Evaluation of Small Mothers against Decapentaplegic 3 and Transforming Growth Factor Beta Levels in Relation to Lung Fibrosis and Function in Treated Pulmonary Tuberculosis Patients.

The aim of this study was to compare the expression of peripheral blood T cell subsets, soluble interleukin-2 receptor (sIL-2R) and interferon-gamma (IFN-γ) in patients with retreatment pulmonary tuberculosis, initial treatment pulmonary and extra-pulmonary tuberculosis, and therefore to explore the cellular immune changes and the significance among different types and severity of tuberculosis. A total of 170 patients with tuberculosis in Pulmonary Hospital of Shanghai from December 2009 to January 2011, including 98 males and 72 females, aged from 16 to 70 years (average 40 years), were included in this study. The patients were divided into retreatment pulmonary tuberculosis group (47 cases), initial treatment pulmonary tuberculosis group (62 cases) and initial treatment extra-pulmonary tuberculosis group (61 cases). Furthermore, the 109 patients with pulmonary tuberculosis were divided into different subgroups according to cavity formation and the lung fields involved: patients without lung cavity (52 cases) vs those with lung cavity (57 cases), patients with involvement of 1 - 2 lung fields (48 cases), vs 3 - 4 lung fields (26 cases) and 5 - 6 lung fields (35 cases). Peripheral blood T cell subsets (by flow cytometry doubled-labeled antibody), sIL-2R and IFN-γ (by ELISA) were determined in 170 patients. Differences between means of 2 groups were tested by t test, differences among multiple groups were tested by analysis of variance (ANOVA), and multiple comparisons among multiple groups were tested by LSD-t test or χ² test. Linear regression equation was used to analyze the correlations. The levels of peripheral blood CD₄/CD₈ in patients with retreatment pulmonary tuberculosis and initial treatment extra-pulmonary tuberculosis patients were significantly lower than that in initial treatment pulmonary tuberculosis patients, [(1.7 ± 0.7), (1.6 ± 0.7) and (2.0 ± 0.7) respectively (F = 4.380, P < 0.05)]. The levels of serum sIL-2R in patients with retreatment pulmonary tuberculosis and initial treatment extra-pulmonary tuberculosis were significantly higher than that in initial treatment pulmonary tuberculosis patients [(224 ± 89) pmol/L, (209 ± 98) pmol/L, (167 ± 73) pmol/L, (F = 6.402, P < 0.01)]. The levels of serum IFN-γ in patients with retreatment pulmonary tuberculosis and initial treatment extra-pulmonary tuberculosis were significantly higher than that in initial treatment pulmonary tuberculosis patients [(37 ± 23) ng/L, (37 ± 24) ng/L, (29 ± 16) ng/L, (F = 2.799, P < 0.05)]. The levels of peripheral blood CD₄/CD₈ in initial treatment and retreatment cavity pulmonary tuberculosis patients were lower than that in pulmonary tuberculosis patients without cavity, but the results of sIL-2R and IFN-γ were the opposite [(1.7 ± 0.6) vs (2.0 ± 0.8), (214 ± 93) pmol/L vs (167 ± 68) pmol/L and (38 ± 22) ng/L vs (27 ± 14) ng/L, t = -2.813 to 3.076, P < 0.05 or P < 0.01]. The level of serum sIL-2R was negatively correlated with peripheral blood CD₄/CD₈ level in all the patients (r = -0.380, P < 0.01). Patients with retreatment pulmonary tuberculosis and initial treatment extra-pulmonary tuberculosis had lower cellular immune function as compared to those with initial treatment pulmonary tuberculosis, and the cellular immune function was significantly correlated with the extent and cavity formation of pulmonary lesions.

This research was conducted from January to August 2018 and took place in 20 Pekanbaru health centers. The purpose of this study was to determine the conditions of air pollution based on PM10 parameters in Pekanbaru City in 2015 and to divide in periods of smog and not haze, the character of new pulmonary tuberculosis (TB) patients undergoing treatment during periods of smog and not smoke haze, expenditure released by the average of each new pulmonary TB patient in the period of smog and not smog and economic losses incurred by new pulmonary TB patients during the period of smog and not haze. The results of the study, months that exceed the quality standard PM10 in the air 150 µg / m3 are July, September and October. Smog period, May, June, July, August, September and October, not smoke haze January, February, March, April, November and December. The majority of those with new pulmonary TB treatment during the non-haze period, men (75.4%) p-value 0.885 and young age group (90.7%) p-values 0.335. The total direct cost of new pulmonary TB patients during smog is Rp. 2,230,000 (141.5,343.1) and as long as it is not smog Rp. 2,020,000 (125,347) with p-value 0.538. The highest expenditure is food costs (p-value 0.043) and mask costs (p-value <0.001). The total indirect cost of new pulmonary TB patients during the smog period is Rp. 1,600,000 (121,297) and not a smog period of Rp. 1,470,000 (45,266.2). Percentage of median total economic loss due to new pulmonary tuberculosis during 20.8% smog (14.6.31.8) and as long as it is not smog 19.5% (12.9, 33) with p-value 0.396.

Objective Detecting plasma level of circular RNA (circRNA) hsa_circ_0009024 in pulmonary tuberculosis (TB) patients, and evaluating its diagnostic value for TB. Methods From January 2016 to December 2016, a hosptial-based, case-control study was performed, which include 90 untreated active pulmonary tuberculosis patients (TB group), 75 healthy people (healthy control)and 84 patient with other diseases (other disease group). Plasma level of circRNA hsa_circ_0009024 was detected by real-time quantitative polymerase chain reaction. Furthermore, the 90 patients with TB were divided into different subgroups according to cavity formation and the lung fields involvement: patients without lung cavity (55 cases) vs those with lung cavity (35 cases), patients with involvement of <2 lung fields (49 cases) vs ≥2 lung fields (41 cases). Plasma levels of hsa_circ_0009024 of 41 TB patientswere monitored andcomparedbefore and after 3 months anti-TB therapy. The sensitivity and specificity of plasma hsa_circ_0009024 were analyzed by using the receiver operating characteristic (ROC) curve. The comparison between two groups was performed with Mann-Whitney U test and the comparison among multigroupswas conducted with Kruskal-Wallis H test. Results Plasma levels of hsa_circ_0009024 in TB patients [1.98 (1.42, 2.71)] were significantly higher than healthy controls [1.03 (0.78, 1.33)] and other disease groups [1.13 (0.77, 1.51)] (H=76.58, P<0.0001). Plasma levels of hsa_circ_0009024 in cavity pulmonary TB patients were higher than pulmonary TB patients without cavity (U=392.50, P<0.0001). Plasma levels of hsa_circ_0009024 in TB patients with involvement of ≥2 lung fields were higher than <2 lung fields (U=590.50, P=0.0008). As compared to pre-treatment [2.01 (1.41, 2.71)], the plasma hsa_circ_0009024 levels decreased significantly in 3 months [1.22 (0.85, 1.47)] (U=292.50, P<0.0001) after anti-TB therapy. The area under the receiver operating characteristics curve (AUC) of plasma hsa_circ_0009024 in discriminating the patients with TB from normal controls, pneumonia patients and lung cancer patients were 0.841 and 0.811, respectively. Conclusion The hsa_circ_0009024 can be used as a potential biomarker in TB diagnosis and monitoring.(Chin J Lab Med, 2018, 41: 399-404) Key words: Tuberculosis, pulmonary; RNA; Biomarkers

Purpose: The transforming growth factor beta1 (TGFB1) pathway has been linked to fibrosis in several tissues including skin, liver, kidney and the cornea. In this study, a RNA interference-based approach using siRNAs targeting three critical scarring genes, TGFB1, TGFB receptor 2 (TGFBR2) and connective tissue growth factor (CTGF), was tested for effects on reducing alpha smooth muscle actin (SMA) and corneal scarring (haze) in excimer laser ablated rabbit corneas. Methods: Levels of TGFB1 and CTGF mRNAs were measured using qRT-PCR in the epithelial and endothelial cell layers of normal and excimer ablated rabbit corneas at 30 minutes, 1 day and 2 days after ablation. Two different scarring models were utilized to assess the effects of the triple siRNA combination on corneal scarring. In the first model, rabbit corneas were unevenly ablated creating a mesh pattern then treated immediately with the triple siRNA combination. After 1 day the ablated areas of corneas were collected and levels of mRNAs for TGFB1, TGFBR2 and CTGF were measured. After 14 days, levels of mRNA for SMA were measured and SMA protein immunolocalized in frozen sections. In the second model, rabbit corneas were uniformly ablated to a depth of 155 microns followed by three daily doses of the triple combination of siRNA. After 14 days, corneas were photographed and images were analyzed using Image J software to assess corneal scarring. Corneas were also analyzed for levels of SMA mRNA. Results: In both unwounded and wounded corneas, levels of TGFB1 and CTGF mRNA were always significantly higher in endothelial cells than in epithelial cells (10 to 30 fold). Thirty minutes after injury, levels of both TGFB1 and CTGF mRNAs increased approximately 20-fold in both epithelial and endothelial cells, and further increased approximately 60-fold in 2 days. In the first therapeutic experiment with a single siRNA dose, two of three rabbits showed substantial reductions of all three target genes after 1 day with a maximum knock down of 80% of TGFb 1, 50% reduction of TGFBR2 and 40% reduction of CTGF mRNA levels and reduced SMA mRNA at day 14. In the second therapeutic experiment with multiple doses of siRNA treatment, both rabbits showed a ~22% reduction in scar formation at day 14 as calculated by image analysis. There was also a corresponding 70% and 60% reduction of SMA RNA expression. Conclusion: These results demonstrate that both TGFB1 and CTGF dramatically increase in rabbit corneal epithelial and endothelial cells after injury. Treatment of excimer ablated rabbit corneas with a triple combination of siRNAs effectively reduced levels of the target genes and SMA, leading to reduced corneal scarring at 14 days, suggesting that this triple siRNA combination may be an effective new approach to reducing scarring in cornea and other tissues.

The study aimed to assess the health-seeking behaviour (HSB) of pulmonary tuberculosis (PTB) patients and its associated factors, which significantly impacts disease management in countries with a high incidence of tuberculosis (TB), such as Kenya. The PTB burden in Kenya has increased significantly in recent years due to poor health-seeking behaviour among PTB patients. Despite the implementation of free PTB testing and treatment, inadequate HSB contributes to high morbidity and mortality rates and increases the spread of PTB. The primary objective was to assess the health-seeking behaviour and associated factors among PTB patients at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kenya. The research was conducted in the TB clinic at JOOTRH, utilizing a cross-sectional descriptive research design. Participants were sampled through purposive and convenience sampling methods . Purposive and convenience sampling methods were selected to achieve a balance between research relevance and practicality. Purposive sampling was employed to ensure the inclusion of patients actively living with pulmonary tuberculosis (PTB) and undergoing treatment. This approach focuses on individuals most relevant to the study objectives, enabling a detailed examination of sociodemographic profiles and factors influencing health-seeking behaviour. By targeting this specific group, the study ensured that the data collected was both high-quality and contextually appropriate. Conversely, convenience sampling was used to enhance the study’s feasibility by including patients who were readily available during clinical visits. This method addressed practical constraints such as time, resource limitations, and accessibility, ensuring efficient data collection within the clinical setting. Combined, these sampling methods provided a practical yet focused strategy, making the research both achievable and directly aligned with its objectives. Data collection was performed using semi-structured questionnaires, with analysis conducted through descriptive statistics and Microsoft Excel. The findings will guide key interventions to improve health-seeking behaviour, informing policy formulation and health education initiatives. A total of 58 respondents participated in the study, representing the complete census of patients who attended the clinic during August 2022, when the research was conducted. The majority were aged 26-35 years (62.1%) and male (65.5%). Financial constraints were identified as a common barrier to seeking TB treatment (79.3%). While knowledge about TB was generally high, stigmatization remained prevalent. Analysis of the collected data revealed that distance to health facilities, financial constraints, and community perceptions of TB had a statistically significant influence on health-seeking behaviour. This study highlights that TB health-seeking behaviour and access to care are greatly hindered by unemployment and low income. Misconceptions about TB's incurability and transmission contribute to stigma and delayed care. Recommendations include enhancing health education, improving healthcare access, and addressing financial barriers through community outreach to destigmatize TB and promote early healthcare-seeking behaviour, particularly among vulnerable populations, to reduce transmission rates and improve outcomes.

Article1 July 1953ANTIMICROBIAL THERAPY OF PULMONARY TUBERCULOSIS: REVIEW OF SIX YEARS' EXPERIENCE AT FITZSIMONS ARMY HOSPITALCARL W. TEMPEL, FORREST W. PITTS, WILLIAM E. DYECARL W. TEMPELSearch for more papers by this author, FORREST W. PITTSSearch for more papers by this author, WILLIAM E. DYESearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-39-1-61 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSix antimicrobial agents have been subjected to a methodical pattern of clinical investigation since 1946 at Fitzsimons Army Hospital. Approximately 1,300 patients have been evaluated under controlled conditions employing streptomycin, para-aminosalicylic acid, amithiozone, viomycin, terramycin and Isoniazid, either singly or in various combinations.1 Therapeutic efficacy, bacteriologic cultural and resistance studies, and toxicity formed the principal criteria for evaluating these drug regimens. Summary data on 875 patients observed on the research wards constitute the basis of this report.Studies were performed on a homogeneous group of patients relative to extent and clinical pathologic type of disease. Almost all were young adult...Bibliography1. Tempel CW: Present status of specific drug treatment of tuberculosis, J. A. M. A. 150: 1165-1170 (Nov. 22) 1952. CrossrefMedlineGoogle Scholar2. TempelHughesMardisTowbinDye CWFJREMNWE: Combined intermittent regimens employing streptomycin and para-aminosalicylic acid in the treatment of pulmonary tuberculosis, Transactions of the Ninth Streptomycin Conference (VA), 36-50 (Apr.) 1950. Google Scholar3. TempelHughesMardisTowbinDye CWFJREMNWE: Combined intermittent regimens employing streptomycin and para-aminosalicylic acid in the treatment of pulmonary tuberculosis; a comparison with daily and intermittent dosage schedules, Am. Rev. Tuberc. 63: 295-311 (Mar.) 1951. MedlineGoogle Scholar4. HughesMardisDyeTempel FJREWECW: Combined intermittent regimens in the treatment of pulmonary tuberculosis, Transactions of the 10th Conference on the Chemotherapy of Tuberculosis (VA), 67-76 (Jan.) 1951. Google Scholar5. HughesMardisDyeTempel FJREWECW: Combined intermittent regimens in the treatment of non-miliary pulmonary tuberculosis; a comparison of streptomycin every third day and para-aminosalicylic acid daily with streptomycin every third day and para-aminosalicylic acid every third day, Dis. Chest 21: 1-16 (Jan.) 1952. CrossrefMedlineGoogle Scholar6. D'EsopoRaleigh NDMD: Further experience with prolonged chemotherapy, Transactions of the Ninth Streptomycin Conference (VA), 56-66 (Apr.) 1950. Google Scholar7. O'DellPittsRowanDyeHughes ETFWAIWEFJ: The administration of amithiozone alone and in combination with intermittent streptomycin in non-miliary pulmonary tuberculosis, Transactions of the Eleventh Conference on Chemotherapy of Tuberculosis (VA), 332-337 (Jan.) 1952. Google Scholar8. PittsO'DellDyeHughesTempel FWETWEFJCW: Intermittent viomycin therapy in pulmonary tuberculosis; a preliminary report, Transactions of the Eleventh Conference on Chemotherapy of Tuberculosis (VA), 270-285 (Jan.) 1952. Google Scholar9. PittsO'DellDyeHughesTempel FWETWEFJCW: Intermittent viomycin therapy in pulmonary tuberculosis, Dis. Chest 23: 241-255 (March) 1953. CrossrefMedlineGoogle Scholar10. MillerSandsWalkerDyeTempel FLJHRWECW: Combined daily terramycin and intermittent streptomycin in the treatment of pulmonary tuberculosis; a preliminary report, Transactions of the Eleventh Conference on Chemotherapy of Tuberculosis (VA), 53-59 (Jan.) 1952. Google Scholar11. MillerSandsWalkerDyeTempel FLJHRWECW: Combined daily terramycin and intermittent streptomycin in the treatment of pulmonary tuberculosis, Am. Rev. Tuberc. 66: 534 (Nov.) 1952. MedlineGoogle Scholar12. PittsMillerDyeTempelFitzpatrick FWFLWECWMJ: Isoniazid therapy in pulmonary tuberculosis, U. S. Armed Forces M. J. 4: 1 (Jan.) 1953. MedlineGoogle Scholar13. PittsTempelMillerSandsFitzpatrickWeiser FWCWFLJHMJO: Isoniazid-streptomycin in the treatment of pulmonary tuberculosis: a preliminary report, J. A. M. A., in press. Google Scholar14. Pinner M: Pulmonary tuberculosis in the adult, 1945, Charles C. Thomas, Springfield, Illinois, p. 299. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Read before the 119th Meeting of the American Association for the Advancement of Science, December 26, 1952, St. Louis, Missouri. Received for publication March 3, 1953.From the Medical Service and Research and Development Branch, Fitzsimons Army Hospital, Denver, Colorado. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTrends in the Management of Pulmonary TuberculosisLONG-TERM OXYTETRACYCLINE (TERRAMYCIN) THERAPY IN ADVANCED CHRONIC RESPIRATORY INFECTIONSCurrent Concepts in the Treatment of Pulmonary TuberculosisATYPICAL TUBERCULOSIS OF THE LIVER WITH JAUNDICE*EDWARD A. CLEVE, JOHN R. GIBSON, WILLIAM M. WEBB 1 July 1953Volume 39, Issue 1Page: 61-73KeywordsAdverse reactionsAntimicrobialsHealth services researchIsoniazidMedical servicesStreptomycinToxicityYoung adults ePublished: 1 December 2008 Issue Published: 1 July 1953 PDF downloadLoading ...

Background: Lung function impairment persists in some patients for months after acute coronavirus disease 2019 (COVID-19). Long-term lung function, radiological features, and their association remain to be clarified. Objectives: We aimed to prospectively investigate lung function and radiological abnormalities over 12 months after severe and non-severe COVID-19. Methods: 584 patients were included in the Swiss COVID-19 lung study. We assessed lung function at 3, 6, and 12 months after acute COVID-19 and compared chest computed tomography (CT) imaging to lung functional abnormalities. Results: At 12 months, diffusion capacity for carbon monoxide (DLCO_corr) was lower after severe COVID-19 compared to non-severe COVID-19 (74.9% vs. 85.2% predicted, p < 0.001). Similarly, minimal oxygen saturation on 6-min walk test and total lung capacity were lower after severe COVID-19 (89.6% vs. 92.2%, p = 0.004, respectively, 88.2% vs. 95.1% predicted, p = 0.011). The difference for forced vital capacity (91.6% vs. 96.3% predicted, p = 0.082) was not statistically significant. Between 3 and 12 months, lung function improved in both groups and differences in DLCO between non-severe and severe COVID-19 patients decreased. In patients with chest CT scans at 12 months, we observed a correlation between radiological abnormalities and reduced lung function. While the overall extent of radiological abnormalities diminished over time, the frequency of mosaic attenuation and curvilinear patterns increased. Conclusions: In this prospective cohort study, patients who had severe COVID-19 had diminished lung function over the first year compared to those after non-severe COVID-19, albeit with a greater extent of recovery in the severe disease group.

Duration of treatment in pulmonary tuberculosis: are international guidelines on the management of tuberculosis missing something?

Type 2 diabetes (T2DM) co-existing with pulmonary tuberculosis (PTB) is associated with increased rates of treatment failure and mortality. Therefore, greater understanding of the occurrence and prevalence of this comorbidity and research to address the prevention and treatment of PTB in patients with T2DM (PTB + T2DM) have become paramount. Weighted gene co-expression network analysis (WGCNA) and Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were employed to identify key gene modules and functions related to PTB + T2DM. Immune cell infiltration and drug sensitivity were compared between PTB + T2DM patients and healthy controls (HCs), with a bioinformatic approach. Several key genes were chosen for in vitro expression assays using quantitative real-time PCR (qRT-PCR), western blotting (WB), and enzyme-linked immunosorbent assay (ELISA). Compared to HCs and T2DM-only patients, PTB + 2DM patients showed upregulated expression of complement component C1q. WGCNA identified five crucial genes associated with PTB + T2DM: C1QA, CD248, LINC00278, MMP8, and MMP9. Multiscale embedded gene co-expression network analysis further identified FN1. The main KEGG pathways in PTB + T2DM patients were related to extracellular matrix-receptor interaction, the interleukin-17 signaling pathway, the AGE-RAGE signaling pathway in diabetic complications, the PI3K-Akt signaling pathway, and neutrophil extracellular trap formation. Receiver operating characteristic (ROC) analysis indicated that CD248, MMP8, MMP9, LINC00278, and C1QA have potential as diagnostic markers for PTB + T2DM. The expression levels of C1QA, LINC00278, MMP8, and MMP9 were significantly higher, and that of CD248 was significantly lower, in PTB + T2DM patients than in HCs. A network comprising highly correlated hub genes and microRNAs revealed the following interactions: C1QA with hsa-miR-363-5p, hsa-miR-671-5p, and hsa-miR-25-5p; CD248 with COL1 A2, COL1 A1, and COL4 A1; MMP8 with hsa-miR-539-5p, MMP9, and CEACAM8; and MMP9 with FN1, MMP8, hsa-miR-29b-3p, hsa-miR-942-3p, hsa-miR-302-5p, and hsa-miR-133a-5p. Seven drugs (ERK_440_1713, JAK_8517_1739, Palbociclib_1054, PLX.4720_1036, Savolitinib_1936, Selumetinib_1736, and VX.11e_2096) exhibited significant sensitivity in patients with high-expression or low-expression of C1QA. ELISA, qRT-PCR, and WB analyses confirmed the upregulated expression of C1QA, MMP8, and MMP9 in the peripheral blood of PTB + T2DM patients. This study elucidated the intricate molecular connections between PTB and T2DM and identified potential shared targets. Five genes (C1QA, MMP8, MMP9, CD248, and LINC00278) have potential as diagnostic markers for PTB + T2DM, and three genes (C1QA, MMP8, and MMP9) were upregulated in the peripheral blood of PTB + T2DM patients. Our findings may serve as a valuable reference for future research and clinical applications.

Backgrounds: Pulmonary tuberculosis (TB) and smoking related disease such as chronic obstructive of lung disease (COPD) are major health problem around the world, particularly in developing countries such as Indonesia. Chronic airway obstruction as impact of TB may results during or after completion of TB treatment. Transforming growth factor beta (TGF-β) is a cytokine which contributes to fibro genesis in post-TB treatment. The aim of this study was to compare the TGF-β in post-TB patients with and without smoking history.&#x0D; Methods: This was an analytic study with cross sectional design, conducted from October 2016 to February 2017 in RSUP H. Adam Malik Medan. All subjects had recovered from TB, confirmed by clinical, radiological and bacteriological examination. Smoking history of the subjects was assessed using Brinkman Index. The TGF-β measurement was performed using venous blood sample processed through Enzyme Link Immunosorbent Assay (ELISA) by means of TGF-β kit.&#x0D; Results: This study included post-pulmonary TB patients, of which 26 subjects were smokers and 25 were non-smokers, consisted of 31 males and 20 females. The mean TGF-β level of all samples was 6690.5±4913.4 mg/ml. The mean TGF-β level in smokers was 6621.5±4856.7 mg/ml, while in non-smokers 6762.2±5071 mg/ml. Statistical analysis using Mann-Whitney test revealed that there were no significant differences of TGF-β level in smokers and non-smokers among post-pulmonary TB patients (P=0.618).&#x0D; Conclusions: There were no significant differences of TGF-β level in smokers and non-smokers among post-pulmonary TB patients. (J Respir Indo. 2020; 40(3): 139-43)

Background: Sierra Leone started the Direct Observation Treatment Strategy (DOTS) for the treatment of pulmonary tuberculosis in 1992. The country’s pulmonary tuberculosis (PTB) treatment program is now standardized according to international scale. Under the national standardized PTB treatment system, the regimen for new PTB patients consists of a 2-month intensive treatment phase with isoniazid, rifampicin, pyrazinamide and ethambutol, followed by a 4-month continuation phase with rifampicin and isoniazid. Aims: To determine and analyse the annual PTB treatment success and incidence rates, treatment defaulters’ rate, and pulmonary tuberculosis mortality from 1992 to 2002 under the DOTS program at the Germany Leprosy Relief Association’s (GLRA) 13 regional diagnostic centers and chest clinics in Sierra Leone and to compare this data with the annual national tuberculosis data stored in WHO tuberculosis database covering the period 1992-2010. Study Design: The study retrospectively analysed pulmonary tuberculosis annual incidence rates for study subjects who registered for diagnosis and later for treatment at the GLRA 13 regional diagnostic centers and chest clinics from 1992 to 2002. From Research Article British Journal of Medicine & Medical Research, 3(4): 2076-2084, 2013 2077 these data we were able to determine the treatment success and defaulters’ rates, and PTB mortality for these subjects. We also analysed data of the annual national tuberculosis incidence and success rates, and mortality rates retrieved from World Health Organisation (WHO) TB data for Sierra Leone for the period 1992-2010. Twenty six (26) healthcare service providers were also interviewed for additional information about the main cause of mortality and reasons for treatment defaults among pulmonary tuberculosis patients during the period under investigation. Study Subjects: A total of 2,958 (1,881 men and 1,077 females) mostly adults of age range 15-65 years were diagnosed and later treated for pulmonary tuberculosis from 1992 to 2002 at the various GLRA diagnostic and treatment centers in the country. Setting: The study was a multicenter study conducted at the Germany Leprosy Relief Association’s (GLRA) main referral diagnostic center and chest clinic at Lakka in Freetown and the Department of Environmental Health Sciences, Njala University in Bo, Sierra Leone. Pulmonary tuberculosis treatment outcomes data used in this study were obtained from TB patients who were admitted at various GLRA chest clinics in Sierra Leone from 1991-2002. Data analysis and literature reviews were done at the Department of Environmental Health Sciences, Njala University in Bo, Sierra Leone from 2011 to 2012. Results: The most important finding of this investigation was that the annual pulmonary tuberculosis incidence and treatment success rates (% cured rate and % completed treatment rate) rose significantly during the period under review for both the GLRA’s study subjects and the cases stored in the WHO tuberculosis database. Conclusion: The significantly high and growing number of annual PTB incidence rates during this HIV/AIDS epidemic reinforces the need for routine PTB treatment monitoring and supervision as well as compulsory HIV testing for tuberculosis patients seeking treatment.

<b>Background:</b> Pulmonary tuberculosis (PTB) is associated with abnormal lung function despite microbiological cure. Few studies assess change in lung function over time or measures of diffusion capacity (DLCO) and there are no prior studies from Australia. <b>Objective:</b> Determine the prevalence and pattern of lung function impairment from a cohort of patients successfully treated for PTB, and describe how lung function changes over time. <b>Methods:</b> Observational cohort study of all patients with Mycobacterium Tuberculosis successfully treated at St Vincent's Hospital, Sydney from 2010-2020. Sociodemographic and baseline clinical data was collected. Pulmonary function test results were evaluated at multiple timepoints including pre-treatment of PTB, on treatment and post-treatment completion. <b>Results:</b> A total of 181 patients were included in the study, 82 of which had PTB and valid lung function data were included in the analysis. Within 12 months of treatment completion, 6/30 patients (20%) had an obstructive defect, which 83.3% had moderate grade severity of COPD. Beyond 12 months, 9/27 (33.3%) had an obstructive defect with 44.4% moderate to severe grade of COPD. All patients (100%) post PTB treatment completion had impaired DLCO. Just 6 patients with lung function available pre TB diagnosis, with 4 non-transplant patients losing a mean 175 mL of FEV1 as a result of their TB episode. <b>Conclusions:</b> There is a significant prevalence of impaired lung function despite microbiological cure in this cohort of PTB patients from Australia. Of concern, there was a high rate of COPD which persisted beyond 12 months of completing PTB treatment. These findings demonstrate the importance of lung function assessment and follow up of PTB patients.

Exposure to individual volatile organic compound (VOC) is associated with reduced lung function and increased respiratory disease (RD) morbidity and mortality. However, whether a mediating pathway among exposure to VOC mixtures, diminished lung function, and increased RD risk exists statistically remains undisclosed. This study analyzed 6156 adults (aged ≥ 18) from National Health and Nutrition Examination Survey (NHANES) 2007-2012. We applied Bayesian Kernel Machine Regression (BKMR) models to analyze the association between VOCs and lung function, and then used mediation models to assess lung function's role in RD morbidity and mortality. Changes of forced vital capacity (FVC) accounted for 12.22%, 29.76%, and 17.34% of the association of nitromethane with asthma [0.004 (0.002, 0.005), P < 0.001], emphysema [0.001 (0.001, 0.002), P < 0.001], and chronic bronchitis [0.003 (0.002, 0.005), P < 0.001], respectively. We also observed significant indirect effect of nitromethane with all-cause mortality through the mediation of FVC [0.042 (0.018, 0.066), P < 0.001, proportion = 23.13%] and forced expiratory volume at 1s (FEV1) [0.054 (0.029, 0.079), P < 0.001, proportion = 27.89%]. Results indicate that VOC exposure reduces lung function, increasing RD morbidity and mortality risks. Nitromethane, in particular, appears to contribute to these risks through lung function impairment.

Excerpt INTRODUCTION Corticotropin (ACTH) and cortisone are regarded as contraindicated in the presence of tuberculosis because of their suppressive effect on inflammation, granulation tissue forma...

Excerpt No drug having been thus far found in the treatment of tuberculosis which kills all tubercle bacilli, the objectives of drug treatment in this disease still fall short of the eradication of...