rome and Tuberculosis--Pulmonary

The prognosis of HIV-infected patients has dramatically improved since the advent of HAART. The immune recovery associated with HAART may result in immuno-pathological reactions and clinical deterioration when HAART is initiated in patients with tuberculosis (TB). This phenomenon is defined as immune reconstitution inflammatory syndrome (IRIS). In this review, we summarise the epidemiology, clinical presentations and management of TB-associated IRIS.

Topics: AIDS-Related Opportunistic Infections; Antiretroviral Therapy, Highly Active; Antitubercular Agents; Drug Therapy, Combination; Evidence-Based Medicine; Glucocorticoids; Humans; Immune Reconstitution Inflammatory Syndrome; Incidence; Prevalence; Risk Factors; Rome; Treatment Outcome; Tuberculosis, Pulmonary

Topics: Catholicism; Famous Persons; History, 17th Century; History, 18th Century; Humans; Male; Rome; Tuberculosis, Pulmonary

Early diagnosis of tuberculosis (TB) is one of the primary challenges in curtailing the spread of TB. This study aimed to determine the diagnostic accuracy of Xpert MTB/RIF for the identification of M. tuberculosis in clinical specimens, and compare this to a microscopist's diagnostic performance. Xpert MTB/ RIF was positive in all specimens with culture-confirmed TB, giving a higher sensitivity than the smear microscopy (100% versus 63%). The use of the Xpert MTB/RIF, as part of routine assay, permits rapid diagnosis of TB and enables clinicians to start an effective treatment.

Topics: Humans; Microscopy; Polymerase Chain Reaction; Rome; Sensitivity and Specificity; Tuberculosis, Pulmonary

We report preventive measures adopted after tuberculosis(TB) transmission from a nurse to a newborn assessed in late July 2011. All exposed neonates born between January and July 2011 were clinically evaluated and tested by QuantiFERON TB gold in-tube; newborns testing positive were referred for prophylaxis.Of 1,340 newborns, 118 (9%) tested positive and no other active cases of TB were found. Active surveillance for TB will be continued over the next three years for all those exposed.

Topics: Adult; Antitubercular Agents; Contact Tracing; Disease Outbreaks; Family Health; Female; Hospitals, Pediatric; Hospitals, University; Humans; Immunity, Cellular; Infant; Infant, Newborn; Infectious Disease Transmission, Professional-to-Patient; Interferon-gamma; Male; Mass Screening; Maternal-Child Nursing; Mycobacterium tuberculosis; Obstetrics and Gynecology Department, Hospital; Population Surveillance; Pregnancy; Rome; Sputum; Tuberculin Test; Tuberculosis, Pulmonary; Tuberculosis, Splenic

To assess changes in clinical presentation and outcome of HIV-associated tuberculosis (TB) before and after widespread implementation of highly active antiretroviral therapy (HAART).. We reviewed clinical charts of HIV-infected patients with culture-confirmed pulmonary TB in two referral clinical centers in Rome, Italy. The 67 patients diagnosed in 1995 to 1996 were compared with 51 patients diagnosed in 1997 to 1998. To analyze factors associated with survival we used a Cox model including antiretroviral therapy as a time-dependent covariate.. Patients diagnosed in 1997 to 1998 were more likely to have TB as the first AIDS-defining illness (78% versus 58%, p <.05), to have HIV diagnosed <2 months before TB (33% vs. 7%, p <.005) and to have typical chest radiograph pattern (45% vs. 25%, p <.05), and had a higher CD4(+) count (median 105 vs. 43, p <.005). Survival at 1 year was 80% for patients diagnosed in 1997 to 1998 vs. 65% for those diagnosed in 1995 to 1996 (p by log-rank =.02). After adjusting at multivariate analysis, time period of diagnosis was not confirmed as associated with survival (hazard ratio, 1.05; 95% confidence interval, 0.39--2.81). Age, CD4+ cell count <25/mm(3), and AIDS-defining illnesses before TB diagnosis were all associated with an higher risk of death, whereas a decreased risk of death was observed in patients starting a triple combination antiretroviral therapy after TB diagnosis (hazard ratio, 0.14; 95% confidence interval, 0.03--0.57).. Cases of HIV-associated TB occurring in patients with advanced immunosuppression and presenting with atypical radiologic appearance tend to be relatively less common in the HAART era. HAART is a major factor in prolonging survival in these patients.

Topics: Adult; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; Disease Progression; Drug Resistance, Microbial; Drug Resistance, Multiple; Female; HIV Infections; Humans; Male; Middle Aged; Proportional Hazards Models; Retrospective Studies; Rome; Substance Abuse, Intravenous; Survival Rate; Time Factors; Tuberculosis, Pulmonary

Topics: Famous Persons; History, Ancient; Rome; Tuberculosis, Pulmonary

Keats trained as a physician at Guy's Hospital, but abandoned medicine for poetry. Progressive tuberculosis, a family disease, led him to Italy in the hope of a cure and to join Shelley and Byron at Pisa. He died in Rome in an apartment overlooking the Spanish Steps. Since 1909 this has been a Keats-Shelley literary memorial. During World War II its most valuable manuscripts narrowly escaped destruction during the bombardment of the Cassino monastery, where they had been sent for safekeeping. Able to devote but 4 years of his short life solely to poetry, Keats achieved distinction as a major English poet known for his sensitivity and sensuous imagery.

Topics: Adult; England; Famous Persons; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Italy; Male; Poetry as Topic; Rome; Tuberculosis, Pulmonary; Warfare

Topics: Education, Medical, Continuing; Epidemiology; Rome; Tuberculosis, Pulmonary

Topics: Hospitals, Special; Hospitals, Teaching; Humans; Research; Rome; Tuberculosis, Pulmonary