Kekkaku : [Tuberculosis]
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Kekkaku : [Tuberculosis] · Oct 2004
[Miss-management in treatment failure of pulmonary tuberculosis].
To investigate the risk factor of treatment failure of pulmonary tuberculosis excluding multi-drug resistant cases from the standpoint of both clinical management and tuberculosis control. ⋯ Clinicians should be aware of these risk factors of treatment failure such as chronic empyema, weak regimen in bacteriological negative cases, rifampicin+ethambutol regimen, and miss-management of drug adverse effect. From the standpoint of tuberculosis control in Japan we considered that, in addition to DOT, strategy to secure the quality of tuberculosis treatment is by all means needed.
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Kekkaku : [Tuberculosis] · Jul 2004
[Evaluation of quantitative fit-testing of N95 filtering facepiece respirators using Mask-Fitting Tester and improvement of mask fitting by instruction].
To evaluate quantitative fitness of N95 filtering facepiece respirators (N95 Mask) using Mask Fitting Tester and improvement of fitness by instruction. ⋯ It is useful to evaluate N95 Mask quantitative fitness using Mask Fitting Tester Model MT-02, Roken type. At the first test, 34.6% of health care workers have large amount of leakage more than 10%, and by instruction or changing a mask type, most of them could achieve 10% or below. But 4.5% could not achieve desired value. On Infection control, it is important to test quantitative fitness of N95 Mask and to provide more than three types of N95 Mask.
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Kekkaku : [Tuberculosis] · Nov 2003
[Efficacy of tuberculosis contacts investigation and treatment, especially of preventive therapy in infants and young children].
Although large clinical trials reported in 1960s suggested that preventive therapy in subjects with tuberculosis (TB) infection reduces the risk of developing TB by 70-90%, the therapy in our TB clinic seems to be more effectiveness. ⋯ The present contacts investigations and treatments in our TB clinic are useful ways to find out and control TB diseases and infections, and it might be suggested to start the six-months preventive therapy after active TB has been ruled out in all infants and children who had close contacts with active TB patients for preventing TB disease and latent TB infection in the future even their clinical and laboratory examinations do not suggest infection.
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Recent development of tuberculosis in Japan tends to converge on a specific high risk group. The proportion of tuberculosis developing particularly from the compromised hosts in the high risk group is especially high. At this symposium, therefore, we took up diabetes mellitus, gastrectomy, dialysis, AIDS and the elderly for discussion. ⋯ CDC mentioned the combined use with RFP and efavirenz (EFV) is possible. So, the treatment with EFV and RFP is recently chosen. However, the monitor of the blood concentration of EFV is required, and the dose of EFV should be increased if it is a low value. (3) When a highly active antiretroviral therapy (HAART) is given to AIDS patients with tuberculosis, transient worsening of tuberculosis may develop after about two weeks. (ABSTRACT TRUNCATED)
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Kekkaku : [Tuberculosis] · Oct 2003
[Characteristics and treatment outcomes of INH-resistant or RFP-resistant tuberculosis].
As an effective regimen for isoniazid-resistant but rifampicin-susceptible tuberculosis (INHr-TB), the use of a 6-month three or four-drug treatment regimen including refampicin (or rifampin) and pyrazinamide has been recommended by many experts of the world. On the other hand, treatment regimen for rifampicin-resistant but isoniazide-susceptible tuberculosis (RFPr-TB) has not been well established because of the small number of such patients. In Japan the standard regimen has not been established even for INHr-TB, and the treatment has been done by each physician on the empirical bases. ⋯ For INHr-TB, even when PZA can't be used because of adverse effects or resistance, 3 or 4 susceptible drugs regimens including RFP for 12 months were effective. For RFPr-TB, the treatment with 4 or more susceptible drugs for 20 months after sputum culture conversion might be adequate.