[Tuberculosis Annual Report 2010–(7) Tuberculosis Characteristics Upon Diagnosis-2].
[Tuberculosis Annual Report 2010–(7) Tuberculosis characteristics upon diagnosis-2].
Filed under: Drug and Alcohol Rehabilitation
Kekkaku. 2012 Dec; 87(12): 783-7
From 2007 to 2010, 229 newly notified tuberculosis (TB) cases with HIV infection were reported. These cases were detected in 204 (89.1%) male and 25 (10.9%) female patients; 50 (21.8%) of these patients were foreigners. The present TB surveillance system does not provide reliable data on whether HIV tests were performed for TB cases; therefore, we report only those TB patients with HIV infection. In 2010, the proportion of newly notified TB cases with diabetes mellitus was 13.3% (3,085/23,261); diabetes was observed in 15.4% of male patients and 9.7% of female patients. In 2010, drug susceptibility test (DST) results were obtained for 8,380 (72.9%) of 11,495 culture-positive pulmonary TB cases through the TB surveillance system. The proportion of multi-drug resistant TB (MDR-TB), isoniazid resistance, and rifampicin resistance among the newly identified cases was 0.5%, 4.1%, and 0.7%, respectively. Among previously tested cases, the proportion was 3.9%, 11.4%, and 5.2%, respectively. Resistance thus appears to have remained stable over the past 4 years (2007-2010). From 2007 to 2010, among the new pulmonary TB cases in foreign nationals, MDR-TB was observed in 2.9% of male patients and 4.2% of female patients.
HubMed – drug
Positively Charged Dendron Micelles Display Negligible Cellular Interactions.
Filed under: Drug and Alcohol Rehabilitation
ACS Macro Lett. 2013 Jan 15; 2(1): 77-81
Pearson RM, Patra N, Hsu HJ, Uddin S, Král P, Hong S
PEGylated dendron-based copolymers (PDC) with different end-group functionalities (-NH(2), -COOH, and -Ac) were synthesized and self-assembled into dendron micelles to investigate the effect of terminal surface charges on size, morphology, and cellular interactions of the micelles. All of the dendron micelles exhibited similar sizes (20-60 nm) and spherical morphologies, as measured using dynamic light scattering and transmission electron microscopy, respectively. The cellular interactions of dendron micelles were evaluated using confocal microscopy and flow cytometry. Surprisingly, although amine-terminated dendrimers are known to strongly interact with cells non-specifically, all of the surface-modified dendron micelles exhibited charge-independent low-levels of cellular interaction. The unexpected results, particularly from the amine-terminated dendron micelles, could be attributed to: i) minimal end-group effects, as each PDC has an approximately 10-fold lower charge-number-to-molecular-weight ratio compared to the dendrimer; and ii) intra- and intermolecular hydrogen bonding between positively charged terminal groups with poly(ethylene glycol) (PEG) backbones, which leads to the sequestration of the charges, as demonstrated by atomistic molecular dynamics simulations. With the narrow size distribution, uniform morphologies, and low levels of non-specific cellular interactions, the dendron micelles offer a promising drug delivery platform.
HubMed – drug
Efficacy of 3 years of adefovir monotherapy in chronic hepatitis B patients with lamivudine resistance.
Filed under: Drug and Alcohol Rehabilitation
World J Hepatol. 2012 Dec 27; 4(12): 389-93
Song MN, Hong MZ, Luo DQ, Huang WQ, Min F, Fan RH, Wu WB, Zhang L
To study the effect of rescue monotherapy with adefovir (ADV) in patients with chronic hepatitis B (CHB) who developed drug resistance to lamivudine (LAM).A total of 76 treated CHB patients with resistance to LAM were enrolled in the present study. The patients’ baseline characteristics, such as age, gender, blood tests and hepatitis B virus (HBV) DNA were collected; therapy duration and the response of each patient were also recorded. ADV monotherapy was set as the observation group A. Twenty-four patients with LAM resistance, who were set as group B, accepted combined therapy with LAM + ADV. Patients were followed up at 0, 12, 24, 52, 104 and 156 wk. Hepatitis B surface antigen status, hepatitis B e antigen (HBeAg)/anti-HBe status, HBV DNA level and biochemical indexes were monitored. Sequencer of HBV polymerase gene was performed on the ABI 3730 automated sequencer. If no desired effects had been achieved during the course of treatment, patients’ choices were also taken into account. The control group was tested at the same time.In the two groups, 27 cases developed viral breakthrough after LAM treatment response. The remaining 49 cases underwent biochemical rebound accompanied by rtM204I/V or rtL180M mutation. In group A, 52 cases finished 156 wk of ADV monotherapy; of whom, 36 cases were HBeAg positive and 16 HBeAg negative. In patients whose baseline HBV DNAs were 10(3)-10(5) copies/mL, 88.8% of patients’ HBV DNAs were lower than the lower test limit (10(3) copies/mL) after 12 to 156 wk of ADV treatment. In patients whose baseline HBV DNAs were ? 10(6) copies/mL, 41.1%-47.0% of patients’ HBV DNAs were lower than the lower test limit after the same course of ADV therapy (?(2) were 4.35-5.4, 41.1%-47.0% vs 88.8% group 10(3)-10(5) copies/mL, P < 0.01). In group A, seroconversion of HBeAg developed in 8 of 36 cases (22.2%). In group B, 24 cases finished 156 wk of LAM + ADV; of whom, 17 cases were HBeAg positive and 7 HBeAg negative. In patients whose baseline HBV DNAs were 10(3)-10(5) copies /mL, 81.8% of patients' HBV DNAs were lower than the lower test limit (10(3) copies/mL) after 12 to 156 wk of treatment. In the patients whose baseline HBV DNAs were ? 10(6) copies/mL, 46.1%-53.8% of patients' HBV DNAs were lower than the lower test limit after the same course of LAM + ADV therapy (?(2) were 4.1-5.0, 46.1%-53.8% vs 81.8% group 10(3)-10(5) copies/mL, P < 0.05-0.01). In group B, 4 of 17 cases (23.5%) developed seroconversion of HBeAg. Treatment outcomes in groups A and B were comparable.In both group A and B, the ratios of virological response have similar efficacy in patients with lower baseline HBV DNAs. HubMed – drug
Management of alcoholic hepatitis: Current concepts.
Filed under: Drug and Alcohol Rehabilitation
World J Hepatol. 2012 Dec 27; 4(12): 335-41
Karsan HA, Parekh S
Alcoholic hepatitis is a devastating form of acute liver injury seen in chronic alcohol abusers with significant morbidity and mortality. It is a multisystem disease that is precipitated by ingesting large quantities of alcohol with genetic and environmental factors playing a role. Prognostic criteria have been developed to predict disease severity and these criteria can serve as indicators to initiate medical therapy. Primary therapy remains abstinence and supportive care, as continued alcohol abuse is the most important risk factor for disease progression. The cornerstone of supportive care remains aggressive nutritional support, and although acute alcoholic hepatitis has been extensively studied, few specific medical therapies have been successful. Corticosteroids remain the most effective medical therapy available in improving short term survival in a select group of patients with alcoholic hepatitis; however, the long-term outcome of drug therapies is still not entirely clear and further clinical investigation is necessary. While liver transplantation for acute alcoholic hepatitis have demonstrated promising results, this practice remains controversial and has not been advocated universally, with most transplant centers requiring a prolonged period of abstinence before considering transplantation. Extracorporeal liver support devices, although still experimental, have been developed as a form of liver support to give additional time for liver regeneration. These have the potential for a significant therapeutic option in the future for this unfortunately dreadful disease.
HubMed – drug
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