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Letteratura scientifica selezionata sul tema "Tuberculosis in old age – Treatment"

Autore: Grafiati

Pubblicato: 4 giugno 2021

Ultima modifica: 11 febbraio 2022

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Articoli di riviste sul tema "Tuberculosis in old age – Treatment"

Gunasekera, Kenneth S., Elisabetta Walters, Marieke M. van der Zalm, Megan Palmer, Joshua L. Warren, Anneke C. Hesseling, Ted Cohen e James A. Seddon. "Development of a Treatment-decision Algorithm for Human Immunodeficiency Virus–uninfected Children Evaluated for Pulmonary Tuberculosis". Clinical Infectious Diseases 73, n. 4 (15 gennaio 2021): e904-e912. http://dx.doi.org/10.1093/cid/ciab018.

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Abstract Background Limitations in the sensitivity and accessibility of diagnostic tools for childhood tuberculosis contribute to the substantial gap between estimated cases and cases notified to national tuberculosis programs. Thus, tools to make accurate and rapid clinical diagnoses are necessary to initiate antituberculosis treatment in more children. Methods We analyzed data from a prospective cohort of children <13 years old being routinely evaluated for pulmonary tuberculosis in Cape Town, South Africa, from March 2012 to November 2017. We developed a regression model to describe the contributions of baseline clinical evaluation to the diagnosis of tuberculosis using standardized, retrospective case definitions. We included baseline chest radiographic and Xpert MTB/RIF assay results to the model to develop an algorithm with ≥90% sensitivity in predicting tuberculosis. Results Data from 478 children being evaluated for pulmonary tuberculosis were analyzed (median age, 16.2 months; interquartile range, 9.8–30.9 months); 242 (50.6%) were retrospectively classified with tuberculosis, bacteriologically confirmed in 104 (43.0%). The area under the receiver operating characteristic curve for the final model was 0.87. Clinical evidence identified 71.4% of all tuberculosis cases in this cohort, and inclusion of baseline chest radiographic results increased the proportion to 89.3%. The algorithm was 90.1% sensitive and 52.1% specific, and maintained a sensitivity of >90% among children <2 years old or with low weight for age. Conclusions Clinical evidence alone was sufficient to make most clinical antituberculosis treatment decisions. The use of evidence-based algorithms may improve decentralized, rapid treatment initiation, reducing the global burden of childhood mortality.

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Kulchavenya, E. V., S. Yu Shevchenko, D. P. Kholtobin e A. A. Baranchukova. "Relapses of urogenital tuberculosis". Tuberculosis and Lung Diseases 98, n. 10 (14 novembre 2020): 19–22. http://dx.doi.org/10.21292/2075-1230-2020-98-10-19-22.

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The objective of the study: to characterize the cases of tuberculosis relapses with lesion in urogenital organs.Subjects and methods. Out of 140 case histories of patients with urogenital tuberculosis (UGTB; tuberculosis of the urinary and male reproductive system), registered for follow-up by the phthisiourologist, all files of patients with tuberculosis relapses were picked up, totally, there were 13 of them.Results. Men prevailed among cases of relapses (61.5%). Patients at the age of 30-50 years old made 46.1%, and 53.9% were 51 years old and above. In the first episode of tuberculosis, lesions of the genitourinary system were observed in 53.9% of patients, bacterial excretion was found in 38.5%. On the average, the relapse developed in 9.1 years after successful cure of the first episode of tuberculosis: after respiratory tuberculosis – in 5.6 years and after UGTB – in 12.3 years. In 3 (23.1%) patients with relapse, mycobacteriuria was documented, in 1 of them, drug resistance (to streptomycin and isoniazid) was detected. In general, in the relapse of tuberculosis with urogenital lesions, the kidneys were most often (69.2%) affected. The treatment of relapse was effective in 12 out of 13 patients. During chemotherapy of tuberculosis, 3 (23.1%) patients developed toxic and allergic reactions that required treatment interruption or cancellation of the drug.

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Mulyati, Tatik, Endy Paryanto Prawirohartono e Toto Sudargo. "Pengaruh pendidikan gizi kepada ibu terhadap konsumsi makanan dan status gizi anak balita penderita tuberkulosis primer di rawat jalan RSUP Dr. Kariadi Semarang". Jurnal Gizi Klinik Indonesia 1, n. 2 (1 novembre 2004): 87. http://dx.doi.org/10.22146/ijcn.17399.

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Background: Tuberculosis is an infectious disease that persists as a public health problem in Indonesia. The tuberculosis infected to the under 5-years old-children namely primary tuberculosis, could decrease the children’s immunity eventually causes death, which were 100.000 death rate 75% are children’s. Conditions of children’s health were deeply depending on the quality and quantity of their food consumption. An adequate consumption is needed to increase their nutrition status. To improve the maternal behavior of children’s food consumption, it is necessary to give nutritional education.Objective: The purpose of this study is to examine the effect of nutritional education on the food consumption and nutrition status of the under 5-years old-children that infected by primary tuberculosis.Methods: The research was an experimental research using randomized controlled trial method. The subject was 1 to 5- year(s) old-children those who infected by primary tuberculosis at Unit Rawat Jalan RSUP Dokter Kariadi Semarang. Two groups chosen by randomized got different treatments, i.e. availability and unavailability of nutritional education. Each group was asked to come to Poliklinik Paru Anak every two-week for two months (4 times). The food consumption data was collected by multiple recalls before treatment and after research. The nutrition status was determined by weight per age and weight per height of Z- Score WHO NCHS.Results: The result of this study showed that after the nutritional education issued, the energy consumption average of children has increase 18.18% from necessity and the protein consumption average of children has increase 21.39% from necessity. There was a significant effect of nutritional education on increasing protein consumption of under 5-years old-children that was infected by primary tuberculosis (p<0.05). It was also showed that the Z-Score increasing (weight per age and weight per height) of children in treatment-group was higher than the control-group.Conclusion: Nutritional education has a significant effect on increasing protein consumption of under 5-years old-children that was infected by primary tuberculosis (p<0.05), or there is increasing of protein consumption about 21.39%.

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Drozdetskaya, I. V., A. V. Mordyk e N. I. Porkulevich. "Urogenital tuberculosis in children 0 - 14 years old in the structure of other localizations of tuberculosis". Vestnik Urologii 9, n. 2 (10 luglio 2021): 34–44. http://dx.doi.org/10.21886/2308-6424-2021-9-2-34-44.

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Introduction. Extrapulmonary tuberculosis (EPTB) still has many features: there is a different approach to its definition in different countries, there is no screening, diagnosis is extremely difficult and requires financial costs, and bacteriological verification does not exceed 46%, complex restorative and reconstructive operations are used in treatment. the proportion of patients with isolated extrapulmonary localizations among tuberculosis patients is low.Purpose of the study. To study the structure of tuberculosis (TB) in children with the accentuation of EPTB in the current conditions to determine the development areas of preventive and diagnostic measures.Materials and methods. A retrospective two-stage study was carried out in the period from 1989 to 2018 among in-patient children aged 0 - 14 yrs. At the first stage, the structure of clinical forms of TB was assessed in 2306 children. Three comparison groups were formed following ten-year periods. At the second stage, 4 groups were identified according to age: early age, preschool age, primary school age, prepubertal age. The data obtained in the course of the study were statistically processed using the Microsoft Office 2007 (Microsoft Corp., USA) and Biostat 2009 (AnalystSoft Inc., USA) software package. The differences between the groups were determined using the χ2 test, and significant differences were considered when the value of the p < 0.05 criterion.Results. It was found that throughout the entire observation period in the region, the predominant localization of the specific process was respiratory TB. The proportion of isolated extrapulmonary lesions in children decreased from 11.1% in the period from 1999 to 2008 to 3.4% in the period from 2009 to 2018 (p = 0.000). At the same time, the most frequent localization (60.4 - 77.8% of cases) among EPTB remains urinary TB. In the dynamics from 1989 to 2018, the number of cases of the disease with combined forms of tuberculosis increased (from 3.1% to 7.2%; p = 0.000), mainly due to the establishment of several localizations of the lesion. The frequency of bacteriological confirmation of the diagnosis was significantly different at various localizations of the specific process. In children of the compared periods of childhood, the predominant localization of the specific process was isolated respiratory TB. The isolated extrapulmonary process localizations were more common in the age groups 7 - 11 and 12 - 14 yo, where it accounted for 10.8 - 12.4% of TB cases (p = 0.000). The localization of the EPTB also depended on the children's age. So, young children often developed damage to the osteoarticular system, in preschool children - the genitourinary and lymphatic (peripheral lymphadenopathy) systems, in younger schoolchildren and preschoolers - the genitourinary system. The frequency of bacteriological confirmation of the EPTB increased with the age. The combined forms of a specific process were more often observed in the age group of 7 - 11 yo, in the other groups their share was 77.4%, 87.1%, and 95.0% of cases. Respiratory TB and TB of other organs was confirmed bacteriologically more often in the age group 7 - 11 yo (19.4%), and in the group 12 - 14 yo in 12.9%, 4 - 6 yo in 10.0%, early age in 9.7%, which is much more frequent than confirmation of isolated respiratory TB.Conclusions. EPTB in children has not lost its position and due to the widespread introduction of the recombinant TB allergen and CT into clinical practice. It has become more often detected in combination with respiratory TB. Among the EPTB, genitourinary tuberculosis prevailed, which can be verified in contrast to damage to other organs. Raising the level of awareness of paediatricians and phthisiatrician-paediatricians about the frequency of EPTB occurrence makes it possible to form alertness in terms of the possibility of their development and to timely detect the disease at an early stage.

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Kim, Jung Ho, Jin Young Ahn, Su Jin Jeong, Nam Su Ku, Jun Yong Choi, Young Keun Kim, Joon-Sup Yeom e Young Goo Song. "Prognostic factors for unfavourable outcomes of patients with spinal tuberculosis in a country with an intermediate tuberculosis burden". Bone & Joint Journal 101-B, n. 12 (dicembre 2019): 1542–49. http://dx.doi.org/10.1302/0301-620x.101b12.bjj-2019-0558.r1.

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Aims Spinal tuberculosis (TB) remains an important concern. Although spinal TB often has sequelae such as myelopathy after treatment, the predictive factors affecting such unfavourable outcomes are not yet established. We investigated the clinical manifestations and predictors of unfavourable treatment outcomes in patients with spinal TB. Patients and Methods We performed a multicentre retrospective cohort study of patients with spinal TB. Unfavourable outcome was defined according to previous studies. The prognostic factors for unfavourable outcomes as the primary outcome were determined using multivariable logistic regression analysis and a linear mixed model was used to compare time course of inflammatory markers during treatment. A total of 185 patients were included, of whom 59 patients had unfavourable outcomes. Results In multivariate regression analysis, the factors associated with unfavourable outcome were old age (odds ratio (OR) 2.51; 95% confidence interval (CI) 1.07 to 5.86; p = 0.034), acid-fast bacilli (AFB) smear positivity in specimens obtained through biopsy (OR 3.05; 95% CI 1.06 to 8.80; p = 0.039), and elevated erythrocyte sedimentation rate (ESR) at the end of treatment (OR 3.85; 95% CI 1.62 to 9.13; p = 0.002). Patients with unfavourable outcomes had a significant trend toward higher ESR during treatment compared with patients with favourable outcome (p = 0.009). Duration of anti-TB and surgical treatment did not affect prognosis. Conclusion Elevated ESR at the end of treatment could be used as a marker to identify spinal TB patients with a poor prognosis. Patients whose ESR is not normalized during treatment, as well as those with old age and AFB smear positivity, should be aware of unfavourable outcomes. Cite this article: Bone Joint J 2019;101-B:1542–1549

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Bagga, Rupali Verma, Sarit Sharma, RK Soni, Anurag Chaudhary e Mahesh Satija. "Factors associated with treatment outcome in adult tuberculosis patients under directly observed treatment short course in Ludhiana city, Punjab, India: a cohort study". International Journal Of Community Medicine And Public Health 4, n. 4 (28 marzo 2017): 933. http://dx.doi.org/10.18203/2394-6040.ijcmph20170900.

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Background: Tuberculosis (TB) is a communicable disease requiring prolonged treatment and poor adherence to a prescribed treatment increases the risk of morbidity, mortality and spread of disease in the community. Objective was to study factors associated with treatment outcome in adult Tuberculosis patients on directly observed treatment short (DOTS) course in Ludhiana city, Punjab, India.Methods: The present study was a community based prospective cohort study. It was conducted in the two tuberculosis units (TU) of Ludhiana city, Punjab, India. A total of 221 registered DOTS patients were taken as study subjects and were followed during the course of treatment to observe their treatment outcome. The information was collected on a pre-designed semi-structured questionnaire through personal interviews.Results: Out of 221, 183 (82.8%) subjects had favorable outcome, 35 (15.8%) had unfavourable outcome and 3 (1.4%) were transferred out. The comparison between favorable and unfavourable treatment was found be statistically significant with respect to different age groups, problems faced by subjects to reach DOTS centre, diabetes, sputum smear status, site of tuberculosis involvement and side effects of treatment.Conclusions: Elderly and diabetic patients were found to have higher unfavourable outcome. There is need for special provisions for older age groups, illiterates and for lower socio-economic status (SES) in the form of counselling for old people and health insurance for those belonging to lower SES. Keeping in mind the default rate of the present study, initial counselling, periodic motivation of patients and prompt defaulter retrieval action would be beneficial.

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Ho Kim, Jung, Jin young Ahn, Su Jin Jeong, Nam su Ku, Jun yong Choi, Young Keun Kim, Joon-Sup Yeom e Young Goo Song. "1366. Prognostic Factors for Unfavorable Outcomes of Patients with Spinal Tuberculosis in a Country with an Intermediate Tuberculosis Burden: a Multi-Center Cohort Study". Open Forum Infectious Diseases 6, Supplement_2 (ottobre 2019): S494—S495. http://dx.doi.org/10.1093/ofid/ofz360.1230.

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Abstract Background Spinal tuberculosis (TB) remains an important concern. Although spinal TB often has sequelae such as myelopathy after treatment, the predictive factors affecting such unfavorable outcomes are not yet known. Therefore, we investigated the clinical manifestations and predictors of unfavorable treatment outcomes in patients with spinal TB. Methods We performed a multi-center retrospective cohort study of patients with spinal TB. The clinical features, comorbidities, laboratory data, imaging findings and treatment outcomes of the patients were analyzed. The unfavorable outcome was defined according to previous studies. The prognostic factors for unfavorable outcomes as the primary outcome were determined using multivariate logistic regression analysis and a linear mixed model were used to compare time course of inflammatory markers during treatment. Results A total of 185 patients (85 males and 100 females) were included. The mean age of the patients was 57.2 years. Of them, 115 underwent surgery during treatment, with a median treatment duration of 12 months. Fifty-nine patients had unfavorable outcomes. In multivariate regression analysis, the factors associated with unfavorable outcome were old age (odds ratio [OR], 2.51; P = 0.034), acid-fast bacilli (AFB) smear positivity in specimens obtained through biopsy (OR, 3.05; P = 0.039), and elevated erythrocyte sedimentation rate (ESR) at the end of treatment (OR, 3.85; P = 0.002). Patients with unfavorable outcomes had a significant trend toward higher ESR during treatment compared with patients with favorable outcome (P = 0.009). Duration of anti-TB and surgical treatment did not affect prognosis. Conclusion Elevated ESR at the end of treatment could be used as a marker to identify spinal TB patients with a poor prognosis. Patients whose ESR are not normalized during treatment, as well as those with old age and AFB smear positivity, should be aware of unfavorable outcomes. Disclosures All authors: No reported disclosures.

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Ilievska-Poposka, Biljana, Marija Metodieva, Maja Zakoska, Cveta Vragoterova e Dejan Trajkov. "Latent Tuberculosis Infection - Diagnosis and Treatment". Open Access Macedonian Journal of Medical Sciences 6, n. 4 (14 aprile 2018): 651–55. http://dx.doi.org/10.3889/oamjms.2018.161.

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INTRODUCTION: Latent tuberculosis infection (LTBI) is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens without evidence of clinically manifested active tuberculosis (TB). Diagnosis and treatment for LTBI are important for TB, especially in high-risk populations. Tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) are used to diagnose LTBI.AIM: The study aims to present the first results with IGRA test compared with TST in the screening of LTBI and the treatment results in the cases with LTBI in Macedonia.MATERIAL AND METHODS: In this study 73 cases diagnosed and treated with LTBI in 2016 were included. For diagnosis of LTBI, we used TST RT -23 5T.U. and commercial IGRA test such as QuantiFERON-TB Gold In-Tube (QFT-IT).RESULTS: Out of 73 cases with LTBI, 61.64% were men, and 38.36% were women. Among all age groups, the most frequent were cases between 5 and 14 years old (54.79%). Among the evaluated risk groups for LTBI, the most frequent were children household contacts with pulmonary TB cases (61-83.65%), followed by people living with HIV (9-12.33%) and only 3 cases with other medical reasons. Positive TST had 34 cases (46.57%) and positive IGRA test 25 cases (34.25%). Regarding the treatment regimes, we use two regimes: 50 cases (68.44%) received 6 months daily regime with Isoniazid, and 23 cases (31.51%) received 3 months daily regime with Isoniazid and Rifampicin. Treatment outcomes showed that the most patients completed treatment regimes: 55 (75.34%) and only 10 (13.09%) interrupted the treatment.CONCLUSION: Despite the progress made in the last few years, several challenges remain to be addressed for better management of LTBI which will contribute to strength TB control in the country.

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Interlandi, Emanuela, Francesco Pellegrini, Carlos Pavesio, Marco De Luca, Rocco De Marco, Alessandro Papayannis, Erika Mandarà et al. "Intraocular Tuberculosis: A Challenging Case Mimicking Wet Age-Related Macular Degeneration". Case Reports in Ophthalmology 12, n. 2 (11 giugno 2021): 519–24. http://dx.doi.org/10.1159/000512578.

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An otherwise healthy 72-year-old Chinese patient diagnosed with exudative age-related macular degeneration and decreased vision in left eye was fully investigated. The retrospective analysis of past multimodal imaging revealed bilateral severe choroidal neovascularization and choroiditis associated with a positive tuberculin skin testing and interferon-gamma release assay (QuantiFERON-TB Gold – Cellestis<sup>®</sup>, Chadstone, VIC, Australia) suggestive of latent ocular tuberculosis. The variable presentation and tests’ results interpretation represent the greatest limitations in understanding and treating intraocular TB (IOTB). This may present without any other systemic symptoms, the intraocular tissues are of limited access to biopsies and other tests, including imaging and immunological tests, are of relative value. This case highlights how variable may be the presentation of IOTB, which can be easily misdiagnosed leading to a delayed treatment and worse prognosis.

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du Preez, Karen, Muhammad Osman, James A. Seddon, Pren Naidoo, H. Simon Schaaf, Zahn Munch, Rory Dunbar, Lindiwe Mvusi, Sicelo S. Dlamini e Anneke C. Hesseling. "The Impact of the Evolving Human Immunodeficiency Virus Response on the Epidemiology of Tuberculosis in South African Children and Adolescents". Clinical Infectious Diseases 73, n. 4 (3 febbraio 2021): e967-e975. http://dx.doi.org/10.1093/cid/ciab095.

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Abstract Background Few studies have evaluated tuberculosis control in children and adolescents. We used routine tuberculosis surveillance data to quantify age- and human immunodeficiency virus (HIV)-stratified trends over time and investigate the relationship between tuberculosis, HIV, age, and sex. Methods All children and adolescents (0–19 years) routinely treated for drug-susceptible tuberculosis in South Africa and recorded in a de-duplicated national electronic tuberculosis treatment register (2004–2016) were included. Age- and HIV-stratified tuberculosis case notification rates (CNRs) were calculated in four age bands: 0–4, 5–9, 10–14, and 15–19 years. The association between HIV infection, age, and sex in children and adolescents with tuberculosis was evaluated using multivariable logistic regression. Results Of 719 400 children and adolescents included, 339 112 (47%) were 0–4 year olds. The overall tuberculosis CNR for 0–19 year olds declined by 54% between 2009 and 2016 (incidence rate ratio [IRR] = 0.46; 95% confidence interval [CI], .45–.47). Trends varied by age and HIV, with the smallest reductions (2013–2016) in HIV-positive 0–4 year olds (IRR = 0.90; 95% CI, .85–.95) and both HIV-positive (IRR = .84; 95% CI, .80–.88) and HIV-negative (IRR = 0.89; 95% CI, .86–.92) 15–19 year olds. Compared with 0- to 4-year-old males, odds of HIV coinfection among 15–19 year olds were nearly twice as high in females (adjusted odds ratio [aOR] = 2.49; 95% CI, 2.38–2.60) than in males (aOR = 1.35; 95% CI, 1.29–1.42). Conclusions South Africa’s national response to the HIV epidemic has made a substantial contribution to the observed declining trends in tuberculosis CNRs in children and adolescents. The slow decline of tuberculosis CNRs in adolescents and young HIV-positive children is concerning. Understanding how tuberculosis affects children and adolescents beyond conventional age bands and by sex can inform targeted tuberculosis control strategies.

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Tesi sul tema "Tuberculosis in old age – Treatment"

Wisch, Michael Henry. "Microemulsions : a new perspective in the treatment of paediatric and geriatric tuberculosis patients". Thesis, Rhodes University, 2000. http://hdl.handle.net/10962/d1003283.

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Tuberculosis(TB) was declared to be a global emergency in 1993, with South Africa declaring it to be the country’s top health priority in 1996, but ineffective treatment strategies have led to fewer than half of all treated patients in South Africa being cured. At present,paediatric treatment remains a problem, as the antitubercular preparations of rifampicin, isoniazid and pyrazinamide, that are currently available, were not initially designed for the treatment of paediatric TB patients, providing a motivation for this project. The aim of this project is thus the development of a microemulsion dosage form for the oral delivery of RIF(Rifampicin), INH(Isoniazid) and PZA(Pyrazinamide) in combination. RIF, INH and PZA were adequately characterised with reference to the monograph standards referenced and were found to be sufficiently pure to be used in subsequent work. A chromatographic system and conditions were selected and validated as being optimal for HPLC analysis of RIF, INH and PZA in combination, with a drug partitioning method for miglyol 812 developed and validated. Ternary and pseudo-ternary phase diagrams were constructed and reported, all employing miglyol 812 as the lipid. It was undoubtedly the imwitor 308 and crillet 3 combination o/w microemulsion system that proved most successful, maintaining homogeneity on dilution. The microemulsion used in formulation comprised imwitor 308 (27.63%), crillet 3 (27.63%), miglyol 812 23.68%) and water (21.06%). The stability of RIF, INH and PZA was investigated in aqueous solution, miglyol 812, corn oil, 10%m/v cremophor RH, 5%m/v imwitor 308, 10%m/v crillet 3 and 70%m/v sorbitol solution. Trends in the stability assessments conducted on RIF, INH and PZA were noted, with slight variation depending on the formulation component being evaluated. RIF invariably demonstrated temperature and oxidation dependent degradation in all vehicles, with a definite distinction possible between samples stored at 25, 40 and 600C over a 7 day trial period. A definite advantage of storing RIF solutions under nitrogen was observed, with these solutions showing less degradation over the course of the trial, than those stored under air. INH produced a pronounced increase in the degree of degradation of RIF, whereas PZA had a negligible effect on it’s stability. INH proved to be most stable in the 70%m/v sorbitol solution with no significant oxidation or temperature dependent degradation indicated. Temperature dependent degradation was only noticable when INH was in combination with RIF, most significant in crillet 3 solution. PZA was the most stable of the three drugs, remaining relatively unaffected by temperature and the presence of air, independent of the vehicle employed, although the drug remaining did decrease slightly in the presence of RIF.Due to drug dose specifications and solubility limitations, the final formulation assessed, only contained RIF and INH, despite INH and PZA having no significant effect on the stability of each other. The solubility of PZA in the lipid and aqueous components of the microemulsion was not great enough to achieve the required 500 mg/10ml dose, while RIF and INH could achieve the respective 150mg/10ml and 100mg/10ml dose. RIF stability was improved, as anticipated, with the incorporation of RIF into the internal phase decreasing contact with INH which has been shown to affect it’s stability. RIF behaved as predicted, possessing greater stability than shown in the individual formulation components, however, INH did not, being less stable in formulation in the absence of antioxidant, than in it’s presence. A novel microemulsion formulation capable of delivering the incompatible RIF and INH in combination, with numerous microemulsion systems mapped,with the ability of being used for the delivery of other lipophilic drugs and drug combinations, was produced.The final formulation provided valuable information into possible future improvements of the microemulsion to improve drug stability.

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He, Xiuqing. "The risk factors for tuberculosis in elderly in Guangzhou". Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42994743.

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何綉卿 e Xiuqing He. "The risk factors for tuberculosis in elderly in Guangzhou". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42994743.

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Morris, Charles David Wilkie. "Pulmonary tuberculosis in the elderly : diagnostic criteria and its epidemiology in old age homes". Doctoral thesis, University of Cape Town, 1993. http://hdl.handle.net/11427/26574.

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The majority of today's elderly people were primarily infected with Mycobacterium tuberculosis at a time when no effective chemotherapeutic treatment was available. With the progressive decline in cell mediated immunity that accompanies aging, the potential to reactivate a dormant lesion, or to be re-infected increases. The latter particularly applies in areas of high density living e.g. homes for the elderly. The incidence of pulmonary tuberculosis in whites in South Africa is very similar to that in industrialized countries (approximately 16/100 000). In a survey of old age homes in East London (South Africa) involving 809 white subjects the prevalence rate was found to be 1403/100 000; clusters were found in individual homes where up to 10% of residents had tuberculosis. The age specific incidence in the community for whites was 86/100 000, and in homes for the aged the incidence in 648 elderly subjects followed for 2 years was 1080/100 000. It is concluded that the elderly living in high density accommodation constitute a high-risk group for the development of the disease. The diagnosis of pulmonary tuberculosis in the elderly may be complicated by the high prevalence of atypical radiographic changes, difficulty in obtaining sputum, and the high false-negative rate of the tuberculin skin test. Thus, the value of haematological and biochemical abnormalities in 93 elderly tuberculotics, 113 elderly non-tuberculotics and 264 young tuberculotics were investigated. The results in the elderly tuberculotic patients were: Normochromic normocytic anaemia (70%), leucocytosis (55%), thrombocytosis (33%), rapid ESR in 90%, lymphopenia (22%) and monocytopenia (37%); hyponatraemia (60%), hypokalaemia (42%) and hypoalbuminaemia (83%), serum bilirubin (20%) and alkaline phosphatase, aspartic transaminase and lactic dehydrogenase are elevated in approximately 2/3 of patients. In comparison with the younger group (mean age 48 years) with cavitating tuberculosis, the prevalence of elderly patients (with generally mild and non-cavitating disease) with elevated bilirubin, alkaline phosphatase and liver enzymes was approximately 50% higher. When the results of liver enzyme elevations in the elderly tuberculotics were compared retrospectively with elderly patients with non-tuberculotic destructive lung disease, the former group had significantly higher values. The sensitivity (76%), specificity (48%) and positive predictive value (60%) suggest that liver enzyme abnormalities may provide useful contributory data in the non-invasive diagnosis of pulmonary tuberculosis in the elderly. The chest radiographs in 93 consecutive cases of bacteriologically proven pulmonary tuberculosis showed infrequent apical involvement (7%), with the most frequent abnormality being opacification of the middle and lower zones of the lungs; half the cases had a pleural reaction. cavitation occurs in only 1/3 of patients, and was sited equally in the apical zones and in the mid and lower zones. These findings contrast with the pattern of cavitating apico-posterior disease commonly seen in reactivated tuberculosis in younger adults. A series of 21 patients was studied to compare the yield of sputum smear examination with sputum culture for M. tuberculosis. Sputum production in non-cavitating disease was found to be infrequent and unpredictable and the number of bacilli is usually scanty. Repeated Culture of sputum for M. tuberculosis is required to improve the likelihood of obtaining a positive bacteriological diagnosis. On the basis of this study at least 4 negative sputum cultures are required to exclude the disease. In a study of 10 patients the impact of 4-drug therapy on the viability of M. tubercle in their sputum was assessed. Viable tubercle bacilli continue to be excreted in patients with cavitating pulmonary disease on treatment for up to 9 weeks. It is suggested that patients with cavitating disease should probably not be allowed to return to high density accommodation for the elderly until their sputum is clear of acid fast bacilli on sputum smear examinations. The usefulness of using annual tuberculin skin reaction (Mantoux) tests as a screening procedure was evaluated in 648 residents in old age homes. The criteria for further investigation for pulmonary tuberculosis was either recent conversion to positive (reaction equal to 10 mm or more) or a year-on-year increase of greater than 12 mm, or any reaction> 20 mm. 206 subjects were identified as "possibly having the disease" and of these the diagnosis of pulmonary tuberculosis confirmed in 13 cases. 10/13 patients had Mantoux reactions of greater than 20 mm and 3/13 between 10 mm and 19 mm. As a result of this study the recommendation is made that a yearly Mantoux test is a useful screening procedure, and will help identify a population who should be further investigated with chest radiographs and sputum cultures.

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Sung, Kei Ka Emily. "Troup treatments for geriatric depression in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B29727510.

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Kaur, Baljit. "Therapy of depressives symptoms among Chinese older adults: a meta-analysis". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45169354.

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Leung, Yee-man Emily, e 梁綺雯. "Systematic review : effectiveness of non-pharmacological interventions in managing depression in elderly". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193788.

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Introduction Geriatric depression is one of the major public health issues around the world. Geriatric depression is often being misinterpreted as a normal aspect of aging process, but it is indeed a complex psychological problem that would result in significant increases in DALYs. With effective treatments, depressive symptoms and signs can be reduced. Nevertheless, pharmacological intervention is often used as the first-line treatment for geriatric depression. In recent years, different types of non-pharmacological intervention have been getting more attention in terms of theirs effectiveness in treating geriatric depression. Objectives Primary objective is to determine whether two categories of non-pharmacological intervention (physical activity and reminiscence therapy) are effective in relieving depression in elderly that are 60 years old or older. The other objectives are to examine enduring effects of physical activity and reminiscence therapy, and compare the effectiveness of reminiscence therapy and physical activity in alleviating depressive symptoms in elderly compared with no intervention and/or other intervention. Methods Relevant studies published between the year of 2000 and 2013 were searched and identified through several electronic databases, including the Cochrane Library, PubMed, Medline, PsycINFO and Google Scholar, with a combination of keywords. All randomized controlled trials that examine physical activity and reminiscence therapy on elderly that are 60 years old or older, being diagnosed or indicated as suffering from depression were included. The methodological quality of each study was assessed. The outcome measure of this review is the depression symptom level. Main Result A total of 12 randomized controlled trials met the inclusion criteria, in which seven were about physical activity and five of them were about reminiscence therapy. Significant immediate reduction in depressive symptoms was found in five out of seven physical activity studies and in four out of five reminiscence studies. Three and two studies respectively on physical activity and reminiscence therapy had assessed the effect at follow-up and looked at the lasting effect. In two physical activity studies that have assessed the short-term effect beyond the completion of intervention, incongruent findings were found. Only one physical activity study has examined the long-term effect and it reported significant positive result. On the other hand, there were two reminiscence therapy studies assessing the short-term effect on depressive symptoms. These two studies reported significant improvement in depressive symptoms. Since there were few studies reporting the medium and long-term effect of physical activity and reminiscence therapy, no conclusion can be made on their enduring effect of reducing depressive symptoms. Conclusions Physical activity and reminiscence therapy appear to be effective non-pharmacological interventions for relieving depressive symptoms in elderly. They may complement pharmacological intervention and/or may offer alternative treatment option for elderly with depression. However, the mode, intensity, duration, type, format of physical activity and reminiscence therapy on depressive symptoms in elderly remain unclear. Further testing is need before these interventions can be routinely used to alleviate depressive symptoms in elderly with depression.
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Public Health
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Master of Public Health

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Cortez-Bazán, Nathaly, Jennifer R. Delgado, Omar Galdos e Luis Huicho. "Pott’s disease in upper thoracic vertebrae in atwo-year-old boy: Case report". Instituto Nacional de Salud, 2018. http://hdl.handle.net/10757/624633.

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Pott’s disease is a health problem in developing countries and its diagnosis in children is a challenge. Here we present the case of a two-year-old boy with Pott’s disease involving T1 to T3 thoracic vertebrae. The clinical presentation was characterized by difficulty walking, fever, cough, and dyspnea. At physical examination, kyphosis and bony prominence were observed in the cervicodorsal area. A positive tuberculin test was obtained, and Mycobacterium tuberculosis was isolated via culture of the gastric aspiration sample. The spine MRI showed a chronic abscess, destruction of two vertebrae, and bone marrow compression. The patient experienced some improvement with anti-TB therapy. Here, we emphasize the importance of giving consideration to the clinical suspicion for the early detection of this condition, as well as a quick TB-treatment start so as to avoid the disability and mortality associated to this disease.
Revisión por pares
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Barker-Read, Mary. "The treatment of the aged poor in five selected west Kent parishes from settlement to Speenhamland (1662-1797)". n.p, 1988. http://ethos.bl.uk/.

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Koffman, Steven D. "Structured reminiscence and gestalt life review : group treatment of older adults for late life adjustment". Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1115724.

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The present analogue study compared the effects of 2 theoretically divergent Life Review group psychotherapies on aspects of late life adjustment and development. Thirty-six adult non-patients, ages 65 years and older, from the Muncie - Delaware County vicinity, were randomly selected from an available subject pool of screened volunteer respondents and randomly assigned to one of three analogue treatment conditions with two groups for each treatment condition. These three treatment conditions were the structured reminiscence life review group (SRLR), the Gestalt life review group (GLR) and a Wait List control group (WLC). Demographic, mental status, and Activities of Daily Living Scale (ADL) data were obtained from initial respondents by telephone interview and followed by written completion of the Symptom Checklist (SCL 90-R). The differential effects of treatment were measured by pre and post testing on four dependent variables: (1) depression, (2) congruence, (3) helplessness, and (4) ego integrity.Results indicated that neither of the two life review group psychotherapy treatments had any statistically significant effect upon the dependent variables. In a post hoc exploratory analysis, evidence emerged which suggested that the participants in the GLR treatment condition may have shown significant improvement on several state mental health variables. The dimensions of improvement for participants in the GLR were Interpersonal Sensitivity, Hostility, Depression, and Positive Symptom report as measured by the SCL 90-R. This contrasted with those in both the SRLR or WLC condition for whom no improvement was shown.
Department of Counseling Psychology and Guidance Services

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Libri sul tema "Tuberculosis in old age – Treatment"

Tideiksaar, Rein. Falling in old age: Its prevention and treatment. New York: Springer Pub. Co., 1989.

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A, Ban Thomas, e Lehmann Heinz E. 1911-, a cura di. Diagnosis and treatment of old age dementias: Symposium on Diagnosis and Treatment of Old Age Dementias, Milan, June 6, 1987. Basel: Karger, 1989.

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Richard, FitzSimons, a cura di. Dearest mum, dearest dad: Adjusting to old-age deafness. Birmingham: PEPAR, 1998.

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Skweyiya, Sayo. Tuberculosis and the aged: The epidemiological implications of tuberculosis for the social structure in South Africa : a socio-anthropological case study of the black elderly in the Durban Functional Region. Durban: Madiba Publications for the Institute for Black Research, Dept. of Sociology, University of Natal, 1991.

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Skin disorders: Diagnosis and treatment. New York: Igaku-Shoin, 1989.

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Burns, Alistair S. Clinical guidelines in old age psychiatry. London: Martin Dunitz, 2002.

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Burns, Alistair S. Clinical Guidelines in Old Age Psychiatry. London: Taylor & Francis Group Plc, 2004.

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Falling in old age: Prevention and management. 2^a ed. New York: Springer Pub. Co., 1997.

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Tideiksaar, Rein. Falling in old age: Prevention and management. 2^a ed. New York: Springer Pub. Co., 1997.

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C, Norman Dean, a cura di. Infectious diseases: Diagnosis and treatment. New York: Igaku-Shoin, 1987.

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Capitoli di libri sul tema "Tuberculosis in old age – Treatment"

Bennett, Gerald. "Clinical diagnosis and treatment". In Old Age Abuse, 113–23. Boston, MA: Springer US, 1994. http://dx.doi.org/10.1007/978-1-4899-3077-4_8.

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Wattis, John, e Carol Martin. "Pharmacological treatment and ECT". In Practical Psychiatry of Old Age, 204–23. Boston, MA: Springer US, 1994. http://dx.doi.org/10.1007/978-1-4899-3029-3_9.

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Moyes, I. C. A. "Long-term antidepressant treatment in old age". In Antidepressants for Elderly People, 269–77. Boston, MA: Springer US, 1989. http://dx.doi.org/10.1007/978-1-4899-3436-9_16.

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Shulman, Kenneth I., Nathan Herrmann e Martha Sajatovic. "Treatment of Bipolar Disorder in Old Age". In Bipolar Psychopharmacotherapy, 369–90. Chichester, UK: John Wiley & Sons, Ltd, 2011. http://dx.doi.org/10.1002/9780470975114.ch18.

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Wattis, John, e Carol Martin. "The organization of services and the law in relation to treatment". In Practical Psychiatry of Old Age, 224–50. Boston, MA: Springer US, 1994. http://dx.doi.org/10.1007/978-1-4899-3029-3_10.

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De Leo, Diego, e Urška Arnautovska. "Prevention and Treatment of Suicidality in Old Age". In International Handbook of Suicide Prevention, 309–28. Chichester, UK: John Wiley & Sons, Ltd, 2011. http://dx.doi.org/10.1002/9781119998556.ch18.

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Allard, M. "Treatment of Old Age Disorders with Ginkgo Biloba Extract". In Rökan, 201–11. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-73686-5_21.

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Nunn, Andrew. "Chapter 2: Tuberculosis Treatment Trials Past and Present: Old and New Challenges". In Antituberculosis Chemotherapy, 10–16. Basel: KARGER, 2011. http://dx.doi.org/10.1159/000324613.

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Ayalon, Liat, e Chaya Koren. "Marriage, second couplehood, divorce, and singlehood in old age." In APA handbook of clinical geropsychology, Vol. 2: Assessment, treatment, and issues of later life., 617–44. Washington: American Psychological Association, 2015. http://dx.doi.org/10.1037/14459-024.

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Bergmann, K. "The Role of Medical Treatment in the Prevention and Reduction of Psychiatric Impairment in Old Age". In Mental Health in the Elderly, 203–7. Berlin, Heidelberg: Springer Berlin Heidelberg, 1986. http://dx.doi.org/10.1007/978-3-642-70958-6_23.

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Atti di convegni sul tema "Tuberculosis in old age – Treatment"

"PREDICTORS FOR TREATMENT RESPONSE IN OLD AGE MAJOR DEPRESSIVE DISORDER". In Psiworld 2016. Romanian Journal of Experimental Applied Psychology, 2017. http://dx.doi.org/10.15303/rjeap.2017.si1.a47.

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Takaku, Takio, Takefumi Saito, Kenji Nemoto, Shuji Oisihi e Kenji Hayashihara. "Comparison of adverse effects in tuberculosis patients over 80 years of age with and without pyrazinamide treatment". In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa3045.

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Wu, Li-na, Chao-jun Li, Ying Chen e Jian-yu Hou. "Research on the Current Situation, Problems and Countermeasures of "Combination of Medical Treatment and Old-age Care" in Heilongjiang Province". In Proceedings of the 2019 5th International Conference on Social Science and Higher Education (ICSSHE 2019). Paris, France: Atlantis Press, 2019. http://dx.doi.org/10.2991/icsshe-19.2019.86.

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Chithra, Sravani, Rahul Manchanda, Hena Kausar, Nidhi Jain e Anshika lekhi. "Dermoid cyst in an 82-year-old woman: Can be non malignant: Its management". In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685399.

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Dermoid cyst of ovary is the second most common type of ovarian germ cell tumor which constitutes 30 to 40% among ovarian tumors. It occurs mostly in women of reproductive age group between 20 and 40 years and very rarely in postmenopausal women. Postmenopause has its own set of symptoms and risks. One such risk is the possibility of malignancy of ovarian cyst with an incidence of 0.5 to 2%. We present an unusual and rare case of an 82 year old woman, who presented with complaints of pain abdomen and constipation for one year duration. Colonoscopy revealed diverticulitis. Despite being treated for diverticulitis, her symptoms persisted. CT was done which showed a right ovarian mass. Diagnostic laparoscopy was done and pus seen in the abdominal cavity was collected, bowel was distended, and dermoid cyst of ovary of 12 × 10 cm size which had undergone torsion three and a half times. Detorsion of ovary with right oophorectomy was done. Histopathology confirmed features of dermoid cyst with torsional changes in the wall and focal gangrene with no evidence of malignancy. Dermoid cyst occurs very rarely in postmenopausal women and treatment of choice is oophorectomy. Authors with this case highlight the proper management of ovarian dermoid cyst in symptomatic postmenopausal women.

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Mifsut García, César Damián. "Historic urban fabric as basis for further urban renewal: later 20th century public urban interventions in Ciutat Vella, Valencia". In 24th ISUF 2017 - City and Territory in the Globalization Age. Valencia: Universitat Politècnica València, 2017. http://dx.doi.org/10.4995/isuf2017.2017.6341.

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Valencian old town –locally called Ciutat Vella- suffered a huge transformation along 20th century. In was almost the whole city in 1900, and became less than 5% of the urban area in 2000. There was not only a process of architectural replacement, but a complete series of plans trying to update the historic spaces. There were three specific stages for those town planning proposals, made by public administrations but not always as public execution. The first group was developed at the beginning of the century following hygienic principles, with public both planning and execution. A second group, in the middle of that time, collected a series of punctual urban corrections and a huge new urban axis -Avenida del Oeste-; all these specially built by private investors. The third, final group of interventions occurred after Bologna protections principles, and the specific treatment of degraded areas into city centre. In this last, the most recent interventions can be studied the hard influence of previous urban fabric in the process of creating new urban spaces. Both historic slots’ and blocks’ geometry provide the definition for further street sections; but, in the other hand, those new street edges must be geometrically balanced with the possibility of construction of the new buildings behind them: structural geometries and functional measures must be attended. So, in this paper a series of clarifying samples are shown about the processes of public urban renewal implementation built in Valencia along the last third of 20th century.

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Lekhi, Anshika, Rahul Manchanda, Nidhi Jain, Sravani Chithra e Hena Kausar. "Presentation of endometrial carcinoma in young women". In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685342.

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Background: Endometrial carcinoma is a disease of older postmenopausal women, and is relatively uncommon in patients younger than 40 years. Endometrial carcinomas in this age group may be familial, associated with Lynch syndrome, or sporadic. Patient usually has increased exposure to estrogen. In 2%–14% of cases, it occurs in young patients (less than 40 years of age) who are eager to preserve their fertility. Its treatment includes hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy and in some cases, radiation therapy. Prevention of fertility is major challenge encountered in such cases. Aim: To present a case of young woman with endometrial carcinoma and through it to review the literature of its presentation and management in such groups. Case: We report a case of endometrial cancer in a 35-year-old woman with previous 3 cesarean treated for abnormal uterine bleeding and cared for in our department. Conclusion: Most endometrial carcinomas presenting in this young age are associated with estrogen excess. Pathologically they are usually low-grade endometrioid carcinomas with lower stage and are associated with favorable clinical outcomes. With this case the authors emphasize the need of endometrial reckoning in young females with abnormal bleeding before starting any medical treatment. Also highlighting the management options in such cases where fertility preservation holds challenge.

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Savita, Pannu, e Khullar Harsha. "Two interesting cases of granulosa cell tumor: A case report". In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685326.

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Introduction: Granulosa cell tumor (GCT) is an ovarian malignancy that arise from granulosa cells of the ovary. This tumour is a type of the sex cord-gonadal stromal tumour. GCT have good prognosis in comparison with other epithelial tumors. Methodology: Two cases of granulosa cell tumors were diagnosed in sir Ganga ram hospital, Rajendernagar, New Delhi in December 2015 and January 2016. The patient’s age, clinical manifestations, radiological and histopathological findings were evaluated. One was in perimenopausal age group and other case was in postmenopausal age group. The clinical manifestations were menorrhagia and abdominal pain. Ultrasonographically, in one case focal hypoechoic zone showing peripheral hypervascularity with possibility of old hemorrhage follicular cyst was seen and in other case of granulosa cell tumors was both solid and cystic areas were seen. Histologically, variety of patterns like diffuse, trabecular, nodular, sheets, nests and fascicular patterns with nuclear grooving in ovarian tissue. In addition endometrial findings were suggestive of simple hyperplasia without atypia. Treatment modalility used was surgery i.e., Total hysterectomy and bilateral salpingo-oophorectomy in both cases. Conclusion: Granulosa cell tumor of the ovary is a rare ovarian malignancy. Endometrial pathology to rule out endometrial carcinomaspecially when postmenopausal bleeding is concomitant finding is advised. Radical surgery is usually not required.

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Introduction: Granulosa cell tumor (GCT) is an ovarian malignancy that arise from granulosa cells of the ovary. This tumour is a type of the sex cord-gonadal stromal tumour. GCT have good prognosis in comparison with other epithelial tumors. Methodology: Two cases of granulosa cell tumors were diagnosed in sir Ganga ram hospital, Rajender Nagar, New Delhi in December 2015 and January 2016. The patient’s age, clinical manifestations, radiological and histopathological findings were evaluated. One was in perimenopausal age group and other case was in postmenopausal age group. The clinical manifestations were menorrhagia and abdominal pain. Ultrasonographically, in one case focal hypoechoic zone showing peripheral hypervascularity with possibility of old hemorrhage follicular cyst was seen and in other case of granulosa cell tumors was both solid and cystic areas were seen. Histologically, variety of patterns like diffuse, trabecular, nodular, sheets, nests and fascicular patterns with nuclear grooving in ovarian tissue. In addition endometrial findings were suggestive of simple hyperplasia without atypia. Treatment modalility used was surgery i.e. Total hysterectomy and bilateral salpingo-oophorectomy in both cases. Conclusion: Granulosa cell tumor of the ovary is a rare ovarian malignancy. Endometrial pathology to rule out endometrial carcinoma specially when postmenopausal bleeding is concomitant finding is advised. Radical surgery is usually not required.

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Киреева, Виктория, Viktoriya Kireeva, Г. Лифшиц, G. Lifshic, Н. Кох, N. Koh, Ю. Усольцев, Yu Usolcev, Константин Апарцин e Konstantin Apartsin. "Advantages of a personalized approach to the prevention and treatment of cardiovascular diseases in the staff of the INC Of the SBRAS". In Topical issues of translational medicine: a collection of articles dedicated to the 5th anniversary of the day The creation of a department for biomedical research and technology of the Irkutsk Scientific Center Siberian Branch of RAS. Москва: INFRA-M Academic Publishing LLC., 2017. http://dx.doi.org/10.12737/conferencearticle_58be81ec9ed47.

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Purpose of the study. To test the functional associations of polymorphic variants of genes in the regulation of blood pressure and vascular tone in employees of the ISC SB RAS. Materials and methods. The study involved patients, employees of the ISC SB RAS, being under care of the outpatient clinic of the Hospital of the ISC SB RAS. During routine laboratory testing the patients were taken 2 ml of blood for genetic analysis and further molecular genetic study on “Hypertension”, “Endothelial dysfunction”, “Pharmacogenetics”, “Inflammatory response” panels. Results. In the analysis of 12 genes coding for key proteins of hormonal enzyme blood pressure regulation systems, polymorphism of CYP11B2 showed statistically significant correlation with the presence of arterial hypertension, which makes its further study promising. The presence of allele C showed protective significance in relation to the development of hypertension with OR = 0,247. When checking associations of functional polymorphic variants of genes, the products of which are involved in the regulation of vascular tone, with hypertension in patients younger than 50 years old we found association of T/T rs5443GNB3 genotype with the debut of hypertensive disease under the age of 50. The data obtained allow the doctor to choose the most personalized and effective safe drug from certain groups, as well as its dose for employees having passed molecular genetic testing. These data can reveal predisposition to the most widespread and socially significant diseases in the surveyed subjects and provide specific personalized recommendations for the prevention of these diseases.

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Matsuda, M., Y. Sakata, T. Sugo, S. Tanabe, J. Mimuro e H. Murayama. "PROTEIN C TOCHIGI: AN ABNORMAL PROTEIN C CHARACTERIZED BY DEFECTIVE RELEASE OF ACTIVATION PEPTIDE BY THROMBIN". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643646.

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A molecular abnormality of protein C (PC) has been found in an 18-year-old female who has been thrombophilic since she was one-year old. Detailed coagulation studies revealed that PC antigen was only 25% of normal while PC activity was substantially undetectable in her plasma. Other related plasma proteins including vitamin K-dependent blood coagulation factors, antithrombinin and plasminogen were all within normal limits.Family study demonstrated that her father, one of her paternal uncles andher half-bred sister had half-normal levels of both activity and antigen of PC. They thus appear to be heterozygotes for PC deficiency. Her mother had anormal level of PC as antigen but only60% of normal as activity. We thus presumed that nearly a half population ofPC was not properly functioning in hermother's plasma. By utilizing insolubilized monoclonal* antibodies against PC, we isolated both single-chain and two-chain forms of PC from the propositus' plasma. They were found to have normal molecular weights by SDS-PAGE, but they failed to exhibit amidolytic activity and to incorporate 3H-labeled DFP after thrombin-treatment. By immunoblotting and ELISA utilizing a monoclonal antibody that recognizes the activation peptide part of the heavy chain of PC, we found that cleavage of the activation peptide by thrombin was impaired totally in the proposi and partly in her mother’s PC. It is thus most probable that the propositus inherited PC deficiency from her father and a molecular abnormality of non-activatable protein C from her mother, respectively. Accordingly, all the PC molecules in the propositus’ plasma are non-functional, which may have culminated in the occurrence of cerebral thrombosis at the age of 1 and severe deep venous thrombosis and bilateral pulmonary embolisms at the age of 10.

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