ABSTRACT
OBJECTIVE: To evaluate C-reactive protein (CRP), globulin and white blood cell (WBC) count as predictors of treatment outcome in pulmonary tuberculosis (PTB). METHODS: An observational study of patients with active PTB was conducted at a tertiary centre. All patients had serum CRP, globulin and WBC measured at baseline and at 2 months following commencement of treatment. The outcome of interest was requirement for extension of treatment beyond 6 months. RESULTS: There were 226 patients included in the study. Serum globulin 45 g/l was the only baseline biomarker evaluated that independently predicted requirement for treatment extension (OR 3.42, 95%CI 1.597.32, P 0.001). An elevated globulin level that failed to normalise at 2 months was also associated with increased requirement for treatment extension (63.9% vs. 5.1%, P 0.001), and had a low negative likelihood ratio (0.07) for exclusion of requirement for treatment extension. On multivariable analysis, an elevated globulin that failed to normalise at 2 months was independently associated with requirement for treatment extension (OR 6.13, 95%CI 2.2316.80, P 0.001). CONCLUSIONS: Serum globulin independently predicts requirement for treatment extension in PTB and outperforms CRP and WBC as a predictive biomarker. Normalisation of globulin at 2 months following treatment commencement is associated with low risk of requirement for treatment extension.
Subject(s)
Biomarkers/blood , Tuberculosis, Pulmonary/blood , Tuberculosis, Pulmonary/drug therapy , Adult , C-Reactive Protein/analysis , Cohort Studies , Female , Follow-Up Studies , Globulins/analysis , Humans , Leukocyte Count , Male , Middle Aged , Treatment OutcomeABSTRACT
Temperature profiles within a mine waste rock dump undergoing pyritic oxidation have been used to estimate the rate of oxidation and the sites where oxidation was occurring. The waste rock dump is located at the abandoned Rum Jungle mine site in Northern Australia and was a major source of pollution to the local river system. The dump was rehabilitated in 1983-84 by reshaping to reduce erosion and covering with clay and soil to reduce infiltration of water.Heat source distributions were derived from temperature profiles measured in the dump. The oxidation of pyritic material is the main cause of heat in the dump, hence the rate and location of oxidation can be obtained from the distribution of heat sources. A comparison of the heat source distributions before and after rehabilitation showed that rehabilitation greatly reduced or stopped the oxidation of pyrite in the dump.
