TUBERCULOSIS
Some Selected Abstracts: | |
1. |
Kabra
SK, Lodha R, Seth V. Some current concepts on childhood tuberculosis.
Indian J Med Res. 2004 Oct; 120(4):387-97. Review. Department
of Pediatrics, All India Institute of Medical Sciences, D II/23, An sari
Nagger, New Delhi 110-029, India. skkabra@hotmail.com As
children acquire infection with Mycobacterium tuberculosis from adults in
their environment, the epidemiology of childhood tuberculosis (TB) follows
that in adults. While global burden of childhood tuberculosis is unclear,
in developing countries the annual risk of tuberculosis infection in
children is 2- 5 per cent. Nearly 8-20 per cent of the deaths caused by
tuberculosis occur in children. It has been
suggested that BCG vaccination is responsible for decrease in the
occurrence of disseminated and severe disease. Localized forms of illness,
e.g., intrathoracic lymphadenopathy, and localized CNS disease have been
reported to occur with greater frequency in vaccinated children. Human
immunodeficiency virus (HIV) infected children are at an increased risk of
tuberculosis, particularly disseminated disease. Diagnosis of TB in
children presents special problems as the sputum is generally not
available for examination. Diagnostic algorithms include scoring system
utilizing clinical parameters and results of investigations. Various
diagnostic techniques such as improved culture techniques, serodiagnosis,
and nucleic acid amplification have been developed and evaluated to
improve diagnosis of childhood tuberculosis. Serodiagnosis is an
attractive investigation but till date none of the tests showed desirable
sensitivity and specificity. Tests based on nucleic acid amplification are
a promising development. Relatively less experience in children, need for
technical expertise and high cost are the limiting factors for their use
in childhood tuberculosis. Short-course chemotherapy for childhood
tuberculosis is well established. Treatment with intermittent regimens is
comparable to daily regimens. Directly observed treatment strategy (DOTS)
has also shown encouraging results. Pattern of drug resistance among
children with TB tends to reflect those found among adults in the same
population. The rates of drug resistance to any drug vary from 20 to 80
per cent in different geographic regions. |
2. |
Misra
UK, Kalita J. The role of sensory and motor evoked potentials in the
prognosis of Pott's paraplegia. Clin Neurophysiol. 2004 Oct;
115(10):2267-73. Department
of Neurology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences,
Raebareily Road, Lucknow-26014, India. ukmisra@sgpgi.ac.in OBJECTIVE: In view of paucity of evoked potential changes in Pott's paraplegia, it is proposed to evaluate the role of motor and somatosensory evoked potentials in predicting the outcome. METHODS: Consecutive patients with Pott's paraplegia during 1993-2003 were subjected to detailed clinical, radiological and evoked potential study. The latter comprised of tibial somatosensory evoked potential (SEP) and motor evoked potential (MEP) study to tibialis anterior. The patients were clinically evaluated at 6 and 12 months and the outcome was defined into poor (bed ridden), partial (dependent for activities of daily living) and complete recovery (independent). The evoked potential findings were correlated with clinical and radiological findings and outcome. RESULTS: There were 39 patients whose age ranged between 16 and 70 (mean 42.1) years and 22 were females. The mean duration of symptoms was 8.2 months. Sensory motor deficit was present in 18 and pure motor signs in 21 patients. Five patients had quadriplegia and remaining had paraplegia. The muscle weakness was severe in 12 and moderate in 15 patients. In 12 patients, lower limb power was normal but they had lower limb hyper-reflexia with or without spasticity suggesting pyramidal dysfunction. Pinprick and joint position sensations were abnormal in 18 patients. MRI was abnormal in all and revealed cervical involvement in 7, thoracic in 22 and lumbar in 10 patients. Paravertebral soft tissue shadow was present in 36 and cord compression in 30 patients. Motor evoked potential was abnormal in 19 patients (unrecordable in 11 patients, 21 sides and prolonged in 8 patients, 14 sides). SEP was abnormal in 18 patients (unrecordable in 15 patients, 25 sides and prolonged central conduction in 8 patients, 9 sides). Both MEP and SEP were abnormal in 16, normal in 18, and only MEP was abnormal in 3 and only SEP in 2 patients. At 6 month 25 patients had complete, 9 partial and 5 poor recovery. At 1 year 33 had complete and 4 partial recovery. SEP and MEP abnormalities correlated with respective sensory and motor functions, vertebral level and outcome at 6 and 12 months. CONCLUSIONS: MEP and SEP both are helpful in predicting 6-month outcome. Combining SEP and MEP gives stronger correlation with 6-month outcome compared to only MEP or SEP. The potential role of evoked potentials in deciding different therapeutic strategies needs further studies. |
3. |
Gupta S, Shende N, Kumar S, Harinath BC. Isolation of excretory secretory protein 6 kDa antigen (ES-6) and its seroreactivity in patients with different stages of pulmonary tuberculosis and healthy household contacts. Biomedical Research, 2005; 16(1): 23-27. An Excretory Secretory protein antigen of 6 kDa (ES-6) was
isolated from Mycobacterium tuberculosis H37Ra culture
filtrate by gel filtration using fast protein liquid chromatography.
Seroreactivity of ES-6 antigen was compared with earlier reported
diagnostically useful ES-31 and ES-43 antigens at different stage of
pulmonary tuberculosis and in household contacts of the patients. The
ES-31 and ES-43 antigens showed good immune response in chronic and
relapse cases respectively while ES-6 antigen has shown comparatively low
immune response in these cases. However ES-6 showed increased
seroreactivity in household contacts of pulmonary tuberculosis patients.
These results suggest the heterogeneous responses of antigens in different
disease conditions and immune response to
ES-6 antigen may be associated with latent infection for predicting
active disease in course of time, as observed in the follow up of these
individuals. |
Diagnosis, Diagnostics,
Immunodiagnosis & Immunodiagnostics: |
11754.
Chou
YH, Tiu CM, Liu CY, Hong TM, Lin CZ, Chiou HJ, Chiou SY, Chang CY, Chen
MS. Tuberculosis of the parotid gland: sonographic manifestations and
sonographically guided aspiration. J Ultrasound Med. 2004
Oct;23(10):1275-81. 11755.
David
S T, Mukundan U, Brahmadathan k N, Jacob John T. Detecting
mycobacteraemia for diagnosing tuberculosis. Indian J med Res 2004, 119
(6), 259-66. 11756.
D'Souza DTB, Birdi TJ, Dholakia Y, Hira S, Anita NH. Importance
of blood samples for drug diagnosis and drug sensitivity testing in HIV
positive patients with suspected tuberculosis. Indian
Journal of Tuberculosis. 2004 Apr; 51(2): 77-81. 11757.
Gupta
S, Shende N, Kumar S, Harinath BC. Isolation of excretory secretory
protein 6 kDa antigen (ES-6) and its seroreactivity in patients with
different stages of pulmonary tuberculosis and healthy household
contacts. Biomedical Research, 2005; 16(1): 23-27. 11758.
Iwamoto
Y, Miyazawa T, Kurimoto N, Miyazu Y, Ishida A, Matsuo K, Watanabe Y.
Interventional bronchoscopy in the management of airway stenosis
due to tracheobronchial tuberculosis. Chest. 2004 Oct;126(4):1344-52. 11759.
Kabra
SK, Lodha R, Seth V. Some current concepts on childhood tuberculosis.
Indian J Med Res. 2004 Oct;120(4):387-97. Review. 11760.
Kashyap RS, Kainthla RP, Satpute RM, Chandak NH, Purohit HJ,
Taori GM, Daginawala H.F. Demonstration of IgG antibodies to 30 Kd
protein antigen in CSF for diagnosis of tuberculous meningitis by
antibody capturing ELISA. Neurology India. 2004 Sep; 52(3): 359-362 11761.
Kulkarni SB, Vora IM, Abraham S, Srivastava S, Sheth J,
Chaturvedi R. Role of synovial fluid analysis and synovial biopsy in
joint diseases. Bombay Hospital Journal. 2004 Oct; 46(4): 386-390.
11762.
Misra
UK, Kalita J. The role of sensory and motor evoked potentials in the
prognosis of Pott's paraplegia. Clin Neurophysiol. 2004
Oct;115(10):2267-73. 11763.
Ormerod
LP. Tuberculosis and anti-TNF-alpha treatment. Thorax. 2004
Nov;59(11):921. 11764.
Paul
Y. Controversies in BCG immunization. Indian J Pediatr. 2004
Nov;71(11):1040; 11765.
Peloquin
C. Use of therapeutic drug monitoring in tuberculosis patients. Chest.
2004 Dec;126(6):1722-4. 11766.
Schachter
EN. Tuberculosis: a global problem at our doorstep. Chest. 2004
Dec;126(6):1724-5. 11767.
Shenai
S, Rodrigues C, Mehta AP. Newer rapid diagnostic methods for
tuberculosis: a preliminary experience. Indian
Journal of Tuberculosis. 2004 Oct; 51(4): 219-230. 11768.
Tripathi
DG, Sriram N, Naik VK, Smita P, Seema G, Desai MW. Efficacy of
immunochromatographic techniques for the serodiagnosis of tuberculosis
[letter] Indian Journal of Medical Microbiology. 2004 Apr; 22(2):
131-132. 11769.
Tsai
MH, Huang YC, Lin TY. Development of tuberculoma during therapy
presenting as hemianopsia. Pediatr Neurol. 2004 Nov;31(5):360-3. Review.
11770.
Vernon
AA, Iademarco MF. In the treatment of tuberculosis, you get what you pay
for... Am J Respir Crit Care Med. 2004 Nov 15;170(10):1040-2. |
Pathogenesis: |
11771.
Cohen
J. Medicine. New TB drug promises shorter, simpler treatment. Science.
2004 Dec 10;306(5703):1872. 11772.
de
Castro AB. Respiratory protection: preventing exposure to communicable
agents. Am J Nurs. 2004 Dec;104(12):88. 11773.
Donald
PR, Schoeman JF. Tuberculous meningitis. N Engl J Med. 2004 Oct
21;351(17):1719-20. 11774.
Hizel
K, Maral I, Karakus R, Aktas F. The influence of BCG immunisation on
tuberculin reactivity and booster effect in adults in a country with a
high prevalence of tuberculosis. Clin Microbiol Infect. 2004
Nov;10(11):980-3. 11775.
Jindani
A, Nunn AJ, Enarson DA. Two 8-month regimens of chemotherapy for
treatment of newly diagnosed pulmonary tuberculosis: international
multicentre randomised trial. Lancet. 2004 Oct 2;364(9441):1244-51. 11776.
Ojcius
D. AIDS and tuberculosis - a lethal combination. Nat Rev Microbiol. 2004
Nov;2(11):858. 11777.
Quagliarello
V. Adjunctive steroids for tuberculous meningitis--more evidence, more
questions. N Engl J Med. 2004 Oct 21;351(17):1792-4. |
Therapy: |
11778. Nelson R. WHO's tuberculosis control strategy said to be insufficient. Lancet Infect Dis. 2004 Nov;4(11):653. |
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