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OBJECTIVE: To establish an UPLC-MS/MS method for the determination of isoniazid and rifampin in tuberculosis patients. METHODS: The blood protein was precipitated by methanol after adding acetaminophen as internal standard, chromatography separation was performed on Thermo Syncronis C18 column (2.1 mm×100 mm,1.7 μm), gradient elution was conducted using methanol and acetic acid aqueous solution(0.1%) as mobile phase, and MS/MS was used for detection. RESULTS: The correlation coefficients were greater than 0.999 0 for isoniazid in the range of 0.05-5 μg•mL-1 and rifampin in the range of 0.01-10 μg•mL-1, the recoveries were 100.5%-102.5% and 92.0%-96.4%, the limits of detection were 0.05 and 0.01 μg•mL-1, and the relative standard deviations (RSDs) were 0.5%-4.3% and 1.1%-3.9%, respectively. CONCLUSION: The established internal standard method can simultaneously detect rifampin and isoniazid with good specificity, high sensitivity, reproducibility and accuracy, which can be used to determine the blood concentrations of rifampin and isoniazid in tuberculosis patients.
ABSTRACT
Objetivo: identificar los factores relacionados al cumplimiento y abandono del tratamiento antituberculoso en pacientes del Hospital Rosario Lacayo de la ciudad de León, Nicaragua. Método: estudio de casos y controles no pareados en pacientes con tuberculosis durante octubre 2015- agosto 2016. Se definieron como casos los pacientes que abandonaron el tratamiento por 30 días consecutivos o más; como controles los que completaron el tratamiento y fueron dados de alta por curación. Los factores se identificaron mediante el cálculo de odds ratios y los intervalos de confianza al 95%. Resultados: se estudiaron 28 casos y 98 controles. El abandono del tratamiento se asoció al sexo masculino, a no recibir explicación acerca de la enfermedad, a que no se brindaran consejos sobre estilo de vida, a no conocer el esquema de tratamiento empleado y a la mala relación con el personal de salud. Conclusión: el abandono del tratamiento antituberculoso se relacionó a factores no modificables (sexo masculino) y a otros cuyo control optimizaría el cumplimiento (no recibir explicación sobre la enfermedad y mala relación con el personal de salud). Además, es prioritario brindar atención de forma integral a los pacientes y mejorar la información recibida sobre tuberculosis.
Objective: to identify factors related to compliance and abandonment of antituberculosis treatment in patients of the Rosario Lacayo Hospital in the city of León, Nicaragua. Method: study of unpaired cases and controls in patients with tuberculosis during October 2015 to August 2016. Patients who abandoned treatment for 30 consecutive days or longer were defined as cases; As controls those who completed the treatment and were discharged by cure. Factors were identified by calculating odds ratios and 95% confidence intervals. Results: we studied 28 cases and 98 controls. The abandonment of the treatment was associated with the male sex, not receiving an explanation about the disease, no advice on lifestyle, not knowing the treatment scheme used and poor relationship with health personnel. Conclusion: the abandonment of tuberculosis treatment was related to non-modifiable factors (male sex) and to others whose control would optimize compliance (not receiving explanation about the disease and poor relation with health personnel). In addition, it is a priority to provide comprehensive care to patients and to improve the information received about tuberculosis.
Objetivo: identificar os fatores relacionados ao atendimento e ao abandono do tratamento da tuberculose em pacientes do Hospital Rosario Lacayo da cidade de Leon, na Nicarágua. Métodos: estudo de caso-controle não pareado em pacientes com tuberculose durante outubro de 2015 e agosto de 2016. Os pacientes que interromperam o tratamento por 30 dias consecutivos ou mais foram definidos como casos; como controles aqueles que completaram o tratamento e receberam alta por cura. Os fatores foram identificados calculando odds ratio e intervalos de confiança de 95%. Resultados: a idade média dos participantes foi de 19,1 anos, o sexo feminino predominou com 82,0%. 25,4% mencionado estudo e trabalho. 65,3% do total da amostra relataram níveis de estresse moderado a elevado. A prevalência do consumo de álcool no último ano e no último mês foi de 59,0 e 32,2%, respectivamente. 27,5% do total da amostra relataram consumo dependente, seguido por 16,6% do consumo prejudicial. Conclusão: o abandono do tratamento da tuberculose foi relacionada a fatores não modificáveis (masculinos) e a outros cujo o controle otimizaria o cumprimento (não receber uma explicação sobre a doença e má relação com o pessoal de saúde). Além disso, é prioridade ofertar atenção integral aos pacientes e melhorar as informações recebidas sobre a tuberculose.
Subject(s)
Tuberculosis , Patient Compliance , Public HealthABSTRACT
This study was conducted to evaluate the change of nutritional status and to analyze related factors in hospitalized tuberculosis (TB) patients during their hospitalization. The subjects were 398 men patients (mean age: 47.3 +/- 14.4 y) who had hospitalized more than 3 months at TB hospital located in Seoul. The anthropometric and blood biochemical indices were measured, and dietary intakes were assessed. At the time of admission the body weight of subjects was about 76% of the average body weight of Korean men with same age, Body mass index (BMI) of subjects was 18.5 kg/m2, and 53.8% of subjects were under weight status. Average level of blood hemoglobin and hematocrit of subjects was lower than the normal value. After 3 months of hospitalization period, the body weight and body mass index were significantly increased compared to admission by 3.9 kg (7.41%) and 1.4 kg/m2 (7.61%)(p<0.001), respectively. Blood levels of hemoglobin, hematocrit, albumin, and total protein were also significantly increased after 3 months of hospitalization period compared to admission (p<0.001). The increment in the body weight and blood indices was significantly higher in below 29 years group than over 60 years group (p<0.05). The increment in the body weight and body mass index was significantly higher in the under-body weight group compared to the normal-body weight group (p<0.05). In conclusion the body weight and body mass index of subjects were significantly increased after 3 months of hospitalization period, and the age and body weight of subjects at admission were supposed to influence the degree of change in the nutritional status.
Subject(s)
Humans , Male , Body Mass Index , Body Weight , Hematocrit , Hemoglobins , Hospitalization , Nutritional Status , Reference Values , Tuberculosis , Tuberculosis, PulmonaryABSTRACT
BACKGROUND: Phagocytosis is probably the first step for mycobacteria to be virulent in host because virulent strains are more readily phagocytosed by macrophage than attenuated strains. According 13 the traditional concept, multi-drug resistant strains have been regarded as less virulent. However, this concept has been challenged, since recent studies(reported) showed that the degree of virulence and drug-resistance is not related. The purpose of this study is to evaluate whether the phagocytic activity of M. tuberculosis by peripheral blood mononuclear cells(PBMC) is different according to drug-resistance or host factor. To evaluate this, we estimated the difference of phagocytic activity of drug-resistant and drug-sensitive M. tuberculosis and also estimated the phagocytic activity of PBMC from intractable tuberculosis patients and healthy controls. METHODS: PBMC from ten intractable tuberculosis patients and twelve healthy control and three different strains of heat-killed M. tuberculosis, ie, ADS(all drug sensitive), MDR(multi-drug resistant), and ADR(all drug resistant) were used. After incubation of various strains of M. tuberculosis with PBMC, the phagocytic activity was evaluated by estimating proportion of PBMC which have phagocytosed M. tuberculosis. RESULTS: Drug-resistant strains of M. tuberculosis were phagocylosed easily than drug sensitive strains(Percentage of PBMC phagocytosed M. tuberculosis in healthy control : ADS : 32.3α2.9%, ADR : 49.6α3.4%, p=0.0022, Percentage of PBMC phagocytosed M. tuberculosis in intractable tuberculosis patients : ADS : 34.9α3.6%, ADR : 50.7α4.5%), p=0.0069). However, there was no difference in phagocytic activity of PBMC from healthy control and intractable tuberculosis patients. CONCLUSION: Drug-resistant strains of M. tuberculosis were phagocytosed easily than drug sensitive strains and host factors does not seems to influence the phagocytosis of M. tuberculosis.