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1.
Dis Aquat Organ ; 139: 81-86, 2020 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-32351238

RESUMO

New Zealand fur seals Arctocephalus forsteri are the most abundant of the 4 otariid (eared seal) species distributed across Australasia. Analyses of stomach contents, scats and regurgitates suggest a diet dominated by bony fish and squid, with cartilaginous species (e.g. sharks and rays) either absent or underrepresented because of a lack of preservable hard parts. Here we report on a subadult specimen from south-eastern Australia, which was found ashore emaciated and with numerous puncture wounds across its lips, cheeks, throat and the inside of its oral cavity. Fish spines embedded in the carcass revealed that these injuries were inflicted by chimaeras and myliobatiform rays (stingrays and relatives), which matches reports on the diet of A. forsteri from New Zealand, but not South Australia. Shaking and tearing of prey at the surface may help to avoid ingestion of the venomous spines, perhaps contributing to their absence from scats and regurgitates. Nevertheless, the number and severity of the facial stab wounds, some of which led to local necrosis, likely affected the animal's ability to feed, and may account for its death. Despite their detrimental effects, fish spine-related injuries are difficult to spot, and may be a common, albeit cryptic, type of trauma. We therefore recommend that stranded seals be systematically examined for this potentially life-threatening pathology.


Assuntos
Otárias , Ração Animal , Animais , Dieta , Comportamento Alimentar , Nova Zelândia , Austrália do Sul
2.
Anaesthesist ; 62(12): 1010-9, 2013 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-24240570

RESUMO

On 24 July 2010 the love parade, a large scale open air concert was held in the city of Duisburg to which more than 500,000 guests were expected. During the course of the early evening a major tragic incident occurred in which 21 people were crushed to death and several hundred others were injured. In this article the preparation of the emergency and rescue services prior to the event is described and their operations entailing more than 1,600 staff members from all over Germany are illustrated. The article focuses on the mass casualty incident which took place in the tunnel in the early evening of that day.


Assuntos
Aniversários e Eventos Especiais , Serviços Médicos de Emergência/organização & administração , Música , Asfixia/terapia , Planejamento em Desastres , Serviços Médicos de Emergência/economia , Alemanha , Humanos , Incidentes com Feridos em Massa , Farmácias , Saneamento , Triagem
3.
S Afr Med J ; 113(3): 125-134, 2023 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-36876352

RESUMO

BACKGROUND: Substantial additional efforts are needed to prevent, find and successfully treat tuberculosis (TB) in South Africa (SA). In thepast decade, an increasing body of mathematical modelling research has investigated the population-level impact of TB prevention and careinterventions. To date, this evidence has not been assessed in the SA context. OBJECTIVE: To systematically review mathematical modelling studies that estimated the impact of interventions towards the World HealthOrganization's End TB Strategy targets for TB incidence, TB deaths and catastrophic costs due to TB in SA. METHODS: We searched the PubMed, Web of Science and Scopus databases for studies that used transmission-dynamic models of TB in SAand reported on at least one of the End TB Strategy targets at population level. We described study populations, type of interventions andtheir target groups, and estimates of impact and other key findings. For studies of country-level interventions, we estimated average annualpercentage declines (AAPDs) in TB incidence and mortality attributable to the intervention. RESULTS: We identified 29 studies that met our inclusion criteria, of which 7 modelled TB preventive interventions (vaccination,antiretroviral treatment (ART) for HIV, TB preventive treatment (TPT)), 12 considered interventions along the care cascade for TB(screening/case finding, reducing initial loss to follow-up, diagnostic and treatment interventions), and 10 modelled combinationsof preventive and care-cascade interventions. Only one study focused on reducing catastrophic costs due to TB. The highest impactof a single intervention was estimated in studies of TB vaccination, TPT among people living with HIV, and scale-up of ART. Forpreventive interventions, AAPDs for TB incidence varied between 0.06% and 7.07%, and for care-cascade interventions between 0.05%and 3.27%. CONCLUSION: We describe a body of mathematical modelling research with a focus on TB prevention and care in SA. We found higherestimates of impact reported in studies of preventive interventions, highlighting the need to invest in TB prevention in SA. However, studyheterogeneity and inconsistent baseline scenarios limit the ability to compare impact estimates between studies. Combinations, rather thansingle interventions, are likely needed to reach the End TB Strategy targets in SA.


Assuntos
Infecções por HIV , Tuberculose , Humanos , África do Sul , Antirretrovirais , Bases de Dados Factuais
4.
Br J Dermatol ; 166(2): 247-51, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21967192

RESUMO

For many years it has been the work of Buschke and Löwenstein that has justified calling the exophytic, locally destructive tumour of the anogenital mucosal surface 'giant condyloma of Buschke and Löwenstein' or GCBL. In order to investigate the early history of this rare disease we examined the writings of the barber-surgeon Wilhelm Fabry (1560-1634) who had a serious interest in dermatological disorders and their treatment. We analysed Fabry's 600 Latin case reports and identified the case of a 'monstrous penile tumour'. We then translated this text into English and compared it point by point with later publications. This was followed by a cursory review of surgical treatises from the 16th to the 18th centuries. In 1614 Fabry described and depicted a tumour of the penis; the clinical characteristics (gradual formation of a warty lesion, considerable size, invasive growth, absence of metastases) indicated it was a giant condyloma. His mention of the urethral fistulization enables discrimination from 'common' condylomata acuminata, and the survival period of 10 years after amputation allows exclusion of a 'true' carcinoma. This report is singular among 17th-century case histories. The neoplasias described 300 years later are most probably biologically identical. Thus, Fabry's is the first clinical report; the histological classification, however, belongs to Buschke and Löwenstein. From now on the disease should be designated with the eponym giant condyloma of Fabry-Buschke-Löwenstein or GCFBL.


Assuntos
Condiloma Acuminado/história , Doenças do Pênis/história , Cirurgiões Barbeiros/história , Condiloma Acuminado/patologia , Epônimos , Alemanha , História do Século XVI , História do Século XVII , História do Século XIX , História do Século XX , Humanos , Masculino , Doenças do Pênis/patologia , Procedimentos Cirúrgicos Urológicos Masculinos/história
5.
Int J Tuberc Lung Dis ; 26(1): 26-32, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34969425

RESUMO

OBJECTIVE: To investigate the uptake and usage of a WhatsApp-based interactive communication strategy to avert pre-diagnosis loss to follow-up (LTFU) from TB care in a high-incidence setting.METHODS: We enrolled adults (≥18 years) who underwent routine sputum TB testing in two primary healthcare clinics in Khayelitsha, Cape Town, South Africa. The intervention consisted of structured WhatsApp-based reminders (prompts) sent prior to a routine clinic appointment scheduled 2-3 days after the diagnostic visit. Pre-diagnosis LTFU was defined as failure to return for the scheduled appointment and within 10 days.RESULTS: We approached 332 adults with presumptive TB, of whom 103 (31%) were successfully enrolled; 213 (64%) did not own a WhatsApp-compatible phone. Of 103 participants, 74 (72%) actively responded to WhatsApp prompts; 69 (67%) opted to include a close contact in group communication to co-receive reminders. Pre-diagnosis LTFU was low overall (n = 7, 6.8%) and was not associated with failure to respond to WhatsApp prompts.CONCLUSION: In this high-incidence setting, enrolment in a WhatsApp-based communication intervention among adults with presumptive TB was low, mainly due to low availability of WhatsApp-compatible phones. Among participants, we observed high message response rates and low LTFU, suggesting potential for interactive messaging services to support pre-diagnosis TB care.


Assuntos
Agendamento de Consultas , Perda de Seguimento , Envio de Mensagens de Texto , Tuberculose , Adulto , Humanos , Seguimentos , Incidência , África do Sul/epidemiologia , Tuberculose/diagnóstico
6.
Unfallchirurg ; 114(9): 794-800, 2011 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-21863384

RESUMO

BACKGROUND: Tragic incidents at the 2010 Love Parade attracted significant public attention. As the frequency of similar events increases, more hospitals and practitioners will face the necessities of planning and response to unforeseeable occurrences. Obligatory guidelines for physicians do not exist, so that essential aspects are repeatedly discussed for each new event. This paper summarizes the experience of hospitals and emergency departments and draws conclusions, allowing recommendations for reasonable proposals for hospitals and practitioners. METHODS AND MATERIAL: A structured analysis of data concerning planning, patient flow and injury statistics led to a profile determining personnel, rooms and material which have to be provided by the hospitals. In a consensus conference afterwards and personal interviews with clinical coordinators the preparation of hospitals was evaluated to separate reasonable from needless efforts. RESULTS: We describe various measures concerning staff, logistics and rooms from the viewpoint of actual application. Reasonable measures for preparation and management of mass panic are analysed and described in detail. Problems are explained and solutions discussed. The result is a qualitative catalogue, which supports the organization of future events. CONCLUSION: Knowledge and reflection on the experience of the 2010 Love Parade optimizes local emergency guidelines and planning for similar events. A coordinated cooperation of all involved is essential.


Assuntos
Planejamento em Desastres/organização & administração , Serviços Médicos de Emergência/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Férias e Feriados/estatística & dados numéricos , Incidentes com Feridos em Massa/prevenção & controle , Incidentes com Feridos em Massa/estatística & dados numéricos , Equipe de Assistência ao Paciente/organização & administração , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/terapia , Adolescente , Adulto , Idoso , Assistência Ambulatorial/estatística & dados numéricos , Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Análise de Sobrevida , Adulto Jovem
7.
Transl Anim Sci ; 5(2): txab068, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34189414

RESUMO

This study aimed to evaluate the effect of autoclave processing on compressive stress of spongy and cortical bones, and the effect of autoclaved bones as chewing agents to reduce dental calculus in adult dogs. Spongy and cortical bones were autoclaved (1 ATM, 30 min, and 120°C) and compressive strength was evaluated in autoclaved and raw bone specimens. Autoclaved bones were offered to ten Beagle dogs divided into two groups of 5 dogs each: Group 1 - received a portion of the autoclaved bovine cortical bone (ACB) and Group 2 - received a portion of the autoclaved bovine spongy bone (ASB). Prior to the experimental period (1-d) and every two days thereafter, oral photographs were taken on both sides of the dental arch to evaluate dental calculus reduction over time. The vestibular surface of the canines, premolars, and molars teeth was evaluated using integration software to measure the proportion between the area covered by calculus and the total teeth area. The effect of bone type, treatment (raw vs. autoclaved), and their interaction were evaluated using the PROC GLIMMIX procedure of SAS (version 9.4). Linear equations were generated to estimate calculus reduction over time for ACB and ASB. Compressive strength was higher (P < 0.05) in cortical bones compared to spongy bones. However, the autoclaving procedure did not affect (P > 0.05) compressive strength, regardless of the bone type. The teeth area covered by calculus of dogs that were offered ACB reduced from 41% to 32% in 5 days, and at the end of 15 days a reduction of 62.2% was observed, resulting in a remaining of 15.5% of teeth area covered by calculus. In this group, the dental calculus area reduced by 57.7% after 5 days, and at the end of the trial, only 5.4% of teeth were still covered by calculus, which represents a reduction of 81%. The linear regression analysis revealed no significant difference between the slopes for the ACB and ASB equations (P > 0.05). No health complications such as tooth fracture, intestinal obstructions, and oral lesions were observed throughout the study. Our results demonstrated that the autoclave processing did not impair compressive strength of spongy and cortical bones. This corroborates with the results observed in vivo, which suggests that autoclaved bones are chewing agents for adult dogs with additional benefits of lower risk of bacterial contamination.

8.
Int J Tuberc Lung Dis ; 25(4): 262-270, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33762069

RESUMO

BACKGROUND: Persistent respiratory symptoms and lung function deficits are common after patients with TB. We aimed to define the burden of post-TB lung disease (PTLD) and assess associations between symptoms and impairment in two high TB incidence communities.METHODS: This was a cross-sectional survey of adults in Cape Town, South Africa who completed TB treatment 1-5 years previously. Questionnaires, spirometry and 6-minute walking distance (6MWD) were used to assess relationships between outcome measures and associated factors.RESULTS: Of the 145 participants recruited (mean age: 42 years, range: 18-75; 55 [38%] women), 55 (38%) had airflow obstruction and 84 (58%) had low forced vital capacity (FVC); the mean 6MWD was 463 m (range: 240-723). Respiratory symptoms were common: chronic cough (n = 27, 19%), wheeze (n = 61, 42%) and dyspnoea (modified MRC dyspnoea score 3 or 4: n = 36, 25%). There was poor correlation between FVC or obstruction and 6MWD. Only low body mass index showed consistent association with outcomes on multivariable analyses. Only 19 (13%) participants had a diagnosis of respiratory disease, and 16 (11%) currently received inhalers.CONCLUSION: There was substantial burden of symptoms and physiological impairment in this "cured" population, but poor correlation between objective outcome measures, highlighting deficits in our understanding of PTLD.


Assuntos
Pulmão , Doença Pulmonar Obstrutiva Crônica , Tuberculose , Adulto , Feminino , Humanos , Estudos Transversais , Volume Expiratório Forçado , África do Sul/epidemiologia , Espirometria , Capacidade Vital , Tuberculose/tratamento farmacológico
9.
Int J Tuberc Lung Dis ; 25(10): 797-813, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34615577

RESUMO

BACKGROUND: Increasing evidence suggests that post-TB lung disease (PTLD) causes significant morbidity and mortality. The aim of these clinical standards is to provide guidance on the assessment and management of PTLD and the implementation of pulmonary rehabilitation (PR).METHODS: A panel of global experts in the field of TB care and PR was identified; 62 participated in a Delphi process. A 5-point Likert scale was used to score the initial ideas for standards and after several rounds of revision the document was approved (with 100% agreement).RESULTS: Five clinical standards were defined: Standard 1, to assess patients at the end of TB treatment for PTLD (with adaptation for children and specific settings/situations); Standard 2, to identify patients with PTLD for PR; Standard 3, tailoring the PR programme to patient needs and the local setting; Standard 4, to evaluate the effectiveness of PR; and Standard 5, to conduct education and counselling. Standard 6 addresses public health aspects of PTLD and outcomes due to PR.CONCLUSION: This is the first consensus-based set of Clinical Standards for PTLD. Our aim is to improve patient care and quality of life by guiding clinicians, programme managers and public health officers in planning and implementing adequate measures to assess and manage PTLD.


Assuntos
Pneumopatias , Qualidade de Vida , Tuberculose , Humanos , Consenso , Pneumopatias/diagnóstico , Pneumopatias/terapia , Tuberculose/complicações
10.
Biochim Biophys Acta Biomembr ; 1862(8): 183246, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32142818

RESUMO

The filamentous fungus Penicillium chrysogenum Q176 secretes the antimicrobial proteins (AMPs) PAF and PAFB, which share a compact disulfide-bond mediated, ß-fold structure rendering them highly stable. These two AMPs effectively inhibit the growth of human pathogenic fungi in micromolar concentrations and exhibit antiviral potential without causing cytotoxic effects on mammalian cells in vitro and in vivo. The antifungal mechanism of action of both AMPs is closely linked to - but not solely dependent on - the lipid composition of the fungal cell membrane and requires a strictly regulated protein uptake into the cell, indicating that PAF and PAFB are not canonical membrane active proteins. Variations in their antifungal spectrum and their killing dynamics point towards a divergent mode of action related to their physicochemical properties and surface charge distribution. In this review, we relate characteristic features of PAF and PAFB to the current knowledge about other AMPs of different sources. In addition, we present original data that have never been published before to substantiate our assumptions and provide evidences that help to explain and understand better the mechanistic function of PAF and PAFB. Finally, we underline the promising potential of PAF and PAFB as future antifungal therapeutics.


Assuntos
Antifúngicos/química , Peptídeos Catiônicos Antimicrobianos/química , Proteínas Fúngicas/química , Micoses/tratamento farmacológico , Antifúngicos/farmacologia , Peptídeos Catiônicos Antimicrobianos/genética , Peptídeos Catiônicos Antimicrobianos/farmacologia , Apoptose/efeitos dos fármacos , Membrana Celular/efeitos dos fármacos , Cisteína/genética , Proteínas Fúngicas/genética , Humanos , Lipídeos de Membrana/química , Micoses/genética , Micoses/microbiologia , Penicillium chrysogenum/química , Penicillium chrysogenum/genética
11.
Int J Tuberc Lung Dis ; 24(8): 820-828, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32912387

RESUMO

ALTHOUGH CURABLE, TB frequently leaves the individual with chronic physical and psycho-social impairment, but these consequences have been largely neglected. The 1st International Post-Tuberculosis Symposium (Stellenbosch, South Africa) was held to discuss priorities and gaps in addressing this issue. A barrier to progress has been the varied terminology and nomenclature, so the Delphi process was used to achieve consensus on definitions. Lack of sufficient evidence hampered definitive recommendations in most domains, including prevention and treatment of post-TB lung disease (PTLD), but the discussions clarified the research needed. A consensus was reached on a toolkit for future PTLD measurement and on PTLD patterns to be considered. The importance of extra-pulmonary consequences and progressive impairment throughout the life-course was identified, including TB recurrence and increased mortality. Patient advocates emphasised the need to address the psychological and social impacts post TB and called for clinical guidance. More generally, there is an urgent need for increased awareness and research into post-TB complications.


Assuntos
Tuberculose , Consenso , Humanos , Pulmão , África do Sul , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico
12.
Pneumologie ; 63(5): 253-60, 2009 May.
Artigo em Alemão | MEDLINE | ID: mdl-19259917

RESUMO

BACKGROUND: Tuberculosis (TB) remains a serious threat to public health in Russia and other former Soviet Union Countries. The purpose of this paper is to describe the current trends of TB and MDR-TB in Russia and identify the characteristics of the traditional Russian TB control model inherited from the Soviet Union. We discuss current challenges to TB control in the country. METHODS: WHO tuberculosis notification data were analysed for Russia and 14 other former Soviet Union countries. To investigate the characteristics of TB control in Russia, we performed a systematic literature review using MEDLINE/EMBASE databases. 136 articles were initially identified of which 66 fulfilled the inclusion criteria. Full texts were reviewed. Additionally, we reviewed non-systematically Russian state reports, guidelines and legislations. RESULTS: In 2006, nearly 125 000 TB cases and 28 000 TB deaths were notified in the Russian Federation. The TB notification rate was 13 times higher than in Germany. The characteristics of the traditional Russian TB control model include: a centralised disease-specific inpatient network for diagnosis and treatment of TB, countrywide population screenings using fluorography, a strong focus on X-ray for diagnosis and disease classification, individualised and lengthy inpatient care, high rates of drug resistance, and inefficient financing systems. CONCLUSIONS: Current challenges to TB control in Russia are: the implementation of a quality-assured laboratory network for sputum-smear microscopy, culture and drug susceptibility testing, ensuring MDR-TB treatment and control, prevention and management of TB/HIV, and reform of health care financing systems. For TB control to be successful in the Russian Federation, the characteristics of the traditional TB control model need to be taken into account.


Assuntos
Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Tuberculose/epidemiologia , Humanos , Incidência , Vigilância da População , Portugal/epidemiologia , Medição de Risco/métodos , Fatores de Risco , Federação Russa/epidemiologia , Tuberculose/prevenção & controle , U.R.S.S./epidemiologia
13.
Int J Tuberc Lung Dis ; 23(8): 891-899, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31533878

RESUMO

OBJECTIVE: To investigate the extent to which relapse and other previously treated tuberculosis (TB) contribute to the notified TB burden in South Africa.DESIGN: We conducted an ecological analysis at the level of the 52 South African health districts using national electronic TB register data. We included all bacteriologically confirmed TB cases treated for presumed drug-susceptible TB in 2011. Treatment history information was based on recorded patient categories (new vs. retreatment).RESULTS: Relapse and other previously treated TB cases constituted between 7.6% and 40% (median 17%, interquartile range 12-22) of all bacteriologically confirmed TB cases in the 52 South African districts. Multivariable analysis suggested that districts with higher proportions of previously treated TB cases had higher TB case notification rates (P < 0.001), lower estimates of antenatal human immunodeficiency virus (HIV) prevalence in the district population (P < 0.001) as well as lower HIV co-infection rates (P < 0.001) among new TB cases.CONCLUSION: Relapse and other previously treated TB cases contributed substantially to the notified TB burden in several South African health districts, particularly those with high case notification rates and lower antenatal HIV prevalence. Additional efforts to prevent TB among previously treated people, such as strengthening treatment monitoring and/or secondary preventive therapy, should be considered.


Assuntos
Efeitos Psicossociais da Doença , Notificação de Doenças/estatística & dados numéricos , Infecções por HIV/epidemiologia , Tuberculose/epidemiologia , Adolescente , Adulto , Antituberculosos/administração & dosagem , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Prevalência , Recidiva , Retratamento/estatística & dados numéricos , África do Sul/epidemiologia , Tuberculose/tratamento farmacológico , Adulto Jovem
14.
Unfallchirurg ; 111(8): 584-6, 588-91, 2008 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-18584143

RESUMO

BACKGROUND: Hinged external fixation is a recognized method to treat instabilities after complex dislocations and fracture-dislocations of the elbow. The hinged external fixator allows stabilization of the elbow while preserving flexion and extension. METHODS: Eighteen patients with an average age of 47 years (range 35-67) were treated with a hinged external fixator between April 2001 and March 2006 for 6 weeks. In 11 patients an internal fixation had to be done; six were treated initially with an AO fixator. After 8 days (3-14), we changed to a hinged external fixator. RESULTS: At 39 months (12-71) of follow-up, all 18 elbows were stable. One stress-fracture of the ulna after pin removal occurred. The mean Mayo Elbow Performance Index (MEPI) was 78 points. Five (28%) patients had an excellent result, six (33%) a good result and seven (39%) a fair result. The average DASH score (disabilities of the arm, shoulder and hand) was 18 points, which indicates a discrete impairment. CONCLUSION: The treatment outcome of complex instabilities treated with a hinged external fixator using our technique is comparable to outcomes from other studies.


Assuntos
Lesões no Cotovelo , Articulação do Cotovelo/cirurgia , Fixação Interna de Fraturas/instrumentação , Fixação Interna de Fraturas/métodos , Ligamentos/lesões , Ligamentos/cirurgia , Traumatismo Múltiplo/cirurgia , Adulto , Idoso , Desenho de Equipamento , Feminino , Humanos , Masculino , Resultado do Tratamento
15.
Int J Tuberc Lung Dis ; 22(2): 139-150, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29506610

RESUMO

Recurrent tuberculosis (TB), defined as TB that recurs after a patient has been considered cured, constitutes a challenge to TB control. In low TB burden countries, the underlying causes and consequences of recurrent TB are poorly understood. We conducted a literature review to summarise the evidence of recurrent TB in low-burden settings and to address current gaps in knowledge. We included peer-reviewed publications on studies conducted in countries with an estimated TB incidence of <100 cases per 100 000 population. The Newcastle-Ottawa scale was used to assess study quality. The review yielded 44 manuscripts, 39 of which were reports of observational studies and 5 of clinical trials. The median percentage of TB patients experiencing an episode of recurrent TB after treatment completion was 3.4% (interquartile range [IQR] 1.6-6.0, range 0.4-16.7) in studies with a median follow-up of 7.8 years (IQR 5-12, range 2-33). The median percentage of recurrences attributable to endogenous reactivation (rather than exogenous reinfection) was 81% (IQR 73.1-85.5, range 49-100). Commonly identified risk factors for recurrence in low-burden settings included infection by the human immunodeficiency virus, low socio-economic status, foreign birth and infection with drug-resistant TB. Current understanding of recurrence in low-burden settings is limited, in part due to substantial methodological differences between studies. Further research is required to delineate the mechanisms of TB recurrence, its health and clinical impact, as well as the implications for TB elimination efforts in low-burden countries.


Assuntos
Tuberculose Pulmonar/epidemiologia , Infecções por HIV , Humanos , Pobreza , Recidiva , Fatores de Risco , Tuberculose Resistente a Múltiplos Medicamentos , Tuberculose Pulmonar/prevenção & controle
16.
J Anim Sci ; 95(2): 752-760, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28380617

RESUMO

Glycerol is a humectant, which reduces water activity when added to the diet. This property seems to offer dietary benefits, specifically in high-moisture diets for cats, where some humectants cannot be used. According to the U.S. Food and Drug Administration, glycerol is generally recognized as sustenance safe (GRAS). It is suggested that cats are able to metabolize glycerol and use it as an energy source without compromising health. Three experiments were conducted to evaluate the following characteristics of glycerol in the diet for cats: 1) a preference test, 2) digestibility, ME, and fecal and urinary characteristics, and 3) postprandial plasma glycemia. Twelve healthy adult female cats were randomly distributed among 4 treatments consisting of a basal diet (4,090 kcal ME/kg DM, 32% CP, 11% fat, 2.3% crude fiber, and 7.0% ash) and 3 diets with varying percentages of glycerol, made by replacing the basal diet with 2.5, 5.0, and 10.0% purified glycerol (99.5%). The inclusion of glycerol proportionally reduced ( < 0.05) water activity in the diets. The preference test was conducted by observing the contrast between the basal diet and the 5.0% and 10% glycerol diets. Cats did not show a preference for any diet in particular ( > 0.05). The digestibility assays showed that increasing dietary glycerol levels did not affect food intake or the apparent total tract digestibility of macronutrients and energy ( > 0.05). The inclusion of glycerol in the diets did not alter the stool moisture, fecal score, or urine volume. However, glycerol was detected in urine when it was incorporated into the diet at 10%. Glycemia increased up to 900 min following the first meal after the fasting period with no difference between treatments, even when the means were adjusted for food intake. The blood glucose area under the curve also showed no significant difference between treatments ( > 0.05). Cats accepted glycerol under the conditions of the study, and its nutritional value was determined as it has been done for other species. The ME of glycerol for adult cats was estimated to be 3,185 kcal/kg DM. Supplementing the diets of the cats with 10% glycerol may exceed their capacity to metabolize glycerol, possibly leading to urinary excretions.


Assuntos
Ração Animal/análise , Gatos/fisiologia , Dieta/veterinária , Digestão/fisiologia , Metabolismo Energético/fisiologia , Glicerol/metabolismo , Fenômenos Fisiológicos da Nutrição Animal , Animais , Glicemia , Suplementos Nutricionais , Ingestão de Alimentos , Fezes , Comportamento Alimentar , Feminino , Glicerol/química , Valor Nutritivo , Período Pós-Prandial
17.
Int J Tuberc Lung Dis ; 21(3): 270-277, 2017 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28225337

RESUMO

SETTING: Interferon-gamma (IFN-γ) release assays (IGRAs) play an important role in the diagnosis of Mycobacterium tuberculosis infection. However, in children with tuberculosis (TB), some studies have shown increased frequencies of false-negative or indeterminate IGRA results. OBJECTIVE: To analyse the spectrum of different cytokines to improve the diagnostic accuracy of IGRAs in latent tuberculous infection (LTBI) and active TB. DESIGN: We performed multiplex cytokine expression analysis of QuantiFERON® Gold In-Tube supernatants in children with active TB (n = 21) and disease-free contacts with (n = 15) and without LTBI (n = 12), to determine the sensitivity and specificity of the modified tests. RESULTS: Of 21 initial cytokines analysed, IFN-γ and six other candidates (interleukin [IL] 2, inducible protein 10 [IP-10], IL-13, IL-1α, tumour necrosis factor alpha [TNF-α] and granulocyte-macrophage colony-stimulating factor [GM-CSF]) were significantly more elevated in children with TB and those with LTBI than in the non-infected controls. Sensitivity and specificity were similar for IFN-γ and IL-2, but lower for the remaining candidates. Notably, a subset of candidates, including IP-10, showed M. tuberculosis antigen-induced specific expression in non-infected children. None of the candidates showed differences in expression between children with TB and those with LTBI. CONCLUSIONS: Our results did not suggest that alternative IGRA cytokines can distinguish between children with active TB and those with LTBI. IFN-γ and IL-2 showed comparable capacity in diagnosing M. tuberculosis infection in our study groups.


Assuntos
Citocinas/metabolismo , Testes de Liberação de Interferon-gama/métodos , Tuberculose Latente/diagnóstico , Tuberculose/diagnóstico , Adolescente , Criança , Pré-Escolar , Reações Falso-Positivas , Humanos , Lactente , Recém-Nascido , Interferon gama/metabolismo , Interleucina-2/metabolismo , Mycobacterium tuberculosis/isolamento & purificação , Sensibilidade e Especificidade
18.
J Anim Sci ; 95(7): 2928-2935, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28727091

RESUMO

Fat plays an important role in the carnivore diet. It has high digestibility and high energy content and likely improves digestibility of the diet when present in greater amounts, suggesting that endogenous fat adversely affects the apparent digestibility of fat in low-fat diets. This study aimed to determine the endogenous fat loss (EFL) and true total tract digestibility (TTTD) of fat in dogs by using diets having different fat:carbohydrate ratios. Furthermore, the apparent total tract digestibility (ATTD) of macronutrients and energy, food intake, fecal output, and stool quality were evaluated. Twelve adult Beagle dogs were stratified into three 10-d periods in a 6 × 3 balanced incomplete Latin square design. Dietary treatments included a low-fat basal diet (3.4% fat) supplemented with 6 poultry fat levels (1, 4, 10, 12, 16, or 20%). The dogs were individually housed in metabolic cages and fed to meet the maintenance energy requirements. The ME intake was similar across the diets, despite the clearly low palatability of the 1 and 4% fat diets. Dietary ATTD of DM, OM, fat, and GE were improved after fat inclusion ( < 0.001). The ATTD of CP was not affected by dietary fat increase ( > 0.05). The amount of fecal output decreased with increasing level of fat in the diet, but the fecal score was not affected. The stool quality was close to ideal (2.4-2.8) and no different among diets. The EFL was estimated using 2 regression methods and was expressed as 155 mg∙kg BW∙d or 7.9 g/kg of DMI. The TTTD of poultry fat was the same irrespective of the dietary fat level. Poultry fat was 99.3% digestible for the dogs. The relation between EFL and fat intake was higher for the lower-fat diets, explaining the ATTD of fat increase according to the dietary fat inclusion. In conclusion, dietary fat is well digested by dogs irrespective of the level included, close to 100%. The ATTD of fat in low-fat diets is underestimated because the endogenous content is proportionally greater than that in high-fat diets.


Assuntos
Dieta com Restrição de Gorduras , Gorduras na Dieta/metabolismo , Cães/metabolismo , Ingestão de Alimentos , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Dieta/veterinária , Dieta Hiperlipídica , Digestão , Fezes/química , Feminino , Trato Gastrointestinal/metabolismo , Masculino , Aves Domésticas
19.
Aust Vet J ; 94(1-2): 18-23, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26814157

RESUMO

OBJECTIVE: Evaluate the effect of raw bovine cortical bone (CB) (medullary bone cross-sectioned) and marrow or epiphyseal 'spongy' bone (SB) as chew items to reduce dental calculus in adult dogs. METHODS: Eight 3-year-old Beagle dogs were observed in two study periods. In the first study, the dogs each received a piece of bovine femur CB (122 ± 17 g) daily and in the second study, a piece of bovine femur SB (235 ± 27 g). The first study lasted 12 days and the second 20 days. Dental calculus was evaluated using image integration software. RESULTS: At the start of the studies, dental calculus covered 42.0% and 38.6% of the dental arcade areas, respectively. In study one, the chewing reduced the established dental calculus area to 27.1% (35.5% reduction) after 3 days and after 12 days the dental calculus covering was reduced to 12.3% (70.6% reduction). In study two, the dental calculus covered 16.8% (56.5% reduction) after 3 days, 7.1% (81.6% reduction) after 12 days and 4.7% (87.8% reduction) after 20 days. The CB remained largely intact after 24 h, but SB was reduced to smaller pieces and in some cases totally consumed after 24 h. No complications such as tooth fractures, pieces of bone stuck between teeth or intestinal obstructions were observed during the studies. CONCLUSIONS: Chewing raw bovine bones was an effective method of removing dental calculus in dogs. The SB bones removed dental calculus more efficiently in the short term.


Assuntos
Ração Animal , Cálculos Dentários/veterinária , Cães , Alimentos Crus , Animais , Osso e Ossos , Cálculos Dentários/prevenção & controle , Mastigação
20.
Biochim Biophys Acta ; 1309(1-2): 81-4, 1996 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-8950182

RESUMO

The nitrate reductase gene (niaD) of the filamentous fungus Penicillium chrysogenum encodes a protein of 864 amino acids. The derived protein sequence shows 78% and 72% sequence identity to the corresponding Aspergillus niger and A. nidulans proteins, respectively. The coding region of the Penicillium gene is interrupted by six small introns, as deduced by comparison with the niaD sequences of A. niger and A. nidulans, whereby the positions of the introns are perfectly conserved between these three fungal genes. Northern blot analysis indicated a 2.8 kb transcript and showed that expression of this gene is controlled at the level of mRNA accumulation depending on both induction by nitrate and nitrogen metabolite derepression. Induction of transcription of niaD was found to be paralleled by expression of the major nitrogen regulatory gene nre.


Assuntos
Regulação Fúngica da Expressão Gênica/efeitos dos fármacos , Nitrato Redutases/genética , Penicillium chrysogenum/genética , Sequência de Aminoácidos , Sequência de Bases , Genes Fúngicos , Íntrons/genética , Dados de Sequência Molecular , Nitrato Redutase , Nitratos/farmacologia , Penicillium chrysogenum/enzimologia , RNA Fúngico/análise , RNA Mensageiro/análise , Alinhamento de Sequência , Análise de Sequência de DNA
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