Postponed treatment outcomes in patients with limited fibrous cavernous pulmonary tuberculosis with use of valve bronchial block

The objective of the study: to evaluate postponed outcomes of comprehensive treatment with use of valve bronchial block in patients with limited fibrous cavernous pulmonary tuberculosis.Subjects and methods. Treatment outcomes of 97 patients suffering from chronic destructive pulmonary tuberculosis with lesions within one lobe were analyzed. Valve bronchial block (VBB+) was used in 42 patients, and it was not used in 55 patients (VBB-). In addition to anti-tuberculosis chemotherapy, artificial pneumoperitoneum was used in all patients as a part of the treatment.Results. Postpones treatment outcomes were followed in 83 patients: in 38 from the Group VBB+ and in 45 from Group VBB-. Clinical cure was achieved in 28/38 (66.7%) patients in Group VBB+ and in 16/45 (29.1%) in Group VBB-, p <0.01. A lethal outcome was registered in 2 (4.8%) patients in Group VBB+ and 10 (18.1%) in Group VBB-, p <0.03.

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Analysis of treatment outcomes for destructive pulmonary tuberculosis in patients with multiple drug resistance of M. tuberculosis

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2020-98-10-23-27 ◽

2020 ◽

Vol 98 (10) ◽

pp. 23-27

Author(s):

Yu. A. Sheyfer ◽

I. S. Gelberg

Keyword(s):

Pulmonary Tuberculosis ◽

Treatment Outcomes ◽

Clinical Cure ◽

Multiple Drug Resistance ◽

Group Versus ◽

Multiple Drug ◽

Continuation Phase ◽

Intensive Phase ◽

Tuberculosis Patients ◽

Sputum Conversion

The objective of the study: to analyze treatment outcomes in patients with pulmonary destructive MDR tuberculosis who completed the intensive phase of treatment and had healed or persisting cavities.Subjects and methods. Treatment outcomes were retrospectively analyzed in 191 patients suffering from destructive pulmonary MDR tuberculosis who underwent the intensive phase of chemotherapy in in-patient settings in 2009-2012 and 2013-2015 (treated by different regime ns); in each of those cohorts, groups were formed depending on persistence/healing of destruction (cavities) during the intensive phase of chemotherapy: (CV-) ‒ the destruction healed, (CV+) – the destruction persisted.Results. In 24 months, treatment was found to be effective only in 19/68 (27.9%) in the (CV+) group versus 31/40 (77.5%) in the (CV-) group, p < 0.05 (cohort 2009-2012); 17/42 (40.5%) versus 29/41 (70.7%), respectively, p < 0.05 (2013-2015 cohort). Within 48 months, treatment outcomes were as follows: clinical cure in the (CV+) group was 38.2% (26/68 people), and in the (CV-) group – 72.7% (29/40 people), p < 0.05 (2009- 2012) and 23/42 (54.7%) and 33/41 (80.5%), respectively, p < 0.05 (2013-2015 cohort).Conclusion. Considering the above, when assessing treatment in the intensive phase of chemotherapy in destructive pulmonary tuberculosis patients, it is necessary to take into account the rate of cavity healing but not being limited to sputum conversion. Patients with persisting cavities should not be transferred to the continuation phase, the surgery or collapse treatment should be considered for such patients.

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Influence of the Acetylation Type on the Incidence of Isoniazid-Induced Hepatotoxicity in Patients with Newly Diagnosed Pulmonary Tuberculosis

Antibiotics and Chemotherapy ◽

10.37489/0235-2990-2020-65-7-8-31-36 ◽

2020 ◽

Vol 65 (7-8) ◽

pp. 31-36

Author(s):

N. M. Krasnova ◽

N. E. Evdokimova ◽

A. A. Egorova ◽

O. I. Filippova ◽

E. A. Alekseeva ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Clinical Laboratory ◽

Clinical Manifestations ◽

Normal Activity ◽

Slow Acetylators ◽

Nucleotide Polymorphisms ◽

Newly Diagnosed ◽

Single Nucleotide ◽

Tuberculosis Chemotherapy ◽

Genetically Determined

Introduction. Liver damage can be a dangerous side effect of using isoniazid. Individual susceptibility to isoniazid in humans is dependent on the presence of N-acetyltransferase 2 allelic variants in genome. It was imperative to assess the effect of genetically determined isoniazid acetylation rate in terms of risk of developing isoniazid-induced hepatotoxicity, as well as prevention of potential hepatopathy, and improvement of tuberculosis chemotherapy safety. Aim. To study the effect of acetylation type on the incidence of isoniazid hepatotoxicity in residents of the Sakha Republic (Yakutia) with newly diagnosed pulmonary tuberculosis. Methods. The study included 112 patients with newly diagnosed pulmonary tuberculosis. Genotyping was performed using real-time polymerase chain reaction. The following single nucleotide polymorphisms were studied: rs1801280, rs1799930, rs1799931, rs1799929, rs1208, rs1041983. Hepatotoxicity was determined based on the results of clinical laboratory monitoring and using the criteria developed by the European Association for the Study of the Liver (2019). Results. Hepatotoxic reactions developed more often in slow acetylators (43.2%), compared to fast acetylators (20.7%) and intermediate acetylators (10.9%); p=0.002. Serum alanine aminotransferase activity was 5 or more times above the upper limit of normal activity in 37.8% of slow acetylators, and in 8.7% of intermediate acetylators; p=0.001. Clinical manifestations of isoniazid hepatotoxicity were observed more often in slow acetylators (29.7%), than in fast acetylators (3.4%); p=0.000. Conclusion. Slow acetylation type ought to be considered an important risk factor for developing isoniazid hepatotoxicity in patients with pulmonary tuberculosis.

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Misdiagnosis of chronic pulmonary aspergillosis as pulmonary tuberculosis at a tertiary care center in Uganda: a case series

Journal of Medical Case Reports ◽

10.1186/s13256-021-02721-9 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Richard Kwizera ◽

Andrew Katende ◽

Felix Bongomin ◽

Lydia Nakiyingi ◽

Bruce J. Kirenga

Keyword(s):

Pulmonary Tuberculosis ◽

Treatment Outcomes ◽

Diagnostic Criteria ◽

Tertiary Care ◽

Chest Imaging ◽

Resource Limited Settings ◽

Pulmonary Aspergillosis ◽

Resource Limited ◽

Chronic Pulmonary Aspergillosis ◽

Hiv Negative

Abstract Background Diagnosis of chronic pulmonary aspergillosis (CPA) is based on a combination of clinical symptomatology, compatible chest imaging findings, evidence of Aspergillus infection and exclusion of alternative diagnosis, all occurring for more than 3 months. Recently, a rapid, highly sensitive and specific point-of-care lateral flow device (LFD) has been introduced for the detection of Aspergillus-specific immunoglobulin (Ig)G, especially in resource-limited settings where CPA is underdiagnosed and often misdiagnosed as smear-negative pulmonary tuberculosis (PTB). Therefore, in our setting, where tuberculosis (TB) is endemic, exclusion of PTB is an important first step to the diagnosis of CPA. We used the recently published CPA diagnostic criteria for resource-limited settings to identify patients with CPA in our center. Case presentation Three Ugandan women (45/human immunodeficiency virus (HIV) negative, 53/HIV infected and 18/HIV negative), with a longstanding history of cough, chest pain, weight loss and constitutional symptoms, were clinically and radiologically diagnosed with PTB and empirically treated with an anti-tuberculous regimen despite negative microbiological tests. Repeat sputum Mycobacteria GeneXpert assays were negative for all three patients. On further evaluation, all three patients met the CPA diagnostic criteria with demonstrable thick-walled cavities and fungal balls (aspergilomas) on chest imaging and positive Aspergillus-specific IgG/IgM antibody tests. After CPA diagnosis, anti-TB drugs were safely discontinued for all patients, and they were initiated on capsules of itraconazole 200 mg twice daily with good treatment outcomes. Conclusions The availability of simple clinical diagnostic criteria for CPA and a LFD have the potential to reduce misdiagnosis of CPA and in turn improve treatment outcomes in resource-limited settings.

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Correlates of Treatment Outcomes and Drug Resistance among Pulmonary Tuberculosis Patients Attending Tertiary Care Hospitals of Kolkata, India

PLoS ONE ◽

10.1371/journal.pone.0109563 ◽

2014 ◽

Vol 9 (10) ◽

pp. e109563 ◽

Cited By ~ 5

Author(s):

Avranil Goswami ◽

Urmita Chakraborty ◽

Tanmay Mahapatra ◽

Sanchita Mahapatra ◽

Tapajyoti Mukherjee ◽

...

Keyword(s):

Drug Resistance ◽

Pulmonary Tuberculosis ◽

Treatment Outcomes ◽

Tertiary Care ◽

Tuberculosis Patients ◽

Tertiary Care Hospitals

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Prevalence of Smoking and Its Impact on Treatment Outcomes in Newly Diagnosed Pulmonary Tuberculosis Patients: A Hospital-Based Prospective Study

Chonnam Medical Journal ◽

10.4068/cmj.2015.51.2.86 ◽

2015 ◽

Vol 51 (2) ◽

pp. 86 ◽

Cited By ~ 22

Author(s):

Vinay Mahishale ◽

Bhagyashri Patil ◽

Mitchelle Lolly ◽

Ajith Eti ◽

Sujeer Khan

Keyword(s):

Pulmonary Tuberculosis ◽

Prospective Study ◽

Treatment Outcomes ◽

Newly Diagnosed ◽

Tuberculosis Patients ◽

Impact On Treatment

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Impact of prior pulmonary tuberculosis in treatment outcomes of HCAP and CAP patients in intensive care units

Journal of Microbiology Immunology and Infection ◽

10.1016/j.jmii.2018.08.012 ◽

2019 ◽

Vol 52 (2) ◽

pp. 320-328 ◽

Cited By ~ 1

Author(s):

Fan-Min Lin ◽

Jia-Yih Feng ◽

Wen-Feng Fang ◽

Chieh-Liang Wu ◽

Chong-Jen Yu ◽

...

Keyword(s):

Intensive Care ◽

Pulmonary Tuberculosis ◽

Treatment Outcomes ◽

Intensive Care Units

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Delay to initiate treatment is associated with unsuccessful treatment outcome among new pulmonary tuberculosis patients in Tigray, Northern Ethiopia: a follow up study

10.21203/rs.3.rs-527930/v1 ◽

2021 ◽

Author(s):

kiros Tedla ◽

Girmay Medhin ◽

Gebretsadik Berhe ◽

Afework Mulugeta ◽

Nega Berhe

Keyword(s):

Treatment Outcome ◽

Pulmonary Tuberculosis ◽

Treatment Outcomes ◽

Treatment Initiation ◽

Statistical Significance ◽

Northern Ethiopia ◽

Follow Up Study ◽

Unsuccessful Treatment ◽

Increased Risk

Abstract Background : Previous studies in Ethiopia indicated that tuberculosis (TB) patient’s elapse long time before treatment initiation. However, there is very limited evidence on the association of delay to initiate treatment with treatment outcome. Objective : To investigate the association of time to treatment initiation delay with treatment outcomes of new adult TB patients in Tigray region of Ethiopia. Methods : We conducted a follow up study from October 2018 to April 2020 by recruiting 875 newly diagnosed Pulmonary Tuberculosis (PTB) patients from 21 randomly selected health facilities. Study participants were selected using simple random sampling technique during treatment initiation from October 1/2018 to October 30/2019. Delay to initiate treatment and treatment outcome were collected using standardized questionnaire and laboratory investigation. Adherence of TB patients to their treatment was collected using a 10 points linear visual analogue scale (VAS) at the end of treatment. The association of delay to initiate treatment with treatment outcome was modeled using log binomial regression model. Statistical significance was reported whenever p-value was less than 0.05. Data was analyzed using SPSS software version 21. Result : The median total delay to treatment initiation was 62 days with inter-quartile range of 16-221 days. A unite increase in a day to initiate treatment results in increment of risk of unsuccessful treatment outcome by 2.3. Other factors associated with unsuccessful treatment outcomes were being less adherent to the treatment, HIV co infection, being smear positive at initiation of treatment and after 2 months of treatment initiation. Conclusion : delay in a day to initiate treatment is associated with increased risk of unsuccessful treatment outcome. Any effort targeted towards reducing the negative effects of PTB should target on strategies that reduces the length of delay to initiate treatment and strengthen community engagement to improve treatment adherence of patients that have started treatment.

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