Setting: A tertiary care facility in Ukraine, a high multi- and extensively drug-resistant tuberculosis (MDR/XDR-TB) burden country.
Objectives: To assess the management and treatment outcomes of MDR, pre-XDR-TB and XDR-TB.
Design: Cohort study using programme data, 2006-2011.
Results: Of 484 individuals with drug-resistant TB, 217 (45%) had MDR-, 153 (32%) pre-XDR- and 114 (24%) XDR-TB. Of all resistant types completing the intensive phase of treatment, 322 (67%) were alive and had culture converted. This included 157 (72%) with MDR- and 61 (54%) with XDR-TB. At the end of the continuation phase of treatment, 106 (22%) had treatment success and 378 (78%) had unfavourable outcomes, including 110 (23%) failures, 21 (4%) deaths, 71 (15%) losses to follow-up and 176 (36%) with an unknown outcome. This was associated with more than one lung cavity being affected, a history of treatment with second-line anti-tuberculosis drugs, poor adherence and XDR-TB. A total of 226 (47%) patients reported at least one adverse drug reaction, the most common being gastrointestinal and vestibular toxicity.
Conclusion: Outcomes of MDR- and XDR-TB were satisfactory in the intensive phase; however, this was not sustained during the ambulatory period. If we are to do better, urgent measures are needed to improve ambulatory management, including making safer, shorter and more effective drug regimens available.
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http://dx.doi.org/10.5588/pha.14.0035 | DOI Listing |
NPJ Digit Med
January 2025
School of Mechanical Engineering, Shandong University, Jinan, China.
Extensive research on retinal layer segmentation (RLS) using deep learning (DL) is mostly approaching a performance plateau, primarily due to reliance on structural information alone. To address the present situation, we conduct the first study on the impact of multi-spectral information (MSI) on RLS. Our experimental results show that incorporating MSI significantly improves segmentation accuracy for retinal layer optical coherence tomography (OCT) images.
View Article and Find Full Text PDFNat Commun
January 2025
National-Local Joint Engineering Laboratory of Druggability and New Drug Evaluation, National Engineering Research Center for New Drug and Druggability (cultivation), Guangdong Province Key Laboratory of New Drug Design and Evaluation, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, 510006, China.
Epitranscriptomic modifications, particularly N6-methyladenosine (mA), are crucial regulators of gene expression, influencing processes such as RNA stability, splicing, and translation. Traditional computational methods for detecting mA from Nanopore direct RNA sequencing (DRS) data are constrained by their reliance on experimentally validated labels, often resulting in the underestimation of modification sites. Here, we introduce pum6a, an innovative attention-based framework that integrates positive and unlabeled multi-instance learning (MIL) to address the challenges of incomplete labeling and missing read-level annotations.
View Article and Find Full Text PDFBiochem Biophys Res Commun
January 2025
San Francisco State University, Department of Chemistry and Biochemistry, San Francisco, CA, 94132, USA. Electronic address:
Enterococcus faecalis is a multi-drug-resistant human pathogen that is found in a variety of environments and is challenging to treat. Under stress conditions, some bacteria regulate intracellular polyamine concentrations via polyamine acetyltransferases to reduce their toxicity. The E.
View Article and Find Full Text PDFJ Hazard Mater
January 2025
Vanke School of Public Health, Tsinghua University, Beijing 100084, China; Institute for Healthy China, Tsinghua University, Beijing 100084, China. Electronic address:
The relationship between fine particulate matter (PM) and cognition has been extensively investigated. However, the causal impact of acute PM purification on cognition improvement and the underlying biological mechanisms remain relatively opaque. Our double-blinded randomized controlled trial assessed the impact of acute PM purification on executive function, underpinned by multi-omics approaches including alternative splicing (AS) analysis.
View Article and Find Full Text PDFJ Hazard Mater
January 2025
Yunnan Dali Research Institute of Shanghai Jiao Tong University, Dali 671000, China.
Erhai Lake, a vital drinking water source for Dali, a highland agricultural city, faces potential contamination from pesticide residues, yet limited studies have assessed their distribution and impacts. This study investigates the occurrence, transport, partitioning, and ecological risks of pesticides in the lake's dissolved phase (DP), suspended particulate matter (SPM), and sediment (SD) samples collected from 22 sites across different seasons. The results showed significant temporal variations across different media, with spatial variations driven by crop-related patterns.
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