Tuberculosis

Tuberculosis

  • Michael T Newhouse added an answer:
    Can anybody tell me how tuberculosis might lead to lung cancer?

    There are so many changes including physiological,histological,biochemical and immunological changes associated with secondary TB. So what is the mechanism that leads to tumour of lung sometimes?

    Michael T Newhouse · McMaster University

    "Scar cancer of the lung" is a well-recognized entity and is usually adenoca that can begin in an area of "healed" Tb. The underlying mechanism is not certain but physical injury to adjacent "normal" lung and/or chronic inflammation would be reasonable hypotheses to explain the possible cause. michael newhouse.

  • Lawrence Broxmeyer, MD added an answer:
    Where can I find age-structured incidence data for AIDS defining opportunistic infections starting from before AIDS epidemic in Sub-Saharan Africa?

    I am interesting in finding prevalence/incidence rates of specific opportunistic infections of young age groups (not adult) from before and after the start of the AIDS epidemic (~1980). 

    In particular I am looking for trends in: Tuberculosis, Cryptosporidium, and Non-Typhi Salmonella. 

    Does anyone know if such data exists and where I can find it? I would want to look in an area where HIV/AIDS is widespread, so somewhere in Sub-Saharan Africa would be ideal (or the whole region). 

    Lawrence Broxmeyer, MD · NY Insitute of Med Research

    "Where can I find age-structured incidence data for AIDS defining opportunistic infections starting from before AIDS epidemic in Sub-Saharan Africa?
    I am interesting in finding prevalence/incidence rates of specific opportunistic infections of young age groups (not adult) from before and after the start of the AIDS epidemic (~1980). 

    In particular I am looking for trends in: Tuberculosis, Cryptosporidium, and Non-Typhi Salmonella. "

    ________________________________

    Very well. But why go to WHO? Perhaps you should start by seeking statistical data and maps for Tuberculosis and M. avium, which still are the leading causes of infectious death in HIV/AIDS. Before such typical and atypical mycobacteria were proclaimed "AIDS-defining illness" by the likes of WHO, you will notice that they admitted that tubercular disease killed close to 3 million people a year. Then since it has magically  "defined" AIDS -  it is now purported that tubercular disease kills merely a million and a quarter annually. Interesting math.

  • Mostafa Eidiani added an answer:
    Where can I find a paper which shows that zoonotic tuberculosis (M bovis) is not transmissible among immunocompetent humans?

    Recently I read a paper which authors state that zoonotic tuberculosis (M. bovis) is not transmitted among immunocompetent humans.
    Now, when I search, I can't locate it. Can anyone help me?

    Mostafa Eidiani · Khorasan Institute of Higher Education

    New paper

    http://www.scirp.org/journal/PaperDownload.aspx?paperID=49555

  • Werner Solbach added an answer:
    Wont Mycobacteria isolated from stool specimen confer TB infection?

    Does isolate from a stool sample prove a person is infected with TB?

    Werner Solbach · Universität zu Lübeck

    I want to stress my previous comment. Mere detection of mycobacteria does not justify Treatment. A thorough species diagnosis has to be made and MOTTs have to be excluded. If M. tuberculosis or M. bovis is found in stool a thorough evaluation of the patient decides whether Treatment is necessary or not. This includes IGRA testing or Mantoux Skin testing and exclusion of co-infections like HIV. Also, a high-Quality resistence testing is mandatory.

  • Tony Ete added an answer:
    How can I manage patients with total resistance for anti TB medications?

    There is no convincing guidelines on how I can approach total drug resistance accordingly. So how do we manage patients who are resistant to medication for XDR - TB?

    Tony Ete · North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences

    Excluding your list of medications there are many drugs known to be effective in Tuberculosis including PAS,Linezolid,Imipenem plus cilastatin,Clofazimine,Amoxicillin and clavulanate,Clarithromycin.What about them?

  • Mani Sankar added an answer:
    What is the difference in Mycobateria growth in flat vs v (conical) - well shaped 96 - well microtiter plates?
    I have been determining MICs for M. tuberculosis using 96 - well microtiter plates, flat well shape. After five days, I confirm positive growth by adding alamar blue to my controls.

    Recently I ran into a supplier issue and I could not obtain plates with flat wells but had to revert to using V or conical shape wells. After five days of incubation, I add alamar blue. There is difference in the color change. In the flat wells, color change after five days is a distinctive pink, whereas in the v or conical shape wells, it's a purple/violet.

    All conditions remain exactly the same between the two.

    What could cause this issue? Is it a surface area problem? Could it be that cells sink to the bottom in v or conical shaped wells and are not in entire contact with the alamar blue?

    Has anybody else observed such an issue?
    Mani Sankar · All India Institute of Medical Sciences

    Dear Shane

    I have not performed alamar blue testing using 'V' bottom plates. But the possible reason may be the surface area difference between the flat and V bottom plates. In V bottom plates the cells could settle in the bottom and could produce a high intensity coloring. whereas in the flat bottom plates the cells are dispersed even the coloring would be of less intensity. I recommend you to continue with the 'Flat bottom' plates instead of V bottom which will seriously affect your results and OD values.

    Best regards

  • Rajendra Takhar added an answer:
    What are the organs in human body never reported to be involved in tuberculosis?

    Is it thyroid, Pancreas, heart ?Is it absolute? What are the remaining organs not involved?Any data on this available or not? 

    Rajendra Takhar · Rajasthan University of Health Sciences

    "TB can present like anything except pregnancy".  Well said.....

  • Shaopeng Yuan added an answer:
    Is 18s rRNA is right option for internal Control in RT PCR?

    I am working on RT PCR for Tuberculosis. I want internal amplification control for my RT PCR. 18s rRNA is one of the house keeping gene. Can we use the same for PCR internal control ? Can it also clear the state of DNA isolation form Sputum?

    Shaopeng Yuan · The Rockefeller University

    DNA from sputum contains mix population of cells and bacterias. I would recommend to use a combination of 3-5 house keeping genes to take geometric mean to use as normalization factor. You can select about 10 potential HK genes and then use GeNorm       method to select the top three HK genes.

  • Mace M Schuurmans added an answer:
    Is bronchoscopy always abnormal or not in Endobronchial Tuberculosis?

    I've seen an italian man, HIV+ on treatment, who had a history of fever, cough, thoracic pain, some episodes of hemoptysis (I saw one of them, a big one, so he is credible).

    We performed a CT scan (infiltrate in the upper right lobe tree-in-bud like) and a bronchoscopy (normal, except for a sign of previous bleeding in correspondence of the CT lesion) with BAL.

    What do you think about the diagnosis? Would you start an anti-TB therapy ex-juvantibus? 

    Mace M Schuurmans · University Hospital Zurich

    In haemoptysis do not forget to sample the expectorated blood as "sputum" for detection of AFB and culture. It comes from the site of potential infection and helps in the diagnosis. 

  • Amar Safdar added an answer:
    Does anyone have any experience in giving Delamanid and Bedaquiline together for the treatment of XDR Tuberculosis?

    I have very limited therapeutic options treating a patient with extensively Drug resistant TB. However there is no evidence in the literature of the association of these two drugs in a regimen. They are now commercially available however there is little consensus to adding them together given the paucity of safety data. Has anyone managed to give the two drugs together, where there any adverse events and/or increases in QTc?

    Amar Safdar · NYU Langone Medical Center

    Agree with above, plaease take a look at CDC provisional guidlines

    Bedaquiline should be used with clinical expert consultation as part of combination therapy (minimum four-drug treatment regimen) and administered by direct observation to adults aged ≥18 years with a diagnosis of pulmonary MDR TB (Food and Drug Administration. SIRTURO [bedaquiline] tablets label. Available at http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/204384s000lbl.pdf ). Use of the drug also can be considered for individual patients in other categories (e.g., persons with extrapulmonary TB, children, pregnant women, or persons with HIV or other comorbid conditions) when treatment options are limited. However, further study is required before routine use of bedaquiline can be recommended in these populations.

    A registry for persons treated with bedaquiline is being implemented by Janssen Therapeutics to track patient outcomes, adverse reactions, laboratory testing results (e.g., diagnosis, drug susceptibility, and development of drug resistance), use of concomitant medications, and presence of other comorbid conditions. Suspected adverse reactions (i.e., any adverse event for which there is a reasonable possibility that the drug caused the adverse event) and serious adverse events (i.e., any adverse event that results in an outcome such as death, hospitalization, permanent disability, or a life-threatening situation) should be reported to Janssen Therapeutics at telephone 1-800-526-7736, to FDA at telephone 1-800-332-1088 or at http://www.fda.gov/medwatch , and to CDC's Emergency Operations Center at telephone 1-770-488-7100.

  • Rajendra Angara added an answer:
    Is there any mycobacterial protein which is non toxic when over expressed in M.tuberculosis but toxic when over expressed in M.smegmatis?

    Hi, I am characterizing the transcriptional regulator of Mycobacteirum tuberculosis .

    Because we don't have facility for M.tuberculosis culture, I am trying to over express (using PVV16 which has Hsp60 promoter) it in M.smegmatis. but I never got colonies though the clone and vector back bone are fine. So I thought over expression might be toxic to M.smegmatis. so to check its toxicity I did frame shift mutations and found its over expression is not lethal.

    However for the same protein Chip-seq data available in MTB Network Portal. By going through their publication in NAR, I realised they over expressed corresponding transcription factors in M.tuberculosis using Tet-inducible system and did Chip-seq analysis.

    My question is, is over expression of my protein not toxic to M.tuberculosis but toxic to M.smegmatis or am I simply doing something wrong?

    How can I get a over expression strain of M.smegmatis?

    Rajendra Angara · The Centre for DNA Fingerprinting and Diagnostics

    Dear @Jan van Ooyen , thank you for your kind reply.

    using Acetamide inducible promoter, i am able to over express the protein.

  • Haradhan Kumar Mohajan added an answer:
    Can anyone help with XDR-TB treatment?
    I want to investigate a rather new chemotherapy with well-known medications for XDR-TB. Unfortunately, there are no facilities and safety to conduct the experiment on TB-infected cell lines here in Iran. Please help me provide the way to do this work.
    Haradhan Kumar Mohajan · Premier University

    I have a paper on TB and we can share our opinions. I am not giving you solution to treat XDR TB.

  • Helmi Sulaiman added an answer:
    Does negative IGRA predicts TB negativity?

    Positive IGRA might suggest infection be it latent or active. But is the relationship true in another direction? Is there any data out there to help me answering the question?

    Helmi Sulaiman · University of Malaya

    I rather not use this expensive test actually to test active TB... not TST too 

  • Saileela Kondapaneni added an answer:
    Can ESR predict TB?

    On infections ESR gets elevated, but correlating with clinical conditions in TB, can ESR serve to predict TB especially in HIV positive and sputum smears are negative/ sputum nonproductive?

    Saileela Kondapaneni · Kamineni Institute of Medical Sciences

    ESR can not predict tuberculosis because it is non specific test and there are many other conditions where ESR is rised.

    But we can always rule  out tuberculosis by doing other specific tests when ESR is rised

  • Krishnat Yadav added an answer:
    Is there any method to detect TB directly using Blood?

    In majority of the cases sputum,body fluids correlating to symptoms TB is diagnosed but can blood samples be used directly?and/or is lysing agent required preferentially?

    Krishnat Yadav · Padmashree Dr. D.Y. Patil University

    There are many methods for detecting TB from blood, are you talking about antigen or antibodies? Kindly narrate your question more specific.

  • Argyrides Argyrou added an answer:
    Has anyone measured or come across the value for the intracellular volume of M. tuberculosis?

    I would like to know the average volume of the cytosol of M. tuberculosis, or a sound approximation of this value.

    Argyrides Argyrou · GlaxoSmithKline plc.

    If you approximate a TB cell as a cylinder, 4 um height (h) and 0.5 um radius (r), then the volume = pi X r(squared) X h = 3 e-18 m(cubed) = 3 e-15 litres = 3 e-3 pL = 3 atto L

  • Lelamekala Vengidasan added an answer:
    Does anyone have experience cloning: 6.7 kb vector and 7.9 kb insert ?
    I am trying to clone a 7.9kb insert (from pGOAL19) in 6.7 kb (p2NIL) of vector and not getting it. I am using chemical competent cells. I want to ask the size constraint of plasmid for chemical competent cell? What is the maximum size of plasmid that can be transformed in chemical competent cells? do i have to use electroporation as size of my Vector plus insert will be around 15 kb?
    Lelamekala Vengidasan · University of Science Malaysia

    Do you you grow the cells in 30oC?

  • Vilemar Magalhaes added an answer:
    Can anyone recommend studies onto the diagnosis and management of tuberculosis related pleural effusions?

    I want to work out the best way of managing a slowly resolving tb effusions.

    Vilemar Magalhaes · Easy Way Intercâmbios

    Dear Adam,

    Have you looked for Dr. Lawrence Broxmeyer at RG:? I think he can be of a great help.

    https://www.researchgate.net/profile/Lawrence_Broxmeyer_Md

  • Saileela Kondapaneni added an answer:
    Can anyone explain to me how to do a study about PM 2.5 and tuberculosis infection?

    Can anyone explain me that how to do a study about PM 2.5 and tuberculosis infection?

    Saileela Kondapaneni · Kamineni Institute of Medical Sciences

    If the droplet size is less than 5 microns, It can be phagocytosed  by alveolar macrophages bacteria can be eliminated by phagocytosis

    If droplet size is more than 5mm, it can be filtered at ala nasi

    To study Particulate matter 2.5  and Tuberculosis infection, Load of tubercle bacilli can be measured in PM 2.5 and also the exposure to open cases in that area.

    Slit sampler can be used and allow the known volume of air is directed on to slide so that acid fast staining can be done. We can increase the sensitivity of the smear by increasing the exposure time. Routine culture media can not be used for tubercle bacilli and incubation period is more.

    collected air can be tested by PCR for M.tuberculosis

    Even I am interested to learn if there is any standard method available for testing tubercle bacilli load in air

    Thank  you 

  • Marc-Antoine Perrenoud added an answer:
    Does anyone know which kit is the best for large spectre PCR (identifiactions Eubacterias, mycobacterias, resistance genes TB)?

    I'm starting my tests next week, I will test 4 different kits from 4 brands and I desire to know if anyone has tested FastPCR for diagnosis purpose with one of those ready-to-use pcr mixes? I Could use some guidance about which one will be the best.

    1. Roche Fastart PCR Master
    2. Takara Clontech Premix Ex Taq Hot Start Version
    3. Applied Biosystems AmpliTaq Gold Fast mastermix
    4. Kapa Biosystems Fast HotStart Readymix(2x)

    The goal is simply to detect pathogens and identify them in culture or directly in samples patients. I also need to be able to analyse resistances genes. I'm trying to make my amplification method a lot faster than it's actually is (about 2:45 now)..

    Thanks a lot !

    Marc-Antoine Perrenoud · University Hospital of Lausanne

    I started my PCR tests 2 weeks ago and i already dropped 3 Master mix due to way too high sensibility, probably those mixs are better for use in human genomics.

    (Roche Fastart PCR Master, Takara Clontech Premix Ex Taq Hot Start Version, Kapa Biosystems Fast HotStart Readymix(2x)

    So I choose the Applied Biosystems AmpliTaq Gold Fast mastermix who seems to works fine for now with a high sensibility of 10^2cp/5ul for large spectre research of eubacterias, with no contaminations and a PCR time of about 45minutes my results were fine enought to continue with all my criterias (Mycobacterias, 28S panfungal, 18S panfungal, Resistance gene INHA, RPOB, KATG, and OXYR.) I'll see next week if it works for those criterias too.

  • Muhammad Javed added an answer:
    How do you rate the success of diagnosis of tuberculosis from blood through PCR?

    Thanks in advance for your replies.

    Muhammad Javed · Hamdard University

    In under developed countries the cost of PcR is very high. A positive tuberculin test in the absences of BCG helps better than pcR

  • Alexandre Carvalho added an answer:
    Should INH prophylaxis be done in patients with long term steroid use?

    45 year-old women was admitted to OPH d/t retinal vasultis. She has a plan to recieve long term and high dose steroid. But, her chest X-ray showd inactive tuberculosis and no history of treatment of TB. Should she take INH for prevention of occurence of acvtive TB ?

    Alexandre Carvalho · University of Minho

    If tuberculosis reactivation is a concern, we can not rely only on X-ray to decide. It is necessary to determine the existence of latent tuberculosis with tuberculin test and, if not definite, with IGRA.

    I believe long term corticotherapy is not an indication for INH prophylaxis, though.

  • Himanshu Taneja added an answer:
    Can someone recommend a Tuberculosis disease dataset?
    I am looking for a dataset regarding Tuberculosis disease. Does anyone know a dataset or how to find a free dataset?

    I would like to design a new hybrid clustering or classification to detect anomaly regarding Tuberculosis disease from big dataset.
    Himanshu Taneja · National Institute of Technology, Kurukshetra

    Did you get any dataset? I am also looking for the same. Please respond if you found one.

  • Demba Jammeh added an answer:
    Which DNA extraction kit do you use for sputum sample stored with Ethanol 90%?

    I have TB sputum samples stored with ethanol 90%. We tried the Genolyse kit but with low DNA yield.

    Maybe boom extraction method is more recommended? 

    Any experience?

    Thank you

    Demba Jammeh · Northumbria University

    I advice you to use Qiagene Kit. you will get better DNA

  • Lawrence Broxmeyer, MD added an answer:
    How should I treat a patient with recurrent meningeal TB who is seven months pregnant?

    She got TB a long time ago and she had taken complete medication, but now she is at the 7th month of pregnancy and she has got TB again, but this time to brain. So what is the best way to treat her?

    All the drugs of TB are teratogenic.

    Is there any anti-tubercular drug without teratogenicity? If there is please suggest it here.

    Lawrence Broxmeyer, MD · NY Insitute of Med Research

    The following antituberculosis drugs are contraindicated in pregnant women:

    Streptomycin
    Kanamycin
    Amikacin
    Capreomycin
    Fluoroquinolones

    Other than that every other Anti-TB drug is fair game. In medicine we weigh the benefits against the potential risks of using drugs. Also, who ever told you that all anti- tubercular drugs where teratogenic? Show me the proof that Ethambutal is teratogenic. You cannot. All anti-tubercular drugs should be used during pregnancy only if the benefit justifies the potential risk to the fetus. In the case that you are describing, the conclusion to this is a no-brainer. Either you give the drugs other than mentioned above or the patient and her fetus die.

  • Peter J Didier added an answer:
    Histopathology shows Granulomatous endometritis but PCR is negative. What can be the reason?

    Two tissue sections are sent to lab for detection of mycobacteium tuberculosis in endometrium, histopathology report shows Granulomatous endometritis and PCR shows negative for mycobacterium tuberculosis what are the possibilities in this issue and  is this situation common or uncommon. primers specific to IS6110 were used, Dear researchers can any one provide your  suggestions and information in this regard 

    Peter J Didier · Tulane University

    I'm going to presume that the patient has a positive skin test for TB and special stains for mycobacteria and fungi are negative which explains why TB PCR was requested. If that's not the case then you should look at a nice review by Almoujahed et al (AM j Clin PAth 2002:117, 771-775) Many of these granulomatous lesions are focal and a reaction to a previous surgery (foreign bodies) or hemorrhage (necrobiosis, endometrial ablation). Systemic conditions like sarcoidosis and Crohn's disease should be ruled out but tuberculosis is the most common systemic etiology. In rare cases, cytomegalovirus infection has been implicated.

    PCR is not flawless. The IS6110 primers test for Mtb complex organisms with about 85-95% sensitivity in some studies but only 30-75% sensitivity in other studies depending on extraction methods. The specificity runs about 75% so false positives are possible including positive tests for distantly related organisms like M. simiae. It will not detect other mycobacteria like M. avium/intacellulare complex, M. xenopi, M. gordonae, M. fortuitum, M. kansasii. In reality positive tests by this method should be confirmed by another method and negative tests do not rule out involvement of other mycobacteria.

  • Hafid Soualhine added an answer:
    Does anyone have the experience of amplification of 2.5 kb plus gene of Mycobacterium tuberculosis??

    I am trying to amplify a 3 kb gene of Mycobacterium tuberculosis which is of high GC rich..

    Hafid Soualhine · Institut National de Santé Publique du Québec (INSPQ)

    I have easily amplified a 3 kb fragments using a two-steps amplification PCR. You have to design your own primers that must be GC rich at the 3' end, and high Tm and choose an amplification program without the annealing step,  A programm containing denaturation and élongation steps. In this case you can set up the denaturation step at 95C for 30s and annealing/élongation step at 72 C for 90s to 120 s  for 35 - 40 cycles. This is particularly interesting if you have a non specific bands less than 3kb with others methods.

    You can try this using the simple AmpliTaq. that is less expensive.

    Alternatively, you can use Phusion (as previously recommanded by other colleagues) and add DMSO,

    Another way is to use a mix of 2 Taq polymerases, we have amplified a fragments more than 15 Kb in lenght. or you can use a mix of two polymerase like Advantage GC 2 Polymerase Mix & PCR Kit (Clontech).

  • Farida Iskakova added an answer:
    A 37 year old female remains sputum positive for AFB in the eastern part of India since 1990 despite treatment. What is the probable explanation?
    A 37 year old female at the age of 15 years in the year 1990 was first diagnosed to have sputum positive tuberculosis. She had been treated many times with first line and 2nd line ATDs. She symptomatically improved but her sputum positivity remains the same. In 2004 she was diagnosed as a case of total drug resistance as per DST report and again at present her DST shows sensitivity to pyrazinamide, ethionamide, PAS and capreomycin. Still she is sputum positive for AFB though there is no symptoms and she is leading a totally normal life.
    What could be the possible explanation for such a scenario?
    Any explanation will be greatly appreciated.
    Farida Iskakova · Kazakh National Medical University named SD.Asfendiarov

    It needs to genotype for the estimation of MBT strains. Are they M.tuberculosis or another types. Might be right, it is the combination of TB and MOTT.

  • Are there any studies about the impact of climate change and variability on the epidemiology of the Tuberculosis?

    In Vector-Borne diseases, but also in some respiratory infectious diseases including influenza, studies have demonstrated relationships and influences of climate change and variability on disease epidemiology, but what about tuberculosis?

    Alfonso J. Rodriguez-Morales · Universidad Tecnológica de Pereira

    Thanks, but not specificly addressing TB.

  • Majid Avijgan added an answer:
    Where can I test and confirm Anti-tuberculosis and Anti-HIV activity for Plant extract samples?

    Hi friends, I wish to do Antituberculosis and Anti HIV activity for Plant samples. Do you people know about any one doing out sourcing these experiments. I am ready to pay for this work. Or I will give authorship This  work is my own interest on natural drug discovery. 

    Majid Avijgan · Isfahan University of Medical Sciences

    I have several studies on the echinophora platyloba as an anti fungal herb. I have experience of what you are looking for. It is easy and simple, just invite from one of the pharmaceutic for co-operation. I have one co-worker in my paper as Dr Mohadese Mahboubi. Her email is as mahboubi1357@yahoo.com

About Tuberculosis

Any of the infectious diseases of man and other animals caused by species of MYCOBACTERIUM.

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