Tuberculosis case study

Case study level Ma - Pulmonary tuberculosis- see page 342... 

Case study level 1 - Alcoholic cirrhosis alcohol withdrawal 338 Case study level 2 - Alcoholic cirrhosis management of bleeding risk and treatment for the maintenance of alcohol abstinence 339 Case study level 3 - Hepatic encephalopathy and ascites 341 Case study level Ma - Pulmonary tuberculosis 342 Case study level Mb - Liver failure 344... 

Studies on skin tuberculosis cases indicated that isoniazid may act as a Be antivitamin. The relation of pyridoxine deficiency to niacin deficiency was investigated by determining both urinary xanthurenic acid and... 

The association between silicosis and pulmonary tuberculosis (PTB) is well established. Epidemiological and case studies show that workers exposed to silica dust have increased morbidity and mortality from PTB. In one study, a cohort of 2255 white RSA gold miners were evaluated for increased risk of PTB froml968to 1971 when they were 45-55 years... 

Infectious patients present a difficult challenge when trying to protect health care workers. These patients must be isolated from the health care workers as well as from the other patients in the hospital. Special isolation rooms are used for this purpose. These rooms are generally used for isolation of infectious tuberculosis (TB) patients, but could be used for patients with other airborne-transmitted diseases. In the United States, there were 22 812 new cases of tuberculosis in 1993, equal to 8.7 per 100 000 population. This represents a 2.8% increase since 1985, following a 6-7% annual decline from 1981-1984.Several studies have documented higher than expected tuberculin skin test (TST) conversion rates in hospital personnel.The National Institute for Occupational Safety and Health " reports that multiple-drug-resistant (MDR) strains of TB have been reported in 40 states and have caused outbreaks in at least 21 hospitals, with 18-35% of exposed workers having documented TST conversions. 

Czeizel AE, Rockenbauer M, Olsen J, Sorensen HT A population-based case-control study of the safety of oral anti-tuberculosis drug treatment during pregnancy. Int J Tu-berc Lung Dis 2001 5 564-568. 

Tuberculosis remains a major global public health problem. The World Health Organization estimates that there are 8 million new cases of tuberculosis and 3 million deaths directly attributable to tuberculosis each year [22], Drug resistance is a serious problem worldwide. In a study in New York City, 33% of patients with tuberculosis were infected by organisms resistant to at least one antituberculosis drug, and 19% were infected by organisms resistant... 

Some studies of survivors of massive chlorine exposures have shown either persistent obstructive or restrictive deficits, but pre-exposure data on these patients were not available. Persistent respiratory symptoms, bronchial obstruction, and bronchial hyperresponsiveness were observed in 82%, 23%, and 41 % of chronically exposed pulp mill workers, respectively, 18-24 months after cessation of exposure." In most cases it is not known whether prolonged symptoms after chlorine exposure are due to aggravation of preexisting conditions such as tuberculosis, asthma, chronic obstructive pulmonary disease, or heart disease." "... 

At the end of World War I, medical thought was turning to the possibility that soldiers who had been gassed with mustard, chlorine, phosgene, and other agents would develop tuberculosis. In the early postwar years, publications described efforts to identify cases of tuberculosis among gas casualties. The expected epidemic failed to appear, and attention subsided. More extensive studies, such as that of Beebe, were initiated.1 Gradually, mustard gas became the... 

Little Is known about possible long-term effects of CS Inhalation. This is due In part to the fact that short-term experiments with experimental animals, carried out for from several days to a month and using much higher (In some cases, nearly lethal) concentrations of CS, showed that ocular, respiratory, and cutaneous alte-. rations were mild and readily reversible, whereas necropsy findings failed to reveal any evidence of systemic alterations. Retrospective studies performed by the Hlmsworth committee at the request of the British Parliament after the extensive use of CS in Northern Ireland showed that no adverse effects of CS use were observed, with respect to eye burns, residual respiratory tract injury, Increased death rate in the elderly, exacerbations of mental Illness, increased Incidence of strokes or heart attacks, or incidence of tuberculosis. At exposure concentrations reported by the Hlmsworth committee (about 90 mg-min/m ), no persistent or notably adverse health effects were observed. 

Currently, efforts are underway to obtain more structural information on desaturases to address the mechanistic issues that have been raised through substrate-based studies. The need for more detailed 3-D active-site information is acute, particularly in the case of membrane-bound desaturases for which only hypothetical models currently are available. Design of mechanism-based inhibitors of medically relevant desaturases such as stearoyl CoA desaturase (SCD) (metabolic syndrome) (32), DesA3 (tuberculosis) (33), and dihydroceramide desaturase (apoptosis) (34, 35) also will be aided by new structural data. 

Tanzanian/British Medical Research Council Collaborative Study. Tuberculosis in Tanzania—a national survey of newly notified cases. Tubercle 1985 66(3) 161-78. 

Schwartz WS. Comparison of ethionamide with isoniazid in original treatment cases of pulmonary tuberculosis. XIV. A report of the Veterans Administration—Armed Forces cooperative study. Am Rev Respir Dis 1966 93(5) 685-92. 

In a retrospective study, 38 cases of toxic epidermal necrolysis were observed in Dakar, and were attributed to thiacetazone in 24 cases 23 died, mainly because of hypovolemic shock during the first week and septic shock during the second (9). Those who died were generally aged over 50 years, had more than 50% skin involvement, and had evolving tuberculosis at the time of presentation or HIV infection. After-effects were vaginal synechia and two cases of blindness. 

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