Alginate-Capped Silver Nanoparticles as a Potent Anti-mycobacterial Agent Against Mycobacterium tuberculosis.

Tuberculosis (TB) is a leading cause of death from a single infectious agent, Mycobacterium tuberculosis (Mtb). Although progress has been made in TB control, still about 10 million people worldwide develop TB annually and 1.5 million die of the disease. The rapid emergence of aggressive, drug-resistant strains and latent infections have caused TB to remain a global health challenge. TB treatments are lengthy and their side effects lead to poor patient compliance, which in turn has contributed to the drug resistance and exacerbated the TB epidemic. The relatively low output of newly approved antibiotics has spurred research interest toward alternative antibacterial molecules such as silver nanoparticles (AgNPs). In the present study, we use the natural biopolymer alginate to serve as a stabilizer and/or reductant to green synthesize AgNPs, which improves their biocompatibility and avoids the use of toxic chemicals. The average size of the alginate-capped AgNPs (ALG-AgNPs) was characterized as nanoscale, and the particles were round in shape. Drug susceptibility tests showed that these ALG-AgNPs are effective against both drug-resistant Mtb strains and dormant Mtb. A bacterial cell-wall permeability assay showed that the anti-mycobacterial action of ALG-AgNPs is mediated through an increase in cell-wall permeability. Notably, the anti-mycobacterial potential of ALG-AgNPs was effective in both zebrafish and mouse TB animal models in vivo. These results suggest that ALG-AgNPs could provide a new therapeutic option to overcome the difficulties of current TB treatments.

Tuberculosis miliar con diseminación renal y genitourinaria, Hospital Escuela Universitario, Honduras, 2017 / Tuberculosis Miliar with Renal and Genitourinary Dissemination, University School Hospital. Honduras, 2017

La tuberculosis continúa siendo un reto diagnóstico al presentarse con características clínicas poco usuales. Objetivo: exponer las características clínicas en un caso inusual de tuberculosis miliar, con diseminación genitourinaria. Presentación del caso clínico: p aciente masculino de 48 años, agricultor, de escasos recursos económicos, sin comorbilidades previas; presentó sintomatología constitucional, pérdida de peso, fiebre y dolor lumbar irradiado a ambos flancos de la región abdominal, de características específicas, de un mes de evolución, acompañado de disuria y oliguria, negó síntomas respiratorios. Al examen físico, luce crónicamente enfermo, en mal estado nutricional, sin deterioro de la conciencia, no evidenció adenopatías cervicales ni inguinales, sin presencia de signos pulmonares y con leve dolor renal bilateral a la puño percusión;en área genital se identifica una masa de borde regular, móvil, sobre el polo superior del testículo derecho. Examen hematológico, presencia de Bicitopenia (anemia microcitica hipocromica y trombocitopenia leve). Además con hiperazoemia e hiperkalemia en la bioquímica sanguínea refractaria al tratamiento; en gases arteriales acidosis metabólica con anión gap elevado, por lo que fue sometido a hemodiálisis aguda. A través de los estudios imagenológicos, por medio de la bacteria alcohol acido resistente de sedimento urinario seriado y la tinción Ziehl Neelsen en orina, se determinó el diagnóstico yse inició terapia antifimica. Conclusión: Es necesario considerar a la tuberculosis como diagnóstico diferencial, especialmente en presentaciones poco usuales, dado que es endémica en Honduras...(AU)

[Methylation Analysis and Validation of Whole Genome DNA in Active Tuberculosis].

OBJECTIVE: To screen and identify the gene of DNA methylation in patients with active tuberculosis. METHODS: ① This study enrolled 9 cases of active tuberculosis patients (including 3 newly diagnosed tuberculosis patients and 6 cases of retreatment of active tuberculosis patients), 3 cases of latent tuberculosis patients and 3 cases of healthy controls. Genome DNA was extracted from Peripheral Blood Mononuclear Cell and following bisulfite conversion treatment. After hybridization with the Illumina HD 450K Infinium Mehtylation BeadChip, the results were compared between patients group and control group, GO and Pathway analysis were performed to evaluate the function of differentially expressed genes; ② We further enrolled 60 cases of active tuberculosis patients and 60 cases of health controls (their age and gender were matched). By using pyrosequencing method to detect the methylation levels of candidate genes (TLR1, TLR2, TLR4) screened by gene chip. RESULTS: ① Compared with healthy controls, we found that most of them were showed demethylation status. GO and Pathway analysis showed that the functions of the differentially methylated regions related genes were mainly enriched in the biological processes of the regulation of leukocyte apoptosis, cytokine regulation and inflammatory response which were closely related to tuberculosis. ②There were 10 CpG sites involved in the verified tuberculosis related genes (TLR1, TLR2, TLR4), the CpG sites of TLR1 gene showed the hypermethylation status (P<0.001), the CpG sites of TLR4 gene showed demethylation status (P=0.012). CONCLUSION: The present study demonstrated that in the course of MTB infection, the methylation status of genomic DNA was altered, and most of the Differentially Methylated Regions (DMRs) were showed status of demethylation. TLR1 gene and TLR4 gene may play an important role in the occurrence and development of tuberculosis.

Factors associated with treatment for latent tuberculosis in persons living with HIV/AIDS / Fatores associados ao tratamento da tuberculose latente em pessoas vivendo com HIV/AIDS / Factores asociados al tratamiento de la tuberculosis latente en personas viviendo con VIH/SIDA

Abstract The aim was to identify factors associated with non-initiation of prophylactic treatment of latent tuberculosis infection (LTBi) in persons living with HIV/AIDS (PLWA), based on a prospective cohort study of PLWA ≥ 18 years of age in two referral services for HIV/AIDS. Of the 232 patients eligible for treatment of LTBi, 69.8% initiated treatment. Following multivariate logistic regression analysis, only treatment in one of the two referral services was associated with non-initiation of treatment for LTBi (p < 0.001). TB incidence in the cohort was 0.6/100 person-years. TB incidence in patients that initiated treatment of LTBi was 0.4/100 person-years, compared to 1.2/100 person-years in those that did not initiate treatment, but the difference was not statistically significant. The study’s most interesting finding was that the main factor associated with the likelihood of treatment for LTBi was the health service where the patient was treated.

Resumo O objetivo foi identificar os fatores associados ao não início do tratamento preventivo para tuberculose (TB) latente (TBLi) em pessoas vivendo com o HIV/AIDS (PVHA). Um estudo de coorte prospectivo foi realizado com PVHA, idade ≥ 18 anos, de dois serviços de referência para HIV/AIDS. De 232 pacientes elegíveis para tratamento da TBLi, 69,8% iniciaram o tratamento. Após análise de regressão logística multivariada, apenas ser tratado em um dos serviços de referência esteve associado ao não início do tratamento para TBLi (p < 0,001). A taxa de incidência de TB na coorte foi de 0,6/100 pessoas/ano. Para os pacientes que iniciaram o tratamento para TBLi, a taxa de incidência de TB foi de 0,4/100 pessoas/ano e para aqueles que não iniciaram, a taxa foi de 1,2/100 pessoas/ano, mas esta diferença não foi estatisticamente significativa. O achado mais interessante deste estudo foi o fato de o principal fator associado ao aumento da probabilidade de ser tratado para TBLi foi a unidade de saúde onde o paciente foi acompanhado.

Resumen El objetivo fue identificar los factores asociados a no iniciar el tratamiento preventivo para la tuberculosis (TB) latente (TBLi) en personas viviendo con VIH/SIDA (PVHA). Un estudio de cohorte prospectivo fue realizado con PVHA, edad ≥ 18 años, de dos servicios de referencia para VIH/SIDA. De 232 pacientes elegibles para el tratamiento de la TBLi, 69,8% iniciaron el tratamiento. Tras el análisis de regresión logística multivariada, simplemente ser tratado en uno de los servicios de referencia estuvo asociado a no comenzar el tratamiento para TBLi (p < 0,001). La tasa de incidencia de TB en la cohorte fue de 0,6/100 personas-año. Para los pacientes que iniciaron el tratamiento para TBLi, la tasa de incidencia de TB fue de 0,4/100 personas-año y para aquellos que no lo iniciaron, la tasa fue de 1,2/100 personas-año, pero esa diferencia no fue estadísticamente significativa. El hallazgo más interesante de este estudio fue el hecho de que el principal factor asociado al aumento de la probabilidad de ser tratado para TBLi fue la unidad de salud donde se realizó el seguimiento del paciente.

Tuberculosis knowledge of newly diagnosed tuberculosis patients in the district tuberculosis clinics of Thai Nguyen province

A retrospective study on 283 people who are 15 years old and more with suspicious tuberculosis seen at District Tuberculosis Clinic, Thai Nguyen province on December 2000. Result: These patients’ knowledge on tuberculosis are quite enough and right: 91% know at least one symptom/sign of suspicious tuberculosis, many people know the symptom of long term cough (87%). 74.2% people know tuberculosis cause by tuberculosis bacteria, 19.1% people though that tuberculosis is caused by hard working and only 1.1% though it is caused by hereditary. Education, occupation and information source access had impacted to the knowledge on tuberculosis.

Early experience of gastrocystoplasty for tuberculous contracted bladder / 대한비뇨기과학회지

Recently the stomach has been used with increasing frequency as an alternative to other bowel segments for auementing the bladder. The proposed advantages include decreased mucus production, reduced urinary infection due to an acid milieu, decreased metabolic abnormalities secondary to chloride excretion, and potential availability in patients with limited bowel length. The wedge gastrocystoplasty was performed in three patients of tuberculous contracted bladder, 2 females and 1 male, aged 22,51 and 57 years. On the excretory urogram, postoperative hydronephrosis was slightly improved as compared with preoperative one. Voiding cystogram showed no vesicoureteral reflux with reasonable capacity in all patients. Urgency, frequency, incontinence and voiding difficulty disappeared within 1 month postoperatively. When postoperative urodynamic studies were compared with the preoperative evaluation, it was noted that overall capacity was increased to an average of 235% (range 91 to 460%) at 2 months after surgery. Compliance has also improved dramatically after surgery. Three patients have been followed for at least 5 months, with the longest followup being 9 months. All patients reveal normal voiding patterns without gastric or urinary complications. We believe that a gastric segment is a suitable alternative to an intestinal segment especially in azotemic patient for reconstructine the urinary bladder. But the longterm effects of gastric augmentation remains to be determined.