Setting: Tajikistan is among the 30 countries with the highest multidrug-resistant tuberculosis (MDR-TB) burden.
Objective: To investigate the risk factors for unfavourable treatment outcomes among rifampicin-resistant (RR)/MDR-TB patients.
Design: Retrospective medical chart review of RR/MDR-TB patients enrolled for treatment in 2012-2013.
Results: Of 601 RR/MDR-TB patients, 58 (9.7%) had pre-extensively drug-resistant TB (pre-XDR-TB; i.e., MDR-TB with additional resistance to a fluoroquinolone or second-line injectable agent) and 45 (8%) had XDR-TB (MDR-TB with additional resistance to both). Treatment failure and death were reported in respectively 40 (7%) and 89 (15%) cases; 60 (10%) patients were lost to follow-up (LTFU). In multivariable analysis, treatment failure was associated with pre-XDR-TB (adjusted odds ratio [aOR] 3.67, 95%CI 1.47-9.18) or XDR-TB (aOR 8.61, 95%CI 3.48-21.34). Death was associated with age >45 years vs. <25 years (aOR 3.47, 95%CI 1.68-7.19) and no record of any adverse event during treatment (aOR 2.55, 95%CI 1.48-4.39). Changing place of residence during treatment was an independent predictor of LTFU (aOR 4.61, 95%CI 2.41-8.8).
Conclusions: Our findings highlight the need for 1) the use of regimens with new anti-tuberculosis drugs; 2) good handover of TB patients and 3) effective tracing mechanisms if patients change a place of residence to prevent LTFU.
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http://dx.doi.org/10.5588/ijtld.18.0311 | DOI Listing |
Surg Innov
January 2025
Morristown Medical Center, Department of Surgery, Morristown, NJ, USA.
Background: In difficult colorectal cases, surgeons may opt for a hand-assisted laparoscopic (HALS) colectomy or attempt a laparoscopic surgery that may require an unplanned conversion to open (LCOS). We aimed to compare the clinical outcomes of these 2 types of surgeries.
Methods: Colectomies for acute diverticulitis with a HALS or LCOS surgery were selected from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) 2022 Targeted Colectomy Database.
J Clin Endocrinol Metab
January 2025
Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.
Background: Thyroid nodules classified cytologically as low-risk indeterminate lesions (TIR3A) on fine-needle aspiration biopsy (FNAB) present a clinical challenge due to their uncertain malignancy risk. This single-center study aimed to evaluate the natural history of TIR3A nodules.
Materials And Methods: FNABs performed between July 2017 and December 2019 were retrospectively retrieved and patients with TIR3A nodules were evaluated at baseline and throughout a follow-up based on ultrasound (US) parameters and clinical data.
J Med Internet Res
January 2025
Cancer Screening, American Cancer Society, Atlanta, GA, United States.
Background: The online nature of decision aids (DAs) and related e-tools supporting women's decision-making regarding breast cancer screening (BCS) through mammography may facilitate broader access, making them a valuable addition to BCS programs.
Objective: This systematic review and meta-analysis aims to evaluate the scientific evidence on the impacts of these e-tools and to provide a comprehensive assessment of the factors associated with their increased utility and efficacy.
Methods: We followed the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and conducted a search of MEDLINE, PsycINFO, Embase, CINAHL, and Web of Science databases from August 2010 to April 2023.
Hepatology
January 2025
Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA.
Background Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) affects about a third of adults worldwide and is projected soon to be the leading cause of cirrhosis. It occurs when fat accumulates in hepatocytes and can progress to metabolic dysfunction-associated steatohepatitis (MASH), liver cirrhosis, and hepatocellular carcinoma. MASLD pathogenesis is believed to involve a combination of genetic and environmental risk factors.
View Article and Find Full Text PDFNeurology
February 2025
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Background And Objectives: Lipid metabolism in older adults is affected by various factors including biological aging, functional decline, reduced physiologic reserve, and nutrient intake. The dysregulation of lipid metabolism could adversely affect brain health. This study investigated the association between year-to-year intraindividual lipid variability and subsequent risk of cognitive decline and dementia in community-dwelling older adults.
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