scholarly journals SpecificgyrAgene mutations predict poor treatment outcome in MDR-TB

2015 ◽  
Vol 71 (2) ◽  
pp. 314-323 ◽  
Author(s):  
L. Rigouts ◽  
N. Coeck ◽  
M. Gumusboga ◽  
W. B. de Rijk ◽  
K. J. M. Aung ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Poor Treatment ◽  
Mdr Tb ◽  
Poor Treatment Outcome

scholarly journals Increasing multidrug-resistant tuberculosis in Ho Chi Minh City: a retrospective study of 2,266 cases from 2011 to 2015

2019 ◽  
Author(s):  
Le Hong Van ◽  
Phan Trieu Phu ◽  
Dao Nguyen Vinh ◽  
Vo Thanh Son ◽  
Nguyen Thi Hanh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Multidrug Resistant ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Poor Treatment ◽  
Mdr Tb ◽  
Poor Outcomes ◽  
Poor Treatment Outcome

Abstract Background: Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcome. Predictors of poor outcomes vary in different regions. Vietnam is among the 30 countries with high burden of MDR-TB. We aim to describe demographic characteristics and identify risk factors for poor outcome of MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam. Methods: This retrospective study included 2,266 patients who initiated MDR-TB treatment from 2011 to 2015 in HCMC. Treatment outcomes were available in 2,240 patients. Data was collected from standardized paper-based treatment cards and electronic records. Kruskal Wallis test was used to diagnose the change of median of age and body mass index (BMI) over 5 years, and Wilcoxon test to compare median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression on multiple imputation was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program. Results: Among 2,266 eligible cases, 60.2% were failure of category I or II regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. Notification rate increased 24.7% from 2011 to 2015.Treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty and 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1kg/m2 of BMI for patients with BMI<21). Conclusion: Our study describes the increasing cases of MDR-TB in HCMC during 2011 to 2015. Patients with HIV, high smear grade, malnutrition and history of previous MDR-TB treatment should receive additional care. Keywords: multidrug resistant tuberculosis; retrospective; treatment outcome; risk factors; Vietnam

scholarly journals Diabetic Ketoacidosis Management and Treatment Outcome at Medical Ward of Shashemene Referral Hospital, Ethiopia: A Retrospective Study

2021 ◽  
Vol 14 ◽  
pp. 117955142110049
Author(s):  
Getu Melesie Taye ◽  
Amente Jorise Bacha ◽  
Fetene Abeje Taye ◽  
Mohammed Hussen Bule ◽  
Gosaye Mekonen Tefera
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Outcome ◽  
Hospital Mortality ◽  
Medical Ward ◽  
Inclusion Criteria ◽  
Potassium Supplementation ◽  
Poor Treatment ◽  
Poor Treatment Outcome ◽  
Concurrent Medication

Background: Diabetic Ketoacidosis (DKA) is the most common and yet potentially life-threatening acute complication of diabetes that progresses rapidly to death and requires immediate medical intervention. Objective: To assess the DKA management and treatment outcome/in-hospital mortality and its predictors among hospitalized patients with DKA at the Medical ward of Shashemene Referral Hospital (SRH). Method: A retrospective study was conducted at the Medical Ward of SRH from 01 February 2015 to 31 January 2017. A systematic random sampling technique was used to select study subjects based on the inclusion criteria. Thus, of 236 reviewed charts, only 225 patients with DKA fulfilled inclusion criteria. Treatment outcome was considered good for patients who have shown improvement at discharge, while poor for patients who left against medical advice or died in the hospital. Logistic regression analysis was done to determine independent predictors for treatment outcome/in-hospital mortality using SPSS version 20 with statistical significant at P ⩽ .05. Results: Of 225 patients with DKA, 124 (55.1%) were male. Regular insulin was prescribed to all patients and antibiotics were administered to 87 (38.7%). Potassium supplementation was given only for 28 (12.4%). Non-adherence to insulin treatment (n = 91; 40.4%) and infection (n = 66; 29.3%) were the principal DKA precipitating factors. Even though 73.8% of hospitalized patients with DKA have shown good treatment outcomes, DKA contributed 12% in-hospital mortality. The result of multivariate logistic regression analysis shown that hypoglycemia is the only independent predictor for in-hospital mortality[ P = .03]. Moreover, the independent predictors for poor DKA treatment outcome were found to be smoker [ P = .04], Urinary tract infection (UTI) relative to other co-morbid condition [ P < .001], severe hypokalemia which increase risk of poor treatment outcome by around 4 times [ P = .02], and use of Metronidazole as a concurrent medication relative to other concurrent medication [ P = .03]. Conclusion: There was a high in-hospital mortality rate due to correctable causes. This mortality is unacceptable as it was majorly related to the poor practice of potassium supplementation and hypoglycemia due to insulin. Thus, clinicians and stakeholders should have to focus on modifiable factors (hypokalemia, UTI, and hypoglycemia) to reduce poor treatment outcome/in-hospital mortality.

scholarly journals Childhood Tuberculosis Treatment Outcome and Its Association with HIV-Co infection in Ethiopia, A Systematic Review and Meta-analysis

2019 ◽  
Author(s):  
Getaneh Mulualem Belay ◽  
Chalachew Adugna Wubneh
Keyword(s):  
Systematic Review ◽  
Treatment Outcome ◽  
Successful Treatment ◽  
Meta Analysis ◽  
Tuberculosis Treatment ◽  
World Health ◽  
Successful Treatment Outcome ◽  
Poor Treatment ◽  
Poor Treatment Outcome ◽  
Tuberculosis Treatment Outcome

Abstract Introduction Globally around one million children are infected with Tuberculosis. Childhood Tuberculosis is underestimated due diagnosis challenge. HIV infection can affect the TB disease progression and treatment outcome.Objectives The aim of this systematic review and meta-analysis is to determine the pooled estimates of childhood tuberculosis treatment outcome and to analyze the impact of HIV-co infection.Methods We searched all available articles using PubMed, Google scholar and a web of science. Additionally, reference lists of included studies and Ethiopian institutional research repositories were used. Searching was limited to studies conducted in Ethiopia and published in English language. Cohort, cross-sectional and case-control studies were included. A weighted inverse variance random effects- model was used. The overall variations between studies were checked by heterogeneity test Higgins’s method (I 2 ). All included studies were assessed with the JBI quality appraisal criteria. Publication bias was checked with the funnel plot and Egger’s regression test.Result A total of 6 studies with 5,389 participants were included in this systematic review and meta-analysis. The overall pooled estimate of successful treatment outcome was found to be 79.54% (95% CI: 73.00, 86.07). Of which 72.44% were treatment completed. Moreover, this study revealed that the treatment failure, defaulter and death were 0.15%, 5.36%, and 3.54%, respectively. Poor treatment outcome was higher among children with HIV co infection with an odds ratio of 3.15 (95% CI: 1.67, 5.94) as compared to HIV negative children.Conclusion The rate of successful treatment outcome of childhood tuberculosis in Ethiopia found to be low compared to the threshold suggested by the world health organization. HIV co infection is significantly associated with poor treatment outcome. Therefore, special attention better to be given for children infected with HIV.

P-059: miRNA profiling of CD138+ plasma cells identifies miR-181a-5p overexpression as independent predictor of short-term progression and poor treatment outcome in multiple myeloma

2021 ◽  
Vol 21 ◽  
pp. S71
Author(s):  
Maria-Alexandra Papadimitriou ◽  
Aristea-Maria Papanota ◽  
Panagiotis Adamopoulos ◽  
Katerina-Marina Pilala ◽  
Christine-Ivy Liacos ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Treatment Outcome ◽  
Plasma Cells ◽  
Independent Predictor ◽  
Short Term ◽  
Mirna Profiling ◽  
Poor Treatment ◽  
Poor Treatment Outcome

scholarly journals Cytogenetic features and serum lactic dehydrogenase level predict a poor treatment outcome for children with pre-B-cell leukemia

Blood ◽  
1986 ◽  
Vol 67 (6) ◽  
pp. 1688-1692 ◽  
Author(s):  
CH Pui ◽  
DL Williams ◽  
DK Kalwinsky ◽  
AT Look ◽  
SL Melvin ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
B Cell ◽  
Chromosomal Translocation ◽  
Lactic Dehydrogenase ◽  
Dna Index ◽  
Black Race ◽  
Serum Lactic Dehydrogenase ◽  
Poor Treatment ◽  
Poor Treatment Outcome ◽  
Lactic Dehydrogenase Level

Abstract Leukemic cells from 89 (24%) of 369 children with newly diagnosed acute lymphoblastic leukemia (ALL) were found to have a pre-B immunophenotype. By comparison with blasts having the common ALL phenotype, the pre-B cells were more likely to have a DNA index less than 1.16 (P = 0.02), a pseudodiploid karyotype (P less than 0.001), and a chromosomal translocation (P = 0.001). Increased serum lactic dehydrogenase levels (P = 0.001) were also characteristic of pre-B ALL; otherwise, the clinical and laboratory features of the two groups were similar. A nonrandom chromosomal translocation, t(1;19)(q23;p13.3), was identified in blast cells from 16 (23%) of the 70 patients with pre-B ALL and adequate chromosome banding studies; different translocations were found in 11 of the remaining patients. The presence of any chromosomal translocation in the pre-B group was significantly related to a higher leukocyte count, an increased level of serum lactic dehydrogenase, an increased percentage of S-phase cells, black race, and a blast cell DNA index less than 1.16. Four presenting features were found to confer an increased risk of treatment failure among pre-B patients: pseudodiploidy, chromosomal translocation, black race, and higher serum lactic dehydrogenase level. In a multivariate analysis, pseudodiploidy emerged as the strongest factor for predicting relapse in pre-B ALL. The frequent association of chromosomal abnormalities of known adverse prognostic significance and high serum lactic dehydrogenase levels with pre-B-cell ALL explains, at least in part, the poor treatment outcome reported for children with this subtype of leukemia.

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