Tuberculosis latente: diagnóstico y tratamiento actual / Latent tuberculosis: current diagnosis and treatment

Resumen La infección tuberculosa latente (TL) afecta al 23% de la población y constituye un reservorio de tuberculosis (TBC) ya que 10% progresa hacia una TBC. La TL se reconoce por pruebas como la tuberculina (PPD o TST) y los ensayos de liberación de Interferón gama (IGRAs). La sensibilidad de IGRAs (versión Quantiferon TB Gold plus) es 94% y del PPD 77%. La especificidad del Quantiferon TB Gold Plus es 97% y del PPD 68%. El valor predictivo de progresión a TBC activa de estas pruebas es bajo (PPD: 1,5%, IGRAs: 2,7%) pero mejora en personas de alto riesgo de contraer TBC (PPD: 2,4%, IGRAs: 6,8%). Las personas con pruebas negativas que posteriormente presentan viraje (prueba positiva) tienen mayor riesgo de progresión a TBC activa. Estas pruebas son útiles en el seguimiento de contactos intradomiciliarios, extranjeros de países con altas tasas de TBC, inmunosuprimidos, enfermedad renal crónica, diabetes, silicosis y secuelas pulmonares de TBC no tratada. En la terapia de TL se utiliza isoniazida (H) auto-administrada por plazos de 6 a 12 meses con eficacia protectora de 60% y riesgo de toxicidad hepática de 2% pero con baja adherencia (50-70%). La asociación de H con rifapentina en dosis única semanal durante 12 semanas tiene eficacia de 81%, adherencia de 82% y baja toxicidad hepática (0,4%). Nuevos biomarcadores de TL y vacunas que mejoren la inmunidad en TL se encuentran en estudio. El tratamiento de la TL puede reducir la incidencia de TBC a largo plazo.

Latent tuberculosis infection (LT) affects 23% of the population and constitutes a reservoir of tuberculosis (TB) as 10% progresses to TB. LT is recognized by tests such as tuberculin (PPD or TST) and Interferon gamma release assays (IGRAs). The sensitivity of IGRAs (Quantiferon TB Gold plus version) is 94% and PPD 77%. The specificity of Quantiferon TB Gold Plus is 97% and PPD 68%. The predictive value of progression to active TB of these tests is low (PPD: 1.5%, IGRAs: 2.7%) but improves in people at high risk of contracting TB (PPD: 2.4%, IGRAs: 6.8%). People with negative tests who subsequently turn around (positive) have a higher risk of progression to active TB. These tests are useful in the follow-up of intra-household contacts, foreigners from countries with high rates of TB, immunosuppressed, chronic kidney disease, diabetes, silicosis and pulmonary sequelae of untreated TB. In LT therapy, self-administered isoniazid (H) is used for periods from 6 to 12 months with protective efficacy of 60% and risk of liver toxicity of 2%, but with low adherence (50-70%). The association of H with rifapentine in a single weekly dose for 12 weeks has efficacy of 81%, adherence of 82% and low liver toxicity (0.4%). New LT biomarkers and vaccines that improve immunity in LT are under study. Treatment of LT may reduce the incidence of TB in the long term.

A new mixed surgical treatment for grades iii and iv hemorrhoids: modified selective hemorrhoidectomy combined with complete anal epithelial retention / Um novo tratamento cirúrgico para hemorroidas mistas graus iii e iv: hemorroidectomia seletiva modificada combinada com retenção epitelial anal completa

ABSTRACT Background: Varicose veins appear above and below the dentate line in mixed hemorrhoids, which seriously affects anal function and quality of life. Aim: To propose an improvement in tissue-selecting therapy repair of anal pad combined with complete anal canal epithelial retention comparing with Milligan-Morgan surgery. Methods: A prospective randomized controlled study was designed enrolling 200 patients with grade III and IV hemorrhoids. They were divided into control and observation groups. The control received Milligan-Morgan surgery, and the observation the modified tissue-selecting therapy stapler combined with complete anal canal preservation surgery. All patients were followed for six months to evaluate the treatment differences. Results: In final, control group included 82 and observation 87. The average operation time of the control group was significantly lower than that of the observation, while the bleeding volume was significantly lower in control group. The control group VAS score was 3 (1, 4), and observation 4 (2, 5). There was no significant difference in the incidence of urinary retention, bleeding and wound margin edema after surgery at one month postoperatively. Digital incidence of anal stenosis in the observation group was significantly lower than in control; the same occurred with residual anal margins. The postoperative anal canal diameter was significantly larger than the control group. Wexner anal incontinence score showed that no anal incontinence occurred in both groups, and the control group scored was significantly higher than observation. In final six months follow-up, the observation group did not experience any relapse and four cases were found among controls. The treatment satisfaction of the observation group was better. Conclusions: In grades III and IV hemorrhoids, modified tissue-selecting therapy combined with complete anal canal preservation had better prognosis and treatment satisfaction than Milligan-Morgan procedure, and it is a new surgical method for patients with advanced mixed hemorrhoids.

RESUMO Racional: Veias varicosas aparecem acima e abaixo da linha dentada nas hemorroidas mistas, afetando seriamente a função anal e a qualidade de vida. Objetivo: Propor melhoria na terapia de seleção de tecido de reparo do coxim anal combinado com retenção completa epitelial do canal anal em comparação com a operação de Milligan-Morgan. Métodos: Estudo prospectivo randomizado controlado foi desenhado envolvendo 200 pacientes com hemorroidas graus III e IV. Eles foram divididos em grupos de controle e observação. O controle recebeu operação de Milligan-Morgan, e o de observação procedimento de seleção de tecido modificado combinado com operação completa de preservação do canal anal. Todos os pacientes foram acompanhados por seis meses para avaliar as diferenças de tratamento. Resultados: No final, o grupo controle incluiu 82 e o de observação 87. O tempo médio de operação do grupo controle foi significativamente menor do que o de observação, enquanto o volume de sangramento foi significativamente menor no grupo controle. O escore VAS do grupo controle foi 3 (1, 4) e no de observação 4 (2, 5). Não houve diferença significativa na incidência de retenção urinária, sangramento e edema da margem da ferida no pós-operatório de um mês. A incidência de estenose anal digital no grupo observação foi significativamente menor do que no controle; o mesmo ocorreu com as margens anais residuais. O diâmetro do canal anal pós-operatório foi significativamente maior nele do que o grupo controle. A pontuação de incontinência anal de Wexner mostrou que nenhuma incontinência ocorreu em ambos os grupos, e a pontuação do grupo de controle foi significativamente maior do que no de observação. Nos últimos seis meses de acompanhamento, o grupo observação não teve nenhuma recaída e quatro casos foram encontrados entre os controles. A satisfação com o tratamento do grupo observação foi maior. Conclusões: Nas hemorroidas graus III e IV, o tratamento de seleção de tecido modificado combinado com a preservação completa do canal anal teve melhor prognóstico e satisfação do que com o procedimento de Milligan-Morgan, e é um novo método cirúrgico para pacientes com hemorroidas mistas avançadas.

Clinical profile of childhood Tuberculosis in a Tertiary Care Rural Hospital and comparision of efficacy of daily vs intermittent chemotherapy

Introduction: Tuberculosis (TB) remains a major public health problem, despite noteworthy socioeconomic development and advances in medical science. It is a curable disease but still millions of people suffer every year and a number of them die from this infectious disease, resulting in devastating social and economic impact. We report the disease course, clinical profile and factors associated with treatment outcome in a tertiary facility of Waghodia. Materials and methods: The study was carried out in the Department of Pediatrics at Dhiraj Hospital, Piparia. Recruitment took place from February 2014 to February 2015. The clinical profile of 71 patients was studied and patients were followed up to 6 months to evaluate the treatment outcome. Results: There was preponderance of males (60.56%, n=43) in study population as compared to females (39.44%, n=28). Most of the patients were belonging to age group of <6 years (32.4%, n=23) and >10 years (38.0%, n=27). Among 6 to 10 years, 21 (29.6%) patients were included in study. Most common form of TB was extra-pulmonary TB (60.56%, n=43) followed by pulmonary TB (39.43%, n=28). Non-specific symptoms like fever (82.5%, n=66) was the commonest presenting symptoms. Other symptoms included cough (33.8%, n=24), altered sensorium (19.71%, n=14), swelling (15.5%, n=11). From all the patient with follow up (n=50), 44 (88.0%) were cured. Conclusion: Diagnosis of paediatric tuberculosis still continues to be a challenge. In the study TB was more common in extra-pulmonary than pulmonary forms in our setting. Diagnosis was based on a combination of epidemiological and clinical suspicion supported by results of various investigations. Aashish Sethi, Prasad Muley. Clinical profile of childhood Tuberculosis in a Tertiary Care Rural Hospital and comparison of efficacy of daily vs. intermittent chemotherapy. IAIM, 2018; 5(5): 69-78. Page 70 Presence of paediatric TB is an indication of prevalence of TB in that community. Extra pulmonary tuberculosis is more common in pediatric population and comparison of daily vs. intermittent treatment shows similar efficacy

Clinical Profile of Childhood Tuberculosis in a Tertiary Care Rural Hospital

Introduction: Tuberculosis (TB) remains a major public health problem, despite noteworthy socioeconomic development and advances in medical science. It is a curable disease but still millions of people suffer every year and a number of them die from this infectious disease, resulting in devastating social and economic impact. TB treatment requires several months of swallowing a combination of 3 to 4 drugs every day. Patients often forget to take their medicines or stop taking them when they start to feel better. The Revised National TB Control Programme (RNTCP), based on the internationally recommended Directly Observed Treatment Short-course (DOTS) strategy was launched. Studies of paediatric TB are scantily available both in global and national context. Reliable data on the treatment of paediatric TB and its follow up are not available. Hence, a study of paediatric TB is designed to evaluate the clinical profile of childhood tuberculosis and following up the treatment outcome upto 6 months Materials and methods: The study was carried out in the Department of Pediatrics at Dhiraj Hospital, Piparia. Recruitment took place from February 2014 to February 2015. The clinical profile of 71 patients was studied. Results: There was preponderance of males (60.56%, n=43) in study population as compared to females (39.44%, n=28). Most of the patients were belonging to age group of <6 years (32.4%, n=23) and >10 years (38.0%, n=27). Among 6 to 10 years, 21 (29.6%) patients were included in study. Most common form of TB was extra-pulmonary TB (60.56%, n=43) followed by pulmonary TB (39.43%, n=28). Non-specific symptoms like fever (82.5%, n=66) was the commonest presenting symptoms. Other symptoms included cough (33.8%, n=24), altered sensorium (19.71%, n=14), swelling (15.5%, Muley P, Odedara T, Memon R, Sethi A, Gandhi D. Clinical Profile of Childhood Tuberculosis in a Tertiary Care Rural Hospital. IAIM, 2017; 4(6): 109-124. Page 110 n=11). From all, the patient with follow up (n=50), 44 (88.0%) were cured, 3 (6.0%) patients expired during the course of treatment, 3(6.0%) patient showed no improvement. Conclusion: Diagnosis of paediatric tuberculosis still continues to be a challenge. In the study TB was more common in extra-pulmonary than pulmonary forms in our setting. Diagnosis was based on a combination of epidemiological and clinical suspicion supported by results of various investigations. Presence of paediatric TB is an indication of prevalence of TB in that community. As the source of transmission of TB to children is usually an adult, control of tuberculosis in adult is necessary to decrease the prevalence of TB in children. DOTS is an effective strategy for treatment of TB.

Prevalence and molecular proifle of theStaphylococcus aureus strains harboring tstand/or pvl genes / 中国感染与化疗杂志

Objective To investigate the prevalence, accessory gene regulator (agr) and staphylococcal cassette chromosome mec (SCCmec, only for methicillin resistantS. aureus, MRSA) types of theS. aureus strains carrying toxic shock syndrome toxin-1 (tst) and/or panton-valentine leukocidin (pvl) genes.Methods Nine hundred and sixteen isolates ofS. aureus were collected from seven hospitals in Shanghai and Zhejiang Province and subjected to detection oftst,pvl,mecA andmecC genes by polymerase chain reaction (PCR). Theagr and SCCmec (only for MRSA) types were determined in thetst orpvl gene positive isolates.Results Of the 916 isolates, 208 carriedtst gene (22.7%), 35 harboredpvl gene (3.8%), and 665 weremecA positive (MRSA). No isolate was mecC positive. Out of the 665 MRSA isolates, 198 hosted thetst gene (29.8%). The most commonagr and SCCmec types were agr 2 (97.0%) and SCCmec II (94.4%), respectively. For thepvl gene, only 14 isolates were positive (2.1%). Theagr 1 (85.7%), SCCmecIII (42.9%) and SCCmec IVa (28.6%) were the most commonagr type and SCCmec type. In the 251 methicillin-sensitiveS. aureus (MSSA) isolates, 10 carriedtst gene (4.0%) and 21 carriedpvl gene (8.4%). The prevalence oftst gene in MRSA was higher than that in MSSA, while the prevalence ofpvlgene was just the opposite. However, the prevalence ofpvlgene in MRSA isolates from Zhejiang Province was higher than that in the MRSA isolates from Shanghai (P severeS. aureus infections.

Tuberculin skin testing: Spectrum of adverse reactions.

Tuberculin skin testing (TST) is one of the primary diagnostic modalities recommended by the World Health Organization (WHO) and the National Institute for Health and Care Excellence (NICE) study conducted in the United Kingdom (UK) for diagnosing tuberculosis (TB). Even after acceptance as a diagnostic modality and stern standardization, TST has its own flaws that include a spectrum of adverse reactions. We report a series of cases with a spectrum of adverse reactions occurring with a higher frequency than present in the available evidence. The study has some demerits such as being a retrospective one with interobserver variation and lack of histopathological confirmation. The observation is presented to accentuate the fact that adverse reactions are not a rarity and that further studies are required to establish the cause and exact incidence of the same.

Ocorrência do gene da toxina da síndrome do choque tóxico em Staphylococcus spp. isolados de leite de vacas com mastite e de leite cru refrigerado / Occurrence of the toxic shock syndrome toxin gene in Staphylococcus spp.isolated from bovine mastitis milk and refrigerated raw milk

Avaliou-se a presença do gene (tst-1) para Toxina da Síndrome do Choque Tóxico-1 (TSST-1), utilizando-se a técnica de Reaçãoem Cadeia da Polimerase (PCR) em um total de 264 Staphylococcus spp. isolados de leite. Desses, 221 eram Staphylococcusaureus, 33 Staphylococcus coagulase negativo (SCN) e 10 Staphylococcus coagulase positivo (SCP). As amostras eram oriundasde vacas com mastite (n=96) e de leite cru refrigerado (n=168), coletadas de 46 e 22 propriedades, respectivamente. As amostrasforam coletadas de rebanhos localizados em diferentes regiões dos Estados de Minas Gerais e Rio de Janeiro. Observou-seproduto de amplificação (250 pares de base-pb) na reação de PCR para tst-1 em sete amostras (2,6%), sendo todas as estirpesidentificadas como Staphylococcus aureus isoladas de leite cru refrigerado. Embora a detecção do gene não indique a produçãoda toxina, o monitoramento de estirpes bacterianas potencialmente produtoras torna-se importante como forma de realizar umlevantamento epidemiológico e controle dos rebanhos leiteiros brasileiros, uma vez que esse gene está associado aos elementosgenéticos móveis, representando um risco à possível transferência horizontal de genes para outras bactérias. Além disso, a presençadesses genes tem sido associada à presença de genes para enterotoxinas estafilocócicas, o que pode implicar o aumento dapatogenicidade dos isolados bacterianos e um potencial risco à saúde pública.

Was evaluated the presence of the gene (tst -1) for toxic shock syndrome toxin - 1 (TSST -1), using the technique of PolymeraseChain Reaction (PCR) on a total of 264 Staphylococcus spp. isolated from milk. Of these, 221 were Staphylococcus aureus, 33Staphylococcus coagulase negative (SCN) and 10 Staphylococcus coagulase positive (SCP). The samples were from cows withmastitis (n=96) and refrigerated raw milk (n=168), collected from 46 and 22 dairy herds, respectively. Samples were collectedfrom herds located in different regions of Minas Gerais and Rio de Janeiro States. Was observed PCR amplification of the tst-1gene (250 base pairs-bp) in seven (2.6 %) samples, and all strains of Staphylococcus aureus isolated from refrigerated raw milk.Although its detection in isolated does not mean that it will be expressed, monitoring of bacterial strains producing potentiallybecomes important as performing an epidemiological survey and control of Brazilian dairy herds, since this gene is associatedwith mobile genetic elements, representing a risk to possible horizontal gene transfer to other bacteria. Furthermore, the presenceof these genes have been associated with the presence of genes for enterotoxins, which may result in increased pathogenicity ofthe isolates and a potential risk to public health.

Evaluation of QuantiFERON-TB Gold in- Tube and Immunological Tests for TB Diagnosis in Iraqi Patients.

Aims: Tuberculosis is an infectious disease caused by the bacillus Mycobacterium tuberculosis and other related species. It typically affects the lungs (pulmonary TB) but can affect other sites (extra-pulmonary TB). A profusion of articles have been published on the accuracy and uses of interferon-gamma releasing assays for detection of this disease. Experimental Design: A prospective study. Place and Duration of Study: This study was done in Kirkuk city between November 2012 to February 2013. Methodology: The present study included 50 individuals (40 suspected tuberculosis patients and 10 healthy controls). The patient were examined for the presence of TB by using QuantiFERON-TB Gold In-Tube(QFT-GIT) assay, polymerase chain reaction (PCR) and compared them with certain new and routine tests like AFB smear, OnSite TB rapid test, erythrocyte sedimentation rate and chest X-ray. Result: The present study showed a relation between QFT-GIT and OnSite TB rapid test, and they were positive in 25(86%) at the same time; QFT-GIT positive and OnSite TB rapid test were negative in 4(14%) of patients; QFT-GIT negative and OnSite TB rapid test positive were seen in 5(45%); while QFT-GIT and OnSite TB rapid test were negative in 6(55%) of patients. In the control group only one QFT-GIT positive but it was OnSite TB test negative. 9(100%) of individuals for both tests were negative, 29 were males and 21 were females. Conclusion: The study highlighted the sensitivity of IGRAs for diagnosis of active TB in combination with the rapid IgM/lgG tests for TB.The QFT assay appeared to be a more specific indicator of latent TB infection than TST. The association with blood groups and vaccination is also significant.

Tuberculin skin testing in inflammatory bowel disease patients from an endemic area of Brazil

Objective: Inflammatory bowel disease (IBD) is a chronic disorder involving the gastrointestinal tract. Immunosuppressive drugs are usually prescribed to treat IBD patients, and this treatment can lead to tuberculosis reactivation. This paper aimed to analyze tuberculin skin test (TST) results in IBD patients at a reference center in Brazil. Methods: We evaluated TST results in IBD patients using a cross-sectional study. We also analyzed the medical records of patients treated at a reference IBD outpatient unit where TST is routinely performed. Results: We reviewed 119 medical records of 57 (47.9%) Crohn's disease (CD), 57 (47.9%) ulcerative colitis (UC) and 5 (4.2%) indeterminate colitis (IC) patients. The mean (SD) age was 43.5 (13.7) years old. TST was positive in 24 (20.2%) of the patients. TST was positive in 16/57 (28.1%) UC and 6/57 (10.5%) CD patients (prevalence ratio [PR] 2.7). Forty-one patients (34.5%) were taking immunosuppressive drugs (azathioprine or prednisone) at the time of the TST, and six of these patients (14.6%) had positive test results. Two patients using infliximab had negative TST results. Thirty-five of the 41 patients (85.4%) on immunosuppressive treatment were anergic compared with 73.1% (57/78) of the untreated patients (PR 1.2). Conclusions: Patients with IBD have TST results similar to the general Brazilian population. Within the IBD population, CD patients have a lower frequency of TST positivity than UC patients. .

Comparative efficacy of behavioral despair models in depicting antidepressant-like effect of tramadol.

Background: Experimental evaluation of antidepressants (ADs) in diverse animal models is the need of time. There is a constant search for newer models with ease and rapid screening of AD activity. As earlier studies highlight AD effect of tramadol in animal models, the study was undertaken to compare antidepressant-like effect of tramadol in two models of behavioural despair in mice. Methods: Tramadol was administered intraperitoneally (i.p.) at two different doses of 20 and 40 mg/kg, once daily for 7 days to Swiss albino mice. The immobility period of control and drug-treated mice was recorded in tail suspension test (TST) and forced swim test (FST). The antidepressant (AD) effect of tramadol was compared with control (NS) and reference drug imipramine (10 mg/kg, p.o.), administered orally (p.o.) for seven successive days. Results: Tramadol in tail suspension test (TST) produced significant antidepressant effect at 20 and 40 mg/kg doses, as depicted by reduction in immobility period of drug-treated mice compared to control group. The efficacy of tramadol at dose of 40 mg/kg was comparable to that of imipramine treated group (p<0.001). Tramadol in forced swim test (FST) produced significant antidepressant effect only at the dose of 40 mg/kg as compared to control, while the results were insignificant as compared to imipramine treated group (p>0.05). Conclusion: The results of the present study depict antidepressant-like activity of tramadol in both the models of depression TST and FST. But TST in mice seems to be more efficacious in appraising the antidepressant like effect of tramadol.

Impact of pre-exposure of tail suspension on behavioural parameters like locomotion, exploration, and anxiety in mice.

The tail suspension test (TST) is a valid tool for assessing antidepressant activity. Association between depression and lower locomotion and exploration activities is also reported. In the present study, photoactometer, hole board and elevated plus maze tests were performed to evaluate locomotion, exploration and anxiety activities on animals of first and second set, however animals of second set were pre-exposed to TST. The comparison between these two sets will help in understanding the impact of pre-exposure to TST on behavioural parameters. In both sets, swiss albino mice were treated with caffeine (10 mg/kg, ip), bupropion (10 mg/kg, ip), duloxetine (10 mg/kg, ip), nicotine (0.8 mg/kg, sc) and normal saline. Control group of second set showed significant decrease in locomotion, exploration and increase in anxiety when compared against control group of first set. In second set, duloxetine, bupropion, and nicotine treated groups showed significant increase in locomotion when compared against control group of same set. Overall, pre-exposure to TST leads to significant decrease in locomotion, exploration activities and increase in anxiety level. Further studies demonstrating it’s time bound impact on brain monoamine levels with correlation to behavioural paradigms may help to validate these outcomes.

Influence of Diabetes Mellitus and Risk Factors in Activating Latent Tuberculosis Infection: A Case for Targeted Screening in Malaysia

A review of the epidemiology of tuberculosis, its contributing risk factors (excluding HIV) and the role of screening latent tuberculosis infection in Malaysia was done. Despite the global and domestic decrease in prevalence rates of tuberculosis in the past decade, there is an alarming increase in the trend of non communicable diseases in the country. High prevalence rates of major risk factors leading to reactivation of tuberculosis were seen within the population, with diabetes mellitus being in the forefront. The rising numbers in the ageing population of Malaysia poses a further threat of re-emergence of tuberculosis in the years to come. Economically, screening of diabetic patients with comorbidities for latent tuberculosis infection (LTBI) using two major techniques, namely tuberculin sensitivity (TST) and Interferon gamma release assay tests (IGRA) could be a viable option. The role of future research in the detection of LTBI in the Malaysian setting might be necessary to gauge the disease reservoir before implementing prophylactic measures for high risk groups involved.

Significance of Family Survey of Index Case for Detection of Tuberculosis.

Tuberculosis is highly prevalent amongst children in India. Contact survey has not received much attention in the Revised National Tuberculosis Control Program guidelines. This study was conducted to look for tuberculosis in asymptomatic family members of pediatric tuberculosis patients at a government hospital attached to a medical college in Central India. 168 siblings and 162 parents of 86 index cases of tuberculosis were studied. 64 tuberculosis infected siblings and 7 sputum positive parents were identified.

Investigation on toxic shock syndrome toxin 1 from Staphylococcus aureus / 中华微生物学和免疫学杂志

Objective To detect the mecA gene and tst gene of toxic shock syndrome toxin 1 (TSST-1)of Staphylococcus aureus by using PCR and to learn the carrier condition of tst gene.Methods The mecA gene and tst gene of Staphylococcus aureus strains that isolated from clinical sources in our hospital during August 2006 to May 2007 were amplified in vitro using PCR,and to establish the rapid,specific,and sensitive method of detecting tst gene of methicillin resistant Staphylococcus aureus(MRSA).Results The mecA gene and tst gene were detected,and were made the gene sequencing successfully.Forty-one of 84 strains had mecA gene(48.81%),16 of 84 strains had tst gene(19.05%),10 of 84 strains had both of them,and the positive rate was 24.39%(10/41).Conclusion The proportion of tst gene positive strains of MRSA iS high in clinic,and it must be paid more attention.

Tuberculin Skin Test and QuantiFERON-TB Gold Assay before and after Treatment for Latent Tuberculosis Infection among Health Care Workers in Local Tertiary Hospital / 결핵및호흡기질환

BACKGROUND: The QuantiFERON-TB Gold assay and tuberculin skin test (TST) have been useful test for diagnosing latent tuberculosis infections (LTBI). However, there are few reports on the efficacy of the QuantiFERON-TB Gold assay and TST in evaluating the response after the treatment of LTBI. This study examined the changes in the TST and QuantiFERON-TB Gold assay before and after a treatment for latent tuberculosis in health care workers (HCWs) at a local tertiary hospital. METHODS: A cohort of volunteers working as nurses and doctors who underwent a TST and QuantiFERON-TB Gold assay was established. The volunteers positive for the QuantiFERON-TB Gold assay had been treated with 3 months of isoniazid (INH) and rifampin (RFP). After completing treatment, the TST and QuantiFERON-TB Gold assay were repeated. RESULTS: Of the 48 participants (14 doctors, 34 nurses, M: F=11:37, mean age=29.9+/-5.5 years, mean employment period=74.9+/-64.3 months), 19 (39.6%) tested positive to the TST (mean induration=19.1+/-9.7 mm) and 8 (16.7%) were QuantiFERON-TB Gold assay. Among them, one had active pulmonary tuberculosis. Seven volunteers were consistently positive to both the TST and QuantiFERON-TB Gold assay after being medicated with INH and RFP for 3 months. CONCLUSION: TST and QuantiFERON-TB Gold assay are unsuitable for evaluating the treatment response of LTBI because they were consistently positive both before and after the anti-tuberculosis medication.

Protective effects of total saponins of tribulus on cerebral ischemia reperfusion injury in rats / 中国药理学通报

Aim: To observe the protective effects of total saponins of tribulus (TST) on cerebral ischemia reperfusion injury in rats. Methods: Rat cerebral ischemia-reperfusion injury was induced by middle cerebral artery occlusion . The neurological outcome was evaluated. CK, LDH and NO activity in serum, SOD and MDA levels of cerebral tissue were measured. Results: The levels of CK, LDH, NO, SOD and MDA in TST(30 mg·kg-1, 10 mg·kg -1) groups were significantly lower than those in model group. The level of cellular and intercellular edema was reduced markly in the pathomorphology examination. The neurological deficits was decreased by TST. Conclusion: TST has protective effects on cerebral ischemia reperfusion injury in rats.

Molecular Epidemiologic Surveillance of TSST-1 Strains Among Pathogenic Staphylococcus aureus / 감염

BACKGROUND: Toxic shock syndrome toxin 1 (TSST-1) is an important pathogenic factor in toxic shock syndrome, and its structural gene, tst has been cloned and sequenced, many of its biological and physicochemical properties have been determined, and immunostimulatory properties such as TNF production have been assigned to it. We investigated to know the proportion of strains possessing tst gene among pathogenic Strains of Staphylococcus aureus isolated from hospitalized patients and to elucidate the coexistence of mecA gene and tst gene. METHODS: S. aureus strains isolated in Asan Medical Center from December 1996 to June 1997 were incubated in brain-heart infusion media and harvested. Chromosomal DNA was prepared and polymerase chain reaction (PCR) was performed to detect mecA gene and tst gene in pathogenic S. aureus. RESULTS: A total of 126 strains were included. Among these, 11 strains (8.7%) were positive in PCR for tst gene. Ten out of these were mecA-positive strains and only one was mecA-negative. That is to say, among 60 strains of mecA-positive MRSA, 10 (16.7%) were tst-positive, and among 66 strains of mecA-negative MSSA, only one (1.5%) was tst-positive. CONCLUSION: Among S. aureus isolated from hospitalized patients, tst- possessing strains were 8.7%. TSST-1 gene was more prevalent in mecA-positive S. aureus than in mecA-negative S. aureus.

Antidepressant effect of Epimedium brevicornum extracts / 中草药

Objective To study antidepressant effects of Epimedium brevicornum extracts.Methods(Behavioral) despair models of male mice,tails suspension test(TST),and forced swimming test(FST) were used to evaluate the effects of E.brevicornum extracts on behavioral,monoamine oxidas(MAOA) and monoamine oxidase B(MAO-B) activities in brain and liver tissue,and MDA level in liver tissue of mouse.Reserpine antagonistic model was also used to investigate possible antidepressant mechanisms of E.brevicornum extracts.Results The extracts of E.brevicornum(25,50, 100,and 200 mg/kg) significantly reduced the duration of murine immobility in TST and FST,inhibited MAO-A and MAO-B activities in brain and liver of mice,and reversed the elevated liver MDA level in mice in TST.There was no significant amelioration in the decreases of body temperature in mice of Reserpine antagonistic model.Conclusion(E.brevicornum) extracts possesses the definite antidepressant properties.

Protective effects of total saponins of tribulus on cerebral ischemia reperfusion injury in rats / 中国药理学通报

Aim To observe the protective effects of total saponi ns of tribulus (TST) on cerebral ischemia reperfusion injury in rats. Meth ods Rat cerebral ischemia-reperfusion injury was induced by middle cer ebral artery occlusion .The neurological outcome was evaluated. CK, LDH and NO a ctivity in serum,SOD and MDA levels of cerebral tissue were measured. Re sults The levels of CK,LDH,NO,SOD and MDA in TST(30 mg?kg -1,1 0 mg?kg -1) groups were significantly lower than those in model group. The level of cellular and intercellular edema was reduced markly in the pathomorpho logy examination. The neurological deficits was decreased by TST.Conclus ion TST has protective effects on cerebral ischemia reperfusion injur y in rats.