Implementing universal rifampicin testing for TB in Pakistan: results and implications for the TB response

2020 ◽  
Vol 24 (8) ◽  
pp. 795-801
Author(s):  
S. Tahseen ◽  
M. R. Siddiqui ◽  
F. M. Khanzada ◽  
M. M. Bhutto ◽  
A. Q. Baloch ◽  
...  
Keyword(s):  
Significant Decline ◽  
Rifampicin Resistance ◽  
Newly Diagnosed ◽  
Retrospective Record Review ◽  
Pulmonary Tb ◽  
Previously Treated ◽  
Smear Negative ◽  
Record Review ◽  
Positive Results

SETTING: A large specialised chest hospital in Pakistan.OBJECTIVE: To study outcomes of comprehensive Xpert® MTB/RIF and universal rifampicin testing.DESIGN: A hospital-based, 3-year retrospective record review of registered TB patients.RESULTS: During the study, 11 744 TB patients were registered when the number of annual notifications remained stagnant. Xpert use increased dramatically in adults with pulmonary TB (PTB) from less than 1% tested with Xpert alone in 2016, to 81.6% by 2018. Significant increases were seen in bacteriologically confirmed PTB in adults from 64% to 77.3% (P < 0.001). No remarkable changes were seen in testing and confirmation of PTB in children or extrapulmonary TB. Significantly lower (P < 0.001) rifampicin resistance (RR) was observed among those with smear-negative compared to those with smear-positive results among new (1.0% vs. 5.1%) and previously treated PTB cases (2.0% vs. 14.4%). Most importantly, a significant decline in RR was observed among previously treated individuals, from 15.4% (95%CI 12.2–19.0) to 8.6% (95%CI 6.6–11.0) during the study. A decrease in RR was also documented in newly diagnosed PTB patients, but this was not statistically significant.CONCLUSION: Universal rifampicin testing is feasible in adult PTB patients; a decline in RR was seen among previously treated individuals with PTB.

scholarly journals Anti-rituximab antibodies in refractory / relapsing cases of chronic lymphocytic leukemia

2020 ◽  
Author(s):  
O.V. Moskalets
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Therapeutic Response ◽  
Lymphocytic Leukemia ◽  
General Question ◽  
Newly Diagnosed ◽  
Serum Concentrations ◽  
World Science ◽  
Rheumatologic Diseases ◽  
Previously Treated ◽  
Positive Results

Rituximab, a chimeric monoclonal antibody targeted against the pan-B-cell marker CD20, is widley used for treatment of lymphomas, rheumatologic diseases and other – 8 – General question of world science disorders. It is known that many monoclonal antibodies such as rituximab can elicit anti-drug antibodies, which may interfere with therapeutic response. The aim of this study was to investigate the incidence of antibodies to rituximab in patients with chronic lymphocytic leukemia. Serum concentrations of anti-rituximab antibodies was determined in blood serum of patients with B-chronic lymphocytic leukemia (newly diagnosed and resistant / recurrent forms, previously treated by rituximab) and healthy controls. Results: none of the patients with newly diagnosed disease have antibodies to rituximab. Positive results were recorded in 8 (33%) patients who received rituximab earlier

scholarly journals Detection of Mycobacterium tuberculosis (MTB) in Fecal Specimens From Adults Diagnosed With Pulmonary Tuberculosis Using the Xpert MTB/Rifampicin Test

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Hiroyuki Kokuto ◽  
Yuka Sasaki ◽  
Shoji Yoshimatsu ◽  
Kazue Mizuno ◽  
Lina Yi ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Diagnostic Methods ◽  
Molecular Diagnostic ◽  
Sputum Smear ◽  
Proof Of Concept ◽  
Retrospective Case ◽  
Pulmonary Tb ◽  
Smear Negative ◽  
Positive Results ◽  
Control Study

Abstract Background.  The Xpert Mycobacterium tuberculosis (MTB)/rifampicin (RIF) is a fully automated diagnostic test that allows for the detection of MTB including its RIF resistance. Although the test is used for the diagnosis of tuberculosis (TB) in sputum samples worldwide, studies using fecal specimens are scarce. We therefore evaluated the efficacy of the Xpert MTB/RIF test for detection of MTB in fecal specimens obtained from adult pulmonary TB patients, confirmed by culture and/or molecular diagnostic methods. Methods.  We conducted a retrospective case-control study to provide proof-of-concept regarding the efficacy of the Xpert MTB/RIF test using fecal samples for diagnosing pulmonary TB via detection of MTB in adult patients (≥20 years) at the Fukujuji Hospital in Tokyo, Japan. Results.  Fecal specimens were obtained from 56 active pulmonary TB patients (including 48 sputum smear-positive and 8 sputum smear-negative patients), 10 non-TB patients (including 4 Myocobacterium avium complex infections), and 27 healthy individuals who were exposed to active pulmonary TB patients. The sensitivity of the fecal Xpert MTB/RIF was 100% (81.7%–100%) for detection of MTB in specimens from sputum smear-positive (1+ to 3+) patients, 81.0% (58.1%–94.6%) in specimens from sputum smear scanty positive patients, and 50.0% (15.7%–84.3%) in specimens from sputum smear-negative patients. Meanwhile, each of the fecal specimens from the non-TB group was negative for MTB (specificity 100%; 95% confidence interval, 86.2–100). Conclusions.  The fecal Xpert MTB/RIF test could detect MTB in a large proportion of smear-positive pulmonary TB patients, without frequent false-positive results at a TB referral hospital in Japan.

The incidence of anti-rituximab antibodies in patients with chronic lymphocytic leukemia

2020 ◽  
Author(s):  
O.V. Moskalets
Keyword(s):  
Monoclonal Antibody ◽  
Chronic Lymphocytic Leukemia ◽  
B Cell ◽  
Lymphocytic Leukemia ◽  
Healthy Controls ◽  
Newly Diagnosed ◽  
Serum Concentrations ◽  
Cell Marker ◽  
Previously Treated ◽  
Positive Results

The aim of this study was to investigate the incidence of antibodies to rituximab, a chimeric monoclonal antibody targeted against the pan-B-cell marker CD20, in patients with chronic lymphocytic leukemia. Serum concentrations of anti-rituximab antibodies were determined in patients with B-chronic lymphocytic leukemia (newly diagnosed and resistant / recurrent forms, previously treated by rituximab) and healthy controls. Results: none of the patients with newly diagnosed disease have antibodies to rituximab. Positive results were recorded in 8 (33%) patients who received rituximab earlier.

scholarly journals DDRE-21. PNOC015: PHASE 1 STUDY OF MTX110 DELIVERED BY CONVECTION ENHANCED DELIVERY (CED) IN CHILDREN WITH NEWLY DIAGNOSED DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG) PREVIOUSLY TREATED WITH RADIATION THERAPY

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii66-ii66
Author(s):  
Sabine Mueller ◽  
Cassie Kline ◽  
Javier Villanueva-Meyer ◽  
Carly Hoffman ◽  
Shannon Raber ◽  
...  
Keyword(s):  
Phase 1 ◽  
Volume Ratio ◽  
Diffuse Intrinsic Pontine Glioma ◽  
Newly Diagnosed ◽  
Convection Enhanced Delivery ◽  
Catheter Position ◽  
Pharmacodynamic Effects ◽  
Distribution Volume Ratio ◽  
Previously Treated ◽  
Grade 3

Abstract OBJECTIVE To determine safety and distribution of MTX110 delivered by CED in newly diagnosed DIPG patients. METHODS DIPG patients (3–21 years) were enrolled after radiation. CED of MTX110 combined with gadoteridol was completed based on dose levels (DL) (30–90 µM with volumes ranging from 3 cc (single dose) to 2 consecutive doses of 6 cc; total number of DL=7). Catheter position was chosen to maximize tumor coverage. Distribution of infusate was monitored with real-time MR imaging. Repeat CED was performed every 4–8 weeks if tolerated. Quality of life (QOL) assessments using PedsQL Generic Core and Brain Tumor modules were obtained at baseline (n=5), 3-months (n=3), and end of therapy (n=2). Single-cell RNA sequencing and analysis of histone modifications was performed to assess pharmacodynamic effects on DIPG cells. RESULTS Between May 2018-Dec 2019, 6 patients were enrolled (median age 8 years, range 5–21). Dose limiting toxicities included: grade 3 gait disturbance (DL7; cycle 1); grade 3 muscle weakness/vagus nerve disorder (DL5; cycle 4) and grade 2 intolerable dysphagia (DL7; cycle 4). Twelve CED procedures were completed at DL7 and repeated cycles ranged from 2 to 7. Infusion to distribution volume ratio was approximately 1:3.5. There were no significant changes in self-reported QOL. Parent ratings of patients’ worry (p = 0.04) and overall QOL (p = 0.03) significantly decreased at 3-months. CONCLUSION Repeat CED of MTX110 at the highest dose is tolerable. Tissue concentrations are likely to be substantially higher compared to oral dosing. Pharmacodynamic effects will be presented.

scholarly journals A Retrospective Cross-Sectional Study of the Utility of Cartridge-Based Nucleic Acid Amplification Test in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in People Living with HIV in Second Highest HIV Prevalent State in India

2021 ◽  
Author(s):  
Tade Bagbi ◽  
Ningthoukhongjam Reema ◽  
S. Bhagyabati Devi ◽  
Thangjam Gautam Singh ◽  
Mohammad Jaleel ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative

Abstract Introduction Tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV) is difficult to diagnose due to fewer organisms in sputum and extrapulmonary samples. Sputum culture takes 4 to 8 weeks for growth of the mycobacteria. Delayed treatment for TB in PLHIV leads to increased mortality. This study evaluated cartridge-based nucleic acid amplification test (CBNAAT) as a diagnostic tool for diagnosis of pulmonary TB (PTB) and extrapulmonary TB (EPTB) in PLHIV in the second most HIV prevalent state in India and for comparing its efficacy between Ziehl–Neelsen (ZN) staining sputum smear–positive and sputum smear–negative TB. Methods This cross-sectional study was conducted in RIMS, Imphal, with 167 PLHIV patients, age 15 years or older, having signs and symptoms of TB. Appropriate samples for sputum microscopy and CBNAAT were sent. Conclusion The overall sensitivity of sputum smear for acid-fast bacillus (AFB) was found to be 30.71% and that of CBNAAT was 38.57%. Sensitivity of CBNAAT for sputum smear–positive and sputum smear–negative TB was 100 and 11.3%, respectively. Sensitivity of ZN smear for AFB of EPTB sample was 48.1% and that of CBNAAT was 59.25%. In both PTB and EPTB, CBNAAT showed an increase in diagnosis of microbiologically confirmed PTB cases by 7.8 and 11.1%, respectively, over and above the cases diagnosed by ZN smear microscopy. Rifampicin resistance was detected in five patients. We conclude that CBNAAT is a rapid test with better sensitivity in diagnosis of PTB and EPTB in PLHIV, compared with ZN smear microscopy. It detects rifampicin resistance for multidrug-resistant TB and helps in early treatment intervention.

scholarly journals Should Sputum Smear Examination Be Carried Out at the End of the Intensive Phase and End of Treatment in Sputum Smear Negative Pulmonary TB Patients?

PLoS ONE ◽  
2012 ◽  
Vol 7 (11) ◽  
pp. e49238 ◽  
Author(s):  
Sumit Malhotra ◽  
Sanjay P. Zodpey ◽  
Shivani Chandra ◽  
Ram Pal Vashist ◽  
Srinath Satyanaryana ◽  
...  
Keyword(s):  
Sputum Smear ◽  
Intensive Phase ◽  
Pulmonary Tb ◽  
Smear Examination ◽  
End Of Treatment ◽  
Smear Negative ◽  
Sputum Smear Examination

Inpatient oncology rehabilitation in Toronto: a descriptive 18-month retrospective record review

2011 ◽  
Vol 20 (7) ◽  
pp. 1541-1547 ◽  
Author(s):  
Sara E. McEwen ◽  
Sarah Elmi ◽  
Murray Waldman ◽  
Mila Bishev
Keyword(s):  
Retrospective Record Review ◽  
Record Review

scholarly journals Sequence analysis of the rifampicin resistance determining region (RRDR) of rpoB gene in multidrug resistance confirmed and newly diagnosed tuberculosis patients of Punjab, Pakistan

PLoS ONE ◽  
2017 ◽  
Vol 12 (8) ◽  
pp. e0183363 ◽  
Author(s):  
Salma Hameed ◽  
Kartyk Moganeradj ◽  
Nasir Mahmood ◽  
Timothy D. McHugh ◽  
Muhammad Nawaz Chaudhry ◽  
...  
Keyword(s):  
Multidrug Resistance ◽  
Sequence Analysis ◽  
Rpob Gene ◽  
Rifampicin Resistance ◽  
Newly Diagnosed ◽  
Tuberculosis Patients

Contemporary Insertion of Central Venous Access Catheters in Pediatric Patients: A Retrospective Record Review Study of 538 Catheters in a Single Center

2017 ◽  
Vol 18 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Max B. van Gent ◽  
Wendeline J. van der Made ◽  
Perla J. Marang-van de Mheen ◽  
Koen E. van der Bogt
Keyword(s):  
Pediatric Patients ◽  
Central Venous Access ◽  
Venous Access ◽  
Single Center ◽  
Central Venous ◽  
Retrospective Record Review ◽  
Review Study ◽  
Record Review

Questionable role of interferon-γ assays for smear-negative pulmonary TB in immunocompromised patients

2012 ◽  
Vol 64 (2) ◽  
pp. 188-196 ◽  
Author(s):  
Ji Ye Jung ◽  
Ju Eun Lim ◽  
Hye-jeong Lee ◽  
Young Mi Kim ◽  
Sang-Nae Cho ◽  
...  
Keyword(s):  
Interferon Γ ◽  
Immunocompromised Patients ◽  
Pulmonary Tb ◽  
Smear Negative
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