RESUMEN
BACKGROUND: Drug-Resistant Tuberculosis (DR-TB) patients for whom a WHO recommended regimen along with Bedaquiline (BDQ) cannot be prescribed, Delamanid (DLM) was added along with other drugs to provide a "Salvage Regimen". The experience of the Institute in respect of early efficacy and safety of both drugs given together is presented. OBJECTIVE: To ascertain the early efficacy, safety and tolerability of Bedaquline and Delamanid given together as a part of salvage regimen. METHODS: BDQ and DLM were used together to make regimens along with other drugs where four effective anti TB drugs could not be prescribed as per WHO recommendations. Patients were followed up for sputum smear and culture conversion and adverse events during the treatment. RESULTS: In this cohort study, 53 DR-TB patients (Median age-24) were initiated on regimens containing both BDQ and DLM. Sputum smear conversion was seen in 35% and 94% patients at the end of 1st week and 3rd month respectively. 84% patients had culture conversion at the end of 4th month. 29 adverse events (AE) were reported among 17 patients and there were 11 deaths. QTc prolongation more than 500 MS was seen in only 1 patient. CONCLUSION: BDQ and DLM given together in a salvage regimen is efficacious with low rate of adverse events. The combination provides hope to DR-TB patients with limited treatment options and should be provided as a life saving option.
Asunto(s)
Diarilquinolinas/uso terapéutico , Nitroimidazoles/uso terapéutico , Oxazoles/uso terapéutico , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Adulto , Cardiotoxicidad/etiología , Cardiotoxicidad/fisiopatología , Clofazimina/uso terapéutico , Diarilquinolinas/efectos adversos , Quimioterapia Combinada/efectos adversos , Electrocardiografía , Femenino , Humanos , Imipenem/uso terapéutico , Masculino , Moxifloxacino/uso terapéutico , Nitroimidazoles/efectos adversos , Oxazoles/efectos adversos , Terapia Recuperativa/métodos , Esputo/microbiología , Tasa de Supervivencia , Adulto JovenRESUMEN
INTRODUCTION: Tinnitus is a disturbing symptom and is often the main reason for otology referral. It is usually associated with hearing loss of varying aetiology, and is thought to begin in the cochlea, with later abnormal central activity. We hypothesise that tinnitus without hearing loss may be caused by central and subcortical abnormalities and altered outer hair cell function. AIM: To compare the auditory brainstem responses, middle latency responses and otoacoustic emissions in normal-hearing individuals with and without tinnitus. METHODOLOGY: The audiological test results of 25 normal hearing subjects with tinnitus (age 18-45 years) were determined, and compared with those of a control group. RESULTS: A statistically significant difference was found between study group tinnitus ears vs control group ears, as regards wave I latency prolongation, shortening of wave V and absolute I-III and I-V interpeak latency, enlargement of wave Na and Pa amplitude, and distortion product and transient evoked otoacoustic emission signal-to-noise ratios. There was no statistically significant difference between unilateral vs bilateral tinnitus ears. CONCLUSION: The pathogenesis and optimum management of tinnitus are still unclear. It often occurs with primary ear disease, usually associated with hearing loss, but may occur in patients with normal hearing. Observed changes in auditory brainstem and middle latency responses indicate central auditory alterations. Tinnitus involves both peripheral and central activity, and complete audiological and neurophysiological investigation is required. Management should be based on both audiological and neurophysiological findings.
Asunto(s)
Cóclea/fisiopatología , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Emisiones Otoacústicas Espontáneas/fisiología , Acúfeno/fisiopatología , Adolescente , Adulto , Audiometría de Tonos Puros , Vías Auditivas/fisiopatología , Umbral Auditivo , Estudios de Casos y Controles , Células Ciliadas Auditivas Externas , Audición/fisiología , Humanos , Persona de Mediana Edad , Adulto JovenRESUMEN
A novel immunology-based point-of-care test has been designed to assess the activated form of matrix metalloproteinase-8 (aMMP-8) for diagnosis and monitoring of periodontal diseases. The test has been automated using an analyzer, which quantitatively measures aMMP-8 in 18 min in gingival crevicular fluid (GCF). Fluid samples were collected from healthy, gingivitis-, and periodontitis-affected teeth. The test results from the analyzer were compared with quantitative aMMP-8 immunofluorometric assay (IFMA) and in-house enzyme-linked immunosorbent assay (ELISA) as well as with the periodontal state. Preliminary results of analyzer measurements of these 34 clinical samples showed a good agreement with the results from IFMA and in-house ELISA and with the clinical picture.
Asunto(s)
Líquido del Surco Gingival/enzimología , Metaloproteinasa 8 de la Matriz/análisis , Sistemas de Atención de Punto , Humanos , Inmunoensayo , Metaloproteinasa 8 de la Matriz/inmunología , Enfermedades Periodontales/diagnóstico , Enfermedades Periodontales/enzimologíaRESUMEN
In a first pilot field study 64 gingival crevicular fluid (GCF) samples were collected from patients of dental practitioners. The dentists (one orthodontist one periodontist, and one general practitioner) were asked to monitor the respective clinical status of the sites of sampling and to collect, if possible, sulcus fluid samples from healthy as well as affected sites from the same patient. The concentration of activated matrix metalloproteinase-8 (aMMP-8) in the GCF was recorded using a set of monoclonal antibodies and a novel DentoAnalyzer. From all three dental offices the distribution of the aMMP-8 values in GCF showed a congruent pattern, where healthy and periodontitis-affected inflamed sites were clearly disparate.
Asunto(s)
Líquido del Surco Gingival/enzimología , Metaloproteinasa 8 de la Matriz/análisis , Sistemas de Atención de Punto , Humanos , Inmunoensayo/métodos , Metaloproteinasa 8 de la Matriz/inmunología , Periodontitis/diagnóstico , Periodontitis/enzimología , Proyectos Piloto , Factores de TiempoRESUMEN
The diagnosis of subclinical paratuberculosis is still considered a major problem worldwide. As part of investigating diagnostic strategies for the paratuberculosis infection, sequential results of various diagnostic methods in a progressive experimental infection in goats were evaluated. Twenty-three goat kids were divided into three groups: the infected, contact and control, comprising 10, five and eight goats respectively. Animals of the infected group were orally inoculated on seven occasions with 5 ml of inoculum containing 2 x 10(9)Mycobacterium avium ssp. paratuberculosis per ml. Lymphoycte proliferation test using johnin PPD detected paratuberculosis infection from 60 days post-infection (DPI) onwards. The johnin PPD was found to be a better antigen for the proliferative assays as compared with the sonicated antigen. The faecal smear examination with acid-fast staining detected more goats as positive than bacterial culture and polymerase chain reaction (PCR). Lipoarabinomannan enzyme-linked immunosorbent assay (ELISA) started detecting infected goats from 150 DPI onwards followed by indirect ELISA and agar gel immunodiffusion from 180 DPI onwards. Histological examination was confirmatory and detected five infected goats as positive.
Asunto(s)
Enfermedades de las Cabras/diagnóstico , Enfermedades de las Cabras/transmisión , Paratuberculosis , Zoonosis , Animales , Animales Recién Nacidos , Proliferación Celular , Recuento de Colonia Microbiana/veterinaria , Diagnóstico Diferencial , Ensayo de Inmunoadsorción Enzimática/métodos , Ensayo de Inmunoadsorción Enzimática/veterinaria , Heces/microbiología , Cabras , Humanos , Inmunodifusión/métodos , Inmunodifusión/veterinaria , Recuento de Linfocitos/veterinaria , Linfocitos , Mycobacterium avium subsp. paratuberculosis/inmunología , Mycobacterium avium subsp. paratuberculosis/aislamiento & purificación , Paratuberculosis/diagnóstico , Paratuberculosis/transmisión , Distribución Aleatoria , Factores de TiempoRESUMEN
A dose of 10(10) Mycobacterium avium subspecies paratuberculosis was administered orally on seven occasions to produce experimental paratuberculosis infection in 10 5-8-week-old goat kids. Bacteriological, immunological, and histopathological changes, their relationships, and the efficacy of the commonly used diagnostic methods were studied during the progressive disease up to 270 days postinfection (DPI). Significant lymphocyte proliferative responses in the peripheral blood of five goats were detected as early as 60 DPI. A lymphoproliferative test was also performed on lymphocytes purified from different compartments of the guts of five infected and five control goats. Significant proliferative responses were observed in lymphocytes of jejunal compartments of all five goats, of which four had also significant lymphocyte proliferation in the blood. The ileal lymphocytes from two goats, one each at 120 and 270 DPI, had significant proliferation. The histological lesions were mainly observed in the gut-associated lymphoid tissues of the ileocecal valve, the ileum, and the terminal jejunum. Acid-fast bacilli were demonstrated in the lesions of two goats at 60 and 210 DPI. Bacterial culture showed poor sensitivity, detecting positive results for only one goat in the fecal and tissue samples at 210 DPI, whereas polymerase chain reaction (PCR) detected one goat in fecal sample at 210 DPI and two goats in tissue samples at 60 and 210 DPIs, respectively. Enzyme-linked immunosorbent assay and agar gel immunodiffusion test were found to be 100% sensitive from 180 and 210 DPI onwards, respectively.
Asunto(s)
Formación de Anticuerpos/inmunología , Enfermedades de las Cabras/inmunología , Enfermedades de las Cabras/microbiología , Mycobacterium avium subsp. paratuberculosis/inmunología , Paratuberculosis/inmunología , Animales , Proliferación Celular , Cartilla de ADN , Ensayo de Inmunoadsorción Enzimática/veterinaria , Heces/microbiología , Enfermedades de las Cabras/patología , Cabras , Inmunodifusión/veterinaria , Yeyuno/inmunología , Recuento de Linfocitos , Linfocitos/citología , Mycobacterium avium subsp. paratuberculosis/genética , Paratuberculosis/patología , Reacción en Cadena de la Polimerasa/veterinariaRESUMEN
A milk and serum ELISA containing lipoarabinomanan (LAM) antigen was evaluated in sheep and goats versus agar gel immunodiffusion (AGID) test and polymerase chain reaction (PCR) using milk and lymph nodes. Milk and serum samples were obtained from six, two, and four flocks with unknown, negative and positive status of infection, respectively. By comparison of serum ELISA activity and PCR results, the positive and negative predictive values were calculated. Receiver operation characteristic (ROC) analysis was used for calculating the specificity and sensitivity at different cut-offs.
Asunto(s)
Ensayo de Inmunoadsorción Enzimática/veterinaria , Enfermedades de las Cabras/microbiología , Lipopolisacáridos/inmunología , Mycobacterium avium subsp. paratuberculosis/aislamiento & purificación , Paratuberculosis/diagnóstico , Enfermedades de las Ovejas/microbiología , Animales , Anticuerpos Antibacterianos/sangre , Anticuerpos Antibacterianos/inmunología , ADN Bacteriano/química , ADN Bacteriano/genética , Ensayo de Inmunoadsorción Enzimática/métodos , Femenino , Enfermedades de las Cabras/diagnóstico , Enfermedades de las Cabras/inmunología , Cabras , Inmunodifusión/veterinaria , Leche/microbiología , Mycobacterium avium subsp. paratuberculosis/inmunología , Paratuberculosis/inmunología , Paratuberculosis/microbiología , Reacción en Cadena de la Polimerasa/veterinaria , Valor Predictivo de las Pruebas , Prevalencia , Sensibilidad y Especificidad , Ovinos , Enfermedades de las Ovejas/diagnóstico , Enfermedades de las Ovejas/inmunologíaRESUMEN
Serum adenosine deaminase (ADA) levels were estimated in a group of 40 patients with head and neck cancer. The mean value was significantly higher in patients compared to controls. The increase was higher in cases of ulcerative growths than of proliferative growths, and activity was increased with advancement in the stage of the cancer. After radiotherapy, a gradual and significant decrease in serum ADA activity was observed.