Uveitis associated with latent tuberculosis: A comparative study of the impact of antitubercular therapy combined or not with systemic corticosteroids

2020 ◽  
pp. 112067212096206
Author(s):  
Sacha Nahon-Esteve ◽  
Arnaud Martel ◽  
Celia Maschi ◽  
Mohamed Alketbi ◽  
Stephanie Baillif ◽  
...  
Keyword(s):  
Remission Rate ◽  
Latent Tuberculosis ◽  
Antitubercular Therapy ◽  
Corrected Visual Acuity ◽  
Systemic Corticosteroids ◽  
Significant Difference ◽  
Treatment Data ◽  
Active Inflammation ◽  
The Impact ◽  
Active Disease

Purpose: To study the outcome of latent tubercular uveitis (LTBU) treated with antitubercular therapy (ATT) combined or not with adjuvant systemic corticosteroids. Methods: Twenty patients (27 eyes) with LTBU were included in a monocentric retrospective study and evaluated for the absence of active disease after treatment. Data on the clinical outcomes (active inflammation), vision (best-corrected visual acuity, BCVA) and treatment were collected retrospectively. Results: Fourteen patients received ATT alone and six patients received ATT combined with systemic corticosteroids. The two groups were not comparable in terms of proportion of tubercular panuveitis cases and initial BCVA (59.3 ± 8.2 letters vs 44.2 ± 15.2 letters). There was no significant difference in remission rate and in BCVA between both groups 3 months after ATT discontinuation. Conclusion: Patients with LTBU treated with ATT alone had visual and inflammatory outcomes at least comparable to those of patients treated with ATT combined with systemic corticosteroids.

The Addition of Gemtuzumab Ozogamicin to Induction Chemotherapy for AML Improves Disease Free Survival without Extra Toxicity: Preliminary Analysis of 1115 Patients in the MRC AML15 Trial.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 13-13 ◽  
Author(s):  
Alan K. Burnett ◽  
William J. Kell ◽  
Anthony H. Goldstone ◽  
Donald Milligan ◽  
Ann Hunter ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Preliminary Analysis ◽  
De Novo ◽  
Remission Rate ◽  
Pilot Trial ◽  
Disease Free Survival ◽  
Gemtuzumab Ozogamicin ◽  
Significant Difference ◽  
The Impact

Abstract The MRC AML15 Trial is primarily for patients with any form of AML who are under 60 years. One of the questions addressed was whether the addition of the immunoconjugate, Gemtuzumab Ozogamicin (GO) to induction (course 1) and/or consolidation (course 3) is beneficial. In induction patients are randomised to receive either DA (Daunorubicin/Ara-C) or ADE (Ara-C/Daunorubicin/Etoposide) or FLAG-Ida (Fludarabine/Ara-C/Idarubicin/G-CSF) and in consolidation either MACE (Amsacrine/Etoposide) or HD Ara-C (3.0g/m2 or 1.5g/m2 per dose). Our prior pilot trial had shown that GO 3mgs/m2 could be safely added to day 1 of each of these treatments (Kell et al Blood102, 4277–4283). Here we report the preliminary results of the effect of combining GO with induction chemotherapy. This randomisation achieved its recruitment target and was closed on 30 June 2006. All other comparisons in the trial, including GO in consolidation, remain open. Patients: A total of 1115 patients were randomised between July 2002 and June 2006. The median age was 49 (range 0–71) years: 53% of patients were male: 92% (n=1027) had de novo disease: 95% had WHO performance score of <2: 43% received DA, 43% FLAG-Ida, and 14% ADE. (Recruitment to ADE+GO opened in June 2005). Patients with WBC > 30 x 109/l and LFT’s > normal were initially excluded but admitted from March 2004. APL patients were not eligible for entry. 15% of patients with data had favourable 71% intermediate, and 14% adverse cytogenetics. Over 83% were CD33 positive. Results: The overall remission rate was 85% with no differences between the arms for GO vs no GO in CR (85% vs 85%) induction death (8% vs 7%) or resistant disease (7% vs 8%). There was a modest increase in mucositis on the GO arm in course 1 only (p=0.04) and increased AST and Alt toxicity in C1 (p=.002; p=.03) but no difference in bilirubin grades. GO patients used more platelets (19 vs 14; p<0.0001), but not red cells, and had more days on IV antibiotics (20.6 vs 18.6 p=0.001). The haemopoietic recovery and days in hospital were similar. With a median follow-up of 15 months (range 0–45), there is no significant difference in deaths in CR (GO vs no GO): 36 vs 45 (HR 0.75; CI.49–1.16 p=0.2), but relapse was reduced: 37% vs 52% at 3 years (HR 0.70 (0.52–0.92) p=0.01) resulting in an improved DFS: 51% vs 40% at 3 years (HR 0.72 (0.56–0.91) p=0.008). There is so far no significant difference in OS (53% vs 46% at 3 years; HR 0.91(0.73–1.14) p=0.4). Conclusion: This preliminary analysis of 1115 randomised patients indicates that the addition of GO to induction chemotherapy can reduce the relapse risk without adding significant extra toxicity and this has significantly improved the DFS in the GO arm. Longer follow up is required to determine the impact on survival.

scholarly journals Short-course regimens of rifapentine plus isoniazid to treat latent tuberculosis infection in older Chinese patients: a randomised controlled study

2018 ◽  
Vol 52 (6) ◽  
pp. 1801470 ◽  
Author(s):  
Lei Gao ◽  
Haoran Zhang ◽  
Henan Xin ◽  
Jianmin Liu ◽  
Shouguo Pan ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
World Health ◽  
Controlled Study ◽  
Short Course ◽  
Significant Difference ◽  
Randomised Controlled ◽  
Active Disease

Latent tuberculosis infection (LTBI) management is now a critical component of the World Health Organization's End TB Strategy.In this randomised controlled trial (Chinese Clinical Trial Registry identifier ChiCTR-IOR-15007202), two short-course regimens with rifapentine plus isoniazid (a 3-month once-weekly regimen and a 2-month twice-weekly regimen) were initially designed to be evaluated for rural residents aged 50–69 years with LTBI in China.Due to the increasingly rapid growth and unexpected high frequency of adverse effects, the treatments were terminated early (after 8 weeks for the once-weekly regimen and after 6 weeks for the twice-weekly regimen). In the modified intention-to-treat analysis on the completed doses, the cumulative rate of active disease during 2 years of follow-up was 1.21% (14 out of 1155) in the untreated controls, 0.78% (10 out of 1284) in the group that received the 8-week once-weekly regimen and 0.46% (six out of 1299) in the group that received the 6-week twice-weekly regimen. The risk of active disease was decreased, with an adjusted hazard ratio of 0.63 (95% CI 0.27–1.43) and 0.41 (95% CI 0.15–1.09) for the treatments, respectively. No significant difference was found in the occurrence of hepatotoxicity (1.02% (13 out of 1279) versus 1.17% (15 out of 1279); p=0.704).The short regimens tested must be used with caution among the elderly because of the high rates of adverse effects. Further work is necessary to test the ultrashort regimens in younger people with LTBI.

Vitamin D deficiency predicts latent TB reactivation independent of preventive therapy: a longitudinal study

2020 ◽  
Vol 24 (9) ◽  
pp. 916-921
Author(s):  
B. Patterson ◽  
D. Smith ◽  
A. Telford ◽  
A. Tana ◽  
D. Johnstone ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Latent Tuberculosis ◽  
Preventive Therapy ◽  
Hydroxyvitamin D ◽  
Latently Infected ◽  
Latent Tb ◽  
Latent Tb Infection ◽  
The Impact ◽  
Active Disease

BACKGROUND: Vitamin D deficiency is associated with progression of latent tuberculosis (TB) infection to active disease. The impact of preventive therapy on this association is unknown.METHOD: Serum 25-hydroxyvitamin D (25(OH)D) levels were retrospectively linked to adults diagnosed with latent TB between April 2010 and January 2019 in a hospital in London, UK. Individuals in the cohort who progressed to active TB were identified by matching to a national notification register. A logistic regression model was used to examine baseline vitamin D deficiency and use of preventive therapy with subsequent incidence of TB disease.RESULTS: Of 1509 latently infected individuals with 3902 patient-years of follow-up, 687 (45.5%) were identified as vitamin D deficient and 691 (45.8%) individuals had a LTBI regimen prescribed. There were 29 (1.9%) instances of TB reactivation. On multivariate analysis, profound (<25 nmol/L) vitamin D deficiency (aHR 5.68, 95%CI 2.18–14.82; P = 0.0003) and the absence of preventive therapy (aHR 3.84, 95%CI 1.46–10.08; P = 0.006) were associated with progression to active TB disease. There was no evidence that preventive therapy modified the association between vitamin D status and TB reactivation.CONCLUSION: Our results show an independent association between vitamin D deficiency and progression from latent TB infection to active disease.

Treatment of Adolescents and Young Adults with Acute Lymphoblastic Leukemia (ALL): An Update of the GIMEMA Experience.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3097-3097 ◽  
Author(s):  
Luciana Annino ◽  
Marco Vignetti ◽  
Francesca Paola Paoloni ◽  
Anna Maria Testi ◽  
Giovanna Meloni ◽  
...  
Keyword(s):  
Overall Survival ◽  
Conflicts Of Interest ◽  
Remission Rate ◽  
Lymphoblastic Leukemia ◽  
Treatment Strategies ◽  
Disease Free Survival ◽  
Free Survival ◽  
Significant Difference ◽  
B Lineage ◽  
The Impact

Abstract Abstract 3097 Poster Board III-34 Backgound Adolescent and young (<30y) adults (AYAs) ALL represent a distinct population from both children and older adults. Recently it has been demonstrated that if AYA are treated according to pediatric schedules, Event Free Survival and Overall Survival (OS) can significantly improve (Ribera et al. 2008, Huguet et al. 2009). Nevertheless, which therapeutic strategy, a pediatric or an adult one, can, indeed, be the best approach in this cohort of pts it is still a matter of debate. (Usvasalo et al. 2008). We retrospectively reviewed the disease outcome of AYAs entered in a period over than 25 y in the 6 consecutive GIMEMA adult ALL trials in order to analyze the impact on Disease Free Survival(DFS) and OS of the different treatment strategies applied. Patients Between 1982-2008, 1218 pts - median age 20.2 ys (range 12.0-30.0y)- were enrolled in the 6 GIMEMA studies; 30.4% of pts were ≤18y old, initial median WBC was 15.0×109/L (range 0.3-848.0), 72.9% of pts and 27.1% of pts were classified as B-lineage and T-ALL respectively, and 84 pts (13.1%) were Ph and/or BCR/ABL+ve. Results Overall Remission Rate was 85.1% with no significant difference in terms of CR between the different protocols. From 1990, Ph and/or BCR/ABL+ve patients received a post-CR treatment including transplant and, since 2000, TKIs were also added. Comparing the studies, ALL0288 vs. ALL0183 and ALL0904, ALL2000 vs. ALL0183 and ALL0904, long-term DFS rate resulted significantly associated to protocol: (p=0.0078, p=0.0051, respectively) and (p=0.0044, p=0.0136, respectively), while OS resulted trend-associated to protocol (p=0.0891). One of the older study - ALL0288 - demonstrated a significantly lower Cumulative Incidence of Relapse (CIR) not only compared with the oldest ALL0183 (p<0.00001), but also with the following ALL0496 (p=0.0009), ALL2000 (0.0022) and ALL0904 (p=0.00002). Whether this was related to a more intensified treatment with reinduction cycles, both in consolidation and maintenance, foreseen in the ALL0288 study remains an open question; however, probably due to the less effective supportive care and, in particular, to the lack of growth factors, non-relapse mortality in CR was higher and the final outcome of ALL0288 did not significantly differed in terms of overall survival from other studies. In conclusion, the overall results of the consecutive GIMEMA adult ALL trials conducted over the past 25 years show that only slight advances for specific subgroup of patients – i.e. Ph+ - have been obtained, mainly thanks to the introduction of targeted agents like TKIs. Also in the AYAs subgroup, the outcome remains dismal, and new approaches, possibly with more intensive pediatric-like regimens must be explored. Disclosures No relevant conflicts of interest to declare.

Measuring Impact of Stress in Sandwich Generation Caring for Demented Parents

GeroPsych ◽  
2014 ◽  
Vol 27 (4) ◽  
pp. 171-179 ◽  
Author(s):  
Laurence M. Solberg ◽  
Lauren B. Solberg ◽  
Emily N. Peterson
Keyword(s):  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Social Worker ◽  
Resource Availability ◽  
Well Being ◽  
Sandwich Generation ◽  
Item Questionnaire ◽  
Significant Difference ◽  
Adult Caregivers ◽  
The Impact

Stress in caregivers may affect the healthcare recipients receive. We examined the impact of stress experienced by 45 adult caregivers of their elderly demented parents. The participants completed a 32-item questionnaire about the impact of experienced stress. The questionnaire also asked about interventions that might help to reduce the impact of stress. After exploratory factor analysis, we reduced the 32-item questionnaire to 13 items. Results indicated that caregivers experienced stress, anxiety, and sadness. Also, emotional, but not financial or professional, well-being was significantly impacted. There was no significant difference between the impact of caregiver stress on members from the sandwich generation and those from the nonsandwich generation. Meeting with a social worker for resource availability was identified most frequently as a potentially helpful intervention for coping with the impact of stress.

Implicit and explicit corrective feedback and feedback exposure conditions

2020 ◽  
Vol 4 (1) ◽  
pp. 3-48
Author(s):  
Takehiro Iizuka ◽  
Kimi Nakatsukasa
Keyword(s):  
Explicit Knowledge ◽  
Corrective Feedback ◽  
Significant Difference ◽  
Oral Corrective Feedback ◽  
Post Test ◽  
Picture Description ◽  
Potential Factors ◽  
Implicit And Explicit ◽  
Instructional Settings ◽  
The Impact

This exploratory study examined the impact of implicit and explicit oral corrective feedback (CF) on the development of implicit and explicit knowledge of Japanese locative particles (activity de, movement ni and location ni) for those who directly received CF and those who observed CF in the classroom. Thirty-six college students in a beginning Japanese language course received either recast (implicit), metalinguistic (explicit) or no feedback during an information-gap picture description activity, and completed a timed picture description test (implicit knowledge) and an untimed grammaticality judgement test (explicit knowledge) in a pre-test, immediate post-test and delayed post-test. The results showed that overall there was no significant difference between CF types, and that CF benefited direct and indirect recipients similarly. Potential factors that might influence the effectiveness of CF, such as instructional settings, complexity of target structures and pedagogy styles, are discussed.

Reducing the Social Stigma Associated with Obsessive Compulsive Disorder: A Controlled Trial of an Intervention Program in a Turkish Community Sample

2020 ◽  
Vol 20 (2) ◽  
pp. 101-120
Author(s):  
Ayça Aktaç Gürbüz ◽  
Orçun YORULMAZ ◽  
Gülşah DURNA
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Intervention Program ◽  
Controlled Trial ◽  
Community Sample ◽  
Case Vignette ◽  
Control Group ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Significant Difference ◽  
The Impact

Scientific research into the reduction of stigmatization, particularly related to specific problems such as Obsessive-Compulsive Disorder (OCD), is scarce. In the present study, we examine the impact of a video-based antistigma intervention program for OCD in a pretest-posttest control group research. After being randomly assigned to either an intervention (n= 101) or control group (n= 96), the participants reported their attitudes on a hypothetical case vignette before and after OCD vs. Multiple Sclerosis (MS) videos, and again six months later as a follow up assessment. The mixed design analyses for the group comparisons indicated that although there was no significant difference in the measures of the control group, the participants watching the anti-stigma OCD video, in which the focus was psychoeducation and interaction strategies, reported significantly lower scores on social distances and negative beliefs for the case vignettes they read, and this difference was maintained six months later. Then, the present results indicate the effectiveness of our anti-stigma intervention program for OCD. Interventions to reduce stigmatization can also be viewed as effective tools for changing the attitudes of people toward OCD, although further research and applications are needed related to specific disorders if a longlasting impact is to be achieved.

Antecedents And Outcomes Of Qwl Among Employees In Banks

2019 ◽  
Vol 118 (7) ◽  
pp. 1-19
Author(s):  
Geethanjali N ◽  
Parveen Roja M ◽  
Lavanya D
Keyword(s):  
Organizational Climate ◽  
Job Stress ◽  
Work Life ◽  
Working Environment ◽  
Quality Of Work Life ◽  
Quality Of Work ◽  
Significant Difference ◽  
Service Productivity ◽  
The Impact

Quality of work life is the major factor to be considered in working environment of any organization. The performance of employees and the organization lies on the ability of the employees based on working environment. The QWL leads to better working environment which improves the performance of organization. The present study has made an attempt to find the level of factors causing QWL and the impact of outcome of QWL in banks. Since the profile of the banks may be associated with the level of outcomes of QWL, the present study has made an attempt to examine it with the help of one way analysis of variance and t-test. The included outcomes of QWL are job satisfaction, job stress, organizational climate, organizational commitment, employees retention behaviour, service quality employees and service productivity of employees. The highly associated determinants of QWL and the significant difference among the PUSBs and PRSBs have been noticed. The significantly associating important profiles of the banks regarding the existence of outcome of QWL are identified.

Оrganic Meat Production of Broiler Chickens Hubbard Redbro Cross

2020 ◽  
Keyword(s):  
Broiler Chickens ◽  
Raw Materials ◽  
Animal Health ◽  
Meat Products ◽  
Poultry Meat ◽  
Meat Production ◽  
Significant Difference ◽  
Environmentally Safe ◽  
The Impact

This article presents the results of studying the impact of housing and feeding conditions on broiler chickens of Hubbard RedBro cross, as well as the quality of products obtained when using floor and cage content, in a farm. It established that when receiving a mixed feed of own production using feed raw materials grown on a farm without the use of pesticides, a statistically significant decrease in potentially dangerous substances for animal health is recorded. Compared with factory feed, it has reduced the content of pesticides by 14 times, and mercury and arsenic by 24 times, cadmium by five times, and lead by ten times. The results of the study of economic indicators of growing Hubbard RedBro cross broiler chickens, as well as the chemical composition and quality of carcasses, indicated that there was no significant difference between the floor and cell conditions of keeping. Still, the use of a diet based on eco-feeds contributed to a statistically significant decrease in the concentration of toxic metals in the muscles of the poultry of the experimental groups. As a result, it found that the use of the studied compound feed in the diets of broiler chickens increased the indicators of Biosafety and ensured the production of environmentally safe ("organic") poultry meat products.

Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

2016 ◽  
Vol 5 (05) ◽  
pp. 4563
Author(s):  
Tariq A. Zafar
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Glycated Haemoglobin ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Age Group ◽  
Hba1c Test ◽  
Significant Difference ◽  
Tract Infections ◽  
The Impact

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah.  The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively.  Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.

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