- Modulation of host defence against bacterial and viral infections by omega-3 polyunsaturated fatty acids. [Review]
- JIJ Infect 2016 Oct 14
- CONCLUSIONS: The effects of n-3-LC-PUFAs on infections depend on the pathogen and the n-3 LC-PUFA dose and timing. Caution should be recommended for high-dose and long-term supplementation in humans.
- [Intestinal and peritoneal tuberculosis in a non-immunocompromised patient]. [Letter]
- GHGastroenterol Hepatol 2016; 39(9):645-646
- Importance of Therapeutic Drug Monitoring of Rifampicin. [Review]
- JAJ Assoc Physicians India 2016; 64(8):68-72
- Therapeutic Drug Monitoring (TDM) is a routinely practised clinical laboratory technique which aids the clinicians with a clear clinical judgement of the drug therapy and optimize the doses if necess...
Therapeutic Drug Monitoring (TDM) is a routinely practised clinical laboratory technique which aids the clinicians with a clear clinical judgement of the drug therapy and optimize the doses if necessary. Rifampicin is the most important and potent component of first line therapy of tuberculosis (TB). Several factors like age, weight, gender, doses and formulations, gastro-intestinal disorders, ethnicity etc alter the absorption and bioavailability of rifampicin thus altering the drug levels. Low plasma levels of rifampicin may play a plausible role in slow response to therapy, treatment failure or relapse or acquired drug resistance. TB Patients with further complicated conditions like diabetes or HIV are at an increased risk for poor drug absorption and drug-drug interactions. A standard treatment regimen may be inadequate for some cases as the clinical status of patients vary from case to case. TDM can be used as a clinical tool for identifying patients at high risk of treatment failure, delayed response, drug-drug interactions and help optimization of therapy. In the past two decades numerous reports of TDM of anti-tuberculosis drugs have been reported wherein low rifampicin levels have been a major concern. Rifampicin exhibit concentration dependent killing of mycobacteria. A 2 hour post-dose sample approximates the peak plasma rifampicin concentration (Cmax) and is recommended for TDM of rifampicin. An additional 6 hour sample may be collected to distinguish between delayed absorption and malabsorption. Combined with clinical and bacteriological data, TDM can help clinicians treat slow response / complicated TB patients.
- Abdominal Tuberculosis. [Review]
- JAJ Assoc Physicians India 2016; 64(2):38-47
- Abdomen is involved in 11% of patients with extra-pulmonary tuberculosis; The most common site of involvement is the ileocaecal region, other locations of involvement, in order of descending frequenc...
Abdomen is involved in 11% of patients with extra-pulmonary tuberculosis; The most common site of involvement is the ileocaecal region, other locations of involvement, in order of descending frequency, are the ascending colon, jejunum, appendix, duodenum, stomach, oesophagus, sigmoid colon, and rectum. Apart from the basic work up, Investigations like CT scan, EUS, Capsule endoscopy, Balloon enteroscopy, Ascitic fluid ADA, TB-PCR, GeneXpert, Laproscopy are being increasingly used to diagnose tuberculosis.Therapy with standard antituberculous drugs is usually highly effective for intestinal TB. Six-months therapy is as effective as nine-months therapy. Multi-Drug Resistance (MDR) has been observed in 13% of MTB isolates. The development of Drug Induced Hepatotoxicity (DIH) during therapy for TB is the most common reason leading to interruption of therapy. There are various guidelines for the management of TB post DIH. Surgery is usually reserved for patients who have developed complications or obstruction not responding to medical management.
- Tuberculosis terminal ileitis: A forgotten entity mimicking Crohn's disease. [Journal Article]
- WJWorld J Clin Cases 2016 Sep 16; 4(9):273-80
- Intestinal tuberculosis (TB) is an uncommon lesion for which differential diagnosis can be difficult. We present a case of a 53-year-old male and a systematic review of the literature, from clinical ...
Intestinal tuberculosis (TB) is an uncommon lesion for which differential diagnosis can be difficult. We present a case of a 53-year-old male and a systematic review of the literature, from clinical symptoms to differential diagnosis, unusual complications and therapy. The patient was admitted to the hospital with signs of acute abdomen as a result of a perforated terminal ileitis. Based on the skip lesions of the terminal ileum and cecum, Crohn's disease (CD) was clinically suspected. An emergency laparotomy and right colectomy with terminal ileum resection was performed and systematic antibiotherapy was prescribed. The patient's status deteriorated and he died 4 d after the surgical intervention. At the autopsy, TB ileotyphlitis was discovered. The clinical criteria of the differential diagnosis between intestinal TB and CD are not very well established. Despite the large amount of published articles on this subject, only 50 papers present new data regarding intestinal TB. Based on these studies and our experience, we present an update focused on the differential diagnosis and therapy of intestinal TB. We highlight the importance of considering intestinal TB as a differential diagnosis for inflammatory bowel disease. Despite the modern techniques of diagnosis and therapy, the fulminant evolution of TB can still lead to a patient's death.
- Spectrum of abdominal-tuberculosis in emergency surgery: 100 cases at a tertiary care Centre Dow University of Health Sciences and Civil Hospital Karachi, Pakistan. [Journal Article]
- JPJ Pak Med Assoc 2016; 66(9):1173-1175
- The study highlights the spectrum of abdominal TB in emergency surgery and its outcome. A proforma based prospective cross sectional study was conducted from March 2008 - March 2014, at the Departmen...
The study highlights the spectrum of abdominal TB in emergency surgery and its outcome. A proforma based prospective cross sectional study was conducted from March 2008 - March 2014, at the Department of General Surgery, Dow University of Health Sciences & Civil Hospital Karachi, Pakistan. Total patients studied were hundred. Ninety percent patients presented through the emergency department. Mean age was 30 ± 7.29 years. Family history of TB was positive in 46 (46%) patients. Pulmonary TB was present in 22 (22%), and 52 (52%) - were already on Antitubercular Therapy-- Emergency exploratory laparotomy was performed in 85 (85%) patients with 61 (61%) having peritonitis. and 24 (24%) having acute intestinal obstruction. A total of 15 (15%) patients were kept on ATT under observation, Of these 7(7%) were diagnosed with Ileocaecal mass, 5 (5%) with enterocutaneous fistula, and 3(3%) had sub-acute intestinal obstruction. Ileum was the most common site for abdominal TB in 36(36%), followed by ileocaecal TB in 13 (13%) and jejunal TB in 12 (12%). Stoma and abdominal washout was the minimum procedure which was performed in 34 (34%) cases. Fourteen (14%) patients diagnosed with ileocaecal TB, received limited right hemi colectomy with two end stoma whereas 7(7%) patients were subjected to limited right hemi colectomy with primary anastomosis. Patients with multiple strictures and perforations were subjected to segmental resection with two end stoma. This was performed, in 12 (12%) cases and primary repair and anastomosis in 9 (9%). Only washouts and laparostomy was performed in 5 (5%) and adhenolysis in 4(4%) cases. Redo surgery was required in 44 (44%). The overall mortality was 18%. This study concludes that abdominal TB patients usually present late with complications in emergency surgery because of diagnostic delay, having a high morbidity and mortality.
- [Health and social conditions in Brod na Savi during World War I]. [Journal Article]
- AMActa Med Hist Adriat 2015; 13 Suppl 1:9-20
- During World War I, social and health conditions were difficult in Brod na Savi, as it stationed a large number of troops, and the military hospital was crowded with patients. With so many able-bodie...
During World War I, social and health conditions were difficult in Brod na Savi, as it stationed a large number of troops, and the military hospital was crowded with patients. With so many able-bodied men and breadwinners mobilised, the town's economy verged on the brink of poverty, but people managed to keep starvation at bay. The most common diseases among civilians were tuberculosis, malaria, intestinal infectious diseases, diphtheria, and venereal diseases, and in 1915 cholera broke out that lasted five months. At the end of 1918 "Spanish flu" also hit the town. The number of wounded and sick soldiers occasionally surpassed the hospital's capacity, so they had to be stationed at the local school facilities for a while. Over two thousand people died in the military hospital, which suggests that the total number of patients who went through the hospital had to be very large. Unfortunately, there are no records to show the hospital's mortality rate or disease prevalence. We are currently trying to establish the demographics of the 2000 dead buried at the local cemetery during WWI using the death records we have.
- Increased 18F-FDG uptake of heterotopic pancreatitis in the small intestine: A CARE-compliant case report. [Journal Article]
- MMedicine (Baltimore) 2016; 95(36):e4465
- CONCLUSIONS: This uncommon case underscores the necessity of considering heterotopic pancreatitis in small intestine with focal F-FDG uptake as a possible differential diagnosis in intestinal tumor and tuberculosis.
- [Cecal tuberculosis: the importance of a high diagnostic suspicion]. [Journal Article]
- ASAn Sist Sanit Navar 2016 mayo-agosto; 39(2):291-3
- Intestinal tuberculosis is less common than pulmonary tuberculosis. Its clinical and endoscopic features are nonspe-cific, so diagnostic suspicion must be high in order to make an early diagnosis and...
Intestinal tuberculosis is less common than pulmonary tuberculosis. Its clinical and endoscopic features are nonspe-cific, so diagnostic suspicion must be high in order to make an early diagnosis and prevent iatrogenia. Pharmacotherapy is often effective, with an excellent clinical and endoscopic evolution. Surgical treatment is reserved for complications. We present the case of cecal tuberculosis diagnosed endoscopically; this is the second case diagnosed in a few months in our center. In this case there were no risk factors, such as recent travel, risk of contacts or inmunosupression.
New Search Next
- [Spondylodiscitis: clinical experience in a Chilean general hospital]. [Journal Article]
- RCRev Chilena Infectol 2016; 33(3):322-30
- CONCLUSIONS: Most patients with SD were older adults. Staphylococcus aureus was predominant and M. tuberculosis was uncommon. Antibiotic side effects were relevant as well as the neurological complications.