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Liverpool, United Kingdom

Konstantinidou E.,Chest Hospital | Konstantopoulos K.,National and Kapodistrian University of Athens
Acta Microbiologica Hellenica | Year: 2015

We discuss the topic of origin of mycobacterial tuberculosis in America under the recent molecular data. Namely, sea mammals seem as having played a role in transmitting the disease to humans long before America was approached by the Europeans. The current genomic and taxonomic analysis of mycobacteria species, favour such a zoonotic transfer event from pinnipeds to humans between 700 and 1000 AD. A lot of information for the history of the diseases and for the movements of the populations can be gathered by analogous genome sequencing data via bioinformatics. © 2015, Greek Society of Microbiology Ascent Ltd. All rights reserved. Source

Chen S.-C.,Da Chien General Hospital | Chen S.-C.,Tungnan University | Chen K.-L.,China University of Science and Technology | Chen K.-H.,China University of Science and Technology | And 2 more authors.
World Journal of Pediatrics | Year: 2013

Background: Childhood tuberculosis (TB) accounts for a significant proportion of the global tuberculosis disease burden. However, current and previous efforts to develop better diagnostic, therapeutic, and preventive interventions have focused on TB in adults, and childhood TB has been relatively neglected. The purpose of this review is to provide an update on the diagnostic and therapeutic recommendations for childhood TB with an emphasis on intrathoracic disease. Data sources: The literature from a range of sources was reviewed and synthesized to provide an overview of the contemporary approaches for the diagnosis and treatment of childhood TB. Results: This review summarizes the clinical, radiological, bacteriological, and immunological approaches to diagnose TB infection and disease in children. In addition, we summarize the updated guidelines for the treatment of TB in children. Conclusions: The development of better diagnostic and therapeutic methods for childhood TB remains a significant challenge. As the strategies for diagnosis and treatment of childhood TB continue to improve and the knowledge base increases, the implementation of these strategies will be crucial. © 2013 Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg. Source

Indermuehle A.,University College London | Bahl R.,University College London | Lansky A.J.,The New School | Froehlich G.M.,University College London | And 4 more authors.
Heart | Year: 2013

Context: The optimal treatment option for in-stent restenosis is currently unclear. Objective: Systematic review and meta-analysis of the effect of drug-eluting balloons (DEB) to treat in-stent restenosis. Data sources: Trials were identified through a literature search from 2005 through 7 November 2012. Study selection: Randomised clinical trials comparing DEB with a control treatment (plain balloon angioplasty or drug-eluting stents). Data extraction and synthesis: Main endpoints of interest were major adverse cardiac events (MACE), target lesion revascularisation (TLR), binary in-segment restenosis, stent thrombosis (ST), myocardial infarction (MI) and mortality. A random-effects model was used to calculate the pooled relative risks (RR) with 95% CIs. Results: Five studies and a total of 801 patients were included in this analysis. Follow-up duration ranged from 12 to 60 months. Most endpoints were significantly reduced for DEB compared with the control groups. For MACE, the relative risk RR was 0.46 (0.31 to 0.70), p<0.001, for TLR it was 0.34 (0.16 to 0.73); p=0.006, for angiographic in-segment restenosis it was 0.28 (0.14 to 0.58); p<0.001. There was a lower mortality for DEB (RR 0.48 (0.24 to 0.95); p=0.034). The incidence of MI was numerically lower, but the differences were not statistically significant (RR 0.68 (0.32 to 1.48); p=0.337). There was no difference in the risk of ST (RR 1.12 (0.23 to 5.50), p=0.891). Conclusions: In-stent restenosis is the bane of coronary angioplasty, and drug-eluting balloon angioplasty is a promising treatment option in this situation. It reduces the risk for MACE compared with plain balloon angioplasty or implantation of a Taxus Liberte drug-eluting stent. Source

Chen T.-Y.,Chung Shan Medical University | Li Y.-C.,Chung Shan Medical University | Liu Y.-F.,Chung Shan Medical University | Tsai C.-M.,Chest Hospital | And 4 more authors.
Annals of Surgical Oncology | Year: 2011

Background: Early detection of hepatocellular carcinoma (HCC) is seldom available because of the lack of reliable markers. Matrix metalloproteinase (MMP) 14 is a cell surface proteinase that displays a broad spectrum of activity against extracellular matrix components and promotes the invasion/metastasis of cells. MMP14 is overexpressed in HCC, and the level is correlated with poor overall survival. The purpose of this study was to examine whether the MMP14 gene polymorphisms are associated with the susceptibility and clinicopathological development of HCC. Methods: A total of 135 patients with HCC and 496 healthy control subjects were recruited. Six single nucleotide polymorphisms (SNPs) of MMP14 genes were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) genotyping and haplotype-base analysis. Results: A significant (p < 0.05) lower risk for HCC was shown in the individuals with MMP14 +6767 G/A and +7096 C/C genotypes compared with those with corresponding wild-type homozygotes; high frequency for anti-hepatitis C virus and cirrhosis positive were shown in the HCC patients with MMP14 +7096 TC/CC genotype after adjusting for other confounding factors. The distribution frequency of -165 T: +221 T: +6727 C: +6767 G: +7096 T: +8153 G haplotype and diplotype was significantly higher in the HCC patients than healthy control subjects. Conclusions: The +6767 and +7096 polymorphic genotypes and haplotype -165 T: +221 T: +6727 C: +6767 G: +7096 T: +8153 G of MMP14 gene might contribute to the prediction of susceptibility and pathological development to HCC. © 2011 Society of Surgical Oncology. Source

Chien J.,National Taiwan University | Chien J.,National Taiwan University Hospital | Chien S.,Chest Hospital | Huang S.,Jianan Mental Hospital | Yu C.J.,National Taiwan University Hospital
Journal of Antimicrobial Chemotherapy | Year: 2014

Objectives: The safety of rifabutin replacing rifampicin among adults having rifampicin-related adverse reactions (ARs) during the treatment of tuberculosis remains unknown. Methods: From June 2006 to June 2010, a total of 2868 newly treated tuberculosis patients without HIV infection in a referral hospital were screened in this retrospective cohort study. Results: Among the screened patients, a total of 221 (8%) patients who received rifabutin replacing rifampicin were included. Of these patients, 158 (72%) tolerated rifabutin during treatment, but 47 (21%) and 16 (7%) experienced mild and severe rifabutin-related ARs (including neutropenia, severe hepatitis and uveitis), respectively, and needed to discontinue rifabutin. Those having previous rifampicin-related arthralgia, dermatological events and cholestasis had a higher AR recurrence rate (60%, 23% and 9%, respectively) than others (5% for hepatitis and gastrointestinal intolerance and 0% for flu-like syndrome, neutropenia and others; P<0.01). Multivariate logistic regression analysis showed that females (OR 3.35; 95% CI 1.06-10.56; P0.04) and patients with hepatitis virus B (HBV) or hepatitis C virus (HCV) coinfection (OR 3.72; 95% CI 1.19-11.67; P=0.02) were at a higher risk of rifabutin-related severe ARs. No development of new drug resistance and no relapse of tuberculosis were found during 2 years of follow-up. Conclusions: Rifabutin replacing rifampicin was well tolerated in most adults who had rifampicin-related ARs. Females and those with HCV or HBV coinfection were more prone to rifabutin-related severe ARs and required more cautious monitoring. © The Author 2013. Source

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