the research goal is to investigate the mechanisms of formation and peculiarities of periodontitisinpatientswithfocaltuberculosis. Patientswithperiodontitis and focaltuberculosis are proved to develop local inlammatory reaction with increased infection and activation of proinlammatory cytokines in parodontal pockets luid. the main risk factor of frequent and durable recurrence of parodontal pathology in case of focaltuberculosis was the development of patho- logic process as a cause of disbalance of lipid peroxidation and antioxidant system, endotoxicosis syndrome.
Participants were recruited in two outpatient pulmonary TB treatment facilities in Durban (South Africa) between August 2000 and November 2001. Participants were eligible when $18 years of age and consenting to HIV pre- and post-test counseling and testing. Drug susceptibility testing was performed at the time of TB therapy initiation and individuals presenting with resistance to isoniazid or rifampicin were excluded from the study. Diagnosis of active pulmonary TB was based on symptoms, roentgenographic evaluation and epidemiologic history. All included patients presented with either positive sputum smear microscopy and/or positive culture for Mtb. Numerical score were used for grading Chest x-ray severity, where (1) corresponds to individuals presenting no cavities; (2) subjects with cavities , 4 cm and (3) individuals with cavities $ 4 cm. Plasma and sputum samples were collected at enrollment, 2, 4, 8, 12, 26, 52 and 78 weeks after the initiation of TB therapy. We studied a subset of 42 individuals who had samples collected at all time points. At the time of screening, 20 subjects were HIV-negative and 22 subjects tested positive for HIV. This study took place prior to the ARV roll-out program and patients did not receive any anti-retroviral therapy at that time. All HIV-infected individuals were viremic at the time of enrollment (median viral load: 18,860 copies/ml [IQR: 13,189– 48,039]) with low CD4 counts (median: 282 cells/mm 3 [IQR: 177–448]). Standard directly observed TB treatment (DOT) was started after enrolment and was in accordance with the South- African Guidelines for the management of TB . All individuals were administered 4-drug fixed-dose combination tablets (rifam- picin, isoniazid, pyrazinamide, ethambutol) for 8 weeks, followed by a 16 week-course of 2-drug fixed dose combination tablets (rifampicin, isoniazid). The ethics committees of Nelson Mandela Medical School and Witwatersrand University approved the initial study, with subsequent approval from the IRB of the University of Medicine and Dentistry of New Jersey, for the cytokine measurements on the plasma samples. All the subjects provided written informed consent for participation in this study.
The emergence and spread of multidrug-resistant tuberculosis (MDR-TB) is hampering efforts to control and manage the TB disease worldwide, since the effect of standard short course che- motherapy is less and second line drugs are less potent, more toxic and much more expensive [1,2]. Moreover, MDR-TB strains, are highly pathogenic, have the great potential for transmis- sion and add to mortality incrementally [3,4]. The latest Global Tuberculosis Report indicates an estimated 5% of TB cases (3.5% of new and 20.5% of previously treated cases) had MDR-TB in 2013, which translates into a somber of 480,000 people developed MDR-TB . According to the fifth national tuberculosis epidemiological survey in China, the rate of MDR-TB was 6.8% with an estimated 339,000 incident cases among population over 15 years old in 2010 .
We did not find some of the risk factors occasionally associated with increased noncompliance with TB treatment, such as being male, unemployed, and HIV- positive [11,13,16]. This may be due to the small sample size. However, other authors have also failed to confirm these associations [25,26]. Alcohol consumption and living alone can predict noncompliance. This has also been found in other studies [17,21]. Furthermore, an evaluation of supervised treatment found an 18% noncompliance rate, and alcohol consumption was one of the significant factors associated with noncompliance . Most patients treated at HDTAA are residents of the city of Goiânia, however there was no significant variation regarding noncompliance when compared withpatients from other cities in the State of Goiás. Preventive treatment has been cited as a factor associated with noncompliance . However, we did not find such an association, probably because diagnosis had been confirmed before initiating treatment. Prior treatment and the need to use a form of drug therapy other than regimen I have also been reported as a predictive factor for noncompliance [8,10,16,28], which suggests that patients undergoing retreatment should be monitored more closely and, if possible, assigned to supervised treatment. The need for hospitalization was significantly greater for noncompliant patients, which demonstrates that hospitalization does not contribute to greater compliance and agrees with the analysis of Natal et al. .
bacteriological confirmation of pediatric TB, a major proportion of childhood TB cases are diagnosed clinically and initiated on first line TB treatment [10–11]. This makes laboratory diagnosis of drug-resistance in the pediatric population quite challenging. Our analysis sug- gests a need for strengthened drug-resistance surveillance in pediatric patients diagnosed with TB and/ or potentially reviewing the diagnostic and treatment strategy in presumptive pediat- ric TB. Second, despite a higher TB prevalence in males than females, TB cases of both genders show, overall, a similar risk of having MDR-TB. Indeed, in Mumbai the risk is greater amongst females than males, even when adjusting for treatment history, age and other factors. Risks of active TB among infected people are similar in both sexes in scenarios where the transmission rates are high [12–15]. A higher proportion of rifampicin resistance in female cases in Mumbai could point towards higher transmission of rifampicin resistance in that population. Although it remains unclear why this appears to be specific to Mumbai, the TB epidemic in Mumbai stands apart in other respects too. The city contains the largest slum in the world, and available evidence points to an MDR-TB epidemic in Mumbai that is more extensive than anywhere else in the country [6–7]. There is increasing recognition for the need to identify the key drivers behind this epidemic  such efforts may also cast valuable light on the patterns observed in the current study.
Fifty-eight JME patients had presented a PD (46.7%). Mood and anxiety disorders, present in 31 (25%) and 26 (21%), respectively, were the most frequently observed. Among mood disorders we found 26 cases of major depression and 5 of dysthymia, while among anxiety disorders, 22 presented GAD, 3 speciﬁc phobias and 1 obsessive-compulsive disorder, while among. There were also 7 cases of somatoform disorders, 6 of them conversive disorders (non-epileptic events) and 1 of somatization, 6 of psychotic disorders and 2 of alcohol abuse. Fourteen patients fulﬁlled criteria for two axis I diagnoses. Comparing the two groups, we did not ﬁnd any statistically signiﬁcant difference in the number of patientswith PD, as well as in the total number of psychiatric diagnoses. There were also no signiﬁcant differences between the groups when the number of patientswith mood, anxiety or somatoform disorders was compared. Psychotic disorders, as a group and separately, were signiﬁcantly related to TLE-MTS group (p = 0.01). The psychiatric diagnoses are described in Fig. 1.
healthy subjects (3 men, 2 women, age range 35–55 years). TB patients had clinical and radiological findings consistent with active pulmonary TB . Diagnosis was confirmed by bacteri- ological isolation of Mtb in 12 patients and 1 further patient was classified as having highly probable pulmonary TB on the basis of clinical and radiological features highly suggestive of TB that were unlikely to be caused by another disease and a decision was made by the attending physician to initiate anti-tuberculosis chemother- apy, which resulted in an appropriate response to therapy. All patients were treated in accordance with italian guidelines and received therapy for 6 months. Treatment was successful in all participants as evidenced by no clinical or radiographic evidence of current disease, the completion of anti-tuberculosis chemother- apy and sterile mycobacterial cultures. Peripheral blood was collected before (T0) and 4 months after chemotherapy (T4). The follow-up time point of four months after starting therapy following was chosen on the basis of previous studies by our and other groups [19,27–29] which have demonstrated change in many different immune responses in TB patients at this time point after therapy, including the CD8 T cell phenotype in childhood TB . None of the TB patients had been vaccinated during Figure 2. Phenotypic analysis of tetramer + Mtb-specific CD8 T-cells.
This study was undertaken with the idea that among type 2 diabetics, the periodontally healthy ones present better glycemic control than those presenting perio- dontitis. Hypothetically, glucose levels would improve in completely edentulous patientswith diabetes, since they cannot develop periodontal disease. According to the American Diabetes Association (2016), FBG cut-off levels for diabetics are equal or greater than 126 mg/dL. 29 In the present study, even under antidiabetic medica- tion, patientswith moderate to severe periodontitis and edentulism presented, on average, glucose levels above the cut-off when compared withpatients presenting no or mild periodontitis. The comparison between the two dentate groups showed statistically significant differences in FBG levels. Patientsin both groups presented a similar number of teeth, but PI, GBI and PD were significantly higher inpatientswith diabetes with moderate to severe periodontitis. After adjusting for age and number of medications taken, these patients presented ORs of 3.08 and 2.77 in relation to no or mild periodontitis for the FBG cut-offs of 126 and 150 mg/dL, respectively. These results were statistically significant and clinically rele- vant since with an increase in glycemic levels there is an increase in the risk for more diabetes complications. 31 Similar findings have been reported in other observa- tional studies and demonstrate that glycemic control is worse inpatientswith more severe forms of periodon- titis compared with those without periodontitis or even those with milder forms of the disease. This suggests that periodontal disease adversely affects glycemic control and diabetes complications. 6 32 Another important topic regarding this is that periodontitis may be an early sign of diabetes. 7
the purpose of the study is to determine clinical and pathogenetic eficacy of cycloferon liniment in the combined therapy of periodontitis of patientswithfocaltuberculosis. It is proved, that use of liniment Cycloferon in the combined treatment of patientswithfocaltuberculosis allows to accelerate process of normalization of parameters of lipid per- oxidation and antioxidant potential of blood, to decrease infection (herpes symplex virus I, candida albicans, staphylo- coccus aureus) in parodontal pockets and local inlammation with reduction of activity of factor tumours necrosis and interleukin 1b. It leads to soon recovery and decrease of frequency of parodontitis recurrences.
We conducted a cross-sectional, retrospective study, characterized by classical and molecular epidemiology, involving M. tuberculosis isolates from a regional prison in southern Brazil. Between January of 2011 and August of 2014, 379 prisoners underwent sputum smear microscopy and culture; 53 (13.9%) were diagnosed with active tuberculosis. Of those, 8 (22.9%) presented with isoniazid-resistant tuberculosis. Strain genotyping was carried out by 15-locus mycobacterial interspersed repetitive unit- variable-number tandem-repeat analysis; 68.6% of the patients were distributed into ive clusters, and 87.5% of the resistant cases were in the same cluster. The frequency of drug-resistant tuberculosis cases and the rate of recent transmission were high. Our data suggest the need to implement an effective tuberculosis control program within the prison system.
Leukemia is a group of diseases characterized by the clonal proliferation of abnormal leukocytes presenting in hematopoietic tissues and other organs. Lymphadenopathy is commonly observed in leukemia and is associated with an unfavorable prognosis (21-23). Leukemia is a systemic disease that can cause generalized lymphadenopathy invol- ving more than two noncontiguous regions (23). In our study, the lower para-aortic region and the inguinal lymph nodes were involved more frequently in the three types of leukemias than in TB (p ,0.017). The main anatomic sites of involvement inpatientswith AML and ALL were the upper para-aortic region, the lower para-aortic region, and the groin. Inpatientswith CLL, the lymph nodes in the lesser omentum, the mesentery, the anterior pararenal space, the upper and lower para-aortic regions, the external iliac region, and the inguinal region were more frequently involved. No calcifications were identified in the cohort of leukemia patients. In TB, calcification occurs in the last phase of recovery from inflammation. Leukemic lympha- denopathy is an unlimited clonal proliferation of abnormal leukocytes in lymph nodes with no limitation. These nodes provide an environment that favors the growth and survival of malignant lymphocytes (24), which seems less likely to cause calcification. However, further explanation may be Table 2 - Comparison of enhancement patterns between tuberculosis and leukemias.
(BOP) and clinical attachment level (CAL). All subjects underwent a periodontal examination performed by the same periodontist (ZTÇ). Prior to the study, the examiner was calibrated for reproducibility of PD and CAL measurements. To determine repeatability of the PD and CAL measurements, six sites per tooth in ten patients, were measured twice. For PD 98% and for CAL 99% of the paired measurements were within ±1 mm. All periodontal parameters were measured with a Williams periodontal probe calibrated in millimeters (Nordent Manufacturing Inc., Elk Grove Village, IL, USA). Periodontal measurements were taken at six sites per tooth (mesio-buccal, mid-buccal, disto-buccal, mesio-palatal, mid-palatal and disto-palatal). The deepest six pockets found in the different segments of each subject were chosen for GCF sampling. Baseline periodontal examination of AMI patients and 24-48 h GCF collection were carried out in their hospital bed under sufficient illumination using artificial light. The examiners could not be “blinded” to the subject’s general condition, since they were examined in a hospital. Within a time period of two months after the proceeding infarction, none of the patients had received
Those identified as having LTBI have all been commenced on isoniazid therapy, apart from two patients who are not expected to survive long term. Treatment has been sim- plified by using directly observed therapy when patients receive dialysis. Those with negative and indeterminate IGRA results will be carefully followed, enabling further clin- ical validation of the test. Most importantly, the IGRA test has given greater confidence to the renal unit staff and has resulted in active management of LTBI in a high risk group.
To enter the study, patients should be able to read and write, and be receiving appropriate antiepileptic medication for at least one year. From a pull of 131 patients, 97 were con- sidered eligible to be studied (able to read and write, and with intelligence quocient (IQ)>80). hus, 90 of them successfully completed the questionnaire; the remaining 7 had either left more than 10% of the questions blank or gave conlicting an- swers in the control questions, which made the test unreli- able. Forty-one were male and forty-nine female. Of these 90 patients, 42 were sufering from generalized epilepsy (GE), 29 from focal epilepsy (FE), and 19 from undetermined epi- lepsy (UE), i.e., diicult to be characterized as either GE or FE based only on the information of the questionnaire and their interview. hey need further more specialized exami- nations (Video EEG, brain CT scan or brain MRI). he GE group comprises 13 males and 29 females exhibiting mean age 32.33±15.19 years, educational level 11.82±3.70 years and mean length of illness 15.24±10.76 years. he FE group com- prises 11 males and 18 females having mean age 31.75±11.47 years, educational level 11.03±2.63 years and mean length of illness 15.25±11.72 years. Finally, the UE group consists of 11 males and 8 females having mean age 36.84±14.40 years, educational level 11.38±4.25 years and mean length of illness 19.05±13.46 years. here was no signiicant statistical difer- ence between the three groups, regarding the demographic parameters such as age, sex, educational level and duration of illnes. It should be noted that the ZDRS allows assessment of the frequency distribution of each depressive symptom for the purpose of matching this distribution with the type of epilepsy 4 . he ZDRS consists of 20 items covering afective,
The present study carries certain limitations, the first being its small size. The number of patients included in the study is not fully representative of the actual number of patients who have received biological thera - py during the studied period of time, as a result of a very high proportion of unknown data regarding the start of the biological drugs. The study also lacked a control group of patients for result comparison. In addi tion, very few patients repeated screening at the reference centre, which accounts for a small number of conversions resulting in low statistical power. We were therefore unable to find common variables among these patients, which might have helped in further identifying high-risk individuals who would most bene fit from annual re-screening. Also, our study was performed in a country with intermediate TB inci- dence, so our results may not apply to countries with low TB incidence. Last but not the least, the greatest limitation of this and most studies on latent TB screen- ing lies in the absence of a gold standard for the diag- nosis of latent TB.
previous active TB or TB treatment, no evidence of current active TB (absence of cough, intermittent fever, and exces- sive night sweating in the past two weeks and absence of unexplained weight loss in the past month). Tuberculosis was diagnosed when subjects with clinical and/or imaging features compatible withtuberculosis had at least one of the follow- ing criteria: positive sputum smear for acid-fast bacilli (AFB); positive culture for M. tuberculosis; biopsy suggestive of tuber- culosis, and/or full response to anti-tuberculosis treatment. Patientswith extrapulmonary TB accompanying pulmonary TB involvement were included in the category of extrapul- monary TB. Treatment of new cases, both pulmonary and extrapulmonary tuberculosis, received two months of isoni- azid (H), rifampicin (R), pyrazinamide (Z) and ethambutol (E) during an intensive phase and four months of HR in the con- tinuation phase. The duration of treatment was six months. Several kinds of extrapulmonary tuberculosis were more dif- ficult to cure. Treatment for an extended period of time was required to ensure disease control. Such as, prolonged therapy had been adopted in TB meningitis (9–12 months) and bone and joint TB (9 months; Fig. 1). 9
2. Лепилин А. В., Ерокина Н. Л., Рогатина Т. В., Хлу- сов И. Ю. Применение динамической магнитотерапии и чре- скожной электронейростимуляции в комплексном лечении больных с переломами нижней челюсти при воспалительных заболеваниях пародонта // Вопросы курортологии, физиоте- рапии и лечебной физической культуры. 2009. № 4. С. 37 – 40. 3. Abd Fl-Aleem S. A., Morales-Aza B. M., Donaldson Lf. Sensory neuropeptide mRNA up-regulation is bilateral inperiodontitisin the rat: a possible neurogenic component to
Each patient underwent full-mouth manual scaling within 24 hours. At the beginning of each session, each patient rinsed with 20 ml of 0.12% CHX (Colgate-Palmolive, São Bernardo do Campo, SP, Brazil) for 30 s (the last 10 s consisted of gargling), and at the end of each session there was 1 min of tongue brushing with CHX gel (1% digluconate chlorhexidine, oral gel basis for 30 g, sodium saccharin 0.05%, and mint flavoring) followed by an additional mouth rinse. After the first supervised rinse, each patient was instructed to rinse at home in the morning and in the evening. In addition, the patients received a monthly fluoride dentifrice, toothbrush, and dental floss. All of the gingivitis and periodontitispatients received oral hygiene instructions.
Molecular testing of paired M.tb isolates in one index patient- contact pair in our study was consistent with direct transmission, based upon identical MIRU-VNTR patterns. In the second patient-contact pair, the isolate of the contact had three less bands in two loci compared to that of the index patient. While the genotype of M.tb in a population can lose or add repeats over time,  in a population with considerable strain heterogeneity, [31,32] the loss of repeats at two separate loci probably indicates this is an independent strain which was acquired from another unrecognised patient. Other molecular epidemiology studies in low and high-prevalence settings have demonstrated that known index patients are not necessarily the source of infection in contacts. [33,34,35] A study from a low-prevalence setting found that 70% (95% CI 56–82%) of isolates from index patient-contact pairs shared identical strains.  In low prevalence settings, small differences in molecular typing can be useful marker of the presence of additional unknown source cases.  However, in high-prevalence settings, such as Vietnam, the risk of an individual being infected by an unrecognised patient is much greater and reactivation of longstanding infection is also more likely. Hence, while household exposure contributes to the risk of TB, it may not be the only source of infection. [37,38] Nonetheless, household contacts should be considered a suitable target population for screening, because they often share other risk factors in addition to exposure to the known index patient.