Diagnosis and Management of Osteoarticular Tuberculosis: A Drastic Change in Mind Set Needed-It is Not Enough to Simply Diagnose TB.

BACKGROUND: In the era of increasing drug resistance in pulmonary tuberculosis (TB), it is prudent to assess causes of poor response to anti tubercular therapy (ATT) and drug sensitivity pattern (DSP) in osteoarticular TB. MATERIALS AND METHODS: As a part of Bombay Orthopaedic society's research project, members were asked to refer non responders to ATT to our institute. Cases were enrolled from October 2010 to March 2014. Deep tissue samples were obtained in all but five cases and subjected to a battery of tests including histopathology (HPE) and TB culture and sensitivity. The DSP was compared with the study performed by the principle author from 2004 to 2007 and published in 2009. RESULTS: 39 male and 50 female patients with a mean age of 24.85 years (2-66) were included and classified in four groups after results. (1) Culture and HPE positive-36. 24 had MDR and three XDR TB. Primary resistance to even second line drugs and deterioration of DSP since last study was noted, (2) culture negative and HPE positive-21. The cause of poor response was surgical in more than half cases, (3) non representative samples or lost to follow-up-15, (4) TB mimics-16. CONCLUSION: There is increasing incidence of primary resistance to second line drugs, primary resistance in children and worsening of resistance patterns as compared to older studies. ATT initiation is a fateful decision and every attempt should be made to rule out TB mimics and establish DSP before initiation.

Accessibility of polybrominated diphenyl ether congeners in aging soil.

Polybrominated diphenyl ethers (PBDEs) are considered to be persistent environmental pollutants. Although soil is considered the most likely sink for these contaminants, little is known about the potential adsorption and aging of these compounds to the soil matrix. A previous study performed in our lab suggested that abiotic sorption of PBDEs to soil constituents was the most important determinant of PBDE accessibility. Building on this work, the present paper examined the availability of congeners of a commercial PBDE mixture (DE-71) in soils that varied in organic matter content, clay content, and pH. Both sterile and non-sterile soils were amended with DE-71 and then monitored over eight weeks of aging. Recovery of all congeners from soil by acetone extraction dropped significantly over time. Comparisons between sterile and non-sterile samples, along with the results of a separate phase partitioning study, indicated a strong affinity between soils and monitored DE-71 components. This general phenomenon was so dominant that, in this study, varying soil characteristics had no significant effect on PBDE recovery. Unexpectedly, final recovery was significantly higher in the non-sterile soil. The biological impact on congener accessibility was also observed when zucchini and radish plants were grown in soil that had been aged 8 weeks following DE-71 fortification. After 10 weeks of growth, recovery of congeners was up to five times higher than it had been prior to planting.

Permeation of tecnazene through human skin in vitro as assessed by HS-SPME and GC-MS.

Permeation of tecnazene into and through human cadaver skin in vitro was assessed using a CC-MS method employing HS-SPME for receptor solution analyses. Two doses of tecnazene dissolved in acetone, corresponding to 103 and 864 microg/cm2 of tecnazene, were applied to skin mounted on Franz diffusion cells and placed in a fume hood. Cells were either occluded with aluminum foil or left unoccluded. Total absorption of tecnazene (dermis + receptor fluid) after 48 h was 2.2-6.1% of the applied dose for the unoccluded treatments and 22-33% for the occluded treatments. Potentially absorbed dose including all tecnazene that may have eventually permeated the skin ranged from 10% unoccluded to 42-53% occluded. Accumulation in the receptor solutions was satisfactorily described by a working diffusion model after upward adjustment of the partition coefficient for tecnazene in all skin layers by a factor of 5-16 versus a priori values. However, residual amounts of tecnazene in both the epidermis and dermis were higher than those estimated from the model, suggesting the existence of tissue binding not accounted for in the calculation. The results indicate that the diffusion model as presently calibrated may significantly underestimate both systemic absorption and skin concentrations of highly lipophilic compounds, as predicted from data generated from in vitro skin permeation assays. Model predictions could be improved by better accounting for partitioning into the epidermis and dermis.

Fate of pentabrominated diphenyl ethers in soil: abiotic sorption, plant uptake, and the impact of interspecific plant interactions.

Polybrominated diphenyl ethers (PBDEs) are potentially harmful and persistent environmental pollutants. Despite evidence that soils are a major sink for PBDEs, little is known regarding their behavior in this medium. An environmentally relevant level of a commercial penta-BDE mixture (75 microg kg(-1)) was added to topsoil, and the extractability of three congeners (BDE-47, -99, and -100) was monitored over 10 weeks in planted and unplanted treatments. The extractability of each congener decreased rapidly in the experimental soil due largely to abiotic sorption to soil particles, which was demonstrated by low PBDE recovery from sterilized and dry soils. Monoculture plantings of zucchini and radish did not affect the recovery of PBDEs from soil. However, PBDE recovery from mixed species plantings was nearly 8 times higher than that of unplanted and monoculture treatments, indicating that interspecific plant interactions may enhance PBDE bioavailablity in soil. Evidence for competitive interactions between the two species was revealed by reduced shoot biomass of zucchini plants in mixed treatments relative to pots containing only zucchini. Both plant species accumulated PBDEs in root and shoot tissue (<5 microg kg(-1) plant tissue). PBDE uptake was higher in zucchini, and translocation of PBDEs to zucchini shoots was congener-specific. Our results suggest that although abiotic sorption may limit the potential for human exposure to PBDEs in soil, plants may increase the exposure risk by taking up and translocating PBDEs into aboveground tissues and by enhancing bioavailability in soil.

Novel mesoporous mixed Nb-M (M = V, Mo, and Sb) oxides for oxidative dehydrogenation of propane.

Novel thermally stable mesoporous mixed metal Nb-M (M = V, Mo and Sb) oxides were synthesized in the presence of a nonionic Pluronic P123 surfactant. These oxides displayed promising pore structures and chemical compositions for selective oxidative functionalization of propane: high surface areas (up to 200 m2/g), large pore sizes (5-14 nm), and high pore volumes (up to 0.46 cm3/g). The oxidative dehydrogenation of propane to propylene over mesoporous mixed metal Nb-M oxides employed as a probe reaction suggested that the M component was dispersed as the molecular surface species and also formed a solid solution with NbOx in the inorganic walls of these mesoporous mixed metal oxides.