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1.
Ann Work Expo Health ; 66(7): 907-922, 2022 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-35510991

RESUMO

Skin hydration and the barrier properties of the stratum corneum have been reported to be influential factors in the potential for retention of solid and semi-solid substances on the skin surface. The measurement of these characteristics of the skin, however, remains relatively uncommon in exposure assessments performed by industrial or occupational hygienists, even when the focus of the assessment is exposure to the skin. This study provides measurements of skin hydration using multiple instruments and multiple relevant skin site locations for comparative analysis. Three different measurement metrics, trans-epidermal water loss (TEWL), hydration index (HI), and percent hydration, were measured for 25 healthy volunteers at two different body locations for comparison: the center of the volar forearm, as previously recommended for interindividual comparison of hydration and barrier property measurements, and also the palmar tip of the index finger. The purpose of the comparative measurements was to allow for comparison between other published baseline volar forearm measurements and the palmar skin, which has not often been quantitatively assessed and reported in the literature, but is a relevant skin surface for sampling of the hands. This comparison will allow for consideration of the potential influence of palmar wipe sampling protocols on TEWL or skin hydration, and for the evaluation of the influence of skin hydration and TEWL on measured dermal transfer values. Collectively, the skin hydration levels and barrier properties at these two different measurement locations were found to be statistically significantly different, and as a result it is suggested that they be measured and recorded separately. Both measurement types and locations are likely to be important for the purposes of establishing skin hydration and health. Volar forearm measurements can also be important for understanding the underlying condition and barrier function of the skin, and palmar index finger measurements are necessary to understand the influence of both TEWL and skin hydration on quantitative dermal loading and transfer of solids and semi-volatile materials.


Assuntos
Exposição Ocupacional , Água , Epiderme/metabolismo , Humanos , Medição de Risco , Água/metabolismo , Perda Insensível de Água
2.
Int J Tuberc Lung Dis ; 26(4): 341-347, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35351239

RESUMO

BACKGROUND: Microbiologic screening of extrapulmonary TB (EPTB) patients could inform recommendations for aerosol precautions and close contact prophylaxis. However, this is currently not routinely recommended in India. Therefore, we estimated the proportion of Indian patients with EPTB with microbiologic evidence of pulmonary TB (PTB).METHODS: We characterized baseline clinical, radiological and sputum microbiologic data of 885 adult and pediatric TB patients in Chennai and Pune, India, between March 2014 and November 2018.RESULTS: Of 277 patients with EPTB, enhanced screening led to the identification of 124 (45%) with concomitant PTB, including 53 (19%) who reported a cough >2 weeks; 158 (63%) had an abnormal CXR and 51 (19%) had a positive sputum for TB. Of 70 participants with a normal CXR and without any cough, 14 (20%) had a positive sputum for TB. Overall, the incremental yield of enhanced screening of patients with EPTB to identify concomitant PTB disease was 14% (95% CI 12-16).CONCLUSIONS: A high proportion of patients classified as EPTB in India have concomitant PTB. Our results support the need for improved symptom and CXR screening, and recommends routine sputum TB microbiology screening of all Indian patients with EPTB.


Assuntos
Tuberculose Pulmonar , Tuberculose , Adulto , Criança , Tosse , Humanos , Índia/epidemiologia , Escarro/microbiologia , Tuberculose/diagnóstico , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/microbiologia
3.
J Toxicol Environ Health A ; 85(3): 89-109, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34569450

RESUMO

Transfer of contaminants to and from the skin surface has been postulated to occur through a number of different pathways and compartments including: object(s)-to-skin, skin-to-skin, skin-to-clothing, skin-to-gloves, air-to-skin, skin-to-lips, and skin-to-saliva. However, many identified transfer pathways have been only minimally examined to determine the potential for measurable transfer. The purpose of this study was to quantitatively evaluate repeated transfer between different compartments using elemental metallic lead (Pb) in the solid form using a series of systematic measurements in human subjects. The results demonstrated that some transfer pathways and compartments are significantly more important than others. Transfer of Pb could not be measured from skin to cotton clothing or skin to laminate countertop surfaces. However, transfer was consistently measured for skin-to-skin and between the skin and the surface of nitrile gloves, suggesting the potential for significant transfer to or from these compartments in real-world exposure scenarios, and the importance of these pathways. With repeated contacts, transfer increased non-linearly between 1 and 5 contacts, but appeared to approach a steady state distribution among the compartments within 10 contacts. Consistent with other studies, relative to 100% transfer for a single contact, the quantitative transfer efficiency decreased with repeated contacts to 29% after 5 contacts and 11-12% after 10 contacts; for skin-to-skin transfer measurements, transfer efficiency after either 5 or 10 contacts was approximately 50% of the single contact transfer. These data are likely to be useful for refining current approaches to modeling of repeated contacts for dermal exposure and risk assessment.


Assuntos
Exposição Ambiental/análise , Mãos , Chumbo , Pele , Vestuário , Fibra de Algodão , Feminino , Luvas Protetoras , Humanos , Masculino , Nitrilas , Exposição Ocupacional/análise
4.
Saudi J Biol Sci ; 28(1): 302-309, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33424310

RESUMO

Urinary tract infections are second most important diseases worldwide due to the increased amount of antibiotic resistant microbes. Among the Gram negative bacteria, P. mirabilis is the dominant biofilm producer in urinary tract infections next to E. coli. Biofilm is a process that produced self-matrix of more virulence pathogens on colloidal surfaces. Based on the above fact, this study was concentrated to inhibit the P. mirabilis biofilm formation by various in-vitro experiments. In the current study, the anti-biofilm effect of essential oils was recovered from the medicinal plant of Solanum nigrum, and confirmed the available essential oils by liquid chromatography-mass spectroscopy analysis. The excellent anti-microbial activity and minimum biofilm inhibition concentration of the essential oils against P. mirabilis was indicated at 200 µg/mL. The absence of viability and altered exopolysaccharide structure of treated cells were showed by biofilm metabolic assay and phenol-sulphuric acid method. The fluorescence differentiation of P. mirabilis treated cells was showed with more damages by confocal laser scanning electron microscope. Further, more morphological changes of essential oils treated cells were differentiated from normal cells by scanning electron microscope. Altogether, the results were reported that the S. nigrum essential oils have anti-biofilm ability.

5.
Saudi J Biol Sci ; 27(12): 3449-3455, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33304155

RESUMO

The development of antibiotic resistant in K. pneumoniae is an emerging thread worldwide due to the poor antimicrobial drugs. To overcome this issue, researchers are focused on plant material and their essential oils to fight against multi drug resistant bacteria. In this context, the current study was concentrated in medicinal plant of guva leaves and their essential oils to combat multi drug resistant bacterial infections. The essential oils were successfully screened and confirmed by HRLC-MS analysis. The anti-bacterial ability of the compounds were loaded into the chitosan nanoparticles and proved by FT-IR analysis. In addition, the chitosan loaded essential oils morphology was compared with chitosan alone in SEM analysis and suggested that the material was loaded successfully. Further, the anti-bacterial ability of the chitosan loaded essential oils were primarily confirmed by agar well diffusion method. At the 100 µg/mL of lowest concentration of chitosan loaded essential oils, the multi-drug resistant K. pneumoniae was inhibited with 96% and confirmed by minimum inhibition concentration experiment. Hence, all the experiments were proved that the essential oils were successfully loaded into the chitosan nanoparticles, and it has more anti-bacterial activity against multi-drug resistant K. pneumoniae.

6.
Int J Tuberc Lung Dis ; 24(1): 48-64, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-32005307

RESUMO

Low serum concentrations of first-line tuberculosis (TB) drugs have been widely reported. However, the impact of low serum concentrations on treatment outcome is less well studied. A systematic search of MEDLINE/Pubmed and the Cochrane Central Register of Controlled Trials up to 31 March 2018 was conducted for articles describing drug concentrations of first-line TB drugs and treatment outcome in adult patients with drug-susceptible TB. The search identified 3073 unique publication abstracts, which were reviewed for suitability: 21 articles were acceptable for inclusion in the qualitative analysis comprising 13 prospective observational cohorts, 4 retrospective observational cohorts, 1 case-control study and 3 randomised controlled trials. Data for meta-analysis were available for 15 studies, 13 studies of rifampicin (RMP), 10 of isoniazid (INH), 8 of pyrazinamide (PZA) and 4 of ethambutol (EMB). This meta-analysis revealed that low PZA concentration appears to increase the risk of poor outcomes (8 studies, n = 2727; RR 1.73, 95%CI 1.10-2.72), low RMP concentrations may slightly increase the risk of poor outcomes (13 studies, n = 2753; RR 1.40, 95%CI 0.91-2.16), whereas low concentrations of INH (10 studies, n = 2640; RR 1.32, 95%CI 0.66-2.63) and EMB (4 studies, n = 551; RR 1.12, 95%CI 0.41-3.05) appear to make no difference to treatment outcome. There was no significant publication bias or between-study heterogeneity in any of the analyses. The potential clinical impact of low concentrations of PZA and RMP warrants further evaluation. Also, comprehensive assessments of the complex pharmacokinetic-pharmacodynamic relationships in the treatment of TB are urgently needed.


Assuntos
Preparações Farmacêuticas , Tuberculose , Adulto , Antituberculosos/uso terapêutico , Estudos de Casos e Controles , Humanos , Isoniazida , Estudos Observacionais como Assunto , Pirazinamida , Estudos Retrospectivos , Resultado do Tratamento , Tuberculose/tratamento farmacológico
7.
Int J Tuberc Lung Dis ; 22(6): 686-694, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-29862955

RESUMO

SETTING: Pre-diabetes mellitus (pre-DM) and DM increase the risk of developing tuberculosis (TB). Screening contacts of TB patients for pre-DM/DM and linking them to care may mitigate the risk of developing TB and improve DM management. OBJECTIVE: To measure the prevalence of pre-DM/DM and associated factors among the adult household contacts (HHCs) of pulmonary TB patients. METHODS: Between August 2014 and May 2017, adult HHCs of newly diagnosed adult PTB patients in Pune and Chennai, India, had single blood samples tested for glycosylated haemoglobin (HbA1c) at enrolment. DM was defined as previously diagnosed, self-reported DM or HbA1c 6.5%, and pre-DM as HbA1c between 5.7% and 6.4%. Latent tuberculous infection (LTBI) was defined as a positive tuberculin skin test (5 mm induration) or QuantiFERON® Gold In-Tube (0.35 international units/ml). RESULTS: Of 652 adult HHCs, 175 (27%) had pre-DM and 64 (10%) had DM. Forty (64%) HHCs were newly diagnosed with DM and 48 (75%) had poor glycaemic control (HbA1c 7.0%). Sixty-eight (22%) pre-DM cases were aged 18-34 years. Age 35 years, body mass index 25 kg/m2, chronic disease and current tobacco smoking were significantly associated with DM among HHCs. CONCLUSIONS: Adult HHCs of TB patients in India have a high prevalence of undiagnosed DM, pre-DM and LTBI, putting them at high risk for developing TB. Routine DM screening should be considered among all adult HHCs of TB.


Assuntos
Diabetes Mellitus/epidemiologia , Programas de Rastreamento/métodos , Estado Pré-Diabético/epidemiologia , Tuberculose/epidemiologia , Adolescente , Adulto , Busca de Comunicante/métodos , Estudos Transversais , Diabetes Mellitus/diagnóstico , Feminino , Hemoglobinas Glicadas/análise , Humanos , Índia/epidemiologia , Tuberculose Latente/diagnóstico , Tuberculose Latente/epidemiologia , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/diagnóstico , Prevalência , Fatores de Risco , Tuberculose/diagnóstico , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Adulto Jovem
8.
J Appl Microbiol ; 125(2): 575-585, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29603538

RESUMO

AIMS: O-polysaccharide (OPS) molecules are protective antigens for several bacterial pathogens, and have broad utility as components of glycoconjugate vaccines. Variability in the OPS chain length is one obstacle towards further development of these vaccines. Introduction of sizing steps during purification of OPS molecules of suboptimal or of mixed lengths introduces additional costs and complexity while decreasing the final yield. The overall goal of this study was to demonstrate the utility of engineering Gram-negative bacteria to produce homogenous O-polysaccharide populations that can be used as the basis of carbohydrate vaccines by overexpressing O-polysaccharide chain length regulators of the Wzx-/Wzy-dependent pathway. METHOD AND RESULTS: The O-polysaccharide chain length regulators wzzB and fepE from Salmonella Typhimurium I77 and wzz2 from Pseudomonas aeruginosa PAO1 were cloned and expressed in the homologous organism or in other Gram-negative bacteria. Overexpression of these Wzz proteins in the homologous organism significantly increased the proportion of long or very long chain O-polysaccharides. The same observation was made when wzzB was overexpressed in Salmonella Paratyphi A and Shigella flexneri, and wzz2 was overexpressed in two other strains of P. aeruginosa. CONCLUSIONS: Overexpression of Wzz proteins in Gram-negative bacteria using the Wzx/Wzy-dependant pathway for lipopolysaccharide synthesis provides a genetic method to increase the production of an O-polysaccharide population of a defined size. SIGNIFICANCE AND IMPACT OF THE STUDY: The methods presented herein represent a cost-effective and improved strategy for isolating preferred OPS vaccine haptens, and could facilitate the further use of O-polysaccharides in glycoconjugate vaccine development.


Assuntos
Proteínas de Bactérias , Glicosiltransferases , Bactérias Gram-Negativas , Proteínas de Membrana Transportadoras , Antígenos O , Vacinas Conjugadas , Proteínas de Bactérias/análise , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Glicoconjugados , Glicosiltransferases/análise , Glicosiltransferases/genética , Glicosiltransferases/metabolismo , Bactérias Gram-Negativas/genética , Bactérias Gram-Negativas/metabolismo , Haptenos , Proteínas de Membrana Transportadoras/análise , Proteínas de Membrana Transportadoras/genética , Proteínas de Membrana Transportadoras/metabolismo , Antígenos O/análise , Antígenos O/genética , Antígenos O/metabolismo
9.
J Antimicrob Chemother ; 73(9): 2305-2313, 2018 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-29701775

RESUMO

Objectives: The objectives of this study were to explore inter-study heterogeneity in the pharmacokinetics (PK) of orally administered rifampicin, to derive summary estimates of rifampicin PK parameters at standard dosages and to compare these with summary estimates for higher dosages. Methods: A systematic search was performed for studies of rifampicin PK published in the English language up to May 2017. Data describing the Cmax and AUC were extracted. Meta-analysis provided summary estimates for PK parameter estimates at standard rifampicin dosages. Heterogeneity was assessed by estimation of the I2 statistic and visual inspection of forest plots. Summary AUC estimates at standard and higher dosages were compared graphically and contextualized using preclinical pharmacodynamic (PD) data. Results: Substantial heterogeneity in PK parameters was evident and upheld in meta-regression. Treatment duration had a significant impact on the summary estimates for rifampicin PK parameters, with Cmax 8.98 mg/L (SEM 2.19) after a single dose and 5.79 mg/L (SEM 2.14) at steady-state dosing, and AUC 72.56 mg·h/L (SEM 2.60) and 38.73 mg·h/L (SEM 4.33) after single and steady-state dosing, respectively. Rifampicin dosages of at least 25 mg/kg are required to achieve plasma PK/PD targets defined in preclinical studies. Conclusions: Vast inter-study heterogeneity exists in rifampicin PK parameter estimates. This is not explained by the available modifying variables. The recommended dosage of rifampicin should be increased to improve efficacy. This study provides an important point of reference for understanding rifampicin PK at standard dosages as efforts to explore higher dosing strategies continue in this field.


Assuntos
Antibióticos Antituberculose/administração & dosagem , Antibióticos Antituberculose/farmacocinética , Voluntários Saudáveis , Rifampina/administração & dosagem , Rifampina/farmacocinética , Tuberculose/tratamento farmacológico , Administração Oral , Adulto , Feminino , Humanos , Masculino
10.
Int J Tuberc Lung Dis ; 20(9): 1231-5, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27510251

RESUMO

OBJECTIVE: To determine the effect of SLCO1B1 gene polymorphisms (rs11045819, rs4149032 and rs4149033) on rifampicin (RMP) concentrations in adult tuberculosis (TB) patients from south India. METHODS: We genotyped adult TB patients for three SLCO1B1 gene polymorphisms-rs11045819, rs4149032 and rs4149033-and compared 2-h post-dosing RMP concentrations of the different genotypes for each of the polymorphisms. Plasma RMP was determined using high-performance liquid chromatography. Genotyping was performed using direct sequencing. RESULTS: Among the 256 study patients, minor allele frequencies were respectively 0.01 (A), 0.46 (C) and 0.07 (A) for rs11045819, rs4149032 and rs4149033 polymorphisms; genotype distributions followed Hardy-Weinberg equilibrium. RMP concentrations did not significantly differ between the different genotypes of the three polymorphisms. CONCLUSION: This is the first study to show that rs11045819, rs4149032 and rs4149033 polymorphisms in the SLCO1B1 gene did not influence RMP concentrations in Indian patients.


Assuntos
Antibióticos Antituberculose/sangue , Transportador 1 de Ânion Orgânico Específico do Fígado/genética , Polimorfismo de Nucleotídeo Único , Rifampina/sangue , População Branca/genética , Adulto , Antibióticos Antituberculose/uso terapêutico , Feminino , Frequência do Gene , Genótipo , Técnicas de Genotipagem , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Rifampina/uso terapêutico , Tuberculose/sangue , Tuberculose/tratamento farmacológico , Tuberculose/genética
11.
Int J Tuberc Lung Dis ; 20(9): 1236-41, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27510252

RESUMO

OBJECTIVE: To study the pharmacokinetics of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA) in adult tuberculosis (TB) patients and examine factors that influence drug pharmacokinetics. METHODS: Adult TB patients (n = 101) receiving thrice-weekly anti-tuberculosis treatment in the Revised National TB Control Programme (RNTCP) were studied. The study was conducted at steady state after directly observed drug administration. RMP, INH and PZA concentrations were estimated using high-performance liquid chromatography and NAT2 genotyping by real-time polymerase chain reaction. RESULTS: RMP peak concentration (Cmax) was sub-therapeutic (<8 µg/ml) in 88% of the patients. The Cmax of RMP, INH and PZA at 2 h was observed in respectively 83.2%, 97.0% and 92.1% of the patients. The Cmax and area under the curve from 0 to 8 h (AUC0-8) of PZA was lower in TB patients with diabetes mellitus than in non-diabetics. Significant associations were observed between the Cmax and the AUC0-8 of RMP, INH and PZA with drug doses; RMP with category of treatment; INH with smoking, body mass index and N-acetyl transferase 2 genotype; and PZA with sex and smoking. CONCLUSIONS: Several risk factors for drug concentration variations were identified. Two-hour post-dosing drug concentrations mimicked Cmax. A high proportion of TB patients had RMP Cmax below the expected range, which is a matter of concern.


Assuntos
Antituberculosos/farmacocinética , Isoniazida/farmacocinética , Pirazinamida/farmacocinética , Rifampina/farmacocinética , Tuberculose/tratamento farmacológico , Adulto , Antituberculosos/uso terapêutico , Arilamina N-Acetiltransferase/genética , Feminino , Técnicas de Genotipagem , Humanos , Índia , Isoniazida/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Pirazinamida/uso terapêutico , Rifampina/uso terapêutico , Tamanho da Amostra , Adulto Jovem
12.
Int J Tuberc Lung Dis ; 20(6): 844-7, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27155191

RESUMO

Assessing treatment adherence and quantifying exposure to anti-tuberculosis drugs among children is challenging. We undertook a 'proof of concept' study to assess the drug concentrations of isoniazid (INH) in hair as a therapeutic drug monitoring tool. Children aged <12 years initiated on a thrice-weekly treatment regimen including INH (10 mg/kg) for newly diagnosed tuberculosis were enrolled. INH concentrations in hair were measured using liquid chromatography-tandem mass spectrometry at 1, 2, 4 and 6 months after initiating anti-tuberculosis treatment. We found that INH hair concentrations in all children on thrice-weekly INH were detectable and displayed variability across a dynamic range.


Assuntos
Antituberculosos/análise , Cabelo/química , Isoniazida/análise , Tuberculose/tratamento farmacológico , Antituberculosos/uso terapêutico , Criança , Pré-Escolar , Cromatografia Líquida , Monitoramento de Medicamentos , Feminino , Humanos , Isoniazida/uso terapêutico , Estudos Longitudinais , Masculino , Cooperação do Paciente , Estudo de Prova de Conceito , Estudos Prospectivos , Espectrometria de Massas em Tandem , Tuberculose/diagnóstico
13.
Clin Pharmacol Ther ; 98(6): 622-9, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26260983

RESUMO

Pediatric tuberculous meningitis (TBM) is a highly morbid, often fatal disease. Standard treatment includes isoniazid, rifampin, pyrazinamide, and ethambutol. Current rifampin dosing achieves low cerebrospinal fluid (CSF) concentrations, and CSF penetration of ethambutol is poor. In adult trials, higher-dose rifampin and/or a fluoroquinolone reduced mortality and disability. To estimate optimal dosing of rifampin and levofloxacin for children, we compiled plasma and CSF pharmacokinetic (PK) and outcomes data from adult TBM trials plus plasma PK data from children. A population PK/pharmacodynamic (PD) model using adult data defined rifampin target exposures (plasma area under the curve (AUC)0-24 = 92 mg*h/L). Levofloxacin targets and rifampin pediatric drug disposition information were literature-derived. To attain target rifampin exposures, children require daily doses of at least 30 mg/kg orally or 15 mg/kg intravenously (i.v.). From our pediatric population PK model, oral levofloxacin doses needed to attain exposure targets were 19-33 mg/kg. Our results provide data-driven guidance to maximize pediatric TBM treatment while we await definitive trial results.


Assuntos
Antituberculosos/administração & dosagem , Cálculos da Dosagem de Medicamento , Levofloxacino/administração & dosagem , Modelos Biológicos , Mycobacterium tuberculosis/efeitos dos fármacos , Rifampina/administração & dosagem , Tuberculose Meníngea/tratamento farmacológico , Administração Intravenosa , Administração Oral , Adolescente , Adulto , Fatores Etários , Antituberculosos/sangue , Antituberculosos/líquido cefalorraquidiano , Antituberculosos/farmacocinética , Peso Corporal , Criança , Pré-Escolar , Ensaios Clínicos Fase II como Assunto , Simulação por Computador , Humanos , Lactente , Levofloxacino/sangue , Levofloxacino/líquido cefalorraquidiano , Levofloxacino/farmacocinética , Ensaios Clínicos Controlados Aleatórios como Assunto , Rifampina/sangue , Rifampina/líquido cefalorraquidiano , Rifampina/farmacocinética , Tuberculose Meníngea/diagnóstico , Tuberculose Meníngea/microbiologia
14.
Clin Pharmacol Ther ; 98(3): 240-4, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26088359

RESUMO

While tuberculosis (TB) typically causes respiratory disease in adults, the spectrum of disease is different in children, ranging from paucibacillary lymphadenitis or limited intrathoracic disease to severe disseminated disease. Diagnosing pediatric TB and monitoring treatment response is challenging, as collecting respiratory specimens is difficult in children and disease may be extrapulmonary. While basic principles of treatment are similar to adults, developmental differences in pharmacokinetics and pharmacodynamics require that drug dosages in children be adjusted for body weight and age.


Assuntos
Antituberculosos/uso terapêutico , Tuberculose/tratamento farmacológico , Fatores Etários , Antituberculosos/administração & dosagem , Antituberculosos/efeitos adversos , Antituberculosos/farmacocinética , Tamanho Corporal , Criança , Pré-Escolar , Comorbidade , Relação Dose-Resposta a Droga , Cálculos da Dosagem de Medicamento , Monitoramento de Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Humanos , Lactente , Recém-Nascido , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Tuberculose/diagnóstico , Tuberculose/metabolismo , Tuberculose/microbiologia , Tuberculose/transmissão
15.
Int J Tuberc Lung Dis ; 19(7): 805-7, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26056105

RESUMO

We compared the pharmacokinetics of rifampicin (RMP) during daily and intermittent (thrice weekly) anti-tuberculosis treatment in human immunodeficiency virus infected tuberculosis patients. Patients treated with a thrice-weekly regimen had significantly lower plasma peak concentration, area under the time concentration curve from 0 to 24 h and higher oral clearance of RMP than those treated with the daily regimen. The median values were respectively 3.7 and 6.4 µg/ml (P < 0.001), 20.7 and 29.4 µg/ml.h (P = 0.03) and 21.7 and 15.3 ml/min (P = 0.03).


Assuntos
Antituberculosos/administração & dosagem , Infecções por HIV/complicações , Rifampina/administração & dosagem , Rifampina/farmacocinética , Tuberculose Pulmonar/tratamento farmacológico , Adulto , Contagem de Linfócito CD4 , Esquema de Medicação , Feminino , Humanos , Índia , Masculino , Estudos Prospectivos
16.
Spectrochim Acta A Mol Biomol Spectrosc ; 128: 603-13, 2014 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-24691375

RESUMO

Fourier transform infrared (FTIR) and FT-Raman spectra of 1,2-benzoxazol-3-ylmenthane sulfonamide in the solid phase were recorded and analyzed. The molecular geometry, vibrational frequencies, infrared intensities, Raman activities and atomic charges were calculated using HF and density functional theory calculation (B3LYP) with standard 6-31G(d, p) basis set. Complete vibrational assignment and analysis of the fundamental modes of the compound were carried out using the observed FTIR and FT-Raman spectra. The thermodynamic functions of the title compound were also performed. Stability of the molecule arising from hyper-conjugative interactions, charge delocalization has been analyzed using natural bond orbital (NBO) analysis. The dipole moment (µ), polarizability (α) and the hyperpolarizability (ß) values of the molecule has been computed. Potential Energy Distribution (PED) were computed for the assignment of unambiguous vibrational fundamental modes. UV-vis spectrum of the compound was also recorded. The theoretical electronic absorption spectra have been calculated by TD-DFT/B3LYP using 6-31G(d,p) basis set. The HOMO and LUMO energy gap reveals that the chemical activity of the molecule. The molecular orbital contributions were studied by density of energy states (DOSs). Thermodynamic properties (heat capacity, entropy and enthalpy) of the title compound at different temperatures were calculated. Finally, simulated FTIR and FT-Raman spectra of 1,2-benzoxazol-3-ylmenthane sulfonamide showed good agreement with the observed spectra.


Assuntos
Sulfonamidas/química , Estrutura Molecular , Espectrofotometria Ultravioleta/métodos , Espectroscopia de Infravermelho com Transformada de Fourier/métodos , Análise Espectral Raman/métodos
17.
Artigo em Inglês | MEDLINE | ID: mdl-24280302

RESUMO

The Fourier transform infrared (FT-IR) and FT-Raman of (1R)-N-(Prop-2-yn-1-yl)-2,3-dihydro-1H-inden-1-amine (1RNPDA) were recorded in the regions 4000-400 cm(-1) and 4000-100 cm(-1) respectively. A complete assignment and analysis of the fundamental vibrational modes of the molecule were carried out. The observed fundamental modes have been compared with the harmonic vibrational frequencies computed using HF method by employing 6-31G(d,p) basis set and DFT(B3LYP) method by employing 6-31G(d,p) basis set. The vibrational studies were interpreted in terms of Potential Energy Distribution (PED). The complete vibrational frequency assignments were made by Normal Co-ordinate Analysis (NCA) following the scaled quantum mechanical force field methodology (SQMFF). The first order hyper polarizability (ß0) of this molecular system and related properties (α, µ, and Δα) are calculated using B3LYP/6-31G(d,p) method based on the finite-field approach. The thermodynamic functions of the title compound were also performed at the above methods and basis set. A detailed interpretation of the infrared and Raman spectra of 1RNPDA is reported. The (1)H and (13)C nuclear magnetic resonance (NMR) chemical shifts of the molecule were calculated using the GIAO method confirms with the experimental values. Stability of the molecule arising from hyper-conjugative interactions and charge delocalization has been analyzed using Natural Bond Orbital (NBO) analysis. UV-vis spectrum of the compound was recorded and electronic properties such as excitation energies, oscillator strength and wavelength were performed by TD-DFT/B3LYP using 6-31G(d,p) basis set. The HOMO and LUMO energy gap reveals that the energy gap reflects the chemical activity of the molecule. The observed and calculated wave numbers are formed to be in good agreement. The experimental spectra also coincide satisfactorily with those of theoretically constructed spectra.


Assuntos
Aminas/química , Indenos/química , Modelos Moleculares , Teoria Quântica , Análise Espectral Raman , Espectroscopia de Ressonância Magnética , Conformação Molecular , Dinâmica não Linear , Espectrofotometria Ultravioleta , Espectroscopia de Infravermelho com Transformada de Fourier , Termodinâmica , Vibração
18.
Int J Tuberc Lung Dis ; 17(12): 1564-8, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24200269

RESUMO

SETTING: Rifabutin (RBT) is reported to be as effective as and to have less inducing effect on cytochrome P450 enzymes than rifampicin against tuberculosis (TB). The optimal dose of RBT during ritonavir (RTV) co-administration remains a matter of debate. OBJECTIVE: To study the pharmacokinetics of 150 mg RBT thrice weekly during concomitant atazanavir/RTV administration in human immunodeficiency virus (HIV) infected TB patients. METHODS: This observational study was conducted in 16 adult HIV-infected TB patients being treated for TB with an RBT-containing regimen and an antiretroviral therapy regimen with RTV; the dose of RBT was 150 mg thrice weekly. Serial blood draws were performed at pre-dosing and at 1, 2, 4, 6, 8, 12 and 24 h after the drug was administered. Plasma RBT was estimated using high-performance liquid chromatography. RESULTS AND CONCLUSIONS: Peak RBT concentration was below the lower therapeutic limit (<0.3 µg/ml) in seven patients, while 10 patients had trough concentrations below the minimal inhibitory concentration against Mycobacterium tuberculosis (0.06 µg/ml), suggesting that the RBT dosage may be inadequate. Prospective studies in different settings are required to arrive at the proper therapeutic dose for RBT to be used during co-administration with RTV.


Assuntos
Antibióticos Antituberculose/farmacocinética , Infecções por HIV/tratamento farmacológico , Inibidores da Protease de HIV/uso terapêutico , Oligopeptídeos/uso terapêutico , Piridinas/uso terapêutico , Rifabutina/farmacocinética , Ritonavir/uso terapêutico , Tuberculose/tratamento farmacológico , Adulto , Antibióticos Antituberculose/administração & dosagem , Antibióticos Antituberculose/sangue , Sulfato de Atazanavir , Cromatografia Líquida de Alta Pressão , Esquema de Medicação , Interações Medicamentosas , Monitoramento de Medicamentos/métodos , Quimioterapia Combinada , Feminino , Infecções por HIV/sangue , Infecções por HIV/diagnóstico , Humanos , Índia , Masculino , Testes de Sensibilidade Microbiana , Polimedicação , Rifabutina/administração & dosagem , Rifabutina/sangue , Tuberculose/sangue , Tuberculose/diagnóstico
19.
Int J Tuberc Lung Dis ; 17(6): 800-6, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23676165

RESUMO

SETTING: The currently recommended dosages of rifampicin (RMP), isoniazid (INH), pyrazinamide (PZA) and ethambutol in children are extrapolated from adult pharmacokinetic studies, and have not been adequately evaluated in children. OBJECTIVE: To describe the pharmacokinetics of RMP, INH and PZA given thrice weekly in children with tuberculosis (TB), and to relate pharmacokinetics to treatment outcomes. METHODS: Eighty-four human immunodeficiency virus negative children with TB aged 1-12 years in Chennai and Madurai, India, were recruited. Phenotypic INH acetylator status was determined. Nutritional status was assessed using Z scores. During the intensive phase of anti-tuberculosis treatment, a complete pharmacokinetic study was performed after directly observed administration of drugs. At 2 and 6 months, drug levels were measured 2 h post-dose. Drug concentrations were measured using high performance liquid chromatography and pharmacokinetic variables were calculated. Multivariable regression analysis was performed to explore factors impacting drug levels and treatment outcomes. RESULTS AND CONCLUSIONS: Children aged <3 years had significantly lower RMP, INH and PZA concentrations than older children, and 90% of all children had sub-therapeutic RMP Cmax (<8 µg/ml). Age, nutritional status and INH acetylator status influenced drug levels. Peak RMP and INH concentrations were important determinants of treatment outcome. Recommendations for anti-tuberculosis treatment in children should take these factors into consideration.


Assuntos
Antituberculosos/farmacocinética , Isoniazida/farmacocinética , Pirazinamida/farmacocinética , Rifampina/farmacocinética , Acetilação , Fatores Etários , Antituberculosos/administração & dosagem , Antituberculosos/uso terapêutico , Criança , Pré-Escolar , Cromatografia Líquida de Alta Pressão , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Índia , Lactente , Isoniazida/administração & dosagem , Isoniazida/uso terapêutico , Masculino , Análise Multivariada , Estado Nutricional , Fenótipo , Pirazinamida/administração & dosagem , Pirazinamida/uso terapêutico , Análise de Regressão , Rifampina/administração & dosagem , Rifampina/uso terapêutico , Fatores de Tempo , Resultado do Tratamento , Tuberculose/tratamento farmacológico
20.
Spectrochim Acta A Mol Biomol Spectrosc ; 107: 386-98, 2013 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-23485937

RESUMO

The experimental and theoretical vibrational spectra of S-S-2 methylamino-1-phenyl propan-1-ol (SSMPL). Fourier transform infrared (FTIR) and FT Raman spectra of SSMPL in the solid phase were recorded and analyzed. The molecular geometry, vibrational frequencies, infrared intensities, Raman activities and atomic charges were calculated using density functional theory calculation (B3LYP) with standard 6-31G(d,p) and high level 6-311++G(d,p) basis sets. Complete vibrational assignment and analysis of the fundamental modes of the compound were carried out using the observed FTIR and FT Raman data. The thermodynamic functions of the title compound were also performed by B3LYP with two basis sets 6-31G(d,p) and 6-311++G(d,p). Stability of the molecule arising from hyper conjugative interactions, charge delocalization has been analyzed using natural bond orbital (NBO) analysis. The calculated HOMO and LUMO energies show that charge transfer occurs within the molecule. Using the method B3LYP, the dipole moment (µ), polarizability (α) and the hyperpolarizability (ß) values of the investigated molecule has been computed. Total energy distribution (TED) was used for the assignment of Unambiguous vibrational fundamental modes. Finally, Simulated FTIR and FT Raman spectra of SSMPL showed good agreement with the observed spectra.


Assuntos
Metilaminas/química , Propanóis/química , Simpatomiméticos/química , Modelos Moleculares , Conformação Molecular , Teoria Quântica , Espectroscopia de Infravermelho com Transformada de Fourier , Análise Espectral Raman
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