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Monaldi Arch Chest Dis. 2000 Aug;55(4):293-8.
Evaluation of tuberculosis treatment results in Italy, report 1998. Tuberculosis section of the National AIPO Study Group on Infectious Disease and the SMIRA Group.

Centis R, Ianni A, Migliori GB.

Eondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione, Care and Research Institute, Tradate, VA, Italy.

In Italy no national data on tuberculosis (TB) treatment results were available. In 1995 the AIPO (Italian Association of Hospital Pneumologists) TB Study Group, in collaboration with the Istituto Superiore di Sanita (technical branch of the Ministry of Health), started a prospective monitoring activity based on World Health Organization (WHO) and International Union against Tuberculosis and Lung Disease (IUATLD) recommendations. Data were collected from a representative network of TB units nationwide, managing a significant proportion of all TB cases notified in Italy each year. The aim of this study was to analyse the case findings and treatment results for the year 1998. The number of TB cases reported was 1162 (61.7% males; 28.2% immigrants), 888 (76.6%) being new cases. Of these cases, 1,001 (86.4%) were pulmonary, 132 (11.4%) extrapulmonary and 26 (2.2%) both pulmonary and extrapulmonary. The main risk factors for TB were a history of recent contact, diabetes and alcohol abuse among native Italians and human immunodeficiency virus-seropositive status and history of recent contact among immigrants. The majority of immigrants were from Africa and South America, and had been in Italy > 24 months before diagnosis of TB. Forty-seven per cent (552 of 1,162) of patients had a positive direct sputum smear examination for alcohol acidfast bacilli; 30% were resistant to any drug (combined monoresistance (the sum of primary and acquired drug resistance) to rifampicin 2.3%; combined multidrug resistance 11.4%). In 97% of cases, the duration of treatment was < 12 months. The overall success rate (cured plus treatment completed excluding transferred out from the denominator) was 83%. A significantly higher percentage of deaths was found in native Italians (being age-related; p < 0.001), whereas immigrants had a higher default rate.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11057082&dopt=Abstract

Pneumonol Alergol Pol. 1999;67(11-12):536-45.
[Primary and acquired drug resistance of tuberculosis bacilli in Poland]

[Article in Polish]

Zofia Z, Ewa AK, Magdalena K.

Zakladu Mikrobiologii Instytutu Gruzlicy i Chorob Pluc w Warszawie.

Information about resistant pattern of Mycobacterium tuberculosis isolates against antituberculon drugs is a very important part of tuberculosis control and indicates the directions of TB policy in each country. Poland joined WHO/IUATLD global project on drug resistance surveillance, and carried out the first prospective survey, simultaneously on primary and acquired drug resistance of tuberculosis patients according WHO/IUATLD recommendations. The programme covered the whole country, basing on cooperation between the National Reference Laboratory (NRL) with regional TB laboratories. Questionnaires and cultures were obtained from patients who excreted TB bacilli during the period from 1 November 1996 to 1 November 1997 (12 months). Drug susceptibility testing to INH, SM, EMB and RMP were performed on Lowenstein-Jensen medium according to the proportion method or/and radiometric Bactec 460 TB system. 3970 TB patients bacteriologically confirmed by culture were included in a one-year study. The male to female ratio was 2.6:1. Patients were at the age of 6 to 83 years. Majority of patients (86% males and 77% of females) was older than 35 years. Primary resistance to any drug was found in 3.6% of new cases and 2.4% of those patients who excreted monoresistant strains. No monoresistance to EMB was found. 18 patients (0.6%) were infected by MDR strains. Total resistance in new cases was for INH--2.6%, for SM--1.8%, for RMP--0.7% and for EMB--0.1%. Acquired resistance to any drug was found in 17.0% of treated. Majority of patients--7.7% excreted monoresistant strains. 7.0% were infected by MDR strains. Total resistance to INH was 14.8%, to SM--9.2%, to RMP--7.8%, and to EBM--2.5%. No correlation was found between sex and primary resistance rates. Among new cases, 3.7% of males and 3.3% of females were infected with resistant strains. However, among treated patients, males (20%) excreted resistant strains twice as much as females (9.1%). Mean age of women and men infected with primary and acquired resistant strains was similar.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11057104&dopt=Abstract

Pneumonol Alergol Pol. 1999;67(11-12):558-63.
[Pseudochylothorax during the course of rheumatoid arthritis]

[Article in Polish]

Klimczak A, Szczepek B, Szopinski J.

II-go Oddzialu Wewnetrznego Centralnego Szpitala Kolejowego Warszawa-Miedzylesie.

Psudochylothorax is uncommon among pleural fluids. It can be observed during tuberculosis or rheumatoid arthritis in majority. A case of a 62 years old man with chronic pleural fluid is presented. Patient had rheumatoid arthritis diagnosed 40 years ago. For last 13 years symptomsless bilateral pleural fluid was observed. Antituberculous drugs were used without success. Plural fluid obtained after puncture had high level of cholesterol with it[symbol: see text]s crystals, without chylomikrons and triglycerides. Diagnosis of pseudochylothorax in the course of rheumatoid arthritis was established. After plural puncture fluid was removed and did not appear later. Differential diagnosis of pleural fluids is presented.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11057107&dopt=Abstract

Can Respir J. 2000 Sep-Oct;7(5):383-9.
Multidrug-resistant tuberculosis: long term follow-up of 40 non-HIV-infected patients.

Avendano M, Goldstein RS.

West Park Hospital, University of Toronto, Toronto, Canada. mavendaestpark.org

BACKGROUND: There has been a steady increase in referrals of patients with multidrug-resistant tuberculosis (MDR-TB) who are human immunodeficiency virus (HIV) negative. Between 1986 and 1999, 40 patients were admitted to the authors' institution, eight of whom were admitted between January and June 1999. The management of such individuals is difficult. Although they are a clinically and epidemiologically important group of patients, few reports detail their management. OBJECTIVES: To review the demographics, clinical management and long term outcome of 40 non-HIV-infected individuals with MDR-TB referred to the only specialized TB inpatient service in Ontario. PATIENTS AND METHODS: Clinical hospital records were reviewed. RESULTS: Twenty-one men and 19 women (mean age 41+/-18 years) were admitted between January 1986 and June 1999 with MDR-TB and negative serology for HIV. Thirty-eight patients (95%) were born outside of Canada. Twenty-six patients (65%) had a history of previous TB. All were symptomatic with productive cough and positive sputum smears for acid-fast bacilli. There was a delay of 4.5 months between the initial diagnosis of TB and the recognition of the presence of MDR-TB. Four patients (10%) had TB resistant to isoniazid and rifampin only. Over 50% of patients had TB with additional resistance to streptomycin, and over 40% had additional resistance to ethambutol. Coexisting resistance was also found in significant numbers for pyrazinamide, ethionamide, para-aminosalicylic acid and cycloserine. Bacteriological conversion was achieved in 34 patients (85%). Six patients underwent surgical resection for localized lung disease. Twenty-four patients completed treatment and have remained free of disease for 33+/-25 months. All five patients (12%) who died had longstanding disease before their referral. CONCLUSIONS: MDR-TB is most frequently seen among immigrants with a previous history of TB, especially if they come from countries in which TB is highly prevalent. Outcome can be improved by a more timely recognition of MDR-TB.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11058206&dopt=Abstract

Trop Anim Health Prod. 2000 Oct;32(5):267-76.
Comparison between comparative tuberculin and gamma-interferon tests for the diagnosis of bovine tuberculosis in Ethiopia.

Ameni G, Miorner H, Roger F, Tibbo M.

Institute of Pathobiology, Addis Ababa University, Ethiopia.

A study to determine and compare the sensitivities and specificities of the comparative cervical tuberculin (CCT) and gamma-interferon (IFN-gamma) tests for the diagnosis of bovine tuberculosis was conducted on 30 zebu oxen. The results of the tests were compared with the presence of acid-fast bacilli found by bacteriological culturing and histopathological examinations. The sensitivity and specificity of CCT test were found to be 90.9% and 100%, respectively. Those of the commercial IFN-gamma test were determined to be 95.5% and 87.7%, respectively. No significant differences were found between the sensitivities (Yates' corrected chi 2 = 0.32; p = 0.57) or the specificities (Yates' corrected chi 2 = 2.54; p = 0.11) of the two tests. Furthermore, a positive correlation (r = 0.76) was recorded between the increase in skin thickness following injection of bovine purified protein derivative (PPD) and the optical density in the gamma-interferon assay with bovine PPD. On the other hand, the correlation (r = 0.47) between the change in skin thickness following injection of avian PPD and the optical density in the gamma-interferon assay with avian PPD was relatively weak. On the basis of this preliminary investigation, it was concluded that the choice between the two tests depends on their cost and simplicity and on livestock management and time factors rather than on their respective diagnostic value.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11059035&dopt=Abstract

The average human scalp is covered by approximatey 100,000 hair follicles. Each hair undergoes hair cycle and normally 50-100 hairs randomly fall out a day, which is unnoticeable because lost hair is replaced by as many new hairs springing up daily. Hair loss results from the fall out of hair from the hair follicle. Alopecia or excessive, premature hair loss is the condition caused by many factors. Loss of hair itself does not pose critical health problems because biological role of human hair is relatively marginal. Hair on our scalp protects the head from mechanical shock, heat loss, and exposure to UV-light. The eyelashes and eyebrowes protect the eyes, and hair in the ear canal or the nasal passages help filter out particles and pathogens, thus protecting our internal organs. However, hair does play important social role: it is one of the major determinants of our appearance and identity in daily life. Fullness of hair also implicates or manifests physical integrity and youthfulness of the person. Losing hair could have more than just emotional impacts on individuals. The hair is a unique organ that goes through a characteristic cycle consisting of an immature phase, a growing phase called anagen, a transitional phase between the growing phase and the resting phase called catagen, and finally a resting phase called telogen in which the hair stops growing, waiting to fall out. 85-90% of hairs on our body are in anagen phase or growing phase, which lasts anywhere from two to five years. This phase is followed by a short regression phase, or catagen, which lasts 2-3 weeks. Approximately 1% of hair follicles are in catagen. Approximately 10-15% of hair follicles are in the resting phase, the telogen, which lasts about 3-5 months. Hair follicles typically goes through 10-20 asynchronous cycles during the lifetime. Persistent loss of more than 150 hairs would consist a state of hair loss, or alopecia, albeit it could be temporary.

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