I consider this text very important for several reasons ... One of them is that I was a carrier and latent tuberculosis and, even without having a place to live, I had to keep the treatment up to date or I would give rise to an active tuberculosis infection and this Could become a tiny tuberculosis, and with the countless number of last-minute deserters, having active tuberculosis and living on the street was not a good idea.
I remembered the Abreugrafia for mere fortuitousness. Today, there is no longer this need to have an abbreviation attesting that you do not have tuberculosis, then tuberculosis, or TB, like a nurse ... you did not understand the designation.
I remember the usual scenario, there on the slope of memory, near the slope of memory (there are hillside, ah slope) with posters offering rude at reasonable prices and I did there at 11 years, my first abreugrafia, that Was tiny, in a paper wallet, as fragile as the people who tried to be an endemic doe, which was an obstacle to getting a job card ...
I took a very short excerpt from Wikipedia and put it here:
Abreugrafia Is the name given in the Brazil A cheap and quick method of taking small lungs, To facilitate the diagnosis of TB, Deadly disease. The test, which records the chest image on a X ray, Has spread throughout the world.
The inventor of the examination, Manuel Dias de Abreu, Was Nobel In 1950 and had the invention baptized in his honor in Brazil. In other countries, the exam was called "schermografia" (Italy), "Roentgenfotografia" (Germany) And photofluorography (France). In Brazil, on January 4 (04 / 01) the "National Day of Abreugrafia" is celebrated,.
Three drugs together outperformed XDR-TB
Although I see a remarkable lack of interest from people with HIV in tuberculosis, it is necessary to reiterate that this combination "AIDS / Tuberculosis" is one of the most fateful co-infections for people living with HIV or AIDS.
The girl I got HIV from had had tuberculosis before she met me and told me that. If I was just a little better informed, I would have lit all the yellow lights in my brain and, I believe, I would have used condoms with her, but, frankly, sex was such a crazy thing that I would eventually forget about the blessed condom And in this way nothing would have changed and I would also be here writing this article and casting my favorite phrase to console people and, I well know, the day will come when I, for one reason or another, will have to look at My image in the mirror and say, with a smile on my face:
"Claudio! ... Everything is as God desires"! .... And I'll still have to smile
And it is on the basis of this that I return, after more than two years without publishing anything about tuberculosis, to publish a text, which will be followed by others, also on Tuberculosis, but not lined up one after the other. In short, important things in the editorial line of this site, which I "forgot", will temporarily come back.
O que eu queria deixar como tiro de advertência é que toda pessoa que é diagnosticada com tuberculose deve fazer um exame para HIV. Não estou estigmatizando pessoas com Tuberculose, a questão é que, muitas vezes, estas duas condições andam de mãos dadas e, na outra via, toda pessoa diagnosticada reagennte e que não foi testada para tuberculose, deve fazê-lo o mais rapidamente possível. Por conta dos beijos e abraços que troquei com a minha namorada, e que beijos, fizeram de mim um portador de tuberculose latente e eu tive de manter a minha terapia preventiva por dezoito meses, mesmo quando, não bastasse toda a desgraça eu ainda voltei a morar nas ruas, por escolha pessoal, porque as Casas de Apoio em que eu vivi, queriam que eu fosse um dado estatístico, e me proibiam de procurar emprego (…) Mas isso já é outra história
A regimen of three oral medications administered for six months was sufficient to eliminate Drug-resistant tuberculosis (XDR-TB) in 29 of the first 31 people to complete the entire course of treatment, Dr. Francesca Conradie of Sizwe Tropical Disease Hospital in Johannesburg 2017 Conference on Retroviruses and Opportunistic Infections (CROI). If the results are replicated in a larger population, the results could revolutionize The prospects for treatment not only of XDR tuberculosis, but also of the more severe cases of MDR (multidrug-resistant tuberculosis) tuberculosis.
XDR-TB is a growing problem in countries with an MDR-TB endemy, such as South Africa. XDR-TB is TB Which is resistant to isoniazid and rifampicin, plus any fluoroquinolone and at least one of the three injectable second-line drugs (Example: amikacin, kanamycin or capreomycin). MDR-TB is TB that is resistant to isoniazid and rifampicin.
Although XDR-TB may be a consequence of failure to treat MR-TB, Research in South Africa has shown that transmission between people, often outside the home, is the main
R of the country's growing XDR tuberculosis. In addition, research presented this week at CROI shows that migration and travel play an important role in the spread of XDR-TB in South Africa's most affected province, KwaZulu-Natal.
Kristin Nelson of Emory University, Atlanta, shared results from a study that sought to identify the geographic locations of individuals with genetically-linked XDR TB infections. The study was designed to determine if specific sites were strongly implicated in the spread of XDR-TB. Surprisingly, the researchers found that the average distance between people's homes in these genetically linked pairs was 111 km and 83% of people in genetically linked pairs lived in different districts of the province. A very high level of mobility for work, the demand for health care and for family reasons seems to be contributing to the spread of XDR-TB. Home transmission, traditionally considered the most important arena of TB transmission and the focus of account tracking and case detection efforts, appears to be less important than previously predicted.
O tratamento atual para XDR-TB requer a montagem de um regime de seis drogas, incluindo uma fase de tratamento de seis meses que inclui drogas injetáveis e outros 12-18 meses de tratamento com cinco medicamentos. Algumas das drogas utilizadas no tratamento da TB-MR e da XDR-TB apresentam efeitos colaterais graves, incluindo perda auditiva e danos nos rins no caso de vários medicamentos injetáveis. Algumas drogas usadas no regime são onerosas e indisponíveis em alguns países, complicando ainda mais a montagem de um regime efetivo que é absolutamente necessário. Interromper este tratamento significa da espaço para o agente etiológico se adapte a resistência a este medicamento, podendo levar a um surto de um NOVO TIPO DE TUVERCULOSE, que poderia se tornar uma epidêmia (talvez uma endemia com proporções que eu, Cláudio Souza, não consigo imaginar nem no meu pior pesadelo)
Even if people have access to XDR-TB treatment and are able to tolerate the regimen, the cure rate is shockingly low. Follow-up of people treated for XDR-TB in South Africa between 2008 and 2012 Shows that only 11% had achieved cure five years after starting treatment, While 73% of the patients died.
Finding a shorter duration regimen that is effective against XDR-TB, with fewer serious side effects, would improve the chances of treating the infection and disrupting the chain of transmission.
The NIX-TB trial tests a three-drug regimen consisting of bilequilin (Sirturo) (The first new anti-TB drug to be approved in 40 years), linezolid (an inexpensive antibiotic), and pretomanid (PA-824), an experimental drug against tuberculosis developed by the Alliance of TB.
Francesca Conradie presented results in the first 72 people to be treated in the study.
Participants were eligible to join the study if they had documented XDR-TB or were intolerant to an MDR-TB regimen and remained culture-positive or had no cure for MDR-TB treatment and remained positive for the culture. Persons with HIV who had a CD4 cell count of less than 50 cells / mm 3, And people with cardiac arrhythmia or severe peripheral neuropathy.
Of the 72 participants, 51% were HIV positive, 65% had XDR-TB, 24% had TB-MR treatment insufficiency and 11% were intolerant to MDR-TB treatment. Participants were divided equally by gender (54% male) and predominantly black (78%).
Treatment is ongoing for some participants, so the participants' mood is as follows:
- 72 people started treatment
- 4 people died during treatment (3 due to disseminated TB - miliary tuberculosis, common in people with HIV and low counts of CD4 - and due to gastrointestinal bleeding)
- 28 people are still asob treatment
- 40 pessoas concluíram o percurso inicial de 6 meses de tratamento
- Of these, 31 people completed treatment and 6 months post-treatment follow-up.
Of the 31 who completed post-treatment follow-up, 29 people eradicated XDR-TB from their organisms. One person was reinfected with drug-susceptible TB. Another person appears to have experienced a relapse of XDR-TB, but genome sequencing is needed to determine if this is a true case of relapse, or if it is a reinfection.
Cultural conversion was uniformly rapid for a population with drug-resistant TB. All participants were culture negative within four months of starting treatment, and 26 of the 40 people who completed the treatment were culture negative at the 8 week of treatment.
Os efeitos adversos durante o tratamento foram atribuídos principalmente ao linezolid e 49 das 60 pessoas que mantiveram-se em tratamento até à data interromperam a dose de linezolid pelo menos uma vez. Em 14 casos, a interrupção da dose foi decorrente de mielossupressão ( diminuição da produção de células sanguíneas e de plaquetas na medula óssea. É um efeito secundário de alguns fármacos citotóxicos) e, em 28%, a interrupção da dose foi devida à dor provocada pela neuropatia periférica.
Dr. Conradie said that peripheral neuropathy pain can be managed with gabapentin, but that it gradually subsides after treatment is completed.
Translated by Cláudio Souza from the original redigioo by Keith Alcor In Three-drug regimen beats XDR-TB in first trial