Characteristics of culture-negative subclinical pulmonary tuberculosis: a single-center observation.

BACKGROUND: Little is known about culture-negative subclinical pulmonary tuberculosis (TB), and its diagnosis remains challenging. Therefore, this study aimed to identify the characteristics and the extent of disease associated with culture-negative subclinical pulmonary TB. METHODS: This retrospective cohort study was conducted on immunocompetent individuals with subclinical pulmonary TB at a university hospital in Thailand from January 2014 to December 2019. Subclinical pulmonary TB was diagnosed based on the presence of radiographic abnormalities consistent with TB in the absence of TB symptoms. All subjects demonstrated significant improvement or resolution of radiographic abnormalities following the completion of treatment. At least two negative sputum cultures were needed to fulfill the definition of culture-negative pulmonary TB. Data were analyzed using univariate and multiple logistic regression analyses to determine the characteristics of those with culture-negative subclinical pulmonary TB compared to culture-positive ones. RESULTS: Out of the 106 individuals identified with subclinical pulmonary TB, 84 met the criteria for inclusion in the analysis. The study found lower radiographic extent and increasing age were key attributes of culture-negative subclinical pulmonary TB. The odds ratios (95% confidence interval) were 7.18 (1.76 to 29.35) and 1.07 (1.01 to 1.13), respectively. They tend to have lower rates of bilateral involvement in both chest x-ray (8.5% vs. 32.0%, p=0.006) and computed tomography (15.4% vs. 42.9%, p=0.035). However, no other specific radiographic findings were identified. CONCLUSIONS: People with culture-negative subclinical pulmonary TB were likely to have less radiographic -severity, reflecting early disease. Nevertheless, no radiographic patterns, except for unilaterality, were related to culture-negative subclinical pulmonary TB.

Analgesic and Anti-Inflammatory Effects of 1% Topical Cannabidiol Gel in Animal Models.

Introduction: Cannabidiol (CBD), a phytocannabinoid isolated from cannabis plants, is an interesting candidate for studying its anti-inflammatory effects, especially in the pre-clinical and animal models. Its anti-inflammatory effects, such as reduction of edema and arthritis, have been demonstrated in animal models. However, topical CBD administration requires further evaluation of CBD dosage and efficacy in animal models and clinical settings. Methods: This in vivo study investigated the anti-inflammatory effects of topical CBD administration in an animal model. Scientific experiments, including the formalin test, writhing test, carrageenan-induced edema, histopathological examination, and detection of various proinflammatory mediators, were performed. Results: The anti-inflammatory effects in vivo after inflammation induction, represented by decreased times of paw licking, degree of paw edema, and decreased writhing response, showed that 1% of tropical CBD use had significantly comparable or better anti-inflammatory effects when compared with tropical diclofenac, an anti-inflammatory agent. Moreover, the anti-inflammatory effects were significant compared with the placebo. In addition, the histopathological examination showed that topical CBD drastically reduced leukocyte infiltration and the degree of inflammation. This study also showed that the levels of various proinflammatory mediators in the plasma of mice treated with topical CBD did not differ from those treated with diclofenac. Conclusions: The topical administration of 1% CBD gel is a potentially effective candidate for an anti-inflammatory agent. Candidate for an anti-inflammatory agent.

Underdiagnosis of silicosis revealed by reinterpretation of chest radiographs in Thai ceramic workers.

Background: In Thailand, epidemiological data on silicosis in the ceramic sector is lacking and the underdiagnosis of silicosis remains an extensive concern. Therefore, this study aimed to determine the prevalence of silicosis and the extent of underdiagnosis among Thai ceramic workers by reinterpreting chest radiographs previously taken by a health check-up unit. Methods: This retrospective cross-sectional study was conducted on ceramic workers undergoing health surveillance using chest radiographs in one ceramic factory in September 2018. All chest radiographs were done retrospectively, then were reinterpreted by professional readers specially trained in using the ILO International Classification of Radiograph of Pneumoconioses (ILO/ICRP). Chest radiographs with a profusion of 1/1 or greater were suggestive of silicosis. Results: Out of the 244 participants undergoing chest radiography, the prevalence of silicosis was 2.9%. Overall, the mean age of the participants was 41 years, and 72.1% were female. Among individuals with silicosis, the median age was 43 years; 71.4% were male; the average employment duration was 26.9 years; while the male sex was the significant variable associated with silicosis with an odds ratio of 7.01 (95% confidence interval 1.31 to 37.4). Regarding the underdiagnosis, the health check-up unit failed to recognize all individuals with silicosis, and could not detect any radiographic chest abnormalities in 57.1% of those with silicosis. Conclusions: Despite the low prevalence of silicosis among Thai ceramic workers, this finding indicates ongoing exposure to silica in the ceramic industry. In addition, a significant proportion of the silicosis cases were underrecognized. Future efforts to prevent underdiagnosis and improve an occupational health surveillance service in Thailand are needed.