rifampin and Alcoholism

To develop the 'Stronger Towns Index': a deprivation index that took into account characteristics of areas encompassing towns that may be eligible for redevelopment funding and explore how this index was associated with self-rated health and migration within England between 2001 and 2011.. There were areas in the lowest deciles of Town Strength who did not receive funding. After multiple adjustment, LS members living in areas with higher deciles were significantly more likely (7% to 38%) to report good health than those in the lowest decile in 2001. Remaining in the same decile between 2001 and 2011 was associated with 7% lower odds of good self-rated health in 2011.. It is important to consider health in towns when allocating funding. Areas in the Midlands may have missed out on funding which might help mitigate poor health.. Ferritin levels <30µg/L were associated with unexplained infertility and might be screened in the future. Further studies with a focus on iron deficiency and iron treatment on women with unexplained infertility are warranted.. This EGM provides a valuable resource for researchers, policy-makers and the public to access the available evidence on the determinants of various COVID-19 health-related behaviours. The map can also be used to help guide research commissioning, by evidence synthesis teams and evidence intermediaries to inform policy during the ongoing pandemic and potential future outbreaks of COVID-19 or other respiratory infections. Evidence included in the map will be explored further through a series of systematic reviews examining the strength of the associations between malleable determinants and the uptake and maintenance of individual protective behaviours.. Patients with polymicrobial bloodstream infections are typically critically ill and harbor multidrug-resistant bacteria. Thus, to minimize mortality rate in critically ill patients, changes in infectious flora should be monitored, antibiotics selected reasonably, and invasive procedures reduced.. Altogether, these findings clearly revealed the great potential of the in vitro biological activity of linseed extract as a safe source for combatting multidrug-resistant. In this work, the capture of carbon dioxide using a dense hollow fiber membrane was studied experimentally and theoretically. The factors affecting the flux and recovery of carbon dioxide were studied using a lab-scale system. Experiments were conducted using a mixture of methane and carbon dioxide to simulate natural gas. The effect of changing the CO. Persistent gender and racial disparities in high-impact medical and critical care journals underscore the need to revise policies and strategies to encourage greater diversity in critical care research.. Thirty evaluable patients were enrolled. Median age was 60.5 years. Median follow-up for all patients was 17 months. Ten patients (33%) experienced grade ≥ 3 treatment-related adverse events, the most common being neutropenia and diarrhea; 50% required ≥ 1 dose reduction. The disease control rate was 90% (progressive disease: 10%, partial response: 23%, stable disease: 67%). There was zero treatment-related mortality. Twenty-two patients (73%, 90% CI 57-86; p = 0.008) completed all chemotherapy and surgery. Two patients (9%) who successfully underwent resection had minor postoperative complications. Median length of hospital stay was 4 days. Median RFS was 7.1 months. Median OS for the entire cohort was 24 months and was not reached in patients who underwent surgical resection.. Neoadjuvant treatment with gemcitabine, cisplatin, and nab-paclitaxel is feasible and safe prior to resection of intrahepatic cholangiocarcinoma and does not adversely impact perioperative outcomes.

Topics: Acetogenins; Acute Disease; Acute Kidney Injury; Administration, Intravenous; Aged; Albumins; Alcoholism; Aldehyde Dehydrogenase; Aldehyde Dehydrogenase, Mitochondrial; alpha-Glucosidases; Anemia; Animals; Anthozoa; Anti-Bacterial Agents; Anti-Infective Agents; Antibodies, Bacterial; Antigens, Bacterial; Antihypertensive Agents; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Antioxidants; Apoptosis; Ascites; Asthma; Bacteria; beta-Lactamases; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Binding Sites; Biological Availability; Biomass; Borderline Personality Disorder; Brain; Brucella abortus; Brucella melitensis; Brucellosis; Calcium; Carbapenems; Case-Control Studies; Caseins; Cattle; CD8-Positive T-Lymphocytes; Ceftaroline; Cell Line; Cell Line, Tumor; Cell Physiological Phenomena; Cell Proliferation; Cephalosporins; Chemotherapy, Adjuvant; China; Chitin; Chlorella; Chlorophyll; Chlorophyll A; Chlorophyta; Cholangiocarcinoma; Cisplatin; Conotoxins; Contrast Media; Conus Snail; Cross-Sectional Studies; Cytokines; Decapodiformes; Deoxycytidine; Diagnostic and Statistical Manual of Mental Disorders; Dietary Fiber; Diterpenes; DNA Methylation; Dogs; Double-Blind Method; Drug Design; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial; Drug Screening Assays, Antitumor; Eicosapentaenoic Acid; Enzyme-Linked Immunosorbent Assay; Epidermis; Escherichia coli; Escherichia coli Infections; Extraintestinal Pathogenic Escherichia coli; Fatty Acids; Fatty Acids, Unsaturated; Fatty Acids, Volatile; Feasibility Studies; Feces; Female; Ferritins; Fluorodeoxyglucose F18; Gastrectomy; Gastrointestinal Microbiome; Gemcitabine; Glomerular Filtration Rate; Glucose; Glycerol; Granulocyte-Macrophage Colony-Stimulating Factor; HeLa Cells; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Hypoxia-Inducible Factor-Proline Dioxygenases; Immunoassay; Immunoglobulin G; India; Infant, Newborn; Infertility; Inflammation; Intensive Care Units; Iron; Iron Deficiencies; Kidney; Lacticaseibacillus rhamnosus; Laurencia; Leukocytes; Lipids; Liver Cirrhosis; Long Interspersed Nucleotide Elements; Longitudinal Studies; Male; Mesenchymal Stem Cells; Methicillin-Resistant Staphylococcus aureus; Mice; Microalgae; Microbial Sensitivity Tests; Microscopy; Middle Aged; Minerals; Molecular Conformation; Molecular Docking Simulation; Molecular Structure; Mycobacterium tuberculosis; Myeloid Cells; Myeloid-Derived Suppressor Cells; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Nephropidae; Nicotinic Antagonists; Nitrogen; Obesity; Oxaliplatin; Paclitaxel; Panax; Pancreatic Neoplasms; Pancreatitis; Personality; Personality Disorders; Personality Inventory; Photobioreactors; Plant Extracts; Plasmalogens; Plasmids; Polymorphism, Genetic; Polynesia; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prebiotics; Predictive Value of Tests; Prognosis; Prolyl-Hydroxylase Inhibitors; Rabbits; Radiopharmaceuticals; Rats; Rats, Wistar; Receptors, Nicotinic; Recombinant Proteins; Retrospective Studies; Rifampin; Risk Factors; RNA, Ribosomal, 16S; Salinity; Seaweed; Sensitivity and Specificity; Sepsis; Sesquiterpenes; Severity of Illness Index; Shock, Septic; Silicones; Single Photon Emission Computed Tomography Computed Tomography; Skin; Snails; Solubility; Solvents; Sputum; Staphylococcal Infections; Stomach Neoplasms; Stramenopiles; Structure-Activity Relationship; Technetium Tc 99m Exametazime; Technology; Terpenes; Tuberculosis; Tuberculosis, Multidrug-Resistant; Urinary Catheters; Urinary Tract Infections; Vascular Endothelial Growth Factor A; Virulence Factors; Water; Wound Healing

Topics: Alcoholism; Analgesics; Anesthetics; Blood Proteins; Chronic Disease; Drug Interactions; Ethanol; Hormones; Humans; Immunity; Liver Diseases; Methadone; Prolactin; Respiration; Rifampin; Serum Albumin; Substance-Related Disorders; United States

Topics: Alcoholism; Aminosalicylic Acids; Bilirubin; Drug Therapy, Combination; Humans; Isoniazid; Patient Dropouts; Rifampin; Streptomycin; Time Factors; Transaminases; Tuberculosis, Pulmonary

To develop the 'Stronger Towns Index': a deprivation index that took into account characteristics of areas encompassing towns that may be eligible for redevelopment funding and explore how this index was associated with self-rated health and migration within England between 2001 and 2011.. There were areas in the lowest deciles of Town Strength who did not receive funding. After multiple adjustment, LS members living in areas with higher deciles were significantly more likely (7% to 38%) to report good health than those in the lowest decile in 2001. Remaining in the same decile between 2001 and 2011 was associated with 7% lower odds of good self-rated health in 2011.. It is important to consider health in towns when allocating funding. Areas in the Midlands may have missed out on funding which might help mitigate poor health.. Ferritin levels <30µg/L were associated with unexplained infertility and might be screened in the future. Further studies with a focus on iron deficiency and iron treatment on women with unexplained infertility are warranted.. This EGM provides a valuable resource for researchers, policy-makers and the public to access the available evidence on the determinants of various COVID-19 health-related behaviours. The map can also be used to help guide research commissioning, by evidence synthesis teams and evidence intermediaries to inform policy during the ongoing pandemic and potential future outbreaks of COVID-19 or other respiratory infections. Evidence included in the map will be explored further through a series of systematic reviews examining the strength of the associations between malleable determinants and the uptake and maintenance of individual protective behaviours.. Patients with polymicrobial bloodstream infections are typically critically ill and harbor multidrug-resistant bacteria. Thus, to minimize mortality rate in critically ill patients, changes in infectious flora should be monitored, antibiotics selected reasonably, and invasive procedures reduced.. Altogether, these findings clearly revealed the great potential of the in vitro biological activity of linseed extract as a safe source for combatting multidrug-resistant. In this work, the capture of carbon dioxide using a dense hollow fiber membrane was studied experimentally and theoretically. The factors affecting the flux and recovery of carbon dioxide were studied using a lab-scale system. Experiments were conducted using a mixture of methane and carbon dioxide to simulate natural gas. The effect of changing the CO. Persistent gender and racial disparities in high-impact medical and critical care journals underscore the need to revise policies and strategies to encourage greater diversity in critical care research.. Thirty evaluable patients were enrolled. Median age was 60.5 years. Median follow-up for all patients was 17 months. Ten patients (33%) experienced grade ≥ 3 treatment-related adverse events, the most common being neutropenia and diarrhea; 50% required ≥ 1 dose reduction. The disease control rate was 90% (progressive disease: 10%, partial response: 23%, stable disease: 67%). There was zero treatment-related mortality. Twenty-two patients (73%, 90% CI 57-86; p = 0.008) completed all chemotherapy and surgery. Two patients (9%) who successfully underwent resection had minor postoperative complications. Median length of hospital stay was 4 days. Median RFS was 7.1 months. Median OS for the entire cohort was 24 months and was not reached in patients who underwent surgical resection.. Neoadjuvant treatment with gemcitabine, cisplatin, and nab-paclitaxel is feasible and safe prior to resection of intrahepatic cholangiocarcinoma and does not adversely impact perioperative outcomes.

Topics: Acetogenins; Acute Disease; Acute Kidney Injury; Administration, Intravenous; Aged; Albumins; Alcoholism; Aldehyde Dehydrogenase; Aldehyde Dehydrogenase, Mitochondrial; alpha-Glucosidases; Anemia; Animals; Anthozoa; Anti-Bacterial Agents; Anti-Infective Agents; Antibodies, Bacterial; Antigens, Bacterial; Antihypertensive Agents; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Antioxidants; Apoptosis; Ascites; Asthma; Bacteria; beta-Lactamases; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Binding Sites; Biological Availability; Biomass; Borderline Personality Disorder; Brain; Brucella abortus; Brucella melitensis; Brucellosis; Calcium; Carbapenems; Case-Control Studies; Caseins; Cattle; CD8-Positive T-Lymphocytes; Ceftaroline; Cell Line; Cell Line, Tumor; Cell Physiological Phenomena; Cell Proliferation; Cephalosporins; Chemotherapy, Adjuvant; China; Chitin; Chlorella; Chlorophyll; Chlorophyll A; Chlorophyta; Cholangiocarcinoma; Cisplatin; Conotoxins; Contrast Media; Conus Snail; Cross-Sectional Studies; Cytokines; Decapodiformes; Deoxycytidine; Diagnostic and Statistical Manual of Mental Disorders; Dietary Fiber; Diterpenes; DNA Methylation; Dogs; Double-Blind Method; Drug Design; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial; Drug Screening Assays, Antitumor; Eicosapentaenoic Acid; Enzyme-Linked Immunosorbent Assay; Epidermis; Escherichia coli; Escherichia coli Infections; Extraintestinal Pathogenic Escherichia coli; Fatty Acids; Fatty Acids, Unsaturated; Fatty Acids, Volatile; Feasibility Studies; Feces; Female; Ferritins; Fluorodeoxyglucose F18; Gastrectomy; Gastrointestinal Microbiome; Gemcitabine; Glomerular Filtration Rate; Glucose; Glycerol; Granulocyte-Macrophage Colony-Stimulating Factor; HeLa Cells; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Hypoxia-Inducible Factor-Proline Dioxygenases; Immunoassay; Immunoglobulin G; India; Infant, Newborn; Infertility; Inflammation; Intensive Care Units; Iron; Iron Deficiencies; Kidney; Lacticaseibacillus rhamnosus; Laurencia; Leukocytes; Lipids; Liver Cirrhosis; Long Interspersed Nucleotide Elements; Longitudinal Studies; Male; Mesenchymal Stem Cells; Methicillin-Resistant Staphylococcus aureus; Mice; Microalgae; Microbial Sensitivity Tests; Microscopy; Middle Aged; Minerals; Molecular Conformation; Molecular Docking Simulation; Molecular Structure; Mycobacterium tuberculosis; Myeloid Cells; Myeloid-Derived Suppressor Cells; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Nephropidae; Nicotinic Antagonists; Nitrogen; Obesity; Oxaliplatin; Paclitaxel; Panax; Pancreatic Neoplasms; Pancreatitis; Personality; Personality Disorders; Personality Inventory; Photobioreactors; Plant Extracts; Plasmalogens; Plasmids; Polymorphism, Genetic; Polynesia; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prebiotics; Predictive Value of Tests; Prognosis; Prolyl-Hydroxylase Inhibitors; Rabbits; Radiopharmaceuticals; Rats; Rats, Wistar; Receptors, Nicotinic; Recombinant Proteins; Retrospective Studies; Rifampin; Risk Factors; RNA, Ribosomal, 16S; Salinity; Seaweed; Sensitivity and Specificity; Sepsis; Sesquiterpenes; Severity of Illness Index; Shock, Septic; Silicones; Single Photon Emission Computed Tomography Computed Tomography; Skin; Snails; Solubility; Solvents; Sputum; Staphylococcal Infections; Stomach Neoplasms; Stramenopiles; Structure-Activity Relationship; Technetium Tc 99m Exametazime; Technology; Terpenes; Tuberculosis; Tuberculosis, Multidrug-Resistant; Urinary Catheters; Urinary Tract Infections; Vascular Endothelial Growth Factor A; Virulence Factors; Water; Wound Healing

A total of 577 Danish patients with tuberculosis were observed for a period of 5 years. A primary phase of treatment with 300 mg Isoniazid (INH), 450 mg Rifampicin (RMP) and 1200 mg Ethambutol (EMB) daily for 3 months was followed by administration of either INH+RMP or INH+EMB for 12 or 18 months after conversion. During the initial period the number of bacteria decreased rapidly, even in patients with the most severe tuberculosis, and all patients became culture negative. There was no significant difference in efficacy of RMP and EMB in the secondary phase. One of the 577 patients again became positive during the follow-up period, but there were no bona fide cases of relapse among patients who completed the treatment.

Topics: Adolescent; Adult; Aged; Alcoholism; Clinical Trials as Topic; Denmark; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Humans; Isoniazid; Male; Middle Aged; Rifampin; Tuberculosis; Tuberculosis, Pulmonary

A history of alcoholism is often regarded as a relative contraindication to the use of isoniazid and rifampin in patients with tuberculosis. To test the validity of this assumption the outcome of 6 months of rifampin-isoniazid therapy was analyzed for the first 531 eligible patients enrolled in a U.S. Public Health Service Cooperative Trial of Short-Course Chemotherapy of Pulmonary Tuberculosis. In this study, data were available to classify a patient as an alcoholic in the following 2 ways: (1) patient's statement that he was a moderate, heavy, or excessive user of alcohol, or (2) patient's score of 6 or more on a Brief Michigan Alcoholism Screening Test (MAST). Based on their statements, 58% of the patients were classified as alcoholic, whereas only 17.9% were thus classified by their MAST scores. Although alcoholics had more abnormal concentrations of aspartate aminotransferase (AST) before and during therapy, there was no significant difference between the alcoholics and non-alcoholics in the incidence of adverse reactions, including hepatotoxic reactions, including hepatotoxic reactions, attributed to the drugs. We concluded that in the absence of clinically significant and persistent pretreatment abnormalities of hepatic function tests, rifampin and isoniazid are not contraindicated in patients categorized as alcoholic by our 2 commonly used methods.

Topics: Alcoholism; Aspartate Aminotransferases; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Drug Therapy, Combination; Humans; Isoniazid; Rifampin; Tuberculosis, Pulmonary

Ethambutol is said to be capable of elevating serum urate concentration. This statement was reconsidered in three investigations using strictly supervised administration of ethambutol in a single daily dose of 25 mg. per kg. of body weight: (1) In short term administration 10 healthy subjects received ethambutol for eight days. (2) In a pilot study 13 patients suffering from pulmonary tuberculosis were treated with a triple combination including thambutol for six months. (3) In a controlled trial 23 patients were randomly allocated to one of the following regiments: In the first group patients received ethambutol plus isoniazid plus rifampicin for six months. In the second group patients received streptomycin plus isoniazid plus PAS for three months and thereafter streptomycin plus isoniazid plus ethambutol for another three months. Serum urate concentrations and clearances of uric acid and of creatinine were determined periodically in all subjects. A slight increase in serum urate concentration occurring in long term therapy showed no relation to ethambutol administration, but was obviously dependant on parameters related to the course of the disease in form of increase in body weight and physical activity, or related to the well known syntropy of chronic alcoholism and tuberculosis.

Topics: Alcoholism; Body Weight; Creatinine; Ethambutol; Humans; Isoniazid; Rifampin; Streptomycin; Tuberculosis, Pulmonary; Uric Acid

Topics: Alanine Transaminase; Alcoholism; Alkaline Phosphatase; Aspartate Aminotransferases; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Rifampin; Streptomycin; Tuberculosis

Topics: Alcoholism; Aminosalicylic Acids; Bilirubin; Drug Therapy, Combination; Humans; Isoniazid; Patient Dropouts; Rifampin; Streptomycin; Time Factors; Transaminases; Tuberculosis, Pulmonary

Nucleus accumbens (NAc) is the ventral part of the striatum of the brain; it is an important part of the mesolimbic pathway involved in the reward system that mediates the formation of various forms of addiction, in particular alcohol addiction. Neuroimaging data and in vitro studies indicate the development of a pronounced neurodegenerative process in the NAc, with long-term alcohol use, but the key mechanisms mediating this process remain unknown. In recent years, the attention of researchers has been focused on studying the system of Toll-like receptors (TLRs), the increased activity of which is clearly shown in the cerebral cortex and hippocampus during prolonged alcohol exposure, but there is a need to study the role of this system in other brain structures. In this study, we have shown that prolonged alcohol exposure (2 months) with moderate doses of ethanol (2 g/kg) promotes a pronounced increase in the expression of the Tlr4 gene and its endogenous ligand Hmgb1 in NAc during the period of alcohol withdrawal in rats. Injections of rifampicin (100 mg/kg) reduced the elevated expression level of Hmgb1, Tlr4, as well as pro-inflammatory cytokine genes (IL1β, IL6), while the administration of the drug increased the reduced level of mRNA of anti-inflammatory cytokines (IL10, IL11).. Prilezhashchee iadro (nucleus accumbens, NAc) — ventral'naia chast' striatuma golovnogo mozga, kotoraia iavliaetsia vazhnoĭ chast'iu mezolimbicheskogo puti, uchastvuiushchego v sisteme vnutrennego podkrepleniia, oposreduiushcheĭ formirovanie razlichnykh form addiktsii, v chastnosti alkogol'noĭ addiktsii. Dannye neĭrovizualizatsii i issledovaniia in vitro svidetel'stvuiut o razvitii vyrazhennogo neĭrodegenerativnogo protsessa v NAc pri dlitel'nom upotreblenii alkogolia, odnako kliuchevye mekhanizmy, oposreduiushchie étot protsess, ostaiutsia neizvestnymi. V poslednie gody vnimanie issledovateleĭ sosredotocheno na izuchenii sistemy Toll-podobnykh retseptorov (TLR), povyshennaia aktivnost' kotorykh vyiavlena v kore i gippokampe golovnogo mozga pri dlitel'noĭ alkogolizatsii, odnako sushchestvuet neobkhodimost' v issledovanii étoĭ sistemy v drugikh strukturakh mozga. V dannoĭ rabote pokazano, chto dlitel'naia alkogolizatsiia (2 mesiatsa) umerennymi ezhednevnymi dozami étanola (2 g/kg) sposobstvuet vyrazhennomu povysheniiu ékspressii gena Tlr4 i ego éndogennogo liganda Hmgb1 v NAc u krys v period otmeny alkogolia. In"ektsii rifampitsina (Rif; 100 mg/kg) snizhali povyshennyĭ uroven' ékspressii Hmgb1, Tlr4, a takzhe genov provospalitel'nykh tsitokinov (IL1β, IL6) v NAc u dlitel'no alkogolizirovannykh krys v period otmeny alkogolia. Pri étom otmecheno uvelichenie ponizhennogo urovnia mRNK protivovospalitel'nykh tsitokinov (IL10, IL11).

Topics: Alcoholism; Animals; Brain; Ethanol; HMGB1 Protein; Nucleus Accumbens; Rats; Rifampin; Substance Withdrawal Syndrome; Toll-Like Receptor 4

Tuberculosis (TB) often concentrates in groups of people with complex health and social issues, including alcohol use disorders (AUD). Risk of TB, and poor TB treatment outcomes, are substantially elevated in people who have AUD. Médecins sans Frontières and the Belarus Ministry of Health have worked to improve treatment adherence in patients with multi-drug or rifampicin resistant (MDR/RR)-TB and harmful use of alcohol. In 2016, a person-centred, multidisciplinary, psychosocial support and harm reduction programme delivered by TB doctors, counsellors, psychiatrists, health-educators, and social workers was initiated. In 2020, we described patient and provider experiences within the programme as part of a wider evaluation.. We recruited 12 patients and 20 health-care workers, using purposive sampling, for in-depth individual interviews and focus group discussions. We used a participant-led, flexible, exploratory approach, enabling participants and the interviewer to shape topics of conversation. Qualitative data were coded manually and analysed thematically. As part of the analysis process, identified themes were shared with health-care worker participants to enable their reflections to be incorporated into the findings.. Key themes related to the patients' and practitioners experience of having and treating MDRTB with associated complex health and social issues were: fragility and despair and guidance, trust and health. Prejudice and marginalisation were global to both themes. Counsellors and other health workers built a trusting relationship with patients, enabling guidance through a multi-disciplinary approach, which supported patients to achieve their vision of health. This guidance was achieved by a team of social workers, counsellors, doctors and health-educators who provided professional and individualised help for patients' illnesses, personal or interpersonal problems, administrative tasks, and job searches.. Patients with MDR/RR-TB and harmful use of alcohol faced complex issues during treatment. Our findings describe how person-centred, multi-disciplinary, psychosocial support helped patients in this setting to cope with these challenges and complete the treatment programme. We recommend that these findings are used to: i) inform programmatic changes to further boost the person-centred care nature of this program; and ii) advocate for this type of person-centred care approach to be rolled out across Belarus, and in contexts that face similar challenges.

Topics: Alcoholism; Antitubercular Agents; Harm Reduction; Humans; Psychosocial Support Systems; Qualitative Research; Republic of Belarus; Rifampin; Tuberculosis; Tuberculosis, Multidrug-Resistant

Topics: Alcoholism; Antitubercular Agents; Conjunctival Diseases; Ethambutol; Eye Pain; Glucocorticoids; Humans; Hyperemia; Interferon-gamma; Isoniazid; Male; Middle Aged; Pyrazinamide; Rifampin; Scleritis; Tobacco Use Disorder; Tuberculosis, Pulmonary

At the University Centre for Chronic Diseases Dekkerswald, a tertiary tuberculosis (TB) referral hospital in The Netherlands, therapeutic drug monitoring (TDM) is used in patients in case of relapse TB, when there is delayed response to TB treatment, and when abnormal TB drug concentrations are suspected for other reasons. In this article, a case series is presented to illustrate the value of individualized TB drug dosing in four patients with low TB drug concentrations. Increased doses of the TB drugs, especially of rifampicin, resulted in adequate peak plasma concentrations and improved clinical response to treatment in these patients, while no adverse events occurred.

Topics: Adult; Aged; Alcoholism; Antibiotics, Antitubercular; Antitubercular Agents; Chromatography, High Pressure Liquid; Diabetes Complications; Diabetes Mellitus, Type 2; Drug Monitoring; Ethambutol; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Precision Medicine; Pyrazinamide; Recurrence; Rifampin; Schizophrenia; Sputum; Treatment Failure; Tuberculosis; Tuberculosis, Multidrug-Resistant

Topics: Alcoholism; Amoxicillin; Aneurysm, Infected; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Aortic Aneurysm, Abdominal; Aortitis; Blood Vessel Prosthesis Implantation; Combined Modality Therapy; Discitis; Disease Susceptibility; Humans; Lumbar Vertebrae; Male; Middle Aged; Naproxen; Pneumococcal Infections; Psoas Abscess; Pulmonary Disease, Chronic Obstructive; Rifampin; Tomography, X-Ray Computed

A 64-year-old man was admitted with abdominal pain 6 weeks after treatment with intravenous flucloxacillin for cellulitis of his right leg. Urgent operation was necessary for a mycotic aneurysm of the abdominal aorta due to infection with Pasteurella multocida, a microorganism residing in the oral cavity of domestic animals that very rarely causes infection of native arteries or grafts. The aorta was repaired with a rifampin-coated tube graft. Despite postoperative duodenal perforation, abdominal Candida infections, wound dehiscence, and renal insufficiency, the patient is alive 1 year postoperatively.

Topics: Abdominal Pain; Alcoholism; Aneurysm, Infected; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Aortography; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Coated Materials, Biocompatible; Humans; Male; Middle Aged; Pasteurella multocida; Prosthesis Design; Rifampin; Tomography, X-Ray Computed; Treatment Outcome

An alternative regimen for the treatment of latent tuberculosis infection is 2 months of rifampin and pyrazinamide, but some patients have died of hepatitis associated with this therapy. One hundred fourteen patients received rifampin/pyrazinamide in Wake County, North Carolina, between December 1999 and May 2002; 60.5% of these patients were homeless, and at least 17% drank alcohol to excess. Seventy-seven patients (67.5%) completed a full 2-month course. Nine patients had a history of viral hepatitis or chronic liver disease. Four of 114 (3.5%; 95% confidence interval, 1.0-8.7%) patients developed hepatitis on therapy, and another two had symptoms consistent with hepatitis but did not report for laboratory testing (total confirmed plus suspected hepatitis rate 5.3%; 95% confidence interval, 2.0-11.1%). No patient who developed hepatitis had a history of viral hepatitis or liver disease, and none had been previously treated with isoniazid. No patients died or were hospitalized due to drug side effects. Rifampin/pyrazinamide was associated with a significantly higher rate of hepatitis than previously described with isoniazid therapy for latent tuberculosis but resulted in a high completion rate. The rifampin/pyrazinamide regimen for latent tuberculosis infection may be useful for high-risk, traditionally nonadherent patient groups, but careful monitoring for toxicity is required.

Topics: Adolescent; Adult; Aged; Alcoholism; Antibiotics, Antitubercular; Antitubercular Agents; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Cohort Studies; Comorbidity; Drug Administration Schedule; Drug Monitoring; Drug Therapy, Combination; Female; Hepatitis B; Hepatitis C; Humans; Ill-Housed Persons; Infant; Liver Diseases; Male; Middle Aged; North Carolina; Pyrazinamide; Rifampin; Safety; Treatment Outcome; Tuberculosis

The present study, conducted from 1986 to 1991, investigated the accuracy of treatment monitoring performed by practitioners in the out-patient treatment of pulmonary tuberculosis.. All patients with smear or culture positive pulmonary tuberculosis, receiving 6-month short-course chemotherapy with Isoniazid (H), Rifampicin (R) and Pyrazinamide (Z), were included. Treatment had been initiated either in our unit, or shortly before, with discharge after an average time of 8 weeks. Practitioners were sent a flow sheet advising how to perform standardized ambulatory controls.. Forty-three patients were included in the study, four of whom did not visit their practitioner after discharge. It must be assumed that they did not complete treatment. The average follow-up time of the remaining 39 patients was 159 weeks. In 13 cases the treatment was prolonged without obvious reason. For four patients who had not converted to a negative sputum culture at discharge, negativity was never been proven thereafter. Objective means of assessing patient compliance by H-urine strip testing were undertaken only in three cases. X-ray controls were performed adequately in 44.4% of the cases. By contrast monthly checks of liver enzymes had been done only in 23.1% of the patients.. We conclude that even a highly standardized protocol of short-course tuberculosis treatment requires a certain level of experience and compliance on the part of the practitioner. We accordingly recommend that every case of pulmonary tuberculosis should be reviewed at least twice by a chest physician.

Topics: Adult; Alcoholism; Ambulatory Care; Antitubercular Agents; Clinical Competence; Drug Combinations; Family Practice; Female; Follow-Up Studies; Humans; Isoniazid; Male; Middle Aged; Prospective Studies; Pyrazinamide; Rifampin; Switzerland; Tuberculosis, Pulmonary

To determine the incidence of hepatotoxicity due to isoniazid and rifampin in inner-city patients with active tuberculosis.. A hospital-based review of 70 consecutive in-patients in a 770-bed, inner-city hospital. The patient population is primarily African-American and Hispanic.. Fifty-eight men and 12 women were followed from 2-12 wk (median 4 wk). Patients had to be treated for at least 2 wk to be eligible for the study. Patients were excluded if they had been on any anti-tuberculous or any other hepatotoxic drug during the 2-month period before their hospitalization. Aminotransferases, alkaline phosphatase, bilirubin, and albumin were obtained at least every 2 wk.. Hepatocellular toxicity, defined as AST and/or ALT greater than 200 IU/L, occurred in eight out of 70 (11.4%) patients. The mean age of these patients was 38.9 yr (22-58 yr). Patients with AIDS were significantly more likely to develop hepatotoxicity than those with any other risk factor (p < 0.01).. Baseline aminotransferases followed by monitoring may be necessary in AIDS patients.

Topics: Adult; AIDS-Related Opportunistic Infections; Alanine Transaminase; Alcoholism; Antitubercular Agents; Aspartate Aminotransferases; Chemical and Drug Induced Liver Injury; Clinical Enzyme Tests; Female; Humans; Incidence; Isoniazid; Liver Function Tests; Male; New York City; Poverty Areas; Rifampin; Risk Factors; Time Factors; Tuberculosis, Pulmonary

Topics: Adult; Alcoholism; Chemical and Drug Induced Liver Injury; Ethambutol; Fatty Liver; Humans; Isoniazid; Male; Rifampin

Two patients with pulmonary disease due to M. xenopi are presented. Predisposing factors were alcoholism in one patient and previous tuberculosis with emphysema in the other. Whereas the disease was successfully treated in the first, M. xenopi was implicated as a contributory factor to death in the second. Histological examination in the latter case allowed no distinction from ordinary tuberculosis. A review of the literature suggests that infection with M. xenopi should be treated with a combination of rifampicin, isoniazid and one second-line drug, adjustments being made as results of sensitivity testing become available.

Topics: Aged; Alcoholism; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Male; Middle Aged; Mycobacterium; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Pulmonary Emphysema; Rifampin; Tuberculosis, Pulmonary

The course of fever was examined in 75 patients with pulmonary tuberculosis treated with modern chemotherapy. Sixteen patients (21%) were afebrile and differed from 59 febrile patients (79%) by having lower incidences of the following: symptoms (p < 0.02), alcoholism (p < 0.01), lung cavitation (p < 0.01), "far advanced disease" (p < 0.05), and sputum smears containing "numerous" acid-fast bacilli (p < 0.01). Resolution of fever was variable (mean, 16 days; median, 10 days; range, 1 to 109 days). Thirty-eight patients (64%) became afebrile within 2 wk (group 1); 21 (36%) had fever for longer than 2 wk (group 2). Far advanced disease and high temperature (> 38.8 degrees C) on admission were more frequent in group 2 (p < 0.05 and p < 0.01, respectively). However, the groups did not differ in demographic features or in the frequency of symptoms on admission, alcoholism, lung cavitation, numerous acid-fast bacilli on sputum smears, or coexisting bacterial respiratory infection. Antimicrobial drug treatment of presumed coexistent bacterial infection in 19 febrile patients did not influence the course of fever. Analysis of variance and covariance were used to compare the independent effects of various antituberculosis drug regimens on the course of fever; no significant differences were observed.

Topics: Alcoholism; Antitubercular Agents; Bacterial Infections; Drug Therapy, Combination; Ethambutol; Female; Fever; Humans; Isoniazid; Lung; Male; Middle Aged; Rifampin; Sputum; Streptomycin; Time Factors; Tuberculosis, Pulmonary

Seventy-five patients who developed mild hepatic reactions (serum transaminase concentrations of 45 to 149 units per liter) and 50 patients who showed more serious liver damage (serum transaminase values greater than 150 units per liter) were compared with 261 consecutive patients who had no liver reactions during treatment with rifampin and isoniazid. Generally, liver toxicity occurred in 18 per cent of patients receiving combined anti-tuberculous drug therapy. Small increases in transaminase occurred in 14 per cent of the patients; large increases occurred in 4 per cent. Elderly women comprised a risk group. Among patients exhibiting a more serious hepatic lesion (transaminase values greater than 150 units per liter), alcoholics, mostly men, formed another risk group, together with other patients with a history of previous liver or biliary disease. Of 261 patients who did not develop a liver reaction, 57 per cent were slow INH acetylators. In this study, the groups with small and large increases in transaminase were clearly separated; in the former group there was no preponderance of phenotype, whereas in the latter group, slow acetylators clearly dominated among early (first 4 weeks of treatment) hepatic reactions (P less than 0.01). Studies of single-drug regimens of isoniazid have shown that neither slow nor rapid acetylation has any causal influence on isoniazid-induced hepatitis. Because the metabolism of rifampin is independent of the acetylation process, rifampin and isoniazid in combination seem to cause a toxic hepatitis that differs from the hepatitis induced by either drug separately.

Topics: Acetylation; Adult; Age Factors; Alanine Transaminase; Alcoholism; Aspartate Aminotransferases; Biliary Tract Diseases; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Female; Humans; Isoniazid; Liver; Male; Middle Aged; Phenotype; Rifampin; Risk; Sex Factors; Time Factors; Tuberculosis, Pulmonary

Topics: Alcoholism; Hospitalization; Humans; Isoniazid; Long-Term Care; Patient Compliance; Rifampin; Social Work; Tuberculosis

Topics: Alcoholism; Ethambutol; Fever; Humans; Isoniazid; Rifampin; Tuberculin Test; Tuberculosis, Pulmonary

Seventy-nine consecutive patients receiving rifampicin in combination with isoniazid and another drug, were found to have an 8-3% incidence of acute clinical liver disease. Half the patients (36) were advanced alcoholics and almost all cases of hepatitis came from this group. Fifteen of the 36 were thought to have evidence of pre-existing liver disease and were studied by means of serial liver biopsies. Most of those with pre-treatment abnormalities of liver function developed abnormalities in their biopsies, not attributable to alcohol. In one patient active chronic hepatitis is believed to have followed irregularly taken rifampicin. Those patients with both normal pretreatment liver function and biopsies did not develop histological abnormalities. The dangers of irregularly taken self-administered rifampicin are stressed. It is suggested that rifampicin is contraindicated in alcoholics with initial abnormal liver function tests.

Topics: Adult; Aged; Alcoholism; Chemical and Drug Induced Liver Injury; Humans; Liver; Liver Diseases; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Aged; Alcoholism; Biopsy; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Female; Humans; Isoniazid; Liver; Liver Function Tests; Male; Middle Aged; Prednisolone; Rifampin; Staining and Labeling; Streptomycin; Tuberculosis, Pulmonary

Topics: Aftercare; Alcoholism; Aminosalicylic Acids; Ethambutol; Hospitals, Special; Humans; Isoniazid; Occupational Health Services; Patient Education as Topic; Population Surveillance; Rifampin; Streptomycin; Tuberculosis, Pulmonary; Virginia

Topics: Alanine Transaminase; Alcoholism; Aminosalicylic Acids; Aspartate Aminotransferases; Cholesterol; Chylomicrons; Drug Therapy, Combination; Fatty Acids, Nonesterified; Humans; Hyperlipidemias; Isoniazid; Male; Middle Aged; Rifampin; Triglycerides; Tuberculosis, Pulmonary

Topics: Alcoholism; Aminosalicylic Acids; Bilirubin; Dihydrostreptomycin Sulfate; Humans; Isoniazid; Rifampin; Sputum; Transaminases; Tuberculosis; Tuberculosis, Pulmonary

Topics: Alcoholism; Aspartate Aminotransferases; Bilirubin; Chronic Disease; Ethambutol; Humans; Liver Cirrhosis; Male; Melena; Middle Aged; Recurrence; Rifampin; Sputum; Thrombocytopenia; Tuberculosis, Pulmonary

Topics: Alcoholism; Chronic Disease; Humans; Liver Cirrhosis; Male; Middle Aged; Rifampin; Thrombocytopenia; Tuberculosis

Topics: Alanine Transaminase; Alcoholism; Aspartate Aminotransferases; Bilirubin; Biopsy; Chronic Disease; Drug Combinations; Follow-Up Studies; Humans; Jaundice; Liver; Liver Diseases; Liver Function Tests; Radiography; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Aged; Alcoholism; Bronchial Neoplasms; Chronic Disease; Diabetes Mellitus; Eczema; Evaluation Studies as Topic; Humans; Male; Middle Aged; Radiography; Rifampin; Tuberculosis, Pulmonary