resistant tuberculosis
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ADMET & DMPK ◽  
2022 ◽  
Author(s):  
Svetlana A. Berns ◽  
Julia A. Isakova ◽  
Polina Pekhtereva

Tuberculosis is one of the critical health problems worldwide. The search for ways to improve the results of tuberculosis treatment and overcome drug resistance lies in understanding the pathogenesis of the development of the infectious process. The interferon system, particularly the role of interferon-gamma, has been identified as the main link in the immune response in tuberculosis. The clinical efficacy of interferon-gamma has been studied and evaluated in clinical trials since the end of the last century. There was obtained evidence of the clinical efficacy of interferon-gamma as part of complex therapy. Recent experimental data make it possible to consider interferon-gamma as a promising therapeutic option for the treatment of multidrug-resistant tuberculosis as part of complex therapy worthy of further studies.  


2022 ◽  
Vol 20 (2) ◽  
pp. 419-424
Author(s):  
Yang Zhao ◽  
Mabin Si ◽  
Zhihui Li ◽  
Xiulei Yu

Purpose: The present study analyzes the comprehensive therapeutic effect of cycloserine, in combination with anti-tuberculosis drugs using chest X-ray and chest CT (computed tomography) scan techniques. Methods: A total of 90 patients, diagnosed with multidrug resistant tuberculosis (MDR TB) were subjected to chest x-ray and CT scan before and after treatment in the two groups. Different views such as sagittal, coronal, lung window and multiplanar imaging of mediastinal window were taken. Some parameters such as case detection rate (CDR) in chest X-ray and CT scan and comprehensive curative effect were observed in two groups. Further, the changes in chest CT signs in addition to absorption of focus, cavity closure and changes in CT extra pulmonary signs were also observed. Results: The clinical profile of the patients and the course of disease were statistically insignificant (p > 0.05). Total effectiveness rate and case detection rate (CDR) values exhibited a significant difference between the groups (p < 0.05). Lung consolidation, nodules and cavities significantly improved in both groups before and after the treatment (p < 0.05). Both groups showed significant improvements in extrapulmonary signs in CT scan (p < 0.05) after the treatment. Conclusion: Based on the study outcomes, the CT scan method has good potentials for diagnosing and treating MDR TB at the early stages. Further, it can clarify the signs and outcomes of the disease at early stages, thus providing the medical fraternity a great opportunity to cure the disease.


Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 188
Author(s):  
Manohar Karki ◽  
Karthik Kantipudi ◽  
Feng Yang ◽  
Hang Yu ◽  
Yi Xiang J. Wang ◽  
...  

Classification of drug-resistant tuberculosis (DR-TB) and drug-sensitive tuberculosis (DS-TB) from chest radiographs remains an open problem. Our previous cross validation performance on publicly available chest X-ray (CXR) data combined with image augmentation, the addition of synthetically generated and publicly available images achieved a performance of 85% AUC with a deep convolutional neural network (CNN). However, when we evaluated the CNN model trained to classify DR-TB and DS-TB on unseen data, significant performance degradation was observed (65% AUC). Hence, in this paper, we investigate the generalizability of our models on images from a held out country’s dataset. We explore the extent of the problem and the possible reasons behind the lack of good generalization. A comparison of radiologist-annotated lesion locations in the lung and the trained model’s localization of areas of interest, using GradCAM, did not show much overlap. Using the same network architecture, a multi-country classifier was able to identify the country of origin of the X-ray with high accuracy (86%), suggesting that image acquisition differences and the distribution of non-pathological and non-anatomical aspects of the images are affecting the generalization and localization of the drug resistance classification model as well. When CXR images were severely corrupted, the performance on the validation set was still better than 60% AUC. The model overfitted to the data from countries in the cross validation set but did not generalize to the held out country. Finally, we applied a multi-task based approach that uses prior TB lesions location information to guide the classifier network to focus its attention on improving the generalization performance on the held out set from another country to 68% AUC.


2022 ◽  
Vol 2022 ◽  
pp. 1-17
Author(s):  
Ying Xiong ◽  
Jingwen Wei ◽  
Yujia Cai ◽  
Yang Zhang ◽  
Li Feng ◽  
...  

Objective. The objective of the current study was to analyze the research hotspot of drug treatment for tuberculosis via top literatures. Materials and Methods. A retrospective analysis was performed on June 7th, 2021. Literatures were searched on the Web of Science Core Collection to identify the top 50 cited literatures related to drug treatment of tuberculosis. The characteristics of the literatures were identified. The outcomes included authorship, journal, study type, year of publication, and institution. Cooccurrence network analysis and visualization were conducted using the VOS viewer (Version 1.6.16; Leiden University, Leiden, The Netherlands). Results. The top 50 cited literatures were cited 308 to 2689 times and were published between 1982 and 2014. The most studied drugs were the first-line drugs such as isoniazid and rifampicin ( n = 22 ), and drug-resistant tuberculosis was most frequently reported ( n = 16 ). They were published in 18 journals, and the New England Journal of Medicine published the most literatures ( n = 18 ), followed by the American Journal of Respiratory and Critical Care Medicine ( n = 7 ), and the Lancet ( n = 6 ). The authors were from 13 countries, and the authors from the USA published most of the literatures ( n = 30 ), while authors from other countries published less than five literatures. The CDC in the USA ( n = 4 ), the World Health Organization (WHO) ( n = 3 ), and the American Philosophical Society ( n = 3 ) were the leading institutions, and only two authors published at least two top-cited literatures as first authors. Conclusions. This study provides insights into the development and most important literatures on drug therapy for tuberculosis and evidence for future research on tuberculosis treatment.


2022 ◽  
Vol 99 (12) ◽  
pp. 22-26
Author(s):  
M. M. Yunusbaeva ◽  
L. Ya. Borodina ◽  
R. A. Sharipov ◽  
E. S. Bilalov ◽  
M. M. Аzamatova ◽  
...  

The objective of the study: to assess changes in the incidence and prevalence of multiple drug resistant tuberculosis (MDR TB) and TB/HIV coinfection (TB/HIV) in Volga Federal District (VFD) and its regions during 2016-2020.Subjects and Methods. Data from FGSN Forms No. 8, 33, and 61, and analytical reviews of main statistical TB rates in the Russian Federation have been studied. The number of those died is presented as per the Rosstat data.Results. An increase in the incidence and prevalence of MDR TB and TB/HIV coinfection has been detected in certain region of Volga Federal District. Perm Region, the Republic of Bashkortostan, the Republic of Udmurtia, and Orenburg and Samara Regions have the highest prevalence of MDR TB and TB/HIV coinfection. In 2020, the Republic of Bashkortostan was the only region where the incidence and prevalence of MDR TB were growing (164.7% and 47.3%, respectively). The highest incidence and prevalence of TB/HIV coinfection was reported in the Republic of Bashkortostan, Perm Kray, Orenburg Region, the Chuvash and Udmurt Republics. Over the last 5 years, the maximum increase in TB/HIV incidence and prevalence was observed in the Republic of Bashkortostan (38.8% and 41.3%, respectively).


Author(s):  
Simon E Koele ◽  
Stijn W van Beek ◽  
Gary Maartens ◽  
James C. M. Brust ◽  
Elin M Svensson

Interruption of treatment is common in drug-resistant tuberculosis patients. Bedaquiline has a long terminal half-life therefore, restarting after an interruption without a loading dose could increase the risk of suboptimal treatment outcome and resistance development. We aimed to identify the most suitable loading dose strategies for bedaquiline restart after an interruption. A model-based simulation study was performed. Pharmacokinetic profiles of bedaquiline and its metabolite M2 (associated with QT-prolongation) were simulated for 5000 virtual patients for different durations and starting points of treatment interruption. Weekly bedaquiline area under the concentration-time curve (AUC) and M2 maximum concentration (Cmax) deviation before interruption and after reloading were assessed to evaluate the efficacy and safety respectively of the reloading strategies. Bedaquiline weekly AUC and M2 Cmax deviation were mainly driven by the duration of interruption and only marginally by the starting point of interruption. For interruptions with a duration shorter than two weeks, no new loading dose is needed. For interruptions with durations between two weeks and one month, one month and one year, and longer than one year, reloading periods of three days, one week, and two weeks, respectively, are recommended. This reloading strategy results in an average bedaquiline AUC deviation of 1.88% to 5.98% compared with -16.4% to -59.8% without reloading for interruptions of two weeks and one year respectively, without increasing M2 Cmax. This study presents easy-to-implement reloading strategies for restarting a patient on bedaquiline treatment after an interruption.


Author(s):  
Cruz S. Sebastião ◽  
João Samulengo ◽  
Euclides Sacomboio ◽  
Ngiambudulu M. Francisco ◽  
Carlos Teixeira ◽  
...  

Tuberculosis (TB) is a major cause of illness and public health concern, especially in resource-limited countries. This study analyzed the characteristics related to anti-TB drug resistance. Moreover, we examined the evidence-based indications for the treatment of active TB in Angola. This study evaluated the medical records of 176 patients screened for TB from January to September 2016 in Luanda, the capital city of Angola. Approximately 66.5% of the patients were newly diagnosed with active TB. The residence area showed a significant relationship with TB (P = 0.025), whereas age group (P = 0.272), gender (P = 0.853), and HIV status (P = 0.284) did not showed any relationship with TB. Overall, 72.4% of TB patients had resistance to at least one of the anti-TB drugs. The risk of anti-TB drug resistance was higher in males (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 0.42–3.58, P = 0.685] and in TB-HIV coinfected patients [OR: 1.39; (95% CI: 0.26–7.28), P = 0.700], whereas it was lower in patients aged 30 years or older (OR: 0.56; 95% CI: 0.18–1.69) P = 0.303) and in patients living in urbanized areas (OR: 0.74; 95% CI: 0.17–3.25; P = 0.685). Our findings showed that drug-resistant TB is emerging in Angola. Further studies on factors related to anti-TB drug resistance are urgently needed to ascertain the magnitude of the problem and to proffer strategies toward TB control in Angola.


2022 ◽  
Vol 386 (1) ◽  
pp. 93-94
Author(s):  
Shaheed V. Omar ◽  
Farzana Ismail ◽  
Norbert Ndjeka ◽  
Koné Kaniga ◽  
Nazir A. Ismail

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