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1.
Biosci Biotechnol Biochem ; 85(7): 1759-1762, 2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34036301

RESUMO

This study tried to quantitatively clarify the usefulness of supercritical fluid extraction for removal of chlorophyll and pheophorbide from Chlorella pyrenoidosa. C. pyrenoidosa powder was subjected to supercritical fluid extraction, and chlorophyll a and pheophorbide a in its extracted fractions were measured by HPLC-UV. Chlorophyll a and pheophorbide a in residue after supercritical fluid extraction became below of detection limit.


Assuntos
Chlorella/metabolismo , Clorofila/análogos & derivados , Clorofila/isolamento & purificação , Cromatografia com Fluido Supercrítico/métodos , Proteínas/metabolismo , Cromatografia Líquida de Alta Pressão , Espectrofotometria Ultravioleta
2.
Ann Noninvasive Electrocardiol ; 26(3): e12828, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33463855

RESUMO

BACKGROUND: SCN5A-related Brugada syndrome (BrS) can be caused by multiple mechanisms including trafficking defects and altered channel gating properties. Most SCN5A mutations at pore region cause trafficking defects, and some of them can be rescued by mexiletine (MEX). OBJECTIVE: We recently encountered symptomatic siblings with BrS and sought to identify a responsible mutation and reveal its biophysical defects. METHODS: Target panel sequencing was performed. Wild-type (WT) or identified mutant SCN5A was transfected into tsA201 cells. After incubation of transfected cells with or without 0.1 mM MEX for 24-36 hr, whole-cell sodium currents (INa ) were recorded using patch-clamp techniques. RESULTS: The proband was 29-year-old male who experienced cardiopulmonary arrest. Later, his 36-year-old sister, who had been suffering from recurrent episodes of syncope since 12 years, was diagnosed with BrS. An SCN5A W374G mutation, located at pore region of domain 1 (D1 pore), was identified in both. The peak density of W374G-INa was markedly reduced (WT: 521 ± 38 pA/pF, W374G: 60 ± 10 pA/pF, p < .01), and steady-state activation (SSA) was shifted to depolarizing potentials compared with WT-INa (V1/2 -WT: -39.1 ± 0.8 mV, W374G: -30.9 ± 1.1 mV, p < .01). Incubation of W374G-transfected cells with MEX (W374G-MEX) increased INa density, but it was still reduced compared with WT-INa (W374G-MEX: 174 ± 19 pA/pF, p < .01 versus W374G, p < .01 versus WT). The SSA of W374G-MEX-INa was comparable to W374G-INa (V1/2 -W374G-MEX: -31.6 ± 0.7 mV, P = NS). CONCLUSIONS: Reduced current density, possibly due to a trafficking defect, and depolarizing shift in activation of SCN5A W374G are underlying biophysical defects in this severe form of BrS. Trafficking defects of SCN5A mutations at D1 pore may be commonly rescued by MEX.


Assuntos
Antiarrítmicos/uso terapêutico , Síndrome de Brugada/tratamento farmacológico , Síndrome de Brugada/genética , Mexiletina/uso terapêutico , Mutação/genética , Canal de Sódio Disparado por Voltagem NAV1.5/genética , Adulto , Síndrome de Brugada/diagnóstico , Eletrocardiografia , Feminino , Humanos , Masculino , Mutação/efeitos dos fármacos , Canal de Sódio Disparado por Voltagem NAV1.5/efeitos dos fármacos , Técnicas de Patch-Clamp , Gravidade do Paciente
3.
J Infect Chemother ; 26(8): 818-822, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32327332

RESUMO

The tuberculosis (TB) notification rate in Japan is gradually decreasing but has not yet achieved "pre-elimination," defined by the World Health Organization. To effectively tackle, control, and eliminate TB, estimating and monitoring the annual risk of TB infection (ARI) using tuberculin skin testing (TST) to understand the dynamics of TB epidemiology are significantly important. However, studies estimating ARIs using TST are few considering that Bacillus Calmette-Guérin vaccination coverage is high in Japan. This was a single-center, cross-sectional study conducted between January 2011 and December 2018 in Tokyo area where interferon-gamma release assays (IGRAs) were performed in newly hired researchers of Keio University School of Medicine and healthcare workers of Keio University Hospital to determine TB infection. We estimated the prevalence of TB infection and ARI based on their IGRA results. Among the 3908 subjects, 83 (2.124%) had positive IGRA results. Multiple logistic regression analysis revealed that age was a significant risk factor for positive IGRA result (adjusted odds ratio, 1.046). The ARIs were 0.049%-0.156% between 1986 and 2004, midyears of TB infection, but have not significantly decreased over approximately two decades. To decrease the risk of TB infection, advanced strategies to control and eliminate TB in Tokyo area are significantly required.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Testes de Liberação de Interferon-gama/métodos , Pesquisadores/estatística & dados numéricos , Tuberculose/epidemiologia , Adulto , Fatores Etários , Idoso , Estudos Transversais , Feminino , Humanos , Tuberculose Latente/diagnóstico , Tuberculose Latente/epidemiologia , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Prevalência , Fatores de Risco , Tóquio/epidemiologia , Tuberculose/diagnóstico , Adulto Jovem
4.
Emerg Infect Dis ; 24(11): 2111-2113, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30334726

RESUMO

We estimated the latent tuberculosis infection (LTBI) rate for foreign-born students at Keio University, Tokyo, Japan, using an interferon-γ release assay. The LTBI rate for students from countries with estimated tuberculosis incidence >100 cases/100,000 persons was high (10.0%). Universities should screen for LTBI in students from countries with high tuberculosis incidence.


Assuntos
Testes de Liberação de Interferon-gama/métodos , Tuberculose Latente/diagnóstico , Adulto , Feminino , Humanos , Incidência , Japão/epidemiologia , Tuberculose Latente/epidemiologia , Tuberculose Latente/microbiologia , Masculino , Estudantes , Universidades , Adulto Jovem
5.
J Infect Chemother ; 24(11): 921-924, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30181031

RESUMO

It is important to evaluate the risk of tuberculosis (TB) infection among health care workers (HCWs) and nursing students in Japan to propose the optimal countermeasure against new TB infection for them. To estimate the annual incidence of TB infection in HCWs at a Japanese university hospital without TB wards and in nursing students at a Japanese university using interferon-gamma release assay (IGRA). Serial IGRAs were prospectively conducted on the HCWs between August 2010 and December 2015. For nursing students, two IGRA tests were conducted before commencement of clinical training and at employment as nurses between April 2007 and December 2015. A total of 328 HCWs and 298 nursing students were followed for 670.15 and 1212.80 person-years, respectively. Assuming IGRA-positive conversions were all attributable to true infection, the incidence of TB infection in HCWs and nursing students was 0.149/100 and 0.0825/100 person-years, respectively. At a Japanese university hospital without TB wards and a Japanese university, the annual incidence of TB infection among HCWs and nursing students estimated from serial IGRA results was low, but continued vigilance for the prevention of TB infection is essential.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Mycobacterium tuberculosis/isolamento & purificação , Exposição Ocupacional/efeitos adversos , Estudantes de Enfermagem/estatística & dados numéricos , Tuberculose/epidemiologia , Adulto , Feminino , Seguimentos , Humanos , Incidência , Testes de Liberação de Interferon-gama , Japão/epidemiologia , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Medição de Risco , Tuberculose/diagnóstico , Tuberculose/microbiologia , Tuberculose/prevenção & controle , Universidades/estatística & dados numéricos , Adulto Jovem
6.
Circulation ; 133(2): 114-23, 2016 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-26541829

RESUMO

BACKGROUND: The existence of an atypical fast-slow (F/S) atrioventricular nodal reentrant tachycardia (AVNRT) including a superior (sup) pathway with slow conductive properties and an atrial exit near the His bundle has not been confirmed. METHODS AND RESULTS: We studied 6 women and 2 men (age, 74 ± 7 years) with sup-F/S-AVNRT who underwent successful radiofrequency ablation near the His bundle. Programmed ventricular stimulation induced retrograde conduction over a superior SP with an earliest atrial activation near the His bundle, a mean shortest spike-atrial interval of 378 ± 119 milliseconds, and decremental properties in all patients. sup-F/S-AVNRT was characterized by a long-RP interval; a retrograde atrial activation sequence during tachycardia identical to that over a sup-SP during ventricular pacing; ventriculoatrial dissociation during ventricular overdrive pacing of the tachycardia in 5 patients or atrioventricular block occurring during tachycardia in 3 patients, excluding atrioventricular reentrant tachycardia; termination of the tachycardia by ATP; and a V-A-V activation sequence immediately after ventricular induction or entrainment of the tachycardia, including dual atrial responses in 2 patients. Elimination or modification of retrograde conduction over the sup-SP by ablation near the right perinodal region or from the noncoronary cusp of Valsalva eliminated and confirmed the diagnosis of AVNRT in 4 patients each. CONCLUSIONS: sup-F/S-AVNRT is a distinct supraventricular tachycardia, incorporating an SP located above the Koch triangle as the retrograde limb, that can be eliminated by radiofrequency ablation.


Assuntos
Sistema de Condução Cardíaco/fisiopatologia , Taquicardia por Reentrada no Nó Atrioventricular/fisiopatologia , Taquicardia Supraventricular/fisiopatologia , Trifosfato de Adenosina/farmacologia , Assistência ao Convalescente , Idoso , Idoso de 80 Anos ou mais , Nó Atrioventricular/fisiopatologia , Fascículo Atrioventricular/fisiopatologia , Cateterismo Cardíaco , Estimulação Cardíaca Artificial , Ablação por Cateter , Eletrocardiografia , Eletrocardiografia Ambulatorial , Feminino , Sistema de Condução Cardíaco/efeitos dos fármacos , Humanos , Isoproterenol/farmacologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taquicardia por Reentrada no Nó Atrioventricular/classificação , Taquicardia por Reentrada no Nó Atrioventricular/diagnóstico , Taquicardia por Reentrada no Nó Atrioventricular/cirurgia , Taquicardia Supraventricular/classificação , Taquicardia Supraventricular/diagnóstico , Taquicardia Supraventricular/cirurgia
7.
Euro Surveill ; 22(12)2017 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-28367799

RESUMO

Although the World Health Organization recommends contact investigations around air travel-associated sputum smear-positive tuberculosis (TB) patients, evidence suggests that the information thus obtained may have overestimated the risk of TB infection because it involved some contacts born in countries with high TB burden who were likely to have been infected with TB in the past, or because tuberculin skin tests were used, which are less specific than the interferon gamma release assay (IGRA) particularly in areas where Bacillus Calmette-Guérin (BCG) vaccination coverage is high. We conducted a questionnaire survey on air travel-associated TB contact investigations in local health offices of Japan from 2012 to 2015, focusing on IGRA positivity. Among 651 air travel-associated TB contacts, average positivity was 3.8% (95% confidence interval (CI): 2.5-5.6) with a statistically significant increasing trend with older age (p < 0.0094). Positivity among 0-34 year-old contacts was 1.0% (95% CI: 0.12-3.5%), suggesting their risk of TB infection is as small as among Japanese young adults with low risk of TB infection (positivity: 0.85-0.90%). Limiting the contact investigation to fewer passengers (within two seats surrounding the index case, rather than two rows) seems reasonable in the case of aircraft with many seats per row.


Assuntos
Aeronaves , Busca de Comunicante/estatística & dados numéricos , Testes de Liberação de Interferon-gama/métodos , Mycobacterium tuberculosis/imunologia , Viagem , Tuberculose/diagnóstico , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Criança , Pré-Escolar , Doenças Transmissíveis/transmissão , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Recém-Nascido , Interferon gama/sangue , Masculino , Fatores de Risco , Sensibilidade e Especificidade , Inquéritos e Questionários , Adulto Jovem
8.
Kekkaku ; 92(3): 365-370, 2017 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-30646459

RESUMO

[Background] Interferon-gamma release assay (IGRA) is necessary for evaluating Mycobacteriun tuber- culosis infection in Japan. Application of IGRA for contact surveys has been extended for the aged population; how- ever, there is little information on positive rates with Quanti- FERON® in Tube (QFT-3G) and T-SPOT.®TB (T-SPOT), which sometimes makes it difficult to interpret the results of IGRA performed in contact investigation including the aged population. [Objective] To estimate the positive rate of IGRAs by age group in the general population as well as among healthcare workers. [Methods] We requested all public health centers in Japan to provide contact investigation data for which the risk of infection is limited. Collected data included results of IGRAs in the target group, sputum bacteriological examinations and chest-image findings, and symptoms of the index cases as well as closeness and duration of contact between the index case and the target group. We scrutinized all the cases and exclude data that were not eligible for this study. Positive rates by age group were calculated by summing the number of contacts who were "positive" and dividing by the number of examinees. [Results] In spite of our effort to exclude newly infected persons from the index case, a small portion (probably 3%) may be due to those newly infected by a source case, as it is difficult to exclude those who get infected by casual contact. It is sometimes difficult to collect information on the close- ness and overall duration of contact with the index case, which is a limitation in the questionnaire. Positive rates of IGRA by age group in the general popula- tion were one third to one fifth of the predicted prevalence of infection, which is consistent with findings in the study using QFT Gold (QFT-2G) that IGRA wanes after infection. There were no differences of IGRA positive rate between the general population and health care workers. It may be because the risk of infection for health care workers is similar, as the number of infectious TB patients has been decreasing and infection control in hospitals has generally improved. It may be also because targets for IGRA in contact examina- tion among health care workers tend to be broad including a certain number of low risk staff. [Conclusion] With reference to past studies, we estimated that IGRA positive rates were 5% in the 60's and 15% in the 70's. It will be useful in assessing the possibility or spread of infection for aged groups in contact investigation.


Assuntos
Testes de Liberação de Interferon-gama , Tuberculose/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Interferon gama/biossíntese , Interferon gama/imunologia , Japão/epidemiologia , Pessoa de Meia-Idade , Prevalência , Tuberculose/epidemiologia , Tuberculose/transmissão , Adulto Jovem
9.
Malar J ; 15: 104, 2016 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-26892875

RESUMO

BACKGROUND: In the Amhara Region of Ethiopia, a steep decline of malaria cases was seen in early 2014. This study verified the decrease of the malaria cases along with the positivity rates among acute febrile illness patients, from late 2012 through 2014 in selected districts of the Amhara Region of Federal Republic of Ethiopia. METHODS: Descriptive epidemiological analysis was conducted on the routine malaria surveillance data from the World Health Organization epidemiological week 28 of 2012 to week 52 of 2014 in three districts: Burie Zuria, Dembia and Mecha, the Amhara Region in Ethiopia. The authors visited the three district health offices, and health centres, when necessary, and collected the surveillance data on malaria for that period. RESULTS: The study found that the malaria cases, along with the positivity rates, decreased from late 2012 to early 2014 in all three districts. Though the situation had slightly reverted in late 2014, the numbers of cases were much smaller than in late 2012 in all three districts. Despite the different diagnostic techniques used at health centres (malaria microscopy) and health posts (rapid diagnostic tests), moderate to high correlations were found, suggesting that the trends were real and not caused by a defect in the reagent, differences in the technicians' skills for microscopy, or a change of the health workers' attitudes toward cases with acute febrile illness. The decrease in malaria cases in early 2014 may have resulted from successful implementation of the three pillars of malaria control-case management, indoor residual spraying and insecticide-treated nets-in the districts where a high percentage of households were protected by indoor residual spraying and/or insecticide-treated nets. CONCLUSION: While the current efforts for malaria control should be strengthened and maintained, the review of malaria surveillance data should also be used to verify the malaria trend in the region.


Assuntos
Malária/epidemiologia , Instituições de Assistência Ambulatorial , Notificação de Doenças , Etiópia/epidemiologia , Humanos , Vigilância em Saúde Pública
10.
Bull World Health Organ ; 92(8): 573-81, 2014 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-25177072

RESUMO

OBJECTIVE: To measure trends in the pulmonary tuberculosis burden between 2002 and 2011 and to assess the impact of the DOTS (directly observed treatment, short-course) strategy in Cambodia. METHODS: Cambodia's first population-based nationwide tuberculosis survey, based on multistage cluster sampling, was conducted in 2002. The second tuberculosis survey, encompassing 62 clusters, followed in 2011. Participants aged 15 years or older were screened for active pulmonary tuberculosis with chest radiography and/or for tuberculosis symptoms. For diagnostic confirmation, sputum smear and culture were conducted on those whose screening results were positive. FINDINGS: Of the 40,423 eligible subjects, 37,417 (92.6%) participated in the survey; 103 smear-positive cases and 211 smear-negative, culture-positive cases were identified. The weighted prevalences of smear-positive tuberculosis and bacteriologically-positive tuberculosis were 271 (95% confidence interval, CI: 212-348) and 831 (95% CI: 707-977) per 100,000 population, respectively. Tuberculosis prevalence was higher in men than women and increased with age. A 38% decline in smear-positive tuberculosis (P = 0.0085) was observed with respect to the 2002 survey, after participants were matched by demographic and geographical characteristics. The prevalence of symptomatic, smear-positive tuberculosis decreased by 56% (P = 0.001), whereas the prevalence of asymptomatic, smear-positive tuberculosis decreased by only 7% (P = 0.7249). CONCLUSION: The tuberculosis burden in Cambodia has declined significantly, most probably because of the decentralization of DOTS to health centres. To further reduce the tuberculosis burden in Cambodia, tuberculosis control should be strengthened and should focus on identifying cases without symptoms and in the middle-aged and elderly population.


Assuntos
Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Idoso , Camboja/epidemiologia , Estudos Transversais , Terapia Diretamente Observada , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Prevalência
11.
Heart Vessels ; 29(6): 817-24, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24121973

RESUMO

The length of the slow pathway (SP-L) in atrioventricular (AV) nodal reentrant tachycardia (NRT) has never been measured clinically. We studied the relationship among (a) SP-L, i.e., the distance between the most proximal His bundle (H) recording and the most posterior site of radiofrequency (RF) delivery associated with a junctional rhythm, (b) the length of Koch's triangle (Koch-L), (c) the conduction time over the slow pathway (SP-T), measured by the AH interval during AVNRT at baseline, and (d) the distance between H and the site of successful ablation (SucABL-L) in 26 women and 20 men (mean age 64.6 ± 11.6 years), using a stepwise approach and an electroanatomic mapping system (EAMS). SP-L (15.0 ± 5.8 mm) was correlated with Koch-L (18.6 ± 5.6 mm; R 2 = 0.1665, P < 0.005), SP-T (415 ± 100 ms; R 2 = 0.3425, P = 0.036), and SucABL-L (11.6 ± 4.7 mm; R 2 = 0.5243, P < 0.0001). The site of successful ablation was located within 10 mm of the posterior end of the SP in 38 patients (82.6 %). EAMS-guided RF ablation, using a stepwise approach, revealed individual variations in SP-L related to the size of Koch's triangle and AH interval during AVNRT. Since the site of successful ablation was also correlated with SP-L and was usually located near the posterior end of the SP, ablating anteriorly, away from the posterior end, is not a prerequisite for the success of ablation procedures.


Assuntos
Fascículo Atrioventricular , Ablação por Cateter , Técnicas Eletrofisiológicas Cardíacas/métodos , Taquicardia por Reentrada no Nó Atrioventricular , Adulto , Nó Atrioventricular/fisiopatologia , Fascículo Atrioventricular/patologia , Fascículo Atrioventricular/fisiopatologia , Fascículo Atrioventricular/efeitos da radiação , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Taquicardia por Reentrada no Nó Atrioventricular/diagnóstico , Taquicardia por Reentrada no Nó Atrioventricular/fisiopatologia , Taquicardia por Reentrada no Nó Atrioventricular/terapia , Resultado do Tratamento
12.
Heart Vessels ; 29(5): 703-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24062184

RESUMO

After entrainment pacing, the postpacing interval of a diastolic potential may be misinterpreted if the distal tip of the ablation catheter captures a remote bystander pathway adjacent to the critical isthmus of a complex reentrant circuit in a structurally diseased heart. We discuss this possible pitfall of entrainment mapping of reentrant ventricular tachycardia, observed after a healed myocardial infarction.


Assuntos
Estimulação Cardíaca Artificial/métodos , Técnicas Eletrofisiológicas Cardíacas , Sistema de Condução Cardíaco/fisiopatologia , Taquicardia Ventricular/diagnóstico , Potenciais de Ação , Idoso , Autopsia , Ablação por Cateter , Evolução Fatal , Sistema de Condução Cardíaco/patologia , Sistema de Condução Cardíaco/cirurgia , Humanos , Masculino , Infarto do Miocárdio/complicações , Valor Preditivo dos Testes , Taquicardia Ventricular/etiologia , Taquicardia Ventricular/fisiopatologia , Taquicardia Ventricular/cirurgia , Fatores de Tempo
13.
Int Heart J ; 55(1): 84-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24463918

RESUMO

An 81-year-old man with long RP narrow QRS tachycardia underwent catheter ablation. Ventricular pacing reset the atrial cycle over a retrograde slow pathway, followed by termination of the tachycardia without atrial capture, confirming the diagnosis of fast-slow atrioventricular nodal reentrant tachycardia (AVNRT). The earliest atrial activation during tachycardia was found in the noncoronary sinus of Valsalva, where the first delivery of radiofrequency energy terminated and eliminated the inducibility of the tachycardia, by retrograde conduction block over the slow pathway. This is the first report of a fast-slow AVNRT, with successful ablation of the slow pathway from a noncoronary sinus of Valsalva.


Assuntos
Ablação por Cateter , Seio Aórtico/fisiopatologia , Taquicardia por Reentrada no Nó Atrioventricular/terapia , Idoso de 80 Anos ou mais , Humanos , Masculino
14.
Int J Mycobacteriol ; 12(1): 43-48, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36926762

RESUMO

Background: The epidemiology of infants who exhibited the Koch-like phenomenon after Bacillus Calmette-Guérin vaccination and who subsequently tested positive in interferon-γ release assay (IGRA) was compared to that of those who tested negative. The reports of pediatricians on the phenomenon to the health authorities of Japan were retrieved and analyzed. Methods: In 2013-2019, 790 infants with such events were reported with IGRA test results available, of whom 81 (10.3%) tested positive and 709 (89.7%) negative. Results: The infants who were IGRA positive did not show an increasing trend (P = 0.06, P = 0.60), whereas those who were IGRA negative showed a significantly increasing trend (P = 0.42, P = 0.0002). The infants who were IGRA positive did not exhibit seasonality, whereas those who were IGRA negative had a higher number of cases in winter than in summer. The rates of infants who were IGRA positive per 10 million live births showed a significant correlation with the tuberculosis (TB) notification rates by prefecture (P = 0.41, P = 0.004), whereas those who were IGRA negative did not (P = 0.04, P = 0.78). Conclusion: The IGRA-positive infants were distributed quite differently from those who were IGRA negative and appeared more likely to be infected with TB. Reports of pediatricians on the Koch-like phenomenon should continuously be collected as the reports reflect a risk of TB infection including TB outbreaks among infants in Japan. The reports should include IGRA test results as IGRA is more specific than tuberculin skin testing. Infants with IGRA-positive results should be followed up for 2-3 years to determine their final outcomes.


Assuntos
Testes de Liberação de Interferon-gama , Tuberculose , Humanos , Lactente , Testes de Liberação de Interferon-gama/métodos , Vacina BCG , Japão/epidemiologia , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Tuberculose/prevenção & controle , Vacinação
15.
Int J Mycobacteriol ; 12(4): 486-490, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38149547

RESUMO

Background: Age-period-cohort (APC) analysis has been employed to differentiate long-term trends in the incidences of communicable diseases, including tuberculosis (TB), into the effects of age, birth year, and calendar period. However, no such study was hitherto conducted for Japan, which has 70 years of surveillance data. Therefore, we conducted APC analysis for TB in Japan. Methods: The national TB data for 1953-2022 were analyzed using the log-transformed linear model of APC analysis. Results: Annual age-and sex-standardized notification rates of TB peaked at 599.0 per 100 000 population in 1955 and fell by 99% to 4.5 in 2022. Adjusting for the effects of the birth cohort and period, the relative age-effect risk of TB peaked at 20-29 years and went down toward 60-69 years. Regarding the birth cohort effect, the TB risk showed a turning point in approximately 1913 for the central years of birth. Another change appeared in 1963 when the decline of the risk slightly stagnated; then, it started declining again at a rate as fast as in 1923-1953. Period effects showed a hump in the late 1950s and early 1960s, then sharply declined to the late 1970s, and reached a near plateau level until 2022. Conclusion: Our results highlight the continuing peak in TB disease risk for young adults and sharp decrease in disease risk in the 1960s and 70s. The introduction of anti-TB drugs in the 1950s and early 1970s had the most important impact on the epidemiology of TB in Japan.


Assuntos
Tuberculose , Adulto Jovem , Humanos , Adulto , Japão/epidemiologia , Tuberculose/epidemiologia , Estudos de Coortes , Incidência
16.
Int J Mycobacteriol ; 11(1): 103-107, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35295031

RESUMO

Background: Health facilities which do not have capacity to diagnose tuberculosis (TB) depend on other facilities. This involves the courier of specimen such as sputum to diagnostic centers. This study was aimed at determining the turnaround time of sputum examinations for TB patients involving a courier system between the treatment and diagnostic centers. Methods: The study tracked the sputum samples between TB treatment and diagnostic centers. Sputum samples for both diagnosis and follow-up reasons were purposely and serially tracked from the time they were sent to the laboratory to the time results were received at the treatment centers. Results: Of the 65 sputum samples tracked at Chazanga, results were available for 49 (75.4%), 6 (9.2%) were unaccounted for, 4 (6.2%) were rejected by the laboratory, 4 (6.2%) had "error" results, and 2 (3.1%) were declared "missing" because it took more than a month to return the results. The turnaround time ranged from 2 days to 18 days with an average of 5.8 days (95% confidence interval [CI]: 4.5-7.1 days). At Kaunda Square, of the 49 samples tracked, results were available for 44 (89.8%), 2 (4.1%) were unaccounted for, 2 (4.1%) were rejected, and 1 (2.0%) was declared "missing." The turnaround time ranged from 2 to 25 days with an average of 6.3 days (95% CI: 5.3-7.4 days). Conclusion: The turnaround times of sputum examinations of the two treatment centers were long. The courier system should be closely monitored to determine if it is performing well because the system is still necessary for facilities without laboratories.


Assuntos
Mycobacterium tuberculosis , Tuberculose , Instalações de Saúde , Humanos , Laboratórios , Mycobacterium tuberculosis/genética , Escarro , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Zâmbia
17.
Jpn J Infect Dis ; 75(5): 527-529, 2022 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-35354703

RESUMO

In mid-September 2019, a teenage Chinese male student and part-time waiter in Tokyo was diagnosed with multidrug-resistant (MDR) sputum smear-positive pulmonary tuberculosis (TB). This study describes the outbreak investigation of his friends and colleagues at the restaurant. We investigated 6 friends and 15 colleagues; 5 friends and 13 colleagues underwent interferon-γ release assay (IGRA). Of these, 3 friends (60.0%) and 4 colleagues (30.8%) were IGRA-positive. Each of the friends and colleagues was found to have MDR-TB (20% and 7.7%, respectively). Challenges during the investigation were the unavailability of regimens for latent TB infection (LTBI) for contacts with MDR-TB, budgetary constraints concerning implementing computed tomography (CT) scans for the contacts, frequent address changes of foreign-born patients and contacts, investigation during the coronavirus disease pandemic, and variations of alphabetical expression of the names of the patients and contacts, particularly for those from China. It is recommended that the national government officially adopt prophylaxis regimens for LTBI with MDR-TB, address the budgetary constraints regarding CT scans, and deploy liaison officers for coordinating investigations involving many foreign-born patients and contacts scattered in multiple municipalities. The names of foreign-born persons could more accurately be identified using both the alphabet and Chinese characters.


Assuntos
Emigrantes e Imigrantes , Tuberculose Latente , Tuberculose Resistente a Múltiplos Medicamentos , Adolescente , Surtos de Doenças , Humanos , Japão/epidemiologia , Tuberculose Latente/tratamento farmacológico , Masculino , Tóquio/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia
18.
Int J Mycobacteriol ; 11(3): 287-292, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36260447

RESUMO

Background: In August 2018, a male worker (Pt1) in an office was diagnosed with smear-positive pulmonary tuberculosis (TB). This study aims to characterize the cases found in the TB outbreak in the office. Methods: The risks of TB disease or infection were compared among the staff members by seating locations. Results: A total of 116 current and ex-staff members were investigated, among whom 13 patients with active TB, including Pt1, and 20 with latent TB infection were found by the end of 2020. One-third of the seating groups located at one end of the office that Pt1 belonged to had the highest risk of TB disease (30.8%, 95% confidence interval [CI]: 14.3%-51.8%) and infection (61.5%, 95% CI: 40.6%-79.8%) with a high relative risk of TB infection (6.2, 95% CI: 2.0-18.8) compared to another one-third of the seating groups at the other end of the office that had the lowest risk of active TB (0%, 95% CI: 0%-11.6%) and TB infection (10.0%, 95% CI: 2.1%-26.5%). Conclusion: The seating groups that Pt1 belonged to had the highest risk of TB disease and infection because the staff members in the groups were exposed to the air containing TB bacilli from Pt1. Local health offices should initiate active case finding using chest X-rays as soon as they are notified of a sputum smear-positive TB case if the delay of the diagnosis is longer than three months.


Assuntos
Tuberculose Latente , Mycobacterium tuberculosis , Tuberculose Pulmonar , Tuberculose , Humanos , Masculino , Japão/epidemiologia , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Surtos de Doenças , Tuberculose Latente/epidemiologia
20.
Int J Mycobacteriol ; 10(1): 8-12, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33707365

RESUMO

Background: Early detection of an outbreak is a role of disease surveillance systems; however, tuberculosis (TB) surveillance systems were underutilized to detect the outbreaks. In mid-2015, a local health office of central Japan noticed the number of TB cases of city in 2012-2014 were well above the expected numbers. This study was conducted to determine whether and when a community TB outbreak could be detected and characterize the cases using the national surveillance data. Method: The surveillance data of the A city and surrounding areas were retrospectively reviewed and analyzed for 2006-2018. Results: The TB notification rates of the A city from 2012 to 2014 were 28.0 (95% confidence interval [CI]: 20.3-38.4), 26.0 (95%CI: 18.6-36.0), 28.2 (95%CI: 20.3-38.4) per 100,000 population, respectively, higher than that of the entire prefecture (13.6, 13.0, 13.3, respectively). Similarly, in the neighboring B city, the rates of 2012 and 2014 were 51.0 (95%CI: 27.2-87.2) and 51.2 (95%CI: 27.3-87.5), respectively, higher than that of its parent prefecture (13.4 and 12.7, respectively). By the end of July 2012 (A city) or August 2012 (B city), the accumulated numbers of TB cases exceeded the previous annual TB cases. The average TB notification rates of A and B cities for 2012-2014 were higher than the surrounding areas. Conclusion: A community TB outbreak without well-defined setting could be detected by monitoring TB surveillance data.


Assuntos
Tuberculose , Cidades , Surtos de Doenças , Humanos , Japão/epidemiologia , Estudos Retrospectivos , Tuberculose/diagnóstico , Tuberculose/epidemiologia
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