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Effect of Antituberculosis Regimen Containing Ethambutol on Serum magnesium Level in Pulmonary Tuberculosis Patients
Mohammad Abbasi Nazari,Farzad Kobarfard,Payam Tabarsi,Maryam Azimi
Iranian Journal of Pharmaceutical Research , 2009,
Abstract: Magnesium is an essential metal that has important roles in physiological function of the body organs. Ethambutol is an oral antitubercular agent with chelating effects owing to its chemical structure. The aim of present study is to determine whether ethambutol usage can alter serum magnesium concentration in patients with pulmonary tuberculosis. Sixty patients with diagnosis of pulmonary tuberculosis were enrolled in the study. Blood samples were obtained before treatment from patients. Ten days after starting anti tuberculosis therapy, second blood samples were obtained. The amounts of serum magnesium were determined in all samples by spectrophotometric method. Statistical analysis showed that serum magnesium concentrations at baseline (0.61±0.08 mmol/l) and at day 10 (0.62±0.11 mmol/l) were not different. It is possible that ethambotol does not affect magnesium concentration in tuberculosis patients, however further studies about the other cationic trace elements are recommended.
"Comparative Study Of The Profiles Of Th1 And Th2 Cytokines In Patients With Sputum Smear- Positive Pulmonary Tuberculosis And PPD–Positive Healthy Persons And Their Changes During Treatment "
M. Hajiabdolbaghi,A.A. Amirzargar,M. Khaledi,F. Khosravi
Tehran University Medical Journal , 2006,
Abstract: Background and Aim: The better understanding of immunopathologic mechanism of tuberculosis (TB) is necessary for the production of new vaccines and adjunctive immunomodulator drugs. Intended to this object, the following study including the measurement of serum concentrations of Th1 (Interferon (IFN)-y and interkeukin (IL)-2 and Th2 cytokines(IL-4AND IL-10 ) in patients with sputum smear-positive pulmonary TB and comparisons of them with PPpositive healthy persons, was designed. Materials and Methods: The HIV-negative patients that had sputum smear-positive pulmonary TB as defined WHO criteria and hospitalized in the infectious diseases ward of Imam Khomeini hospital or referred to health care centers in the south of Tehran, were included in the study. The PPD-positive healthy persons who were close contacts with pulmonary TB patients, were considered as control group. Results: In this research 34 active pulmonary TB patients (including17men and 17 woman)and 23 healthy persons with PPD skin test results or = 10mm (including 12men and 11 woman) were studied. The mean ages of the patients and the healthy persons were 73 and 41 years and 74 and 27 years, respectively. The mean serum IFN-Y concentration was significantly higher in TB patients but the mean serum IL-2 IL-4and IL-10 concentrations were significantly higher in healthy persons. The com parison of the mean serum levels of these cytokines before and during treatment (about 2 months after starting treatment) showed that the amounts of IFN-y and IL4 were increased and the amounts of IL2 and IL-10 were decreased but only the changes of IL-10 were statistically significant. There were no effect on the cytokine changes before and during treatment by age and gender of the patients. Conclusion: The results of the study of serum Th1 and Th2 cytokines in pulmonary TB patients were different in comparison with the results of the studies of peripheral blood mononuclear cells (PBMCs) stimulated with M.tuberculosis antigens. SO, the simultaneous measurement of them in serum, pleural fluid, BAL fluid and the medium culture of PBMCs stimulated with the antigens is recommended.
Effects of Gender and Age on Development of Concurrent Extrapulmonary Tuberculosis in Patients with Pulmonary Tuberculosis: A Population Based Study  [PDF]
Chun-Yu Lin, Tun-Chieh Chen, Po-Liang Lu, Chung-Chih Lai, Yi-Hsin Yang, Wei-Ru Lin, Pei-Ming Huang, Yen-Hsu Chen
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0063936
Abstract: Most cases of adult-onset tuberculosis (TB) result from reactivation of a pre-existing Mycobacterium tuberculosis infection. Mycobacterium tuberculosis usually invades the respiratory tract and most patients develop intrapulmonary TB; however, some patients develop concurrent pulmonary and extra-pulmonary TB. The purpose of the present study was to identify the demographic and clinical factors associated with an increased risk of concurrent extra-pulmonary diseases in patients with pulmonary TB. We compared patients who had isolated pulmonary TB with patients who had concurrent pulmonary and extra-pulmonary TB. We initially analyzed one-million randomly selected subjects from the population-based Taiwan National Health Insurance database. Based on analysis of 5414 pulmonary TB patients in this database, women were more likely than men to have concurrent extra-pulmonary TB (OR: 1.30, p = 0.013). A separate analysis of the Kaohsiung Medical University Hospital database, which relied on sputum culture-proven pulmonary TB, indicated that women were more likely than men to have concurrent extra-pulmonary TB (OR: 1.62, p = 0.039). There was no significant gender difference in extra-pulmonary TB for patients younger than 45 years in either database. However, for patients 45 years and older, women were more likely than men to have concurrent extra-pulmonary TB (insurance database: 9.0% vs. 6.8%, p = 0.016, OR: 1.36; hospital database: 27.3% vs. 16.0%, p = 0.008, OR = 1.98). Our results indicate that among patients who have pulmonary TB, older females have an increased risk for concurrent extra-pulmonary TB.
Trace estimates and invariance of the essential spectrum  [PDF]
G. Barbatis
Mathematics , 2006,
Abstract: We provide sufficient conditions under which the difference of the resolvents of two higher-order operators acting in $\R^N$ belongs to trace classes $\cC^p$. We provide explicit estimates on the norm of the resolvent difference in terms of $L^p$ norms of the difference of the coefficients. Such inequalities are useful in estimating the effect of localized perturbations of the coefficients.
Gender in geography: An essential basis of analysis  [PDF]
Buehler Elisabeth
Journal of the Geographical Institute Jovan Cvijic, SASA , 2007, DOI: 10.2298/ijgi0757039b
Abstract: Cultural values and norms about women, men, gender relations and about femininity and masculinity not only are fundamental in the construction processes of societies; they also shape the constitution and the use of spaces and places from individual to global level. The home, the company, neighborhoods, public spaces, the labor market, the city, the nation state or the global market: all of these spaces are closely and inextricably characterized by specific activities of women and men, by specific gendered power relations and by specific symbolic meanings of gender. Geographic research should therefore acknowledge gender as an essential basis of analysis. In my statement I will present some recent results of geographic research on gender in Switzerland focusing on the spaces "home", "labor market" and "welfare state". I am convinced that geographic science with its traditional focus on specific socio-spatial contexts at different levels is capable to make substantial contributions to the rapidly developing and inherently interdisciplinary field of gender studies.
Gender and HIV-associated pulmonary tuberculosis: presentation and outcome at one year after beginning antituberculosis treatment in Uganda
Peter Nsubuga, John L Johnson, Alphonse Okwera, Roy D Mugerwa, Jerrold J Ellner, Christopher C Whalen
BMC Pulmonary Medicine , 2002, DOI: 10.1186/1471-2466-2-4
Abstract: We enrolled and followed up a cohort of 105 male and 109 female HIV-infected adults on treatment for initial episodes of culture-confirmed pulmonary tuberculosis between March 1993 and March 1995. A favorable outcome was defined as being cured and alive at one year while an unfavorable outcome was not being cured or dead. Subjects were followed-up by serial medical examinations, complete blood counts, serum β2 microglobulin, CD4+ cell counts, sputum examinations, and chest x-rays.Male patients were older, had higher body mass indices, and lower serum β2 microglobulin levels than female patients at presentation. At one year, there was no difference between male and female patients in the likelihood of experiencing a favorable outcome (RR 1.02, 95% CI 0.89–1.17). This effect persisted after controlling for symptoms, serum β2 microglobulin, CD4+ cell count, and severity of disease on chest x-ray (OR 1.07, 95% CI 0.54–2.13) with a repeated measures model.While differences existed between males and females with HIV-associated pulmonary tuberculosis at presentation, the outcomes at one year after the initiation of tuberculosis treatment were similar in Uganda. Women in areas with a high HIV and tuberculosis prevalence should be encouraged to present for screening at the first sign of tuberculosis symptoms.Tuberculosis is estimated to cause at least three million deaths per year worldwide [1] and also accounts for more than one-quarter of all preventable adult deaths in developing countries [2]. Infection with the human immuno-deficiency virus (HIV) is thought to be the single most important factor that has contributed to the increased incidence of tuberculosis globally in the last decade [2]. Tuberculosis is now the leading cause of death among HIV-infected individuals worldwide and accounts for at least 40% of deaths among HIV-infected persons in Africa [3]. Furthermore, tuberculosis kills more women than any other infectious disease, including malaria and AIDS [4].Repor
Elevated ex vivo monocyte chemotactic protein-1 (CCL2) in pulmonary as compared with extra-pulmonary tuberculosis
Zahra Hasan, Irfan Zaidi, Bushra Jamil, M Aslam Khan, Akbar Kanji, Rabia Hussain
BMC Immunology , 2005, DOI: 10.1186/1471-2172-6-14
Abstract: Serum levels of CCL2, CXCL8 and TNFα were measured in patients with pulmonary tuberculosis (N = 12), extra-pulmonary tuberculosis (N = 8) and BCG-vaccinated healthy volunteers (N = 12). Whole blood cells were stimulated with non-pathogenic Mycobacterium bovis bacille-Calmette Guerin (BCG) vaccine strain or bacterial lipopolysaccharide (LPS) and cyto/chemokines were monitored in supernatants.Circulating serum levels of CXCL8 and TNFα were raised in all tuberculosis patients, while CCL2 levels were not. There was no difference in spontaneous cytokine secretion from whole blood cells between patients and controls. M. bovis BCG-induced ex vivo CCL2 secretion was significantly greater in pulmonary as compared with both extra-pulmonary tuberculosis patients and endemic controls. In response to LPS stimulation, patients with pulmonary tuberculosis showed increased CCL2 and TNFα responses as compared with the extra-pulmonary group. BCG-, and LPS-induced CXCL8 secretion was comparable between patients and controls.CCL2 is activated by TNFα and is essential for recruitment of monocytes and T cells to the site of mycobacterial infection. Increased CCL2 activation in pulmonary tuberculosis may result in a stronger cellular response as compared with extra-pulmonary tuberculosis patients, and this may contribute to the localization of infection to the pulmonary site.Tuberculosis is a major cause of morbidity and mortality worldwide, causing approximately 3 millions deaths annually [1]. Mycobacterium tuberculosis, the causative agent of tuberculosis is a successful pathogen due to its ability to down regulate host immune responses. The primary site of infection for M. tuberculosis is the alveolar macrophage. In cases where pulmonary infection cannot be controlled the organism disseminates via blood to other sites. Pulmonary involvement is seen in the majority of tuberculosis cases however infections of extra-pulmonary sites such as lymph nodes, skeletal, abdominal and genito-urina
Previous Pulmonary Fibrosis in Dermatomyositis/Polymyositis: A Predictive Factor for Pulmonary and Extra-Pulmonary Tuberculosis  [PDF]
Taysa Cristiane Moreira da Silva, Adriana Coracini Tonacio de Proen?a, Samuel Katsuyuki Shinjo
Open Journal of Rheumatology and Autoimmune Diseases (OJRA) , 2018, DOI: 10.4236/ojra.2018.84011
Abstract: Objective: With scant studies in the literature, little is known about the risk factors for tuberculosis in patients with dermatomyositis/polymyositis. Therefore, the aim of the present study was to analyze the predictive factors for tuberculosis development in dermatomyositis/polymyositis. Methods: This single-center, retrospective, cohort study initially included 290 patients with dermatomyositis/polymyositis, from 2002 to 2016. Tuberculosis (pulmonary and/or extra-pulmonary) was confirmed after dermatomyositis/polymyositis diagnosis in 12 patients (4.1%) (Tuberculosis+ group). For the control group (Tuberculosis), 24 patients without tuberculosis were arbitrarily selected in the same period and matched for age, ethnicity, gender, age at disease diagnosis, disease duration and type (dermatomyositis or polymyositis). Results: Tuberculosis occurred for a median of 16 months after dermatomyositis/polymyositis diagnosis. Clinical, laboratory and treatment features were similar in Tuberculosis+ and Tuberculosis groups (P > 0.05). However, previous pulmonary fibrosis in dermatomyositis/polymyositis was more prevalent in the Tuberculosis+ group (41.7 vs. 8.3%; P = 0.029). Moreover, on a multivariate logistic regression model, pulmonary fibrosis was significantly associated with Tuberculosis (Odds ratio: 9.59, 95% confidence interval: 1.17 - 78.82). Tuberculosis affected 3 dermatomyositis cases for every 1 polymyositis case, with predominantly pulmonary followed by extra-pulmonary involvement (pleura, cutaneous, muscular, joint, soft tissue and hematologic). Two or more sites were affected in 41.7% of cases. Conclusions: Previous pulmonary fibrosis in dermatomyositis/polymyositis was a predictive factor associated with tuberculosis development. Further studies are needed to confirm these results.
A study of iga antibody response to different mycobacterium tuberculosis antigens in the diagnosis and monitoring of pulmonary tuberculosis
Bezerra, Janaina Miranda;Beck, Sandra Trevisan;Kanunfre, Kelly Aparecida;Leite, Olavo Munhoz;Ferreira, Ant?nio Walter;
Brazilian Journal of Infectious Diseases , 2009, DOI: 10.1590/S1413-86702009000100012
Abstract: we evaluated the performance of the elisa technique in the detection of iga antibodies against different mycobacterium tuberculosis antigenic preparations in serum samples from 49 patients with pulmonary tuberculosis collected before and after the start of specific treatment. the controls consisted of serum samples from healthy patients without any prior contact with the bacteria and serum samples from patients with other pneumopathies. glycolipid antigen gave the best diagnostic performance, with a sensitivity of 88% and specificities varying from 88 to 100% in the control groups. these antigens constitute a powerful tool for the diagnosis and monitoring of patients with pulmonary tuberculosis.
Role of Serum Procalcitonin Level in Differentiating between Pulmonary Tuberculosis and Community-Acquired Pneumonia  [PDF]
Mohammad Shameem, Mazhar Alam, Shagufta Moin, Rakesh Bhargava, Zuber Ahmad, Jamal Akhtar
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.515121

Pulmonary Tuberculosis (PTB) and Community-Acquired Pneumonia (CAP) are common causes of consolidation patch in chest radiograph. Sputum Z-N staining is positive in 30% to 60% cases only and sputum examination has poor yield in CAP. This study aimed to assess the value of serum Procalcitonin (PCT) levels in patients with Pulmonary Tuberculosis (PTB) and Community-Acquired Pneumonia (CAP). Patients with new opacity in chest radiograph were included in the study. Serum sample were taken at admission and stored. Patient’s diagnosis were confirmed and categorized into pulmonary TB group (32) and community-acquired pneumonia group (23). Their mean PCT level was compared with mean PCT level of 25 controls. Serum procalcitonin levels were found to be significantly elevated in patients of community-acquired pneumonia as compared to patients of pulmonary tuberculosis. In presence of consolidation in x-ray chest, increased level of serum procalcitonin might be used to differentiate pulmonary tuberculosis from community-acquired pneumonia. High level of serum procalcitonin was associated with high mortality rate in community-acquired pneumonia patients.

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