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Interferon research abs 1 || Hemoglobin research abs || Stem cell research abs || Nucleic acid research abs || Herpes research abs || Bronchitis research abs || Schizophrenia research abs || Tuberculosis research abs

Singapore Med J. 2002 Aug;43(8):415-20.
The pattern of utilisation and accuracy of a commercial nucleic acid amplification test for the rapid diagnosis of Mycobacterium tuberculosis in routine clinical practice.

Yee YC, Gough A, Kumarasinghe G, Lim TK.

Department of Medicine, National University Hospital, Lower Kent Ridge Road, Singapore 119074.

BACKGROUND: Several nucleic acid amplification (NAA) tests are available for the rapid detection of Mycobacterium tuberculosis (MTB) in clinical specimens. AIMS: To identify the pattern of utilisation and accuracy of the AMPLICOR test in routine clinical practice in an acute care setting. DESIGN: A retrospective descriptive study. METHOD: We studied 159 consecutive specimens in which the AMPLICOR (Roche; Branchburg, NJ) test was requested by attending doctors. The sensitivities and specificities of the AMPLICOR for detection of active tuberculosis (TB) were calculated in relation to types of specimens, smear and culture results. RESULTS: The number of requests more than doubled from 1999 to 2000. Thirty-eight percent of the specimens were not from the respiratory tract.The majority of the specimens had requests for one or more additional test (mean 1.8). The rate of active TB was 18%. The sensitivities of the AMPLICOR on per specimen, per patient, per smear negative specimen and per smear negative patient basis were found to be 81%, 80%, 66.7% and 71.4% respectively. The specificities for these groups accordingly were 99%, 98.6%, 99% and 98.6% respectively. The sensitivity and specificity for respiratory specimens were 97.5% and 98.5%, while for non-respiratory specimens, they were 60% and 100%. In smear negative specimens, the sensitivity and specificity for respiratory specimens were 60% and 98.5%, while for non-respiratory specimens, they were 75% and 100%. The AMPLICOR assay was negative in all 21 specimens of pleural or spinal fluid. CONCLUSIONS: There is a growing demand for NAA in the rapid diagnosis of TB with a high proportion of non-respiratory specimens. The number of additional diagnostic tests performed on each specimen should be limited. In routine clinical practice, the AMPLICOR assay is a useful confirmatory test for active pulmonary TB. The utility of the AMPLICOR assay for MTB detection in exudative fluid specimens needs further evaluation.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12507028&dopt=Abstract

J Zoo Wildl Med. 2002 Dec;33(4):378-80.
Survey of tuberculin testing in Swedish zoos.

Sternberg S, Bernodt K, Holmstrom A, Roken B.

National Veterinary Institute, SE-751 89 Uppsala, Sweden.

Tuberculin test results from 214 animals in three Swedish zoos, tested between the years 1993 and 2000, were compiled from a questionnaire sent out to zoo veterinarians. Comparative testing with bovine and avian tuberculin was used on various sites of injection. A total of five skin test reactors were found: three cotton-top tamarins (Saguinus oedipus) in one zoo and two tapirs (Tapirus terrestris) in another zoo. Postmortem culture from one of the tapirs revealed growth of Mycobacterium tuberculosis, and a stamping out policy was adopted in the herd. Tuberculosis in the primates was ruled out by further investigations. Zoo veterinarians should try to adopt a common scheme for the regular testing of zoo animals to improve the diagnostic ability and comparison of results between institutions.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12564537&dopt=Abstract

Hum Immunol. 2003 Jan;64(1):124-9.
Allelic distribution of human leukocyte antigen in Iranian patients with pulmonary tuberculosis.

Mahmoudzadeh-Niknam H, Khalili G, Fadavi P.

Department of Immunology, Pasteur Institute of Iran, Tehran, Iran

There is convincing evidence for a genetic component in susceptibility to tuberculosis (TB) in humans. Attempts to link susceptibility to TB to human leukocyte antigen (HLA) phenotype have produced conflicting data. The purpose of this study was to determine whether HLA phenotype is associated with clinical TB. We compared the frequencies of HLA alleles in 44 Iranian sputum smear positive pulmonary TB patients with allele frequencies of 108 healthy adults. HLA typing was performed by lymphocytotoxicity assay. The frequencies of HLA-B17 and -DR14 were higher in TB patients and the frequencies of HLA-A26 and -B27 were higher in healthy controls (p value < 0.05, corrected p value [p(c)] >0.05). Our findings suggest that these alleles are associated (either positively or negatively) with pulmonary TB in an Iranian population. However, considering corrected p value, our data are not conclusive and should be considered preliminary.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12507823&dopt=Abstract [PubMed - in process]

J Infect Dis. 2003 Jan 1;187(1):117-23. Epub 2002 Dec 02.
Deletion of RD1 from Mycobacterium tuberculosis mimics bacille Calmette-Guerin attenuation.

Lewis KN, Liao R, Guinn KM, Hickey MJ, Smith S, Behr MA, Sherman DR.

Department of Pediatrics, University of Washington, Seattle 98195, USA.

The tuberculosis (TB) vaccine bacille Calmette-Guerin (BCG) is a live attenuated organism, but the mutation responsible for its attenuation has never been defined. Recent genetic studies identified a single DNA region of difference, RD1, which is absent in all BCG strains and present in all Mycobacterium tuberculosis (MTB) strains. The 9 open-reading frames predicted within this 9.5-kb region are of unknown function, although they include the TB-specific immunodominant antigens ESAT-6 and CFP-10. In this study, RD1 was deleted from MTB strain H37Rv, and virulence of H37Rv:DeltaRD1 was assessed after infections of the human macrophage-like cell line THP-1, human peripheral blood monocyte-derived macrophages, and C57BL/6 mice. In each of these systems, the H37Rv:DeltaRD1 strain was strikingly less virulent than MTB and was very similar to BCG controls. Therefore, it was concluded that genes within or controlled by RD1 are essential for MTB virulence and that loss of RD1 was important in BCG attenuation.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12508154&dopt=Abstract

J Law Med Ethics. 2002 Fall;30(3 Suppl):189-96.
Immigrant health: legal tools/legal barriers.

Moua M, Guerra FA, Moore JD, Valdiserri RO.

University of North Carolina School of Government, Chapel Hill, North Carolina, USA.

The United States is a country of immigrants, our government having been formed by recent arrivals. This trend has continued throughout our history; according to the Center for Immigration Studies, more than 26 million immigrants have settled in the United States since 1970, and approximately one million new immigrants come to the United States each year. The immigrant population faces highly diverse health issues that states, cities, and counties must address, many of which pose significant legal and policy issues. Social, cultural, and linguistic factors complicate those challenges, as does the overlay of federal immigration and health policy. Two federal laws, the Welfare Reform Act of 1996 and Title VI of the federal Civil Rights Act of 1964, have affected immigrants in two very different ways. The former made it difficult for immigrants to qualify for publicly funded benefits. In contrast, Title VI made it easier for immigrants to obtain benefits by requiring federally funded service providers to offer translating services to persons with limited English language skills. Tuberculosis treatment is perhaps the most pressing health need among recent arrivals to the United States. Methods to slow down and hopefully eliminate this disease are underway, but a more comprehensive approach to not only tuberculosis but to immigrant health in general is needed. Indeed, it will benefit those directly affected by tuberculosis and will have serious implications for the entire population for generations to come.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12508525&dopt=Abstract

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