The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
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Int. J. Tuberc. Lung Dis. · Feb 2010
Timing of relapse in short-course chemotherapy trials for tuberculosis.
We have reviewed the results from 15 tuberculosis treatment trials initiated by the British Medical Research Council between 1970 and 1983 in Africa and East Asia. Of 574 relapses, 447 (78%) occurred within 6 months of stopping treatment and 525 (91%) within 12 months. We suggest that investigators should consider terminating follow-up after the last enrolled patient completes 6 months following treatment, while continuing to follow patients enrolled earlier until that time. Compared to following all patients to 24 months, the total trial duration could be reduced by 18 months, with no increase in patient numbers in a non-inferiority design.
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Int. J. Tuberc. Lung Dis. · Feb 2010
First- and second-line drug resistance patterns among previously treated tuberculosis patients in India.
Culture and drug susceptibility testing results of 2816 tuberculosis (TB) patients from across India who had failed repeated treatments from 2001 to 2004 were retrospectively analysed at the Tuberculosis Research Centre, Chennai. Of 1498 (53%) identified as having multidrug-resistant TB (MDR-TB), 671 (44.8%) were resistant to > or =1 second-line drugs (SLDs): 490 (32.7%) to ethionamide, 245 (16.4%) to ofloxacin and 169 (11.3%) to kanamycin; 69 (4.6%) were extensively drug-resistant TB (XDR-TB). ⋯ The prevention of MDR/XDR-TB through quality DOTS services, however, remains the priority. In addition, rapid scale-up of quality programmatic management under the RNTCP is needed, with more control and rational use of SLDs outside the programme.
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Int. J. Tuberc. Lung Dis. · Jan 2010
Review Meta AnalysisVitamin D receptor genetic polymorphisms and tuberculosis: updated systematic review and meta-analysis.
Host genetic susceptibility has been suggested as one of the most important explanations for inter-individual differences in tuberculosis (TB) risk. The vitamin D receptor (VDR) gene has been studied as a candidate locus due to genetic polymorphisms that affects the activity of the receptor and subsequent downstream vitamin D-mediated effects. ⋯ The association of VDR polymorphisms with risk of TB observed in our analyses supports the hypothesis that vitamin D deficiency might play a role as risk factor during the development of TB.
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Int. J. Tuberc. Lung Dis. · Jan 2010
Comparative Study Controlled Clinical TrialAdding moxifloxacin is associated with a shorter time to culture conversion in pulmonary tuberculosis.
To investigate whether adding moxifloxacin (MXF) to the standard anti-tuberculosis regimen can shorten the time to sputum culture conversion in pulmonary tuberculosis (PTB). ⋯ Adding MXF to the standard anti-tuberculosis regimen in the first 2 months was associated with a shorter time to culture conversion, a higher 6-week culture conversion rate and reduced transmission of tuberculosis.
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Int. J. Tuberc. Lung Dis. · Jan 2010
Comparative StudyComparison of the APACHE II, GCS and MRC scores in predicting outcomes in patients with tuberculous meningitis.
To evaluate different scoring systems, including Acute Physiology and Chronic Health Evaluation (APACHE) II, the Glasgow Coma Scale (GCS) and the Medical Research Council (MRC) staging system, as well as other prognostic factors, in predicting the discharge outcomes of adult patients with tuberculous meningitis (TBM). ⋯ The APACHE II scoring system is at least as effective as GCS and superior to MRC in predicting the discharge outcomes of adult patients with TBM.