis. Mais il y avait une différence significative entre l'ESR et la tuberculose. INTRODUCTION. Tuberculosis (TB) is an infectious disease caused by the bacterium. Mycobacterium tuberculosis. It was first described in 1882 by Robert Koch, who won the. Nobel Prize in Physiology/ Medicine ...
malnutrition, and clinical features on treatment outcomes of patients with pulmonary tuberculosis. Tesfaye Madebo'- 2, Bemt Lindtjom'. Abstract: We studied the inﬂuence of functional performance, clinical features, state of nutrition and HIV status at diagnosis on the outcome results of patients with pulmonary tuberculosis at ...
Feb 1, 2018 ... ... the WHO End TB Strategy to achieve the objectives identified in the 2015-2019 NSP. * This is an extract from the Guideline for Tuberculosis & TB/HIV Prevenfion, Care and Control in South Sudan,. Third Edifion, 2016 (Ministry of Health). The Diagnosis of tuberculosis flow chart is shown on the back cover.
Background: Window opening during bus transportation is recommended as a tuberculosis prevention strategy.Yet, drivers are affected by lack knowledge and risk perception of passengers and assistants. Boosting knowledge of and notifying the high risk of tuberculosis transmission for every passenger could be too costly.
against getting tuberculosis (Huntley, 2008). Risk factors for tuberculosis include: Latent TB infection, Aging, Elderly, Young children, HIV,. Diabetes mellitus, Alcoholism and smoking,. Overcrowding, Migrants, Prisons, Airborne droplet transmission, coughing etc. (Huntley, 2008). In England 42 was the mean age of patients.
Madhu Babu Chekur
Full Text Available INTRODUCTION Cutaneous tuberculosis is a chronic disease caused by Mycobacterium tuberculosis. It is primarily a granulomatous disease. We studied the clinical pathological profile of 42 cases of cutaneous tuberculosis in Osmania General Hospital from December 2010 – October 2012. METHODS A total of 42 cases of cutaneous tuberculosis attending DVL OPD at Osmania General Hospital were studied along with clinical features, age, sex, duration of illness in correlation with Mantoux test and types of cutaneous lesions. RESULTS Out of 42 cases, commonest variant was Lupus vulgaris (38.06%. Majority (37.5% of the cases were in the age group of 21- 30 years. Male preponderance was noted in the study with highest incidence in the low socioeconomic group. The location of cutaneous tuberculosis was high in head and neck region (23.80% and clinically majority of cases were (38.06% found to be Lupus vulgaris variant. CONCLUSIONS Among the various types of cutaneous tuberculosis, Lupus vulgaris is the commonest variant followed by scrofuloderma in the study population. The other variants like Tuberculosis verrucosa cutis accounted to 19.04% of the study cases. A small percentage were contributed by Lichen scrofulosorum (2.38% and Papulonecrotic tuberculids (2.38% respectively. Lupus vulgaris was the most common histopathological variant. Most of the components of cutaneous tuberculosis on histopathology exhibited hyperkeratosis, hyperplasia, pseudoepitheliomatous changes; lymphocytic dermal infiltrate, epithelioid cell granulomas in the dermis, vasculitis changes in the dermis with changes of septal or lobular panniculitis.
Freier, Grace; Wright, Allen; Nelson, Gregory; Brenner, Eric; Mase, Sundari; Tasker, Sybil; Matthews, Karen L.; Bohnker, Bruce K.
We conducted a tuberculosis contact investigation for a female military recruit with an unreported history of multidrug-resistant tuberculosis (MDRTB) and subsequent recurrence. Pertinent issues included identification of likely contacts from separate training phases, uncertainty on latent MDRTB infection treatment regimens and side effects, and subsequent dispersal of the contacts after exposure.
Background: The increasing prevalence of extrapulmonary manifestation of tuberculosis with the HIV scourge is a cause for concern. Objective: To determine the role of fine needle aspiration cytology (FNAC) in the diagnosis of extrapulmonary tuberculosis. Patients and Methods: This is a consecutive 9-year analysis of ...
Tuberculosis (TB) is a disease which can affect various organs, including human's genital organs such as the endometrium. Tuberculosis endometritis can cause clinical symptoms of secondary amenorrhea and infertility. Infertility in genital TB caused by the involvement of the endometrium. The case presentation is ...
Buu, T.N.; van Soolingen, D.; Huyen, M.N.T.; Lan, N.N.T.; Quy, H.T.; Tiemersma, E.W.; Borgdorff, M.W.; Cobelens, F.G.J.
Using population-based data from rural Vietnam, we assessed tuberculosis (TB) transmission within and outside of households. Eighty-three percent of persons with recent household TB were infected by different strains of Mycobacterium tuberculosis than were their household members. This result argues
Prompt and effective response to anti tuberculosis drugs informed the diagnosis of tuberculosis of the cervical vertebra and tuberculous otitis media with multiple cranial nerve palsies. This case underscores the value of high index of suspicion, thorough and complete clinical evaluation in any patient with chronic symptoms ...
To evaluate the main features of TB epidemiology in 2014 in Poland and to compare with the data on the same phenomena in EU/EEA countries. Analysis of case- based data on TB patients from National TB Register, data on anti-TB drugsusceptibility testing results in cases notified in 2014, data from National Institute of Public Health- NationalInstitute of Hygiene on cases of tuberculosis as AIDS-defining disease, data from Central Statistical Office ondeaths from tuberculosis based on death certificates, data from ECDC report „ European Centre for DiseasePrevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2016. Stockholm: European Centre for Disease Prevention and Control, 2016”. 6 698 TB cases were reported in Poland in 2014. The incidence rate was 17.4 cases per 100 000, withlarge variability between voivodeships from 9.3 to 26.5 per 100 000. The mean annual decrease of TB incidence in 2010- 2014 was 2.1%. 6 066 cases had no history of previous treatment i.e. 15.8 per 100 000. 632 cases i.e. 1.6 per 100 000 – 9.4% of all registered subjects were relapses. The number of all notified pulmonary tuberculosis cases in 2014 was 6311 i.e. 16.4 per 100 000. Pulmonary cases represented 94.2% of all TB cases. In the presented year 387 extrapulmonary TB cases were reported. Children with TB (70 cases) accounted for 1.0% of all cases notified in Poland. The incidence of tuberculosis increases with age from 1.2 per 100 000 among children to 30.4 per 100 000 among patients 65 years old and older. The incidence among men i.e. 24.6 per 100 000 was 2.3 times higher than among women i.e. 10.7 per 100 000. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 45 to 49 years – 40.4 vs. 9.3. The TB incidence in rural population was lower than in urban, respectively 17.0 per 100 000 and 17.7 per 100 000. The number of all registered culture positive TB cases, including relapses, was 4
Letícia Nazareth Fernandes da Paz
Full Text Available OBJETIVO: Analisar as estratégias que influenciam a efetividade do tratamento da tuberculose em Unidades Básicas de Saúde (UBS. MÉTODOS: Levantamento epidemiológico, descritivo, retrospectivo, envolvendo os prontuários médicos de 588 pacientes com tuberculose cadastrados no programa de controle da tuberculose, entre janeiro de 2004 e dezembro de 2008, em duas UBS - Centro de Saúde Escola do Marco (CSEM e UBS da Pedreira (UBSP - localizadas na cidade de Belém (PA. Os critérios de exclusão foram ter idade 59 anos e ter alta por transferência ou mudança de diagnóstico. Os dados coletados foram idade, sexo, tipo de tratamento (autoadministrado ou supervisionado, coinfecção por HIV e desfecho do tratamento. Os profissionais de saúde envolvidos no programa da tuberculose das duas UBS foram entrevistados quanto às estratégias utilizadas no controle da doença e à rotina de atendimento. RESULTADOS: Não houve diferenças significativas quanto a idade, sexo e coinfecção com HIV nas duas UBS. A utilização de tratamento supervisionado foi significativamente maior no CSEM que na UBSP, assim como a taxa de cura, enquanto a taxa de abandono foi maior na UBSP que no CSEM. CONCLUSÕES: Para pacientes cadastrados em programas de controle da tuberculose em UBS no Brasil, o tratamento supervisionado provavelmente é uma estratégia de extrema importância para se alcançar uma menor taxa de abandono.OBJECTIVE: To analyze the treatment strategies that influence the effectiveness of tuberculosis treatment at primary care clinics (PCCs in Brazil. METHODS: This was a descriptive, retrospective epidemiological survey based on the medical records of 588 tuberculosis patients enrolled in the tuberculosis control programs at two PCCs located in the city of Belém, Brazil: Centro de Saúde Escola do Marco (CSEM and Unidade Básica de Saúde da Pedreira (UBSP. The survey was limited to patients enrolled between January of 2004 and December of 2008
Joseph Robert Fitchett
Full Text Available In this era of increasing drug resistance among infectious diseases such as tuberculosis (TB, the complex population dynamics of border areas must be monitored more extensively. TB remains a major public health threat; its antimicrobial treatment is long; and the only vaccine licensed in the world, live-attenuated Mycobacterium bovis Bacille Calmette-Guérin (BCG, exhibits varying efficacy. In addition to epidemiological surveillance, the underlying determinants contributing to the health and wellbeing of populations are of key importance. Although it received heightened attention in the past, tuberculosis transmission in the United States-Mexico border area demands renewed interest. Lessons learned should be applied to similar areas around the globe.En esta época en la que cada vez es mayor la farmacorresistencia de enfermedades infecciosas como la tuberculosis, es preciso vigilar más ampliamente la compleja dinámica de la población de las zonas fronterizas. La tuberculosis sigue siendo un problema muy importante de salud pública, el tratamiento antimicrobiano es prolongado y la vacuna BCG (Bacilo de Calmette-Guérin -la única autorizada en el mundo, elaborada con bacilos atenuados de Mycobacterium bovis- tiene eficacia variable. Además de la vigilancia epidemiológica, revisten suma importancia los determinantes fundamentales que inciden en la salud y el bienestar de las poblaciones. Si bien la transmisión transfronteriza de la tuberculosis entre México y los Estados Unidos recibió gran atención en el pasado, la situación actual exige renovar el interés por este tema. Es necesario aplicar las lecciones aprendidas en zonas similares del resto del mundo.
Before discussing the epidemiology of extrapulmonary tuberculosis (EPTB) and particularly urogenital tuberculosis (UGTB), unification of the terminology is necessary. The term ‘urogenital tuberculosis’ is preferable to ‘genitourinary tuberculosis’, as renal and urinary tract tuberculosis is more common than genital tuberculosis. Some understand the term ‘extrapulmonary tuberculosis’ as a specific tuberculosis (TB) lesion of all organs excluding the bronchus, lungs, pleura and intrathoracic bronchopulmonary lymph nodes, but others consider pleural TB as one form of EPTB – and it is a reason for very different proportions in the spectrum of EPTB. Enigmatic tendencies have also been revealed in patients' distribution – in neighbouring regions the incidence rate may differ significantly. Although there is no clear explanation for these tendencies, careful study of the epidemiology of EPTB in different conditions will improve early diagnosis. PMID:25165556
Filippou, D.C.; Rizos, S.; Nissiotis, A.
Background. The differential diagnosis of primary breast tuberculosis with other benign or malignant conditions can be difficult with the current imaging techniques that used to recognize breast pathologies. In many cases mammographic and ultrasound characteristics of breast tuberculosis are similar to those of breast cancer. Case report. We present a case of primary breast tuberculosis, with no previous history of the disease, which was diagnosed during the operation. Conclusions. Primary breast tuberculosis can be misdiagnosed. In these cases a tuberculosis infection history is negative, the mammographic and radiological findings obscure and the mass can be misdiagnosed as carcinoma. The diagnosis is achieved after the surgical removal of the mass and histological examination of the specimen. (author)
Robert Steven Wallis
Full Text Available 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 etiology of tuberculosis in patients treated with tumor necrosis factor antagonists, 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.
Goncalves, Ivone M; Alves, Daniela Costa; Carvalho, Aurora; do Ceu Brito, Maria; Calvario, Fernando; Duarte, Raquel
Tuberculosis remains an infectious disease with a high prevalence worldwide and represents a major public health issue. Although venous thromboembolism is a rare complication of this disease, it may be a potentially life-threatening event. We report two cases of severe pulmonary tuberculosis associated with venous thromboembolism. A 38 year-old caucasian male that had a thromboembolic event as an unsual presentation form of tuberculosis and a 51 year-old caucasian male that developed deep venous thrombosis later in the course of the disease. An association between inflamation induced by tuberculosis and a hypercoagulable state has been described. Therefore, the occurence of deep venous thrombosis or pulmonary embolic episods, should be considered in patients with tuberculosis particulary during the first weeks of treatment. The physician's awarness of these phenomena is important to an early diagnostic suspicion and prompt treatment in order to prevent fatal outcomes.
Bae, In Young; Kim, Mi Young; Cho, Soon Gu; Suh, Chang Hae; Park, Won Hee
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)
Mitano, Fernando; Sicsú, Amélia Nunes; Sousa, Luciana de Oliveira; Silva, Laís Mara Caetano da; Palha, Pedro Fredemir
To analyze the meanings produced in the Health Surveillance actions for tuberculosis control, carried out by healthcare professionals in Mozambique. Qualitative study using the theoretical and methodological framework of the French Discourse Analysis. A total of 15 healthcare professionals with more than one year of experience in disease control actions participated in the study. Four discursive blocks have emerged from the analysis: tuberculosis diagnosis process; meeting, communication and discussion of treatment; local strategies for tuberculosis control; involvement of family and community leaders in the tuberculosis control. The statements of the healthcare professionals suggest, as Health Surveillance actions, practices that include collecting sputum in the patient's home and sending it to the laboratory; deployment of the medical team with a microscope for tuberculosis testing; and testing for diseases that may be associated with tuberculosis. In this context, the actions of Health Surveillance for tuberculosis control involve valuing all actors: family, community leaders, patients and health professionals. Analisar os sentidos produzidos sobre as ações de Vigilância em Saúde no controle da tuberculose desenvolvidas por profissionais de saúde em Moçambique. Estudo qualitativo que tem como referencial teórico-metodológico a Análise de Discurso de matriz francesa. Participaram do estudo 15 profissionais de saúde, com mais de 1 ano de experiência em ações de controle da doença. Da análise, emergiram quatro blocos discursivos: processo do diagnóstico da tuberculose; reunião, comunicação e discussão do tratamento; estratégias locais para o controle da tuberculose; envolvimento da família e dos líderes comunitários no controle da tuberculose. Os dizeres dos profissionais de saúde sugerem, como ações de Vigilância em Saúde, práticas que incluem a coleta de escarro na residência do paciente e seu encaminhamento ao laboratório; o
En este artículo se estudia la monografía de Manuel Martín Salazar sobre la tuberculosis, publicada en Cádiz, en 1887; además del prólogo de Benito Alcina Rancé, esta obra presenta apartados específicos sobre la etiología de la tuberculosis, el contagio, la herencia, la vacunación, la desinfección, la alimentación y el clima, así como epígrafes dedicados a la higiene social y a la tuberculosis en el ejército. Esta obra de Martín Salazar no ha recibido la atención que se merece, sobre todo ten...
Doherty, T Mark; Demissie, Abebech; Olobo, Joseph
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...
Haefliger, E; Rieder, H L
The mortality rate still is an important index for assessment of tuberculosis. Statistical records are kept on the mortality rate on a worldwide basis--more than in the case of other tuberculosis parameters. They allow us to make valuable comparisons. They are also useful because the mortality is closely related to the morbidity. The present thesis is based on comparative figures from the 1989 volume of the WHO Health Statistics Annual. Various countries have been specially selected by the publisher--and subsequently also by us--for sake of clarity. The figures vary strongly within these countries, which was to be expected. The mortality rate varies in Europe (for each 100,000 residents) e.g. from 0.2 in the Netherlands to 8.15 in the Soviet Union. In the Americas the rates vary from 0.4 for Canada to 12.9 for Ecuador. In the Western Pacific region the mortality rates vary from 0.35 for Australia to 14.65 for China. On a worldwide basis, the share of deaths from tuberculosis among all causes of death varies from 0.02% in the Netherlands to 2.10% in the Republic of Korea. The relation of tuberculosis deaths with regard to sexes in Switzerland: 75.7% men, 24.3% women, which is more or less the European average. The lower the mortality rate for tuberculosis are, the lower the difference between the sexes appears to be. Similar facts are found with regard to the distribution of tuberculosis deaths according to age groups: the lower the tuberculosis rate, the more tuberculosis is found in older age groups. The tuberculosis deaths are percentage-wise similarly distributed to the respiratory organs and the other tuberculosis forms.(ABSTRACT TRUNCATED AT 250 WORDS)
Full Text Available Mycobacterium bovis, también llamado bacilo de la tuberculosis (TBC bovina, fue en otras épocas el principal agente etiológico de la TBC en países industrializados. Actualmente, los casos humanos se han vuelto poco frecuentes, excepto en aquellas naciones donde la enfermedad es aún endémica en el ganado. En pacientes inmunodeficientes, suele presentarse como una enfermedad sistémica. Presentamos el caso de una mujer con SIDA y TBC diseminada por M. bovis. La micobacteria aislada resultó ser resistente a la rifampicina y a la pirazinamida. Se realizó tratamiento con isoniacida, etambutol y ofloxacina con buena respuesta clínica. Este caso resultó ser el primer aislamiento de M. bovis en una paciente con SIDA, en el Hospital Muñiz.M. bovis, the agent of bovine tuberculosis, was in other times, the main ethiological agent of tuberculosis (TBC in industrialized countries. At the moment, the human cases have become not very frequent, except in those countries where the illness is even endemic. In patients with immunodeficiency syndrome, it usually presents as a systemic illness. We present the case of a woman with AIDS and disseminated TBC caused by M. bovis. The isolated micobacteria turned out to be resistant to rifampin and pyrazinamide. She was treated with isoniazid, ethambutol and ofloxacin with good clinical evolution. This case turned out to be the first isolation of M. bovis in a patient with AIDS, in Muñiz hospital.
Irma Yolanda Castillo Ávila
Full Text Available Objetivo: determinar los factores asociados a la prevalencia de tuberculosis en el Distrito de Cartagena. Metodología: se realizó un estudio analítico de casos y controles. La población objeto de estudio estuvo constituida por 240 personas diagnosticadas con tuberculosis en Cartagena. Se definió como caso toda persona ingresada al programa de control de tuberculosis del Distrito. Se realizó control comunitario a vecinos cercanos en la misma localidad, del mismo sexo, con más o menos cinco años de edad que el caso, quienes nunca habían padecido la enfermedad y sin síntomas respiratorios. Se almacenó los datos en el programa estadístico SPSSS versión 20.0, se calcularon razones de disparidad para estimar la relación entre variables. Resultados: participaron del estudio 303 personas (101 casos y 202 controles. Con un promedio de edad de 35.7 años (DE=17.9, para casos y 40.3 años (DE=20.3 para controles. Se encontraron como factores asociados a la presencia de tuberculosis el estado de vacunación con BCG (OR=0.11 IC 95% 0.05 - 0.22, tener pareja estable (OR= 0.54 IC 95% 0.30 - 0.96 y el antecedente familiar de Tuberculosis. (OR=20.97 IC 95%: 6.26 - 70.24. Conclusiones: el fortalecimiento de los programas de promoción y prevención de tuberculosis a nivel comunitario y familiar, puede mejorar el estado de salud de los individuos. La aplicación de prácticas como la vacunación de niños y niñas y las medidas preventivas en el hogar son necesarias para prevenir la aparición de la enfermedad.
Scriba, Thomas J; Penn-Nicholson, Adam; Shankar, Smitha; Hraha, Tom; Thompson, Ethan G; Sterling, David; Nemes, Elisa; Darboe, Fatoumatta; Suliman, Sara; Amon, Lynn M; Mahomed, Hassan; Erasmus, Mzwandile; Whatney, Wendy; Johnson, John L; Boom, W Henry; Hatherill, Mark; Valvo, Joe; De Groote, Mary Ann; Ochsner, Urs A; Aderem, Alan; Hanekom, Willem A; Zak, Daniel E
Our understanding of mechanisms underlying progression from Mycobacterium tuberculosis infection to pulmonary tuberculosis disease in humans remains limited. To define such mechanisms, we followed M. tuberculosis-infected adolescents longitudinally. Blood samples from forty-four adolescents who ultimately developed tuberculosis disease (“progressors”) were compared with those from 106 matched controls, who remained healthy during two years of follow up. We performed longitudinal whole blood transcriptomic analyses by RNA sequencing and plasma proteome analyses using multiplexed slow off-rate modified DNA aptamers. Tuberculosis progression was associated with sequential modulation of immunological processes. Type I/II interferon signalling and complement cascade were elevated 18 months before tuberculosis disease diagnosis, while changes in myeloid inflammation, lymphoid, monocyte and neutrophil gene modules occurred more proximally to tuberculosis disease. Analysis of gene expression in purified T cells also revealed early suppression of Th17 responses in progressors, relative to M. tuberculosis-infected controls. This was confirmed in an independent adult cohort who received BCG re-vaccination; transcript expression of interferon response genes in blood prior to BCG administration was associated with suppression of IL-17 expression by BCG-specific CD4 T cells 3 weeks post-vaccination. Our findings provide a timeline to the different immunological stages of disease progression which comprise sequential inflammatory dynamics and immune alterations that precede disease manifestations and diagnosis of tuberculosis disease. These findings have important implications for developing diagnostics, vaccination and host-directed therapies for tuberculosis. Clincialtrials.gov, NCT01119521.
Thomas J Scriba
Full Text Available Our understanding of mechanisms underlying progression from Mycobacterium tuberculosis infection to pulmonary tuberculosis disease in humans remains limited. To define such mechanisms, we followed M. tuberculosis-infected adolescents longitudinally. Blood samples from forty-four adolescents who ultimately developed tuberculosis disease (“progressors” were compared with those from 106 matched controls, who remained healthy during two years of follow up. We performed longitudinal whole blood transcriptomic analyses by RNA sequencing and plasma proteome analyses using multiplexed slow off-rate modified DNA aptamers. Tuberculosis progression was associated with sequential modulation of immunological processes. Type I/II interferon signalling and complement cascade were elevated 18 months before tuberculosis disease diagnosis, while changes in myeloid inflammation, lymphoid, monocyte and neutrophil gene modules occurred more proximally to tuberculosis disease. Analysis of gene expression in purified T cells also revealed early suppression of Th17 responses in progressors, relative to M. tuberculosis-infected controls. This was confirmed in an independent adult cohort who received BCG re-vaccination; transcript expression of interferon response genes in blood prior to BCG administration was associated with suppression of IL-17 expression by BCG-specific CD4 T cells 3 weeks post-vaccination. Our findings provide a timeline to the different immunological stages of disease progression which comprise sequential inflammatory dynamics and immune alterations that precede disease manifestations and diagnosis of tuberculosis disease. These findings have important implications for developing diagnostics, vaccination and host-directed therapies for tuberculosis.Clincialtrials.gov, NCT01119521.
Paula A. Correa
Full Text Available El factor de necrosis tumoral alfa (TNF-a está incriminado tanto en enfermedades autoinmunes como en infecciosas. En el presente estudio se examinó el polimorfismo de la región promotora -308 del gen del TNF-a en enfermedades autoinmunes [lupus eritematoso sistémico (LES, artritis reumatoidea (AR, síndrome de Sjögren primario (SSp] y en tuberculosis. La genotipificación del polimorfismo -308 del TNF-a se realizó en ADN de pacientes con AR (N=165, LES (N=118, SSp (N=67, tuberculosis (N=138 y controles sanos (N=419, mediante reacción en cadena de la polimerasa con polimorfismos en los tamaños de los fragmentos de restricción (PCR-RFLP. El alelo TNF2 se asoció con la AR (OR=1,6; IC95% 1,2-2,3, p=0,008, el LES (OR=2,3; IC95% 1,6-3,3, p
Robert L. Serafino Wani
Full Text Available Inhalation of Mycobacterium tuberculosis leads to one of four possible outcomes: Immediate clearance of the organism Latent infection The onset of active disease (primary disease Active disease many years later (reactivation disease. Among individuals with latent infection, and no underlying medical problems, reactivation disease occurs in 5 to 10 percent of cases . The risk of reactivation is markedly increased in patients with HIV . These outcomes are determined by the interplay of factors attributable to both the organism and the host.
Leonardo F. Jurado; Martha I. Murcia; Patricia Hidalgo; John E. Leguizamón; Lorena R. González
La tuberculosis se considera la causa más frecuente de muerte producida por un solo agente infeccioso. El diagnóstico de la tuberculosis extrapulmonar no siempre es posible mediante los métodos convencionales debido al lento crecimiento del bacilo y a la naturaleza paucibacilar de las muestras, por lo que es necesario recurrir a las técnicas moleculares. El riesgo de tuberculosis, así como la mortalidad, aumenta en los pacientes con infección por HIV, en quienes el compromiso extrapulmonar es...
Kulkarni Dinesh R, Sulegaon Ritesh V, Chulki Shashidhar F
Full Text Available Tuberculosis is an endemic disease in India. Primary conjunctival tuberculosis is an uncommon condition and with better treatment of pulmonary tuberculosis it is now becoming extremely rare. Primary conjunctival Tuberculosis can present as unilateral conjunctivitis, hence laterality, chronicity and non-resolution of symptoms on treatment are indications for biopsy. In our patient conjunctival Tuberculosis was diagnosed on histopathology, which resulted in early implementation of antikochs’ treatment and complete resolution of the disease condition.
Allegrucci, María Daniela
La presente ponencia tiene como objeto de análisis desentramar los sentidos del discurso de la murga platense. Se trata de concebir a ese espacio como un lugar en el que convergen cantidad de redes de significados, sentidos, prácticas, rituales, subjetividades y percepciones que forman y establecen un discurso. En ese sentido, en la ciudad de La Plata desde la década del 90 se creó un circuito de murgas que dieron forma a la fisionomía de la región. La ciudad tomó gran parte de la tradició...
Gonzalo Carbó, Antoni
En 'Algunos lugares de la pintura' María Zambrano, comentando el conocido cuadro de La tempestad de Giorgione, escribe: «Como si el cuadro estuviese visto a través de un cristal y no se le pudiera tocar [ ]». Nuestra autora parece hacer referencia aquí a una imagen de origen platónico que sin duda es recurrente en su obra: la transparencia del alma o del corazón, pues la «transcendencia es transparencia». María Zambrano concibe el plano del cuadro como una superficie vítrea, pulimentada, tran...
Full Text Available O pensar como montagem e imagem tornou-se um método revelador nos processos de estudos práticos e teóricos do artista e dos pesquisadores nos séculos XX e XXI. Este artigo procura articular três formas de pensar por montagem: nas obras de Bertolt Brecht, Sergei Eisenstein e Georges DidiHuberman. O filósofo e historiador da arte Georges Didi-Huberman reinaugura o debate e o exercício de pensar a antropologia da imagem e a montagem como metalinguagem e forma de conhecimento.
Laura Inés Plata-Casas
Full Text Available Objetivo: describir los factores de riesgo asociados a la no adherencia al tratamiento en los pacientes adscritos al programa de tuberculosis en el Municipio de Villavicencio, cohorte 2012. Materiales y Métodos: se ha realizado un estudio descriptivo de corte transversal con enfoque cuantitativo. Se obtuvieron datos de caracterización sociodemográfica sobre factores de riesgo de personas que abandonaron el tratamiento para la enfermedad- cohorte 2012- mediante la aplicación de un instrumento diseñado por el investigador y revisado por expertos. Los datos fueron tabulados y analizados mediante la herramienta Microsoft Excel® 2007 y Epi-info 7.0. Resultados: el 75% de los pacientes pertenecen al género masculino; el promedio de edad es de 30 años, el 63% pertenecen al régimen subsidiado de salud. Las principales causas de abandono fueron: efectos adversos a los medicamentos (58%, inadecuada atención del personal de salud (43%, dificultad de acceso al servicio (32%. Los factores sociales encontrados fueron hacinamiento 67% y desempleo 62%. Conclusiones: algunos factores no modificables como la edad y el género, así como factores modificables como estilos de vida inadecuados y efectos adversos; cuyo control mejoraría el cumplimiento; contribuyen al abandono del tratamiento. Las variables psicológicas y sociales deben ser evaluadas para que se conviertan en predictores de probables abandonos o irregularidades en el tratamiento antituberculoso.
Fredrik O Vannberg
Full Text Available Tuberculosis causes significant morbidity and mortality worldwide, especially in sub-Saharan Africa. DC-SIGN, encoded by CD209, is a receptor capable of binding and internalizing Mycobacterium tuberculosis. Previous studies have reported that the CD209 promoter single nucleotide polymorphism (SNP-336A/G exerts an effect on CD209 expression and is associated with human susceptibility to dengue, HIV-1 and tuberculosis in humans. The present study investigates the role of the CD209 -336A/G variant in susceptibility to tuberculosis in a large sample of individuals from sub-Saharan Africa.A total of 2,176 individuals enrolled in tuberculosis case-control studies from four sub-Saharan Africa countries were genotyped for the CD209 -336A/G SNP (rs4804803. Significant overall protection against pulmonary tuberculosis was observed with the -336G allele when the study groups were combined (n = 914 controls vs. 1262 cases, Mantel-Haenszel 2 x 2 chi(2 = 7.47, P = 0.006, odds ratio = 0.86, 95%CI 0.77-0.96. In addition, the patients with -336GG were associated with a decreased risk of cavitory tuberculosis, a severe form of tuberculosis disease (n = 557, Pearson's 2x2 chi(2 = 17.34, P = 0.00003, odds ratio = 0.42, 95%CI 0.27-0.65. This direction of association is opposite to a previously observed result in a smaller study of susceptibility to tuberculosis in a South African Coloured population, but entirely in keeping with the previously observed protective effect of the -336G allele.This study finds that the CD209 -336G variant allele is associated with significant protection against tuberculosis in individuals from sub-Saharan Africa and, furthermore, cases with -336GG were significantly less likely to develop tuberculosis-induced lung cavitation. Previous in vitro work demonstrated that the promoter variant -336G allele causes down-regulation of CD209 mRNA expression. Our present work suggests that decreased levels of the DC-SIGN receptor may therefore be
Enarson, Donald A
The current global strategy for control of tuberculosis, Directly Observed Treatment, Short-course (DOTS) focuses, as a priority, on the management of patients with sputum smear positive tuberculosis. As tuberculosis in children is rarely sputum smear positive, this has led many to believe that children are not important in tuberculosis control. This is a misconception. The ultimate goal of tuberculosis services should be the eradication of Mycobacterium tuberculosis. To date, only diseases for which effective vaccines are available have been eradicated. Vaccination aims to protect the population (and especially vulnerable groups, such as children) from the disease against which it is applied. Presently, there is no vaccine able to prevent infection with Mycobacterium tuberculosis. Protection against infection must be achieved in other ways. Thus, early identification and successful treatment of the most infectious cases of tuberculosis has become the focus of attempts and is presently the most effective means to protect children from infection with M. tuberculosis. This is the theory; does it really work? Evidence put forward to support this position has come primarily from industrialised countries where tuberculous infection was already on the decline before any substantial public health activities had been instituted. What of the situation in low income countries where the highest proportion of the tuberculosis patients live at the present time? There is very little evidence available to address this question. The most convincing information published to date comes from the Beijing Municipality of China where the DOTS strategy has been implemented since 1978. Progressive expansion of the strategy occurred over the first five years after which a very high proportion of all tuberculosis patients were managed by this means. The major impact was to progressively and rapidly reduce the prevalence of tuberculosis in the community. The incidence was only more slowly
Conclusión. La prueba Xpert® MTB/RIF tuvo un buen desempeño en muestras de diferentes tejidos y líquidos, y constituye un avance significativo como apoyo para el diagnóstico de la tuberculosis extrapulmonar en términos de tiempo y porcentaje de positividad.
Edwaldo E. Camargo
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.
About a century after Koch's discovery of the TB bacilli the tuberculosis epidemic which had appeared to be under control was again recognized as a major global health threat. The decline in the epidemic in this century had been largely through the improved living standards and, eventually, the availability and use of effective antibiotics. While tuberculosis gradually disappeared from the health agenda in the western world it remained a big killer throughout the century and in 1992 an estimated 2.7 million TB deaths occurred; 30 million will die from TB during the 1990s if current trends are not reversed. The annual number of new cases will increase from 7.5 million estimated in 1990 to more than 10 million in the year 2000. The main factors for this increase are demographic forces, population movements, the HIV epidemic and increasing drug resistance. The impact of the HIV epidemic is already felt in many sub-Saharan African countries and now threatens Asia where almost two-thirds of the world's TB infected population live and where HIV is spreading. Tuberculosis has also reemerged as a major public health problem in industrialized countries due to international migration, the breakdown of health services, including TB services etc. The control of the epidemic can only be through a concerted action to reinstate TB as priority among health concerns, reflected in national and international resources. A coalition of public and private supporters must be mobilized to support the effort to fight the disease. Governments, non-governmental organizations, the business community, refugee organizations, medical institutions, and other UN agencies are invited to join with WHO in this effort.
María Ríos Hipólito
Full Text Available Objetivo: Determinar los factores de riesgo asociados a recaídas por tuberculosis en Lima Este - Perú, entre marzo y diciembre del 2000. Materiales y métodos: estudio caso-control. Se definió a los casos (184 como los pacientes que recibieron tratamiento con el esquema I alguna vez, egresaron como curados y volvieron a presentar otro episodio de tuberculosis BK positivo durante 1999. Los controles (368 fueron los pacientes nuevos con tuberculosis BK positivo tratados en 1998 que no recayeron. Resultados: se asociaron significativamente a las recaídas el sexo masculino, la edad mayor de 50 años, el consumo de drogas, la residencia en un área urbana, el hacinamiento, la percepción errada de la enfermedad (PEE y la desocupación, no así el contacto con un paciente tuberculoso. Luego del análisis multivariado, sólo se asociaron el área urbana, el hacinamiento, la PEE y el tratamiento irregular. Conclusiones: la residencia en un área urbana, el hacinamiento, la PEE y la irregularidad en el tratamiento son factores asociados significativamente a recaídas en pacientes con TBC pulmonar BK(+ de Lima Este, Perú.
Oscar Pulido Cortés
Full Text Available Escribir se ha convertido en una de las prácticas más solicitadas y promocionadas en la actualidad. En el mundo académico no solo como una posibilidad de comunicación de los hallazgos de los procesos y proyectos de investigación, sino como una forma de mercantilización de los saberes y circulación de discursos impersonales que se han constreñido a formatos, condiciones específicas y normas para seguir paso a paso. Qué pena que este arte de la vida, la existencia y la razón haya sido colonizado y utilizado por los centros de poder y de saber, que en favor del capital y de sus flujos e intensidades la han colocado, a la escritura, como una esclava, para legitimar la circulación y apropiación de ciertos estatutos teóricos hegemónicos, a los intelectuales y académicos, a su vez como los medios para conseguir estos fines a cambio de salarios, puntos, índices de citación y clasificación en los rankings propios de las diferentes manifestaciones de la ciencia.
Higueras García, Esther
LA CIUDAD COMO ECOSISTEMA URBANO .- La ecología y los ecosistemas .- El ecosistema urbano, definición, alcance y oportunidad .- El metabolismo urbano .- Los síntomas de la patología urbana .- Los objetivos del nuevo ecosistema urbano .- Las aportaciones de los ecobarrios
Garcia, Rui; Velez, Jorge; Reis, Conceição; Porto, Armando
A tuberculose é uma infecção bacteriana pleomórfica, podendo atingir qualquer tecido ou órgão. O caso clínico relata uma situação que implicou grandes dificuldades de diagnóstico diferencial, sobretudo pela diferente interpretação dos exames auxiliares de diagnóstico. Apesar disso, e após a determinação do diagnóstico certo, instituiu-se um esquema terapêutico segundo as normas aceites e recomendadas, encontrando-se o doente bem. Tuberculosis may target any organ or system and present a...
Zhang Fan; Zhang Xuelin; Qiu Shijun; Zhang Yuzhong; Wen Ge; Zhong Qun
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)
Iftikhar, R.; Kamran, S. M.; Haider, E.; Qadir, A.; Usman, H. B.
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)
Gaspar, Renato Simões; Nunes, Natália; Nunes, Marina; Rodrigues, Vandilson Pinheiro
To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection. Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0- to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV co-infection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis. Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished. Investigar os casos notificados de tuberculose e de sua coinfecção com o HIV na população brasileira no período entre 2002 e 2012. Realizou-se um estudo observacional de série temporal, no qual
G Pizzariello; P Fernández Pardal; G D´Atri; V Novac; A Uranga
La Tuberculosis (TBC) es producida por el Mycobacterium tuberculosis o bacilo de Koch, y se ha observado en las últimas décadas, una reemergencia de casos pulmonares y extrapulmonares. La TBC cutánea es infrecuente, y presenta un amplio espectro clínico dependiendo del interjuego existente entre el agente, el huésped y el ambiente. TBC cutánea, ilustrándola con casos clínicos de pacientes que concurrieron a nuestro servicio.Tuberculosis (TBC) is caused by Mycobacterium tuberculosis or Koch's ...
Adil, A.; Chikhaoui, N.; Ousehal, A.; Kadiri, R.
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
Corbella, C.; Ares, J.; Rene, A.; Canales, L.; Marcos, J.A. de
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
Full Text Available Abstract Background Although various hematologic abnormalities are seen in tuberculosis, immune thrombocytopenic purpura is a rare event. Case Presentation We report a case of a 29 year-old male who was presented with immune thrombocytopenia-induced hemoptysis, macroscopic hematuria and generalized petechiae. The patient was found to have clinical, microbiological and radiological evidence of active pulmonary tuberculosis. The immune thrombocytopenic purpura was successfully treated with anti-tuberculous drugs combined with corticosteroids and high dose immune globulin therapy. Conclusion Immune thrombocytopenic purpura can be one of the hematological manifestations of tuberculosis which has a global prevalence with increasing incidence secondary to HIV infection.
Wildner, Leticia Muraro; Gould, Katherine A; Waddell, Simon J
The emergence of drug resistance threatens to destroy tuberculosis control programs worldwide, with resistance to all first-line drugs and most second-line drugs detected. Drug tolerance (or phenotypic drug resistance) is also likely to be clinically relevant over the 6-month long standard treatment for drug-sensitive tuberculosis. Transcriptional profiling the response of Mycobacterium tuberculosis to antimicrobial drugs offers a novel interpretation of drug efficacy and mycobacterial drug-susceptibility that likely varies in dynamic microenvironments, such as the lung. This chapter describes the noninvasive sampling of tuberculous sputa and techniques for mRNA profiling M. tb bacilli during patient therapy to characterize real-world drug actions.
Moon, Woo Kyung; Kim, Woo Sun; Lee, Hoan Jong; Kim, In One; Yeon, Kyung Mo; Han, Man Chung
This paper illustrates the spectrum of CT findings of pulmonary tuberculosis in children and shows the advantages and complementary nature of CT compared with conventional radiography. Common CT manifestations of pulmonary tuberculosis in children are mediastinal or hilar lymphadenopathy, air-space con-solidation, atelectasis, and disseminated nodules. CT is useful in the detection of the disease in equivocal chest radiographs, in the characterization of lesions, by demonstrating caseation necrotic areas, calcification and bronchogenic spread nodules, and in defining the extent of the disease and its complications. This information will be helpful in the diagnosis and evaluation of tuberculosis in children
Full Text Available 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 infection or de novo infection more likely than among non-pregnant women. TB treatment in pregnancy poses several problems that have been under-researched, such as contraindications to anti-TB and anti-HIV drugs and potential risks to the neonate, which are particularly important with respect to second-line TB treatment. Whilst congenital TB is thought to be rare, data from high HIV burden settings suggest this is not the case. There is a need for more studies screening for TB in neonates and observing outcomes, and testing preventative or curative actions. National tuberculosis control programmes (NTPs should work with antenatal and national HIV programmes in high-burden populations to provide screening at antenatal clinics, or to establish functioning systems whereby pregnant women at high risk can drop in to routine NTP screening stations.
Mohammad Reza Sasani
Full Text Available Endobronchial tuberculosis and chest radiography I read, with interest, the article entitled “Clinical and Para-clinical Presentations of Endobronchial Tuberculosis” by Ahmadi Hoseini H. S. et al. (1 published in this journal. I would like to focus on some details about the chest X-ray of patients as elaborated by the authors in the results section. Accordingly, the findings of chest radiography in the available patients were as follows: pulmonary consolidation (75%, reduced pulmonary volume (20%, and hilar adenopathy (10%. This is an incomplete statement because the authors did not explain whether there was any normal chest radiography in the study population. In addition, it is not clear whether the X-ray examinations of the patients were normal, how many abnormal plain films yielded the presented data. On the other hand, the fact that the studied patients had no normal chest radiography is controversial since in the literature, 10-20% of the patients with endobronchial tuberculosis are reported to have normal chest X-ray (2, 3. In fact, this is one of the problems in the diagnosis of the disease, as well as a potential cause of delayed diagnosis and treatment of the patients. Therefore, the absence of normal chest radiographs is in contrast to the available literature, and if not an error, it could be a subject of further investigation.
Anil K Jain
Full Text Available Drug-resistant spinal tuberculosis (TB is an emerging health problem in both developing and developed countries. In this review article, we aim to define management protocols for suspicion, diagnosis, and treatment of such patients. Spinal TB is a deep-seated paucibacillary lesion, and the demonstration of acid-fast bacilli on Ziehl-Neelsen staining is possible only in 10%–30% of cases. Drug resistance is suspected in patients showing the failure of clinicoradiological improvement or appearance of a fresh lesion of osteoarticular TB while on anti tubercular therapy (ATT for a minimum period of 5 months. The conventional culture of Mycobacterium tuberculosis remains the gold standard for both bacteriological diagnosis and drug sensitivity testing (DST; however, the high turn around time of 2–6 weeks for detection with added 3 weeks for DST is a major limitation. To overcome this problem, rapid culture methods and molecular methods have been introduced. From a public health perspective, reducing the period between diagnosis and treatment initiation has direct benefits for both the patient and the community. For all patients of drug-resistant spinal TB, a complete Drug-O-Gram should be prepared which includes details of all drugs, their doses, and duration. Patients with confirmed multidrug-resistant TB strains should receive a regimen with at least five effective drugs, including pyrazinamide and one injectable. Patients with resistance to additional antitubercular drugs should receive individualized ATT as per their DST results.
Full Text Available Antimycobacterial chemotherapy is the mainstay of treatment for the majority of patients with genitourinary tuberculosis (GUTB. A large body of evidence from clinical trials suggests that short-course chemotherapy regimens, employing four drugs including rifampicin and pyrazinamide, achieve cure in most of the patients with tuberculosis (TB and are associated with the lowest rates of relapse. Standard six-month regimens are adequate for the treatment of GUTB. Directly observed treatment, short-course (DOTS is the internationally recommended comprehensive strategy to control TB, and directly observed treatment is just one of its five elements. DOTS cures not only the individual with TB but also reduces the incidence of TB as well as the prevalence of primary drug-resistance in the community. Corticosteroids have no proven role in the management of patients with GUTB. Errors in prescribing anti-TB drugs are common in clinical practice. Standardized treatment regimens at correct doses and assured completion of treatment have made DOTS the present-day standard of care for the management of all forms of TB including GUTB.
Tschopp, R; Berg, S; Argaw, K; Gadisa, E; Habtamu, M; Schelling, E; Young, D; Aseffa, A; Zinsstag, J
Bovine tuberculosis (BTB) is endemic in Ethiopian cattle. However, the status of the disease in wildlife populations that often share habitat with livestock is unknown. We screened for BTB in wildlife in five regions in Ethiopia. Blood and tissue samples from 133 mammals of 28 species were collected from 2006 to 2008. We used a rapid serology test (RT) based on lateral flow technology, and performed culture of lymph node specimens inoculated onto Lowenstein-Jensen and Middlebrook 7H11 media. Acid-fast colonies were further analyzed by molecular typing. Sera from 20 of 87 animals (23%) were positive for BTB by RT; acid-fast bacilli were cultured from 29 of 89 animals (32.5%). None of the positive cultures yielded mycobacteria from the Mycobacterium tuberculosis complex but many environmental mycobacteria were isolated. Among these, Mycobacterium terrae was the most common. We demonstrated a high prevalence of environmental mycobacteria in wildlife, the role of which is unknown. Flagship rare endemic species such as the mountain nyala (Tragelaphus buxtoni) and the Ethiopian wolf (Canis simensis) may be at risk for BTB. We also assessed the utility of RT for field purposes.
Jain, Anil K; Jaggi, Karan Raj; Bhayana, Himanshu; Saha, Rumpa
Drug-resistant spinal tuberculosis (TB) is an emerging health problem in both developing and developed countries. In this review article, we aim to define management protocols for suspicion, diagnosis, and treatment of such patients. Spinal TB is a deep-seated paucibacillary lesion, and the demonstration of acid-fast bacilli on Ziehl-Neelsen staining is possible only in 10%-30% of cases. Drug resistance is suspected in patients showing the failure of clinicoradiological improvement or appearance of a fresh lesion of osteoarticular TB while on anti tubercular therapy (ATT) for a minimum period of 5 months. The conventional culture of Mycobacterium tuberculosis remains the gold standard for both bacteriological diagnosis and drug sensitivity testing (DST); however, the high turn around time of 2-6 weeks for detection with added 3 weeks for DST is a major limitation. To overcome this problem, rapid culture methods and molecular methods have been introduced. From a public health perspective, reducing the period between diagnosis and treatment initiation has direct benefits for both the patient and the community. For all patients of drug-resistant spinal TB, a complete Drug-O-Gram should be prepared which includes details of all drugs, their doses, and duration. Patients with confirmed multidrug-resistant TB strains should receive a regimen with at least five effective drugs, including pyrazinamide and one injectable. Patients with resistance to additional antitubercular drugs should receive individualized ATT as per their DST results.
Shetty, Seema; Umakanth, Shashikiran; Manandhar, Bhawani; Nepali, Pankaj Bahadur
Leprosy and tuberculosis (TB) are endemic to India, however, their coinfection is not frequently encountered in clinical practice. Here, we report a 32-year-old female patient who presented with a history of high-grade intermittent fever, cough and painless skin lesions since a month, along with bilateral claw hand (on examination). The haematological profile was suggestive of anaemia of chronic disease, chest radiograph showed consolidation, sputum smears were positive for Mycobacterium tuberculosis, and skin slit smear confirmed leprosy. The patient was prescribed WHO recommended multidrug therapy for multibacillary leprosy with three drugs. Additionally, prednisolone was added to her regimen for 2 weeks to treat the type 2 lepra reaction. For treatment of TB, she was placed on the standard 6-month short course chemotherapy. She was lost to follow-up, and attempts were made to contact her. Later, it came to our notice that she had discontinued medications and passed away 3 months after diagnosis. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Kioumehr, F.; Dadsetan, M.R.; Rooholamini, S.A.; Au, A.
The MRI findings of 18 proven cases of central nervous system (CNS) tuberculosis were reviewed; 10 patients were seropositive for HIV. All had medical, laboratory, or surgical proof of CNS tuberculosis. Eleven patients had meningitis, of whom two also had arachnoiditis. Five patients had focal intra-axial tuberculomas: four brain masses and one an intramedullary spinal lesion. Two patients had focal extra-axial tuberculomas: one in the pontine cistern, and one in the spine. In all 11 patients with meningitis MRI showed diffuse, thick, meningeal enhancement. All intraparenchymal tuberculomas showed low signal intensity on T2-weighted images and ring or nodular enhancement. The extra-axial tuberculomas had areas isointense or hypointense relative to normal brain and spinal cord on T2-weighted images. Although tuberculous meningitis cannot be differentiated from other meningitides on the basis of MR findings, intraparenchymal tuberculomas show characteristic T2 shortening, not found in most other space-occupying lesions. In the appropriate clinical setting, tuberculoma should be considered. (orig.)
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.
Full Text Available Abstract Background Young women in conflict-affected regions are at risk of a number of adverse outcomes as a result of violence, economic deterioration and the breakdown of community structures and services. This paper presents the findings of a systematic review of quantitative literature reporting how key sexual and reproductive health (SRH outcomes among young women under the age of 20 years are affected by exposure to armed conflict; namely, sexual debut, first marriage and first birth. Increases in these outcomes among young women are all associated with potential negative public health consequences. It also examines and documents possible causal pathways for any changes seen. Methods To fit with our inclusion criteria, all reviewed studies included outcomes for comparable populations not exposed to conflict either temporally or spatially. A total of 19 studies with results from 21 countries or territories met our inclusion criteria; seven presented findings on marriage, four on fertility and eight on both of these outcomes. Only one study reporting on sexual debut met our criteria. Results Findings show clear evidence of both declines and increases in marriage and childbirth among young women in a range of conflict-affected settings. Several studies that showed increases in marriage below the age of 20 years reported that such increases were concentrated in the younger teenagers. Trends in fertility were predominantly driven by marriage patterns. Suggested causal pathways for the changes observed could be grouped into three categories: involuntary, gender and psycho-social and economic and material factors. Conclusion The review reveals a paucity of literature on the impact of conflict on SRH outcomes of young women. Further quantitative and qualitative studies are needed to explore how conflict influences SRH events in young women over both the short- and longer-term.
Adolfo Vásquez Rocca
Full Text Available Se intenta aquí superar la tradicional antinomia entre arte y tecnología. En cambio, se propone una comprensión del arte posmoderno a partir de la inscripción del artista en el seno de una cultura de la información. Es así como asistimos a un cambio de paradigma en el estatuto del arte, a una revolución en la escena artística y de nuestros regímenes de visibilidad, de allí la necesidad de explorar el desarrollo de las estéticas de la virtualidad que nos instalan en nuevas lógicas de producción de verdad, emancipadas del museo como instancia última de legitimación artística.
Full Text Available A tuberculose testicular é uma entidade clínica rara que ocorre em aproximadamente 3% dos doente com tuberculose genital. Clinicamente, a tuberculose do testículo não pode ser distinguida de lesões como o tumor testicular ou enfarte, podendo em alguns casos mimetizar uma torção testicular. Os homens com idades compreendidas entre os 20 e os 50 anos são os mais frequentemente afectados e queixam-se habitualmente de dor ou aumento de tamanho do testículo. A ecografia e actualmente a melhor técnica para a visualização e a orientação diagnostica de lesões testiculares. Os autores apresentam o caso de um homem de 58 anos, seguido em consulta de Pneumologia por tuberculose pulmonar, que inicia quadro de dor e aumento testicular direito ao 2.o mês de tratamento antibacilar e cuja avaliação inicial, secundada por ecografia, foi sugestiva de lesão neoplásica. O diagnóstico final revelou tratar-se de uma tuberculose testicular.Testicular tuberculosis is rare, occurring in approximately 3% of patients with genital tuberculosis. It is often clinically indistinguishable from lesions such as testicular tumour and infarction and may even mimic testicular torsion. Men aged 20-50 years old are most commonly affected and often present with painful or painless enlargement of the scrotum. Ultrasound (US is currently the best technique for imaging the scrotum and its contents and for diagnosing testicular lesions. We present the case of a 58 year-old male, followed in pneumology for pulmonary tuberculosis, who complained of pain and right scrotum enlargement in the second month of anti-tuberculosis chemotherapy. First assessment, seconded by US, suggested a neoplasic lesion, and the final diagnosis revealed testicular tuberculosis.
Mesa, Paula; Gallo, Alejandro; Chlopecki, Oreste; Balderrabano, Sergio
En las teorías contemporáneas de la música tonal, observamos que el concepto del movimiento sur-ge como consecuencia de la interacción entre el ritmo, el metro y las alturas. Desde este lugar, el movimiento musical es vinculado a cuestiones del orden de la notación, de lo mensurable, de lo cuantificable. Facultad de Bellas Artes
Alexandre Andre Nodari
Full Text Available Se décadas atrás, Lyotard identificou a crise de legitimação política e do conhecimento de então como a crise dos grandes relatos, talvez se possa dizer que a crise atual é uma crise do grande Relator: a crise das humanidades seria, assim, parte mais geral da crise do Humano. Diante do Antropoceno, as ciências do homem (as antropologias têm como um dos seus desafios converterem-se em humanidades, isto é, especular sobre as definições de homem e mundo, descobrindo outras humanidades e mundos. Aqui, a literatura, entendida a partir de Juan José Saer como uma “antropologia especulativa”, pode revelar-se uma linha de fuga: diante do contingenciamento econômico das humanidades, ela apresenta a contingência ecológica desse modelo de mundo. This work is licensed under a Creative Commons Attribution 3.0 License.
Mª PIA ARENYS
Full Text Available En este artículo se recogen las discusiones de grupo que se realizaron durante cuatro meses en Barcelona como preparación del "II congreso de la gent gran" (II congreso de ancianos de esta ciudad, en noviembre de 1993. las discusiones se llevaron a cabo en las sedes de cada distrito, previa presentación de la ponencia por parte de un técnico. los componentes de los grupos son personas mayores sensibilizadas y comprometidas que forman parte del consejo de bienestar social del ayuntamiento de Barcelona. la metodología utilizada es cualitativa para el análisis del discurso, que se ha estructurado en los siguientes puntos: bajo el epígrafe "los ancianos como ciudadanos de derechos y obligaciones" se recogen los temas de valoración de la vejez, la familia, la jubilación, las implicaciones de los ancianos como ciudadanos de derechos y deberes y las funciones sociales de los ancianos.-- sobre estos temas, los mayores expresaron sus opiniones, que se vertieron, resumidamente, en la redacción final de la ponencia. aquí se recogen y se han analizado los materiales que ofrecen una versión de primera mano sobre lo que opinan los ancianos respecto al tema de "la valoración de la vejez".
Full Text Available El número de casos de tuberculosis registrados en los Estados Unidos de América (EE.UU. disminuyó entre 1990 y 1999, pero la proporción de casos ocurridos en personas nacidas en el extranjero aumentó de 24 a 43%. Gran parte de estas personas habían venido de México y de Centroamérica y entre ellas había individuos y familias que habían entrado en los EE.UU. legalmente, así como otras sin permiso ni documentación. El problema de la tuberculosis en los EE.UU. está concentrado en gran medida en los cuatro estados fronterizos con México: Arizona, California, Nuevo México y Tejas. Como reacción a estas tendencias, en junio de 1999 los Centros para el Control y la Prevención de Enfermedades (CDC de los EE.UU. organizaron una reunión de los funcionarios responsables del control de la tuberculosis en estos cuatro estados, con el fin de desarrollar una estrategia nacional coordinada. Este grupo de trabajo especial ha elaborado recientemente un documento con información sobre los antecedentes del problema y propuestas para acciones futuras por parte de los organismos gubernamentales de los EE.UU. y de los programas estatales y locales. El informe se centra en cuatro áreas principales: 1 necesidades de la vigilancia; 2 tratamiento de los casos y su cumplimiento; 3 indicadores de rendimiento y evaluación del programa, y 4 necesidades de investigación. El grupo especial de trabajo identificó los problemas clave, los objetivos y los recursos necesarios en cada una de estas áreas para potenciar los esfuerzos para prevenir y controlar la tuberculosis a lo largo de la frontera.
Syahrini, Intan; Sriwahyuni; Halfiani, Vera; Meurah Yuni, Syarifah; Iskandar, Taufiq; Rasudin; Ramli, Marwan
Tuberculosis is an infectious disease which has caused a large number of mortality in Indonesia. This disease is caused by Mycrobacterium tuberculosis. Besides affecting lung, this disease also affects other organs such as lymph gland, intestine, kidneys, uterus, bone, and brain. This article discusses the epidemic of tuberculosis through employing the SEIR model. Here, the population is divided into four compartments which are susceptible, exposed, infected and recovered. The susceptible population is further grouped into two which are vaccinated group and unvaccinated group. The behavior of the epidemic is investigated through analysing the equilibrium of the model. The result shows that administering vaccine to the susceptible population contributes to the reduction of the tuberculosis epidemic rate.
Sester, Martina; van Leth, Frank; Bruchfeld, Judith
RATIONALE: In the absence of active tuberculosis, a positive tuberculin skin test (TST) or interferon-γ release assay (IGRA) result defines latent infection with Mycobacterium tuberculosis, although test results may vary depending on immunodeficiency. OBJECTIVES: This study compared the performance...... of TST and IGRAs in five different groups of immunocompromised patients, and evaluated their ability to identify those at risk for development of tuberculosis. METHODS: Immunocompromised patients with HIV infection, chronic renal failure, rheumatoid arthritis, solid-organ or stem-cell transplantation......, and healthy control subjects were evaluated head-to-head by the TST, QuantiFERON-TB-Gold in-tube test (ELISA), and T-SPOT.TB test (enzyme-linked immunospot) at 17 centers in 11 European countries. Development of tuberculosis was assessed during follow-up. MEASUREMENTS AND MAIN RESULTS: Frequencies of positive...
Li Yizhao; Liu Jianming; Ke Yong; XiaoYong; Liu Rihua
Objective: To investigate the CT diagnosis and differential diagnosis of spinal tuberculosis. Methods: CT manifestations were retrospectively analyzed in 43 cases of spinal tuberculosis. This series included 24 males and 19 females, aged 10-57 years. 15 cases were confirmed by operation and pathology; 18 cases were confirmed by biopsy and 10 cases were cured by antituberculosis therapy. Results: The CT manifestations of spinal tuberculosis were: 1) mottling, patchy, caved or faveolate bone destructions (43/43 cases); 2) elevated density of the involved vertebrae (13/43 cases); 3) destruction of intervertebral discs (32/43 cases); 4) formation of sequester (30/43 cases); 5) para-vertebral abscess, often with calcification (38/43 cases); 6) osseous vertebral canal narrowing (8/43 cases); 7) vertebrae compression (28/43 cases). Conclusion: CT scan is a valuable modality for the diagnosis and differential diagnosis of spinal tuberculosis
Son, Hyun Ju; Kim, Kun II; Juhng, Dong Hi; Lee, Suk Hong; Kim, Byung Su; Park, Soon Kew
To evaluate high-resolution CT(HRCT) findings of the miliary tuberculosis and their significance. We retrospectively studied clinical records, HRCT and chest radiographs of 14 patients with miliary tuberculosis. On HRCT, nodules were seen in all 14 cases, 10 of them evenly, and 4 were irregularly distributed. The size of each nodule was less than 1 mm in 7 cases, 1 - 2 mm in 6 cases, and 3 mm or more in 1 case. The ground - glass opacity was accompanied in 8 cases, and fine reticular opacity was also noted in 8 cases. Other associated findings were pleural effusion (n=4), hilar and mediastinal lymphadenopathy (n=3), consolidation of the exudative tuberculosis (n=4). HRCT findings of miliary tuberculosis are diffusely distributed micro nodules of variable size, less than 5 mm in diameter. The ground-glass opacity can be combined
Lee, Y. H.; Yoo, H.S.; Kim, K. W.; Lee, J. T.; Park, C. Y.
Intestinal tuberculosis is generally diagnosed using conventional barium studies, however recent diagnostic modalities such as ultrasonography and CT scan are widely applicated in conjunction with conventional studies for the search of lymph node presentation and associated extra-intestinal organs. It is important to differentiate intra-abdominal tuberculosis from metastatic or lymphomatous disease clinically. And it might be especially of worth to find out if there is any differential point between tuberculosis and other lymph nodal disease entities when we meet similar findings on imaging modalities. Authors have tried to evaluate ultrasonographic findings in conjunction with other studies in nine cases of abdominal tuberculosis which showed mainly extra-intestinal and/or lymph nodal involvement
Forrellad, Marina A.; Klepp, Laura I.; Gioffré, Andrea; Sabio y García, Julia; Morbidoni, Hector R.; Santangelo, María de la Paz; Cataldi, Angel A.; Bigi, Fabiana
The Mycobacterium tuberculosis complex (MTBC) consists of closely related species that cause tuberculosis in both humans and animals. This illness, still today, remains to be one of the leading causes of morbidity and mortality throughout the world. The mycobacteria enter the host by air, and, once in the lungs, are phagocytated by macrophages. This may lead to the rapid elimination of the bacillus or to the triggering of an active tuberculosis infection. A large number of different virulence factors have evolved in MTBC members as a response to the host immune reaction. The aim of this review is to describe the bacterial genes/proteins that are essential for the virulence of MTBC species, and that have been demonstrated in an in vivo model of infection. Knowledge of MTBC virulence factors is essential for the development of new vaccines and drugs to help manage the disease toward an increasingly more tuberculosis-free world. PMID:23076359
Zidi, A.; Hantoux, S.; Mestiri, I.; Ben Miled-Mrad, K.
Pulmonary tuberculosis may at times simulate lung carcinoma on bronchoscopic examination or imaging studies. Diagnosis can be delayed and lead to surgical resection. Based on review of 25 cases, the different CT features are reviewed. (author)
ROELSGAARD, E; IVERSEN, E; BLOCHER, C
Up to the end of the nineteenth century the tubercle bacillus apparently had little opportunity of disseminating among the rather isolated tribes of tropical Africa. With the creation of large centres of trade and industry in the wake of European colonization, tuberculosis seems to have spread rapidly over the continent and is today found everywhere.In a number of tuberculosis prevalence surveys conducted by WHO during 1955-60, randomly selected population groups were tuberculin tested, X-rayed and had sputa examined by direct microscopy. The three methods of examination were applied independently of one another.Data collected during the surveys have been analysed with a view to discovering common epidemiological features of tuberculosis in tropical Africa, assessing the reliability of the diagnostic methods employed and discussing their usefulness in future tuberculosis control programmes.
East African Medical Journal Vol. 88 No. 12 December 2011. MYCOBACTERIUM TUBERCULOSIS GENETIC DIVERSITY AND DRUG RESISTANCE CONFERRING MUTATIONS. IN THE DEMOCRATIC REPUBLIC OF THE CONGO. L. Fenner, Institute of Social and Preventive Medicine, University of Bern, Switzerland, S.
Jain, Rashi; Mohan, Anant; Guleria, Randeep
Sarcoidosis and tuberculosis are chronic, multisystemic, granulomatous disease of alike clinical, radiological and histopathological manifestations. Idiopathic nature of the disease and a strong clinical similarity with tuberculosis make the effectiveness of various clinical examinations for the diagnosis of sarcoidosis difficult in a tuberculosis endemic area. Presently confirmation of a diagnosis of sarcoidosis in most cases requires a biopsy which is often not confirmatory. A variety of novel medical approaches is under research to replace invasive diagnostic procedures for a simple non-invasive investigation for the identification of sarcoidosis. Here we discussed the studies focussing on the features that can be useful for distinguishing sarcoidosis from tuberculosis. Multiple studies have found molecular, cellular, immunological and clinical biomarkers efficient to lead the way of clinicians for the exact diagnosis of sarcoidosis. Copyright © 2017. Published by Elsevier B.V.
Jutte, Paul; Wuite, Sander; The, Bertram; van Altena, Richard; Veldhuizen, Albert
Tuberculosis of the spine may cause kyphosis, which may in turn cause late paraplegia, respiratory compromise, and unsightly deformity. Surgical correction therefore may be considered for large or progressive deformities. We retrospectively analyzed clinical and radiographic parameters to predict
Full Text Available 26 years old male presented with two large plaques of lupus vulgaris and a lesion of tuberculosis verrucosa cutis on the right thigh and foot, respectively. Both the lesions were confirmed by histopathological examinations.
APOPO) recent use of specially trained African giant pouched rats as detectors of pulmonary tuberculosis in people living in Tanzania. It summarizes the achievements and challenges encountered over the years and outlines future prospects.
Tobin, David M
Host-directed therapies are a relatively new and promising approach to treatment of tuberculosis. Modulation of specific host immune pathways, including those that impact inflammation and immunopathology, can limit mycobacterial infection and pathology, both in cell culture and in animal models. This review explores a range of host pathways and drugs, some already approved for clinical use that have the potential to provide new adjunctive therapies for tuberculosis. Drugs targeting host processes may largely avoid the development of bacterial antibiotic resistance, a major public health concern for tuberculosis. However, these drugs may also have generally increased risk for side effects on the host. Understanding the specific mechanisms by which these drugs act and the relationship of these mechanisms to Mycobacterium tuberculosis pathogenesis will be critical in selecting appropriate host-directed therapy. Overall, these host-directed compounds provide a novel strategy for antituberculosis therapy. Copyright © 2015 Cold Spring Harbor Laboratory Press; all rights reserved.
Pratap C Mali
rich molecules as an energy source obtained from host cell debris remains interesting. Additionally, the potential of M. tuberculosis to survive under different stress conditions leading to its dormant state in pathogenesis remains ...
Schopfer, K; Rieder, H L; Steinlin-Schopfer, J F; van Soolingen, D; Bodmer, T; Chantana, Y; Studer, P; Laurent, D; Zwahlen, M; Richner, B
SUMMARY We analysed Mycobacterium tuberculosis strains from children, hospitalized from January 2004 to July 2008 in the largest paediatric hospital complex in Cambodia. Specimens were tested for drug susceptibility and genotypes. From the 260 children, 161 strains were available. The East African-Indian genotype family was the most common (59.0%), increasing in frequency with distance from the Phnom Penh area, while the frequency of the Beijing genotype family strains decreased. The drug resistance pattern showed a similar geographical gradient: lowest in the northwest (4.6%), intermediate in the central (17.1%), and highest in the southeastern (30.8%) parts of the country. Three children (1.9%) had multidrug-resistant tuberculosis. The Beijing genotype and streptomycin resistance were significantly associated (P tuberculosis in children reflects recent transmission patterns in the community, multidrug resistance levels inform about the current quality of the tuberculosis programme.
Full Text Available The W.H.O. (1982 estimates that the annual risk of infection with tuberculosis in most developing countries is in the order of 3 to 5%. Every year 4-million to 5-million highly infectious cases of tuberculosis occur in those countries, according to the WHO Technical Report No. 671. This report also states that case finding and chemotherapy, combined as one entity, must be considered to be the most powerful weapon in tuberculosis control. Since case finding in those countries depends principally on the examination of patients presenting with relevant symptoms to a health facility, it is recommended that all staff at such facilities should be properly trained and motivated to identify potential tuberculosis patients.
Gutiérrez García, José Manuel
El año más importante para la investigación de la tuberculosis fue 1882 en que Robert Koch descubrió el bacilo causante de tan desastrosa dolencia, identificado en material tuberculoso tanto humano como animal, y que confirmaba la unidad de la tisis en el hombre y en los animales y el hecho del contagio ante el mundo científico.
In this podcast, Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, discusses the December 9, 2011 CDC guidelines for the use of a new regimen for the treatment of persons with latent tuberculosis infection. Created: 3/15/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). Date Released: 3/15/2012.
Rahman, Nadia; Pedersen, Karin Kæreby; Rosenfeldt, Vibeke
Clinical investigations of childhood tuberculosis (TB) are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. We investigated the challenges in diagnosing TB in children in a low-incidence country.......Clinical investigations of childhood tuberculosis (TB) are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. We investigated the challenges in diagnosing TB in children in a low-incidence country....