Some Selected Abstracts:


Barreto ML, Cunha SS, Pereira SM, Genser B, Hijjar MA, Yury Ichihara M, de Brito SC, Dourado I, Cruz A, Santa'Ana C, Rodrigues LC. Neonatal BCG protection against tuberculosis lasts for 20 years in Brazil. Int J Tuberc Lung Dis. 2005 Oct;9(10):1171-3.

Instituto de Saude Coletiva, Universidade Federal da Bahia, Salvador-Bahia, Brazil.

Bacille Calmette-Guerin (BCG) efficacy against pulmonary disease is highly variable; until very recently there was no evidence of protection after 10 years. In the control arm of a trial of efficacy of revaccination of schoolchildren in Brazil we found substantial protection (39%; 95%CI 9-58) of neonatal BCG against all forms of tuberculosis (TB) 15-20 years after vaccination, much longer than previously believed. This confirms recent findings from an earlier trial, and must be considered in the design of trials of new TB vaccines and in policy decisions based on assumed lack of neonatal BCG protection with time.  



Bavdekar SB, Pawar M. Evaluation of an Internet delivered pediatric diagnosis support system (ISABEL) in a tertiary care center in India. Indian Pediatr. 2005 Nov;42(11):1086-91.

Department of Pediatrics, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400 012, India.

BACKGROUND: Young graduates manning the emergency rooms in public hospitals often need guidance in diagnosing critically ill patients due to their limited clinical experience. Textbooks, manuals and several websites are of limited assistance, as they do not generate patient-specific advice. ISABEL diagnostic tool, an Internet-delivered pediatric diagnosis support system that provides such information has not been evaluated in developing countries. AIM: To study the sensitivity of the ISABEL diagnostic tool. MATERIAL AND METHOD: Records of patients admitted in the pediatric intensive care unit in a metropolitan hospital in India during January 2000-July 2002 were retrieved. Resident medical officers wrote key clinical and laboratory findings on the basis of admission notes and results of investigations carried out within 30 min of admission. The list of diagnoses generated by the diagnostic tool at the ISABEL site after submission of these terms was entered in a performa. The presence of final diagnosis in the list generated by the ISABEL was the outcome measure studied. RESULTS: Records of 200 subjects (boys 111, girls 89, aged 28 days-12 years) were analyzed. Congenital heart disease, respiratory tract infections, meningitis, tetanus and septicemia were the most frequently encountered diagnoses. The diagnostic tool missed 27 diagnoses (such as septicemia, tuberculosis and seizures) in 39 subjects providing a sensitivity of 80.5%. CONCLUSION: Even without any training offered to the users, ISABEL provided a reasonable sensitivity of 80.5%. The tool holds promise of being useful in the developing countries.


Bonnet M, Sizaire V, Kebede Y, Janin A, Doshetov D, Mirzoian B, Arzumanian A, Muminov T, Iona E, Rigouts L, Rusch-Gerdes S, Varaine F. Does one size fit all? Drug resistance and standard treatments: results of six tuberculosis programmes in former Soviet countries. Int J Tuberc Lung Dis. 2005 Oct;9(10):1147-54.

Medecins Sans Frontieres, Paris, France.

SETTING: After the collapse of the Soviet Union, countries in the region faced a dramatic increase in tuberculosis cases and the emergence of drug resistance. OBJECTIVE: To discuss the relevance of the DOTS strategy in settings with a high prevalence of drug resistance. DESIGN: Retrospective analysis of one-year treatment outcomes of short-course chemotherapy (SCC) and results of drug susceptibility testing (DST) surveys of six programmes located in the former Soviet Union: Kemerovo prison, Russia; Abkhasia, Georgia; Nagorno-Karabagh, Azerbaijan; Karakalpakstan, Uzbekistan; Dashoguz Velayat, Turkmenistan; and South Kazakhstan Oblast, Kazakhstan. Results are reported for new and previously treated smear-positive patients. RESULTS: Treatment outcomes of 3090 patients and DST results of 1383 patients were collected. Treatment success rates ranged between 87% and 61%, in Nagorno-Karabagh and Kemerovo, respectively, and failure rates between 7% and 23%. Any drug resistance ranged between 66% and 31% in the same programmes. MDR rates ranged between 28% in Karakalpakstan and Kemerovo prison and 4% in Nagorno-Karabagh. CONCLUSION: These results show the limits of SCC in settings with a high prevalence of drug resistance. They demonstrate that adapting treatment according to resistance patterns, access to reliable culture, DST and good quality second-line drugs are necessary.


Griffith R, Tengnah C. Public health 2: Criminal liability for spreading disease. Br J Community Nurs. 2005 Oct;10(10):475-8. Review.

School of Health Science, Swansea University.

Last month's article considered the role of the law in preventing the spread of infectious disease in cases such as tuberculosis and SARS where isolation, quarantine and treatment are effective in controlling the outbreak. Other forms of infectious disease that district nurses encounter--such as hepatitis B and C and the HIV virus that are spread through contact with blood or sexual intercourse--rely far more on the infected individual to act responsibly in preventing others from being infected. This month's article considers whether those who act recklessly and put others at risk of infection should be held criminally liable and prosecuted for their actions.


Nicolls DJ, King M, Holland D, Bala J, del Rio C. Intracranial tuberculomas developing while on therapy for pulmonary tuberculosis. Lancet Infect Dis. 2005 Dec;5(12):795-801.

Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.

We describe the case of a south Asian man who developed symptomatic intracranial tuberculomas while on therapy for pulmonary tuberculosis. The development or progression of intracranial tuberculomas during the course of appropriate antituberculous therapy has been recognised previously. We review the epidemiology, pathophysiology, diagnosis, and treatment of this paradoxical phenomenon. Although the aetiology of this reaction is unknown, it may be related to an enhanced immune response during the course of therapy. Routine brain imaging for all patients diagnosed with tuberculosis is not recommended; however, in patients presenting with new neurological findings, neuroimaging is clearly warranted. Stereotactic brain biopsy should be done whenever the diagnosis of an intracranial tuberculoma is in doubt. When intracranial tuberculomas become symptomatic, antituberculous therapy generally does not need to be changed. Corticosteroids are indicated in all symptomatic cases.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

14123.   Banerjee S, Banerjee M. Diabetes and tuberculosis interface. J Indian medAss 2005; 103(6): 318-22,332-5.

14124.   Da Silva BB, Dos Santos LG, Costa PV, Pires CG, Borges AS. Primary tuberculosis of the breast mimicking carcinoma. Am J Trop Med Hyg. 2005 Nov;73(5):975-6.

14125.   Dhingra VK, Rajpal S, Bhalla P, Yadav A, Jain S k, Hanifm. Prevalence of initialdrug resistance to M. tuberculosis in new sputum positive RNTCPpatients. J Commun Dis 2003; 35(2):82-9.

14126.   Devi SB, Naorem S, Singh TJ, Singh Ksh B, Prasad L, Devi Th S. HIV and TB co-infection (a study from RIMS Hospital, Manipur). Journal, Indian Academy of Clinical Medicine. 2005 Jul-Sep; 6(3): 220-223 .

14127.   Dewey M, Eddicks S, Hamm B. Images in cardiology: Armoured heart. Heart. 2005 Oct;91(10):1256.

14128.   Dheda K, Booth H, Huggett JF, Johnson MA, Zumla A, Rook GA. Lung remodeling in pulmonary tuberculosis. J Infect Dis. 2005 Oct 1;192(7):1201-9.  Review.

14129.   Heininger U.  Diagnosing tuberculosis. Arch Dis Child. 2005 Nov;90(11):1104. Review.

14130.     Jai Bikhchandani, Malik VK, Kumar V, Sharma S. Hepatic tuberculosis mimicking carcinoma gall bladder . Indian Journal of Gastroenterology. 2005 Jan-Feb; 24(1): 25 .

14131.   Kakarala G, Rajan D. Rare presentation of osteoarticular tuberculosis. Acta Orthop Belg. 2005 Oct;71(5):626-7.

14132.   Lambie D, Campbell P, Strutton GM. Forgotten but not gone: urinary tract tuberculosis. Pathology. 2005 Oct;37(5):392-3. 

14133.   Marais BJ, Gie RP, Obihara CC, Hesseling AC, Schaaf HS, Beyers N.   Well defined symptoms are of value in the diagnosis of childhood pulmonary tuberculosis. Arch Dis Child. 2005 Nov;90(11):1162-5. 

14134.   Meyer D. Eye signs that alert the clinician to a diagnosis of AIDS. SADJ. 2005 Oct;60(9):386-7.

14135.   Pai M. Alternatives to the tuberculin skin test: interferon-gama assays in the diagnosis of mycobacterium tuberculosis infection. Indian Journal of Medical Microbiology. 2005 Jul; 23(3): 151-158.

14136.   Prasanthi K, Kumari AR . Efficacy of fluorochrome stain in the diagnosis of pulmonary tuberculosis co-infected with HIV . Indian Journal of Medical Microbiology. 2005 Jul; 23(3): 179-181.

14137.   Rodrigues J, Pinto R G W, Rodrigues S, Barreto G. A case ofbilateral tuberculous mastitis. J Cytol 2004; 21(3): 149-51.

14138.   Scherubl H, Zeitz M. Tuberculous colitis. Gut. 2005 Dec;54(12):1820. 

14139.   Swingler GH, du Toit G, Andronikou S, van der Merwe L, Zar HJ. Diagnostic accuracy of chest radiography in detecting mediastinal lymphadenopathy in suspected pulmonary tuberculosis. Arch Dis Child. 2005 Nov;90(11):1153-6.

14140.   Tripathi D G, Sriram N, Naik VK, Smita P, Seema A, Shakila G, Desai MW. Efficacy of immunochromatographic techniquesfor the serodiagnosis of tuberculosis. Indian J med Microbiol 2004; 22(2): 131-2.

14141.  Xia H. More innovative strategies needed to achieve the goal of tuberculosis elimination. Am J Public Health. 2005 Oct;95(10):1674-5.  


14142.   Agarwal R, Gupta D. TB or TB plus vasculitis: Occam versus Hickam. J Intern Med. 2005 Dec;258(6):581; author reply 582-3. 

14143.   Chiang CY, Riley LW. Exogenous reinfection in tuberculosis. Lancet Infect Dis. 2005 Oct;5(10):629-36. Review.

14144.   Da Silva Telles MA, Chimara E, Ferrazoli L, Riley LW. Mycobacterium kansasii: antibiotic susceptibility and PCR-restriction analysis of clinical isolates. J Med Microbiol. 2005 Oct;54(Pt 10):975-9.

14145.   Mehta JB. New face of the old foe: central nervous system tuberculosis. South Med J. 2005 Oct;98(10):965-6. 

14146.   Vaerewijck MJ, Huys G, Palomino JC, Swings J, Portaels F. Mycobacteria in drinking water distribution systems: ecology and significance for human health. FEMS Microbiol Rev. 2005 Nov;29(5):911-34.  Review.

14147.  Van  den Berge M, de Marie S, Kuipers T, Jansz AR, Bravenboer B. Psoas abscess: report of a series and review of the literature. Neth J Med. 2005 Nov;63(10):413-6. 



14148.     Kumar R, Dwivedi A, Kumar P, Kohli N. Tuberculous meningitis in BCG vaccinated and unvaccinated children. J Neurol Neurosurg Psychiatry. 2005 Nov;76(11):1550-4.

14149.   Lang T, Hill AV, McShane H, Shah R, Towse A, Pritchard C, Garau M.  New TB vaccine granted orphan drug status. BMJ. 2005 Dec 17;331(7530):1476. 

14150.   Lienhardt C, Zumla A. BCG: the story continues. Lancet. 2005 Oct 22-28;366(9495):1414-6. 



14151.    Baltussen R, Floyd K, Dye C. Cost effectiveness analysis of strategies for tuberculosis control in developing countries. BMJ. 2005 Dec 10;331(7529):1364. 

14152.   Celik US, Alabaz D, Yildizdas D, Alhan E, Kocabas E, Ulutan S. Cerebral salt wasting in tuberculous meningitis: treatment with fludrocortisone. Ann Trop Paediatr. 2005 Dec;25(4):297-302.

14153.   Chi BH, Fusco H, Sinkala M, Goldenberg RL, Stringer JS.  Cost and enrollment implications of targeting different source population for an HIV treatment program. J Acquir Immune Defic Syndr. 2005 Nov 1;40(3):350-5.

14154.   Falkensammer J, Behensky H, Gruber H, Prodinger WM, Fraedrich G. Successful treatment of a tuberculous vertebral osteomyelitis eroding the thoracoabdominal aorta: a case report. J Vasc Surg. 2005 Nov;42(5):1010-3.

14155.   Gibbs N. Saving 1 life at a time. Time. 2005 Nov 7;166(19):53-67. 

14156.   Golden MP, Vikram HR. Extrapulmonary tuberculosis: an overview. Am Fam Physician. 2005 Nov 1;72(9):1761-8. Review.

14157.   Kordy FN, Al-Jumaah S, Al-Ghonaim A. Severe CD8 deficiency in a child with miliary tuberculosis. J Trop Pediatr. 2005 Oct;51(5):316-8. 

14158.   Lambert ML, Van der Stuyft P. Delays to tuberculosis treatment: shall we continue to blame the victim? Trop Med Int Health. 2005 Oct;10(10):945-6. 

14159.   Lee GS, Kim SJ, Park IY, Shin JC, Kim SP.  Tuberculous peritonitis in pregnancy. J Obstet Gynaecol Res. 2005 Oct;31(5):436-8; discussion 438.

14160.   Markel H. The medical detectives. N Engl J Med. 2005 Dec 8;353(23):2426-8. 

14161.  Onyebujoh P, Zumla A, Ribeiro I, Rustomjee R, Mwaba P, Gomes M, Grange JM.   Treatment of tuberculosis: present status and future prospects. Bull World Health Organ. 2005 Nov;83(11):857-65.  Review.

14162.   Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore). 2005 Nov;84(6):350-62.

14163.   Sheff B, Hayes DD. Connecting the DOTS to treat pulmonary TB. Nursing. 2005 Oct;35(10):24-5.