- Community-based active case-finding to reach the most vulnerable: tuberculosis in tribal areas of India. [Journal Article]
- IJInt J Tuberc Lung Dis 2019 Jun 01; 23(6):750-755
- CONCLUSIONS: </title> In India, particularly among tribal populations, many people with TB are missed by current approaches due to poor access. Community-based active case-finding can help identify more people with TB in tribal and remote rural areas by addressing barriers to health seeking as well as help reach ambitious country and global notification targets. </sec>.
- Prevalence of pulmonary tuberculosis in Tibet Autonomous Region, China, 2014. [Journal Article]
- IJInt J Tuberc Lung Dis 2019 Jun 01; 23(6):735-740
- <sec> <title>SETTING</title> Tibet Autonomous Region, China. </sec> <sec> <title>OBJECTIVES </title> To determine the prevalence of pulmonary tuberculosis (TB) in Tibet. </sec> <sec> <title>DESIGN</t…
<sec> <title>SETTING</title> Tibet Autonomous Region, China. </sec> <sec> <title>OBJECTIVES </title> To determine the prevalence of pulmonary tuberculosis (TB) in Tibet. </sec> <sec> <title>DESIGN</title> We conducted a population-based, cross-sectional survey among residents aged ≥15 years in Tibet, China, in 2014. A door-to-door survey was conducted for each randomly selected cluster, followed by a screening interview and a chest X-ray (CXR). Those with symptoms of TB and/or abnormal CXR underwent sputum microscopy testing and culture. </sec> <sec> <title>RESULTS </title> Of 31 527 eligible residents, 30 113 (95.5%) participated, 215 of whom were active TB cases, including 49 (22.8%) known cases. Adjusted prevalence of smear-positive, bacteriologically positive and all pulmonary TB cases was respectively 8 (95%CI 62-97), 144 (95%CI 107-152) and 758 (95%CI 662-766) per 100 000 population. This represented a decline of 37% in the prevalence of active cases, and of 21.3% in smear-positive cases compared with a 1990 survey. About 51.3% of bacteriologically positive TB patients in Tibet showed no symptoms. </sec> <sec> <title>CONCLUSION</title> We observed a sharp decline in TB prevalence and a low rate of bacteriologically positive cases among all active patients. The low proportion of known cases in the survey reflected possible underdetection by the National TB Programme. </sec>.
- Point-of-care urine lipoarabinomannan antigen detection for diagnosis of tuberculosis in children. [Journal Article]
- IJInt J Tuberc Lung Dis 2019 Jun 01; 23(6):714-719
- <sec> <title>BACKGROUND </title> Diagnosis of tuberculosis (TB) in children remains challenging due to the paucibacillary nature of the disease. Detection of TB using urine lipoarabinomannan (LAM) an…
<sec> <title>BACKGROUND </title> Diagnosis of tuberculosis (TB) in children remains challenging due to the paucibacillary nature of the disease. Detection of TB using urine lipoarabinomannan (LAM) antigen was evaluated in children with presumed TB. </sec> <sec> <title>MATERIAL and METHODS </title> Children with presumed intrathoracic tuberculosis (ITTB) and lymph node TB (LNTB) were enrolled. Expectorated or induced sputum or gastric aspirates from ITTB patients and fine-needle cytological aspirates from LNTB patients were subjected to Ziehl-Neelsen staining, MGIT™960™ culture and Xpert® MTB/RIF testing. Urine samples were tested to detect LAM, and the sensitivity and specificity calculated. </sec> <sec> <title>RESULTS </title> Of 280 children with presumed ITTB and 101 with presumed LNTB, respectively 71 (25.3%) and 25 (24.7%) were categorised as 'confirmed TB', 70 (25%) and 33 (32.7%) as 'unconfirmed TB', and 139 (49.6%) and 43 (42.5%) as 'unlikely TB'. Respectively 8 (2.8%) children with ITTB and 3 (2.9%) with LNTB were positive on smear, 56 (20.0%) and 23 (22.7%) on Xpert, and 50 (17.8%) and 9 (8.9%) on culture. LAM assay sensitivity was 73.2% in confirmed ITTB cases, and 76% in confirmed LNTB cases; LAM assay specificity in children with ITTB and those with LNTB initiated on anti-tuberculosis treatment was respectively 92% and 93%. Detection of TB using the LAM assay was significantly better than detection using Xpert (P < 0.05 vs. P < 0.002). </sec> <sec> <title>CONCLUSION</title> Urinary LAM testing showed high specificity and sensitivity, was detected in more cases initiated on treatment than reference tests, and improved disease detection by 38.5% in ITTB patients and by 41.6% in LNTB patients. </sec>.
- A randomised controlled trial of stepwise sputum collection to increase yields of confirmed tuberculosis. [Journal Article]
- IJInt J Tuberc Lung Dis 2019 Jun 01; 23(6):685-691
- CONCLUSIONS: </title> If implemented effectively in resource-limited primary care clinics, our simple stepwise procedure combining instruction and sputum induction could increase the proportion of bacteriologically confirmed TB significantly. </sec>.
- Streptococcus gordonii Empyema: A Rare Presentation of Streptococcus gordonii Infection. [Case Reports]
- CCureus 2019 May 07; 11(5):e4611
- Empyema is often caused by Streptococcus pneumoniae, Staphylococcus aureus, and a variety of gram-negative organisms as well as anaerobes. Streptococcus gordonii (S. gordonii) is among some of the in…
Empyema is often caused by Streptococcus pneumoniae, Staphylococcus aureus, and a variety of gram-negative organisms as well as anaerobes. Streptococcus gordonii (S. gordonii) is among some of the initial colonizers of the periodontal environment that is recognized to cause bacterial endocarditis. However, there are only a few case reports of S. gordonii causing empyema in the literature. We report the case of a 75-year-old male who presented with coughing up blood-tinged sputum. Physical examination revealed decreased breath sounds in the right lung base. Chest X-ray demonstrated a lower, right-sided, loculated pleural effusion. He underwent ultrasound-guided chest tube placement. The pleural fluid culture grew S. gordonii. He was started on ampicillin/ sulbactam. The follow-up computed tomography (CT) scan showed no significant improvement. Given his inability to improve with antibiotics and chest tube drainage, he was referred to an advanced care center for decortication of lung tissue.
- Dysregulation of the endothelial nitric oxide pathway is associated with airway inflammation in COPD. [Journal Article]
- RRRespir Res 2019 Jul 16; 20(1):156
- CONCLUSIONS: Our data suggest impaired eNOS function in stable COPD, which is transiently aggravated during an exacerbation and partly reversed by systemic steroid treatment. Serum ADMA and SDMA correlate with airway inflammatory markers implying a possible effect of anti-inflammatory therapy on endothelial dysfunction. Serum nitrite can serve as a compensatory pool for impaired endothelial NO generation.
- Management of hospitalized drug-sensitive pulmonary tuberculosis patients during the Hajj mass gathering: A cross sectional study. [Journal Article]
- TMTravel Med Infect Dis 2019 Jul 13
- CONCLUSIONS: Healthcare providers training and supervision are paramount to improve their knowledge and skill and ensure their compliance with existing TB management guidelines. However, there may be a need for the introduction of an international policy/guideline for TB control and management during mass gatherings such as the Hajj to guide providers' choices and facilitate monitoring.
- Patterns of sensitization to aeroallergens and their effect on airway hyper-responsiveness in Busan, Korea. [Journal Article]
- APAsian Pac J Allergy Immunol 2018 Jul 16
- CONCLUSIONS: Sensitization to house dust mites and tree pollen was found to be common in Busan. These aeroallergens significantly affected AHR, particularly in the younger group.
- Mechanisms and therapeutic strategies for Non-T2 Asthma. [Journal Article]
- AAllergy 2019 Jul 16
- Non T2 asthma is traditionally defined as asthma without features of T2 asthma. The definition is arbitrary, and is generally based on the presence of neutrophils in sputum, or the absence (or normal…
Non T2 asthma is traditionally defined as asthma without features of T2 asthma. The definition is arbitrary, and is generally based on the presence of neutrophils in sputum, or the absence (or normal levels) of eosinophils or other T2 markers in sputum (pauci-granulocytic), airway biopsies or in blood. This definition may be imprecise as we gain more knowledge from applying transcriptomics and proteomics to blood and airway samples. The prevalence of non-T2 asthma is also difficult to estimate as most studies are cross-sectional and influenced by concomitant treatment with glucocorticosteroids, and by the presence of recognized or unrecognized airway infections. No specific therapies have shown any clinical benefits in patients with asthma that is associated with a non-T2 inflammatory process. It remains to be seen if such an endotype truly exists and to identify treatments to target that endotype. Meanwhile, identifying intense airway neutrophilia as an indicator of airway infection and airway hyperresponsiveness as an indicator of smooth muscle dysfunction, and treating them appropriately, and not increasing glucocorticosteroids in patients who do not have obvious T2 inflammation, seem reasonable. This article is protected by copyright. All rights reserved.
New Search Next
- Susceptibility pattern of tracheal tube isolates from Intensive Care Unit of Fauji Foundation Hospital Rawalpindi. [Journal Article]
- JPJ Pak Med Assoc 2019; 69(7):981-984
- CONCLUSIONS: Acinetobacter baumannii was the most prevalent strain in tracheal tubes and polymyxin B was the most effective medicine.