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Purpose：In recent years, the proportion of older people diagnosed with lung tuberculosis is increasing in Japan. There have been no previous reports on detailed evaluation of swallowing function in patients with pulmonary tuberculosis. This study aimed to retrospectively evaluate the severity and characteristics of dysphagia using videoendoscopic evaluation of swallowing (VE) in patients with lung tuberculosis.Methods：A total of 58 patients (average age, 85.2 years) were selected. They are diagnosed with active pulmonary tuberculosis and underwent VE (performed an average 23 days after admission) at our hospital between January 2017 and March 2020. The severity of dysphagia was assessed using the functional oral intake scale (FOIS)．Activities of daily living (ADL) of the patients was evaluated by using Barthel Index (BI).Results：The average body mass index of the patients was 17 kg/m2, average serum albumin was 2.3 mg/dl, and average BI score was 8.6. Approximately, 71％ of the patients showed severe dysphagia (FOIS 1-2), and BI score of the group was significantly lower than that of the moderate group (FOIS＞3). We observed residual thickened water in 76％ of the patients. Before the VE, 45％ patients were administered oral anti-tuberculosis drugs. Only 35％ of the patients continued those drugs after VE, and 45％ of the patients died in hospital.Conclusion：The results suggest that patients with pulmonary tuberculosis might have a high frequency of severe dysphagia. Appropriate method of anti-tuberculosis drug administration should be selected based on their swallowing functions.
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Purpose：In recent years, the proportion of older people diagnosed with lung tuberculosis is increasing in Japan. There have been no previous reports on detailed evaluation of swallowing function in patients with pulmonary tuberculosis. This study aimed to retrospectively evaluate the severity and characteristics of dysphagia using videoendoscopic evaluation of swallowing (VE) in patients with lung tuberculosis.Methods：A total of 58 patients (average age, 85.2 years) were selected. They are diagnosed with active pulmonary tuberculosis and underwent VE (performed an average 23 days after admission) at our hospital between January 2017 and March 2020. The severity of dysphagia was assessed using the functional oral intake scale (FOIS)．Activities of daily living (ADL) of the patients was evaluated by using Barthel Index (BI).Results：The average body mass index of the patients was 17 kg/m2, average serum albumin was 2.3 mg/dl, and average BI score was 8.6. Approximately, 71％ of the patients showed severe dysphagia (FOIS 1-2), and BI score of the group was significantly lower than that of the moderate group (FOIS＞3). We observed residual thickened water in 76％ of the patients. Before the VE, 45％ patients were administered oral anti-tuberculosis drugs. Only 35％ of the patients continued those drugs after VE, and 45％ of the patients died in hospital.Conclusion：The results suggest that patients with pulmonary tuberculosis might have a high frequency of severe dysphagia. Appropriate method of anti-tuberculosis drug administration should be selected based on their swallowing functions.
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@# Objective To investigate the relationship between interleukin 10 (IL-10) -592 (rs1800872) and -819 (rs1800871) promoter genetic polymorphisms and the susceptibility of antituberculosis drug-induced liver injury (ADLI). Methods A case-control study was conducted. Epidemiology survey data and peripheral blood samples were obtained from the patients. Two IL-10 gene polymorphisms (-592 A/C and 819 C/T) were genotyped with PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) in Chinese Han ADLI subjects (n=180) and sex matched by frequency matching in control subjects (n=180). Results No significant differences in genotypes of IL-10 -592 site and IL-10 -819 site between ADLI group and that of the control group were noticed (all P>0.05). The mutant alleles -592 C of IL-10 gene polymorphism was significantly higher in ADLI subjects compared to controls, and in dominant model, the frequency of CC+AC genotype was 1.62 higher among the cases than controls (all P<0.05). Significant difference in allele -819 C/T between the ADLI group and the control group were not found (P=0.190). The polymorphisms at -819 C/T and -592 A/C variants of IL-10 gene were found to be good linkage disequilibrium. The CC haplotype represent genetic risk factor (OR=1.37, 95% CI: 1.02-1.85) and CA haplotype represent genetic protect factor (OR=0.49, 95% CI: 0.34-0.70) for ADLI in the subjects. Conclusions The polymorphisms in IL-10 gene -592 A/C and -819 C/T are associated with ADLI.
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OBJECTIVE:To explore the risk factors of antituberculosis drug-induced liver injury,and provide scientific basis for the prevention and treatment of drug-induced liver injury. METHODS:Retrospective analysis was adopted to investigate 410 pa-tients with antituberculosis treatment,single factor and multi-factor Logistic regression analysis were adopted to analyze the risk fac-tor that may induce liver injury in antituberculosis treatment. RESULTS:Single factor regression analysis showed that gender,hepa-titis history and drinking history were associated with drug-induced liver injury,multi-factor regression analysis showed that female (OR=2.320,P=0.021),hepatitis history(OR=4.332,P=0.006),drinking history(OR=4.512,P=0.003) and malnutrition(OR=3.202,P=0.015) were risk factors of antituberculosis drug-induced liver injury,and the degree of danger was drinking history>hepatitis history>malnutrition>female. CONCLUSIONS:The antituberculosis drug-induced liver injury is mainly affected by fe-male,hepatitis history,drinking history and malnutrition,the prevention of drug-induced liver injury based on related risk factors is helpful to improve the clinical symptoms and reduce the incidence of adverse reactions.
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Hyperpigmentation caused by medication or toxic agents accounts for 10~20% of all the cases of acquired hyperpigmentations. Nonsteroidal anti-inflammatory drugs, antimalarials, amiodarone, cytotoxic drugs, tetracyclines, heavy metals and psychotropic drugs are most commonly responsible for hyperpigmentation. A 74-year-old man who had taken antituberculosis drugs (rifampin and isoniazid) for 4 months developed generalized hyperpigmentation. The histopathologic finding revealed an increased number of dermal melanophages with pigment incontinence. Eight months after termination of the antituberculosis medication, his skin lesion improved without any treatment. To the best of our knowledge, this is the first reported case of generalized hyperpigmentation due to rifampin and isoniazid in a patient without adrenal insufficiency in the dermatological literature.
Subject(s)
Aged , Humans , Adrenal Insufficiency , Amiodarone , Antimalarials , Hyperpigmentation , Isoniazid , Metals, Heavy , Psychotropic Drugs , Rifampin , Skin , TetracyclinesABSTRACT
Drug-induced hypersensitivity syndrome is a rare, but severe, life-threatening disease with multiorgan failure. Aromatic antiepileptic drugs are frequent causes of this syndrome. The association of the human herpes virus-6 has been recently reported in patients with drug-induced hypersensitivity syndrome. We report two patients who were diagnosed as having antituberculosis drug-induced hypersensitivity syndrome based on clinical course and laboratory data. In addition, human herpes virus-6 DNA was detected by polymerase chain reaction in peripheral blood mononuclear cells and the serum. There was a favorable outcome after discontinuation of the causative drug, plus corticosteroid therapy. After the treatment, human herpes virus-6 DNA was not detected by polymerase chain reaction. This is the first report of antituberculosis drug-induced hypersensitivity syndrome associated with reactivation of human herpes virus-6.
Subject(s)
Humans , Anticonvulsants , DNA , Hypersensitivity , Polymerase Chain ReactionABSTRACT
OBJECTIVE:To analyze the characteristics of adverse drug reactions(ADR) induced by antituberculosis drugs so as to provide references for the rational use of drugs in the clinic.METHODS:409 ADR cases induced by 5 main antituberculosis drugs in domestic medical journal from Jan.1997 to Dec.2006 were collected and analyzed statistically.RESULTS:Many systems were involved in ADR,such as skin,urinary system,neural system,hematological system,etc.,which were associated with allergic reaction and toxicity of drugs.Acute renal failure(ARF),drug eruption,fever and anaphylactic shock showed high incidences.CONCLUSION:Attention should be paid to ADR induced by antituberculosis drugs to standardize treatment.
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Objective To explore the protective effect of herbal medicine to tonify qi and strengthen the spleen on liver damage induced by antituberculotic according to the TCM theory "reinforce the earth to reduce the wood".Methods The 100 tuberculosis patients randomized into two groups,50 in each,all took antituberculosis drugs with the liver-protecting medicine,Tiopronin,and the herbal medicines to nourish qi and strengthen the spleen were administered to those in the treatment group.Incidence of liver damage and the changes of liver function including serum alanine aminotransferase(ALT),aspartate aminotransferase(AST) and total bilirubin(TBiL) were observed for four weeks.Results In the treatment group,the incidence of liver damage was significantly lower than that in the control group(P
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OBJECTIVE: To analyze status quo of utilization of liver-protective medicines in our hospital. METHODS: Consumption sum and DDDs of liver-protective medicines were analyzed statistically in our hospital during 2004～2008. RESULTS: The proportion of consumption sum of liver-protective medicines in total was 21.09%. The main medicines was inosine to prevent antituberculosis drug-induced hepatic lesion during 2004～2005. The utilization of new and expensive liver-protective medicines was used more than before during 2006～2008. The consumption sum was increased greatly. CONCLUSION: The utilization of liver-protective medicines is rational and economical in the previous two years. But the price of used liver-protective medicines is higher than before during 2006～2008. So some interventions should be adopted to control the utilization of liver-protective medicines rationally and economically.