Medical Treatment For Tuberculosis Research Articles

Anévrisme tuberculeux de l'aorte thoracique descendante traité par endoprothèse : à propos d'un cas

Tuberculous aneurysm is a rare but lethal disease. It preferentially affects the aorta. The contamination occurs either secondarily to a tuberculosis site in contact with the aorta or by blood contamination. It presents an increased and unpredictable risk of rupture, hence the interest of urgent diagnostic and therapeutic management. His treatment was long based on surgery, but currently the endovascular approach is increasingly used. The treatment, whatever its type, will always be associated with a medical treatment for tuberculosis. We report the case of a patient with a descending thoracic aortic aneurysm considered tuberculous on the basis of epidemiological, clinical and biological arguments; who was treated by deployment of an endoprosthesis with good clinical and radiological evolution.

Selank and semax as potential hepatoprotectors in medical treatment of tuberculosis

Introduction: Drug-induced hepatitis is common in clinical practice. This problem is particularly relevant in the treatment of tuberculous infection, because for this purpose, up to 5–6 hepatotoxic drugs are used simultaneously for a long time, which often (in 15–20% of cases) leads to medical liver lesion. To protect the liver, Semax and Selank are offered – drugs of regulatory peptides group.
 Materials and Methods: The research was conducted on 96 outbred white male rats weighing 180–220 g. The experimental group included about 10 animals. Drug-induced hepatitis was simulated through the combined 21-day administration of isoniazid, rifampicin and ethanol. Semax and Selank, as well as Essentiale N and Mexidol (comparison drugs) were administered once a day during the experiment. Healthy control animals with experimental hepatitis were used for comparison. Subsequently, the obtained biochemical and histomorphological parameters were evaluated.
 Results and Discussion: In the experiment, Semax and Selank showed a greater therapeutic activity than the recognized hepatoprotectors – Essentiale and Mexidol. Only in the case of administering Selank and Semax, there was parallelism between the restoration of biochemical parameters of blood and histomorphological parameters of the liver. Selank was also characterized by an increased activity of regenerative processes.
 Conclusion: Administering Selank and Semax to patients with tuberculosis would significantly reduce the number and severity of hepatotoxic reactions.

Craniovertebral tuberculosis in children: experience of 23 cases and proposal for a new classification.

The aim of this study was to review cases of paediatric patients with craniovertebral junction (CVJ) tuberculosis with a view to try and stratify the cases into different groups which would help plan treatment and hence develop a protocol for treatment of a fairly uncommon condition still widely seen in the developing world. Twenty-three cases of paediatric craniovertebral tuberculosis had their clinical features and radiology reviewed. The treatment plan in each case was analyzed according to their presentation. The results of treatment after 1 year were assessed in each case. The clinical presentations varied from neck pain with hypoglossal nerve palsy to frank spastic quadriparesis, and frank instability at the atlanto-axial junction was seen in five out of 23 patients. Cold abscesses were seen in 18/23 cases, and severe torticollis was the presentation in 6/23. We graded the children with this condition into three groups: 1) those with instability and gross neurodeficit who required early operative intervention (1 needed trans-oral decompression with posterior fixation and 4 required posterior fixation) 2) those who had severe torticollis and large cold abscesses who were treated with trans-oral aspiration of cold abscess followed by neck immobilization (6/23) and 3) those who did not have significant neck muscle spasm or torticollis and who were treated with immobilization alone (12/23). Only one child in group 3 required delayed intervention for instability which developed after completion of the course of anti-tubercular medication. We concluded that children with craniovertebral tuberculosis should be treated according to their clinical presentation coupled with evidence of radiological instability. Those with gross deficit and instability need early stabilization, those with minimal deficit and no instability but severe pain or torticollis need aspiration of the cold abscess with external immobilization, whereas those without deficit, instability or severe pain may be managed by external orthoses alone. Of course, medical treatment for tuberculosis is necessary in each case.

Boron‐Containing Peptidomimetics – A Novel Class of Selective Anti‐tubercular Drugs

Medical treatment for tuberculosis is complicated nowadays by the appearance of new multiresistant strains, and therefore, new antibiotics are in great need. Here, we report the synthesis and in vitro testing of a new class of highly selective antimicrobial boron-containing peptidomimetics with compounds exhibiting activity against Mycobacterium tuberculosis at ≤5 μg/mL. The new approach developed makes it possible to synthesize variously substituted β-aminoboronic acids and their derivatives with a high level of diastereoselectivity.

Tuberculosis and utilization of healthcare facilities by the Lepchas of Sikkim

All tuberculosis (TB) control programs in India since their inception have heavily depended on a medical model of diagnosis and cure. The socio-economic factors associated with TB control in India have not been adequately investigated. In spite of the heavy investments made on TB control, its prevalence rates remain high among a few sub-populations such as the Scheduled Tribes who live in isolation far away from urban areas. The state of Sikkim, for example, has a TB prevalence rate of 1002 per 100,000 population. Nearly 23% of this population is classified under Scheduled Tribes. Very little is known about the likelihood of tribals seeking modern medical treatment for TB in India. The objective of this study is to explore utilization of medical services among those suffering from TB in Sikkim. For this study a sample of 50 households was acquired using the quota sampling method from a tribal village called Chota-Singtham, in East Sikkim. We found that those who have TB are more likely to use modern healt...

Tuberkulose der Lunge und Pleura im Alter*

With the increase of the proportion of the elderly in the total population more cases of pulmonary and extrapulmonary tuberculosis (TB) are observed in this age group as well. Symptoms of TB are unspecific, often less apparent in the elderly, and may therefore cause a delay in the diagnostic process. A history of TB and comorbidities are more common in elder as compared to younger TB patients. The tuberculin skin test is less frequently positive. The interferon-gamma-release assay is complementary and together with clinical, radiologic, and bacteriologic test results helpful for the diagnosis or the exclusion of an active or latent TB infection. Medical treatment of TB in the elderly follows the established guidelines in the same way as for younger patients. The likelihood of drug-induced side effects and interactions with concomitant medications, however, is increased. Comorbidity and age-related immunosuppression may lead to a delay in the healing process. Higher age, comorbidity, and immunosuppression are predictors of an increased TB mortality. Even in a low-incidence country like Germany, TB should be recognized as an explanation for clinical symptoms particularly in the elderly patient group in order to allow an early diagnosis and therapy and thus a reduction of mortality and prevention of a further spread of this disease.

Establishing Of Laboratory Conditions For Tdm Of Isoniazid, Rifampicin And Pyrazinamid As A Tool For A Quality Assurance Of The Medical Treatment Of Tuberculosis

Establishing Of Laboratory Conditions For Tdm Of Isoniazid, Rifampicin And Pyrazinamid As A Tool For A Quality Assurance Of The Medical Treatment Of Tuberculosis

結核性肩峰下滑液包炎の一症例

A sixty-year-old man was seen complaining of discomfort and swelling without pain in his left shoulder. On examination slight restriction of motion was found, but the muscle strength of left upper extremity was within normal limits. The only positive result from the laboratory studies was elevation of the level of rheumatoid factor. Tuberculin test was found to be strongly positive. Thickening of the wall of subacromial bursa and a large number of rice bodies suspended in the fluid were observed by echo gram, MRI and bursography.The subacromial bursa was resected surgically. After the operation, medical treatment for tuberculosis was started. Symptoms and abnormal data recovered to normal six months after operation. Pathological study of the tissue showed granuloma with caseous necrosis and multi-uncleated giant cells. Tuberculous bacteria was detected from the cultivation of the tissue. The diagnosis of tuberculosis of the subacromial bursa was thus confiremed.We suggest that early surgical treatment is necessary to avoid invasion of the infected lesion to surrounding tissues.

Current Concepts in the Medical Treatment of Tuberculosis

The thoracic surgeon is playing an everincreasing role in the treatment of pulmonary tuberculosis. His vision is unbounded, and his techniques improve splendidly. Operative procedures, excellent in conception, and brilliant in execution, have become somewhat standardized, and yet the medical practitioner plans what shall be done for the tuberculous person, steers large numbers through successful cure regimes, and exercises control over those who go to surgery. If there is a difference of opinion between the surgeon and the physician, the decision of the physician is conclusive. On tuberculosis hospital services, the physician and the surgeon are a team. The surgeon and physician have, or are expected to have, a thorough knowledge of both the medical and the surgical aspects of the case. The attitude of most physicians to surgery is conservative, serving as a check upon trends toward surgical adventures. This has proven to be a satisfactory arrangement. The treatment of tuberculosis cannot be stated categorically. Each case must be studied and individual factors must determine types of treatment suitable for each. Perhaps some statement of what treatment seeks to accomplish is in order. Outstanding is the effort to change a positive sputum to a negative one. Obviously, this must occur in order to protect nearby and remote well tissues from invasion by bacilli, and also to protect those who come in contact with the tuberculous person. The conversion of a positive case to a negative one is a prime objective. When such conversion has been made permanent, the person returns to his community as a useful functioning entity, without danger to himself or to others. There are large numbers of cases of reinfection tuberculosis which have healed spontaneously when discovered by x-ray. Surveys of entire communities of apparently well populations uncover many cases of healed tu-

THE SURGICAL TREATMENT OF INTESTINAL TUBERCULOSIS.

The title of this paper will probably appear somewhat strange and out of place to the general practitioner and the surgeons who have not kept fully abreast with the great advancements that have been made during the last decade in the diagnosis and surgical treatment of localized lesions of the intestinal tract. Our increased knowledge of the location, nature and clinical tendencies of accessible tubercular affections has opened a wide and fertile field for successful surgical intervention. There is hardly an organ in the body which when the seat of a localized tubercular process has not been exposed and subjected to direct treatment with a fair expectation of removing or limiting the further extension of the disease. The medical treatment of tuberculosis in its various forms at the present time is not much in advance of that of fifty years ago. The numerous specifics invented and vaunted in different