RESUMO
Literature Highlights is a digest of notable papers recently published in the leading respiratory journals. Coverage includes clinical trials of a new vaccine for COVID-19; phase 3 trials of two shorter regimen for drug-resistant TB; evaluation of early diagnosis and treatment of TB in children; understanding the costs of TB services; use of digital eHealth for TB care; a review of the diagnostic accuracy of different molecular assays for TB in children.
RESUMO
Literature Highlights is a digest of notable papers recently published in the leading respiratory journals. Coverage includes clinical trials to investigate the diagnostic and clinical effect of trial of antibiotics on TB; a Phase 3 trial to assess if glucocorticoids decrease mortality among patients with pneumonia; a Phase 2 trial on pretomanid use for treating drug-susceptible TB; contact investigation for TB in China; and post-TB sequelae after TB treatment in children.
Assuntos
Pneumonia , Tuberculose , Criança , Humanos , Antituberculosos/efeitos adversos , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Esquema de Medicação , Busca de Comunicante , Pneumonia/diagnóstico , Pneumonia/tratamento farmacológico , Pneumonia/induzido quimicamenteRESUMO
Literature Highlights is a digest of notable papers recently published in the leading respiratory journals, allowing our readers to stay up-to-date with research advances. This month we include coverage on use of monoclonal antibodies for prevention of COVID-19, acoustic epidemiology and cough assessment; immunotherapeutic interventions for viral and bacterial infections; the potential for harmful use of dexamethasone in COVID-19 patients; diagnostic accuracy of a new finger stick blood test for TB; Clinical standards for pulmonary TB.
Assuntos
COVID-19 , Tuberculose Pulmonar , Anticorpos Monoclonais , Tosse/diagnóstico , Dexametasona , Humanos , Tuberculose Pulmonar/diagnósticoRESUMO
Together, SARS-CoV-2 and M. tuberculosis have killed approximately 5.7 million people worldwide over the past 2 years. The COVID-19 pandemic, and the non-pharmaceutical interventions to mitigate COVID-19 transmission (including social distancing regulations, partial lockdowns and quarantines), have disrupted healthcare services and led to a reallocation of resources to COVID-19 care. There has also been a tragic loss of healthcare workers who succumbed to the disease. This has had consequences for TB services, and the fear of contracting COVID-19 may also have contributed to reduced access to TB services. Altogether, this is projected to have resulted in a 5-year setback in terms of mortality from TB and a 9-year setback in terms of TB detection. In addition, past and present TB disease has been reported to increase both COVID-19 fatality and incidence. Similarly, COVID-19 may adversely affect TB outcomes. From a more positive perspective, the pandemic has also created opportunities to improve TB care. In this review, we highlight similarities and differences between these two infectious diseases, describe gaps in our knowledge and discuss solutions and priorities for future research.
Assuntos
COVID-19 , Tuberculose , Humanos , Controle de Doenças Transmissíveis , COVID-19/epidemiologia , COVID-19/prevenção & controle , Mycobacterium tuberculosis , Pandemias , SARS-CoV-2 , Sindemia , Tuberculose/epidemiologia , Tuberculose/prevenção & controleRESUMO
BACKGROUND: In accordance with the existing hypothesis, the application of an endobronchial valve (EbV) leads to selective curative atelectasis of the affected part of the lung, contributing to early closure of cavities. OBJECTIVE: To assess the effect of EbV treatment on the course of tuberculosis (TB). METHODS: We compared the efficacy of EbV treatment and complex second-line treatment in treating patients with destructive pulmonary multidrug-resistant TB (MDR-TB). Bacteriological conversion and closure of cavities were selected as criteria to assess the effectiveness of EbV application. A total of 102 patients with destructive MDR-TB were enrolled into the study and randomly divided into two groups: 49 patients had an EbV installed (intervention group) and 53 patients received complex second-line treatment (control group). Complex chemotherapy was administered to both groups throughout the study period. RESULTS: The cure rate in the short- and long-term follow-up periods in the intervention group was shown to be much higher, 95.9% by bacteriological conversion and 67.3% by cavity closure. On comparison with the control group, this was respectively 37.7% and 20.7% (P < 0.0001). CONCLUSIONS: The application of EbV treatment can significantly improve the effectiveness of second-line chemotherapy regimens in MDR-TB patients.