scholarly journals Vitamin D2 as Adjunctive Therapy of Tuberculosis (OR15-04-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Tibebeselassie Keflie ◽  
Hans K Biesalski
Keyword(s):  
Vitamin D ◽  
Adjunctive Therapy ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Intervention Group ◽  
Oyster Mushroom ◽  
Sputum Smear ◽  
Vitamin D2 ◽  
Karnofsky Performance Status Scale ◽  
Tb Treatment

Abstract Objectives Despite the availability of effective antimicrobials, tuberculosis (TB) remains as a public health threat globally. There is a need for simple and inexpensive strategies to improve the treatment outcomes.The objective of our study was to deal with the potential use of vitamin D2 derived from sun-exposed oyster mushroom as adjunctive therapy to standard anti-TB treatment Methods Randomized controlled trial was conducted on 64 pulmonary TB patients (32 assigned to intervention and 32 assigned to control) in North Shewa, Ethiopia. Intervention group was provided with a sandwich prepared from sun-exposed oyster mushroom containing 146 µg (5840 IU) vitamin D2 continuously from Monday to Friday during the first 16 weeks of anti-TB treatment. Blood and sputum specimens were taken at the beginning and end of the study. The primary outcomes were changes in vitamin D status, clinical improvements (assessed by TB score and Karnofsky performance status scale) and immunologic responses. Sputum smear and culture conversion were evaluated as secondary outcomes. P < 0.05 was considered as statistically significant. Results Vitamin D2 intervention brought significant difference of 8.1 ± 6.2 ng/mL (95% CI: 5.9 to 10.3 ng/mL) in the serum 25(OH)D level and corrected vitamin D deficiency in more than 35% of TB patients. After intervention, 96.9% vs 21.5% of TB patients found in TB score SC-I and had mean ± SD of Karnofsky performance status scale of 80.3 ± 6.9% vs 64.7 ± 5.7% in the intervention group vs control group, respectively. IFN-g and cathelicidin LL-37 levels were showed significant improvement solely in the intervention group. the changes in the IL-4 and IL-10 levels were insignificant and sputum smear culture conversion was not achieved in both groups. Conclusions Vitamin D2 derived from sun-exposed oyster mushroom was effective in improving vitamin D status, clinical outcomes and immune responses. And hence, it could serve as potential, safe, easily available and cost-effective adjunctive therapy for TB. Funding Sources None.

scholarly journals Consumption of Sun-Exposed Oyster Mushrooms Help Patients Fight Tuberculosis

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Tibebeselassie Seyoum Keflie ◽  
Aregash Samuel ◽  
Ashagrie Zewdu Woldegiorgis ◽  
Christine Lambert ◽  
Donatus Nohr ◽  
...  
Keyword(s):  
Vitamin D ◽  
Treatment Outcomes ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Sun Exposure ◽  
Adjunctive Treatment ◽  
Enzyme Linked Immunosorbent Assay ◽  
P Value ◽  
Karnofsky Performance Status Scale ◽  
Oyster Mushrooms

Introduction: Tuberculosis (TB) is an airborne infectious disease that usually affects the lungs leading to severe coughing, fever, and chest pains. Objective: This study aimed to assess the effects of consuming sun-exposed mushrooms on the treatment outcomes of TB Methods: Participants were TB patients and categorized into block-1 (32) and block-2 (32) based on their willingness to consume sandwich bread containing sun-exposed oyster mushrooms. Blood and sputum samples were taken at the beginning (Day 0) and end of the study (4th month). Assays of 25-hydroxy (OH) D, cytokines, LL-37, and CRP were performed using Enzyme Linked- Immunosorbent Assay (ELISA) technique, and mycobacterial cultures were performed using Lowenstein Jensen media. A p-value less than 0.05 was considered significant. Results: Consumption of the sandwich bread induced a 27.8% increase in the mean serum 25(OH)D level with 35.5% and 32.3% reduction in the proportion of vitamin D deficiency (VDD) and insufficiency (VDI), respectively. There were progressive changes in TB score (mean } SD of 2.6 } 1.8; 95% CI of 1.95 to 3.17; p<0.001) and Karnofsky performance status scale (80.3 } 6.9%, p < 0.001) with significant improvements in IFN-γ and LL-37 levels (p<0.05). Conclusion: Consumption of sun-exposed oyster mushrooms effectively improved the deficiencies of vitamin D in TB patients. The accelerated improvements on the clinical and immunological outcomes give us a clue that sun-exposed oyster mushrooms could serve as a potential, safe, easily available, and affordable adjunctive treatment and help patients fight TB. Keywords: Sun-exposure; Mushrooms; Vitamin D; Tuberculosis; Treatment outcomes

scholarly journals Functional Outcome Following Synthetic Vertebral Body Implantation in the Management of Spinal Disorders

2020 ◽  
Vol 8 (B) ◽  
pp. 76-80
Author(s):  
Moneer K. Faraj ◽  
Bassam Mahmood Flamerz  Arkawazi ◽  
Hazim Moojid Abbas ◽  
Zaid Al-Attar
Keyword(s):  
Functional Outcome ◽  
Vertebral Body ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Spinal Tuberculosis ◽  
Vertebral Body Replacement ◽  
Spinal Tumors ◽  
Karnofsky Performance Status Scale ◽  
Significant Change

OBJECTIVE: Synthetic vertebral body replacement has been widely used recently to treat different spinal conditions affecting the anterior column. They arrange from trauma, infections, and even tumor conditions. In this study, we assess the functional outcome of this modality in different spinal conditions. PATIENTS AND METHODS: Thirty-six cases operated from October 2010 to December 2017. Twelve patients had spinal type A3 fractures, 11 cases with spinal tuberculosis (TB), and 13 cases with spinal tumors. They were followed clinically for a mean period of 2.4 years. RESULTS: All the cases were approached anteriorly. Seven cases had a post-operative infection. No neurological worsening reported. We had dramatic neurological improvement in all spinal TB cases. Mortality recorded in only 4 cases with metastatic spinal tumor during the mean period of follow-up. Karnofsky performance status scale showed statistically significant change for spinal TB, and tumor cases during the follow-up period, but there was no significant change in cases of spinal type A3 fractures. CONCLUSION: The positive outcome of this surgery makes it recommended for properly selected patients, especially with spinal TB and tumors.

scholarly journals Dialysis Membranes Influence Perfluorochemical Concentrations and Liver Function in Patients on Hemodialysis

2018 ◽  
Vol 15 (11) ◽  
pp. 2574 ◽  
Author(s):  
Wen-Sheng Liu ◽  
Hsiang Chan ◽  
Yen-Ting Lai ◽  
Chih-Ching Lin ◽  
Szu-Yuan Li ◽  
...  
Keyword(s):  
Karnofsky Performance Status ◽  
Demographic Data ◽  
Performance Status ◽  
Cellulose Triacetate ◽  
The Body ◽  
Karnofsky Performance Status Scale ◽  
Body Function ◽  
Glucose Levels ◽  
Dialysis Membranes ◽  
Hydrophilic Membranes

Introduction: Perfluoro-octanesulfonate (PFOS) and perfluoro-octanoic acid (PFOA) are two toxic perfluorochemicals (PFCs) commonly used as surfactants. PFCs are difficult to be eliminated from the body. We investigated the influence of different dialysis membranes on the concentrations of PFCs in patients under hemodialysis. Method: We enrolled 98 patients. Of these, 58 patients used hydrophobic polysulfone (PS) dialysis membranes, and the other 40 had hydrophilic membranes made by poly-methyl methacrylate (PMMA) or cellulose triacetate (CTA). Liquid chromatography tandem mass spectrometry coupled was used with isotope dilution to quantify PFOA and PFOS. Results: The predialysis concentrations of PFOA and PFOS in patients with hydrophobic PS dialysis membranes were 0.50 and 15.77 ng/mL, respectively, lower than the concentrations of 0.81 and 22.70 ng/mL, respectively, in those who used hydrophilic membranes (such as CTA or PMMA). Older patients have higher PFOS and poorer body function, with lower Karnofsky Performance Status Scale (KPSS) scores. The demographic data of the two groups were similar. However, patients with hydrophobic PS dialysis membranes had lower predialysis aspartate transaminase (AST) (p = 0.036), lower glucose levels (p = 0.017), and better body function (nonsignificantly higher KPSS scores, p = 0.091) compared with patients who used other membranes. These differences may be associated with the effects of different membranes, because PFOA positively correlated with AST, while PFOS negatively correlated with body function. Conclusions: This is the first study comparing PFC levels in uremic patients with different dialysis membrane. PS membrane may provide better clearance of PFCs and may, therefore, be beneficial for patients.

Factors Associated with Functional Performance among Patients on Hemodialysis in Taiwan

2018 ◽  
Vol 46 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Yu-Cheng Lai ◽  
Chun-Yeh Wang ◽  
Sin-Hua Moi ◽  
Chien-Hsing Wu ◽  
Cheng-Hong Yang ◽  
...  
Keyword(s):  
Cox Regression ◽  
Functional Performance ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Karnofsky Performance Status Scale ◽  
Cox Regression Analysis ◽  
Clinical Variables ◽  
Factors Associated ◽  
All Cause Mortality ◽  
Mortality Hazard Ratio

Background/Aims: We investigated factors associated with functional performance in hemodialysis (HD) patients as well as their relationships with mortality. Methods: We enrolled 790 HD patients who were followed up from 2009 to 2013. Functional performance was evaluated by Karnofsky Performance Status Scale (KPSS) scores. We examined the associations of clinical variables and all-cause mortality with KPSS scores. Results: Of the participants, 460 had high KPSS scores (range 90–100) and 330 had low KPSS scores (below 80). On multivariate analysis, age and weekly HD sessions were associated with significantly increased odds of a lower KPSS score (age: OR 1.05, 95% CI 1.04–1.07, p < 0.001; weekly HD: OR 2.10, 95% CI 1.37–3.21, p = 0.001). A low KPSS score was a significant predictor of increased all-cause mortality (hazard ratio 1.49; 95% CI 1.02–2.16, p = 0.037), as determined using Cox regression analysis. Conclusion: Functional performance was associated with clinical variables and all-cause mortality in HD patients.

scholarly journals The Phenomenology of Delirium: Presence, Severity, and Relationship between Symptoms

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Soenke Boettger ◽  
Susanne Boettger ◽  
William Breitbart
Keyword(s):  
Karnofsky Performance Status ◽  
Performance Status ◽  
Assessment Scale ◽  
Advanced Age ◽  
Cognitive Domain ◽  
Cancer Center ◽  
Karnofsky Performance Status Scale ◽  
Delirium Assessment ◽  
Disturbance Of Consciousness ◽  
Prevalence Of Dementia

Objective. To examine the phenomenological characteristics of delirium based on the Memorial Delirium Assessment Scale (MDAS) in order to explore the presence, severity of, and relationship between symptoms. Methods. An analysis of 100 cases of delirium recruited at Memorial Sloan Kettering Cancer Center (MSKCC) was performed. Sociodemographic and medical variables, the Memorial Delirium Assessment Scale (MDAS) subitems, and Karnofsky Performance Status scale (KPS) were analyzed of respect of the phenomenological characteristics and their interrelationship. Results. The most severe and frequent symptoms were recorded in the cognitive domain, psychomotor behavior, sleep-wake cycle, and disturbance of consciousness. Within the cognitive domain, concentration was the most severely affected task. The severity of impairment in most domains increased with delirium severity, whereas perceptual disturbances and delusions were independent of delirium severity. Advanced age and the prevalence of dementia increased with delirium severity in contrast to the functional status which declined. The presence of perceptual disturbances and delusions was independent of cognitive impairment and psychomotor abnormality, however, associated with the disturbances of consciousness and attention. Conclusion. Cognition, in particular concentration, was the most severely affected domain. Advanced age and the prevalence of dementia contributed to more severe delirium. Perceptual disturbances and delusions were independent of delirium severity; however, they were associated with disturbances of consciousness and attention.

Increased xCT Expression Correlates With Tumor Invasion and Outcome in Patients With Glioblastomas

Neurosurgery ◽  
2012 ◽  
Vol 72 (1) ◽  
pp. 33-41 ◽  
Author(s):  
Satoru Takeuchi ◽  
Kojiro Wada ◽  
Terushige Toyooka ◽  
Nariyoshi Shinomiya ◽  
Hideyuki Shimazaki ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Overall Survival ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Progression Free Survival ◽  
Resonance Imaging ◽  
Partial Removal ◽  
Isocitrate Dehydrogenase 1 ◽  
Karnofsky Performance Status Scale ◽  
Free Survival

Abstract BACKGROUND: xCT is a light chain of the cystine/glutamate antiporter system xc−. Glutamate that is released by system xc− plays an important role in the infiltration of glioblastoma (GBM) cells. Furthermore, increased glutathione synthesis by system xc− may protect tumor cells against oxidative stress induced by radiotherapy and chemotherapy. OBJECTIVE: To investigate whether the levels of xCT expression correlated with infiltrative imaging phenotypes on magnetic resonance imaging and outcomes in patients with GBMs. METHODS: Forty patients with histologically confirmed primary GBMs were included in the study. Patient charts were retrospectively reviewed for age, sex, Karnofsky Performance Status Scale score, Mini-Mental State Examination score, magnetic resonance imaging features, xCT expression, isocitrate dehydrogenase 1 R132H expression, O6-methylguanine-DNA methyltransferase promoter methylation status, type of surgery, progression-free survival, and overall survival. RESULTS: In invasive margins, xCT expression was weak in 20 patients and strong in 20 patients. A Cox regression model revealed that a Karnofsky Performance Status Scale score less than 60 (hazard ratio [HR]: 4.525; P = .01), partial removal (HR: 2.839; P = .03), and strong xCT expression (HR: 4.134; P &lt; .001) were significantly associated with shorter progression-free survival and that partial removal (HR: 2.865; P = .03), weak isocitrate dehydrogenase 1 R132H expression (HR: 15.729; P = .01), and strong xCT expression (HR: 2.863; P = .04) were significantly associated with shorter overall survival. CONCLUSION: These findings suggest that xCT is an independent predictive factor in GBMs.

scholarly journals The transbasal approach to the anterior skull base: surgical outcome of a single-centre case series

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
A. Kaywan Aftahy ◽  
Melanie Barz ◽  
Arthur Wagner ◽  
Julia S. Bermeitinger ◽  
Claire Delbridge ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Skull Base ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Case Series ◽  
Extent Of Resection ◽  
Anterior Skull Base ◽  
High Morbidity ◽  
Karnofsky Performance Status Scale ◽  
Male Patients

AbstractA variety of sinonasal tumours, meningiomas or other lesions of the anterior skull base involve the paranasal sinuses and the periorbital area. The transbasal approach (TBA) has turned out to be a feasible technique to reach those lesions. A retrospective review at a neurosurgical university department between November 2007 and January 2020 with adult patients who underwent resection of oncologic pathologies through TBA. Surgical technique, extent of resection (EOR), clinical outcome and postoperative complications were analysed. 18 TBAs between November 2007 and January 2020 were performed. Median age was 62 (range 25–83), 7 female and 11 male patients. Gross total resection rate was 85.8% throughout all entities. Four (22.2%) patients suffered from WHO°I meningiomas and 14 (77.7%) from other extra-axial lesions. Preoperative Karnofsky Performance Status Scale (KPSS) was 80% (range 40–90), postoperative KPSS 80% (range 20–100). Rate of postoperative complications requiring intervention was 16.7%. Median follow-up was 9.8 (range 1.2–71.8) months. Modifications and extensions of the classic TBA are not mandatory. Complete resection can be performed under functional and cosmetic-preserving aspects. Second-step procedures such as transnasal approaches may be performed to avoid high morbidity of more aggressive TBAs, if necessary. Surgical considerations should be kept simple and straightforward.

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