Aged ; Anti-Bacterial Agents ; therapeutic use ; Humans ; Levofloxacin ; Middle Aged ; Ofloxacin ; therapeutic use ; Pneumoconiosis ; complications ; Tuberculosis, Pulmonary ; complications ; drug therapy

BACKGROUND: Recently, medical treatment of multi-drug resistant pulmonary tuberculosis has been unsuccessful. Through analyzing the cases with surgical treatment, we hope to provide some help in treating multi-drug resistant pulmonary tuberculosis in the future. MATERIAL AND METHOD: A retrospective review was performed with 138cases of surgical treatment of multi-drug resistant tuberculosis during 10years from January 1994 to December 2003 at National Masan Hospital. RESULTS: The ratio of men to women, 5.1:1 indicates that there were more incidences in men. The number of the resistant drugs was 5.3 with a mean age of 42.6 years. Cavitary lesions on the plain chest X-rays were seen in 94cases (68.1%). 128cases had positive sputum culture preoperatively. Types of operations were 24 pnemonectomies, 83 lobectomies, 10 bilobectomies, 19 lobectomies with segmentectomies or wedge resections, 1 wedge resection, and 1 carvenoplasty. There was no death after operation. There were 6cases of air leakage over a week, 6cases of postoperative bleeding, 8cases of bronchopleural fistula and empyema, 16cases of dead space, 1case of atelectasis, 1case of wound infection, 1case of cyst as postoperative complication. Postoperative complication showed higher long-term negative conversion rate of 92.8%. CONCLUSION: There has been many discussions about operative indications, postoperative drug regimens, length of postoperative chemotherapy. In our study, we showed higher long-term success rate of postoperative chemotherapy with pulmonary resection on multi-drug resistant pulmonary tuberculosis.
Drug Therapy ; Empyema ; Female ; Fistula ; Hemorrhage ; Hope ; Humans ; Incidence ; Male ; Mastectomy, Segmental ; Postoperative Complications ; Pulmonary Atelectasis ; Retrospective Studies ; Sputum ; Thorax ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary* ; Wound Infection

We assessed the role of diabetes mellitus (DM) on treatment effects in drug-susceptible initial pulmonary tuberculosis (PTB) patients. A prospective study was conducted in eight provinces of China from October 2008 to December 2010. We enrolled 1,313 confirmed drug-susceptible initial PTB patients, and all subjects received the treatment regimen (2H3R3E3Z3/4H3R3) as recommended by the national guidelines. Of the 1,313 PTB patients, 157 (11.9%) had DM; these patients had more sputum smear-positive rates at the end of the second month [adjusted odds ratios (aOR) 2.829, 95% confidence intervals (CI) 1.783-4.490], and higher treatment failure (aOR 2.120, 95% CI 1.565-3.477) and death rates (aOR 1.536, 95% CI 1.011-2.628). DM was a contributing factor for culture-positive rates at the end of the second month and treatment failure and death of PTB patients, thus playing an unfavorable role in treatment effects of PTB.
Antitubercular Agents ; therapeutic use ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; therapy ; Female ; Humans ; Male ; Mycobacterium tuberculosis ; drug effects ; Tuberculosis, Pulmonary ; complications ; drug therapy ; epidemiology ; microbiology

BACKGROUND: In spite of initial intensive and long-term chemotherapy for pulmonary tuberculosis, many problems remain in the treatment of the residual lesion. The role of surgical intervention for pulmonary tuberculosis is getting rid of such residual lesion of pulmonary tuberculosis to support the healing process and to induce bacteriologically negative conversion in the end. METHOD: We experienced 30 cases of pulmonary resection for pulmonary tuberculosis from Aug. 1994 through Apr. 1995 in National Masan Tuberculosis Hospital. We conducted retrospective study to analyze several variables for the cases. RESULTS: 1) The ratio between male and female was 4:l(male 24, female 6) and the age of peak incidence was in 3rd and 4th decades. 2) Indications for pulmonary resection in the radiographic findings were cavitary lesions of 19 cases(63.3%), destroyed one side of 8 cases(26.7%) and destroyed one lobe of 3 cases(10%). 3) 16 of 20 cases with unilateral lesions and all of 10 cases with bilateral lesions on chest X-ray films showed AFB positive on preoperative sputum smears. 14 cases(87.5%) of unilateral lesions and 9 cases(90%) of bilateral ones were converted into AFB negative postoperatively. Negative conversion rates of pneumonectomy and lobectomy cases were 100% and 85.7%, respectively. 4) Preoperative combined disease was 3 cases(10%) of DM and postoperative complications were 2 cases(6.7%) of dead space and no death. CONCLUSION: Chemotherapy only has some limitation in treatment of all tuberculosis. So, surgical intervention for pulmonary tuberculosis is an effective method as partner of chemotherapy.
Drug Therapy ; Female ; Hospitals, Chronic Disease ; Humans ; Incidence ; Male ; Pneumonectomy ; Postoperative Complications ; Retrospective Studies ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary* ; X-Ray Film

No abstract available.
Adult ; Antitubercular Agents/therapeutic use ; Digestive System Fistula/diagnosis/drug therapy/*etiology ; Endoscopy, Digestive System ; Female ; Humans ; Tuberculosis, Pulmonary/*complications/drug therapy/pathology

Aged, 80 and over ; Antitubercular Agents ; therapeutic use ; Biopsy ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Mycobacterium tuberculosis ; isolation & purification ; Pneumonia, Lipid ; diagnosis ; drug therapy ; etiology ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; diagnosis ; drug therapy ; etiology ; Zenker Diverticulum ; complications ; diagnosis

OBJECTIVE: To analyze the intervention efficacy of lamivudine on liver dysfunction in patients undergoing anti-tuberculosis treatment for pulmonary tuberculosis complicated with chronic hepatitis B.
 METHODS: Corresponding data were retrieved from PubMed, Web of Science, Embase, the Cochrane Library, Chinese Biomedical Literature (CBM), VIP, China National Knowledge Infrastructure (CNKI) and Wanfang Database with randomly controlled trials regarding the chronic hepatitis B and tuberculosis by lamivudine. Statistical analysis was performed by Meta-analysis using Stata11.0.
 RESULTS: Fifteen randomly controlled trials including 967 chronic hepatitis B and tuberculosis cases met the inclusion criteria (564 cases in observation group and 403 cases in control group). Meta-analysis showed that the values of ALT, AST, TBIL and HBV-DNA load in the observation group were lower than those in the control group. The values of standardized mean difference (95% CI) were -2.58 (-3.55, -1.60), -2.43 (-3.33, -1.54), -1.56 (-2.18, -0.94) and -6.91 (-8.90, -4.92), while the combined effect of OR values for liver damage was 0.11 (0.06, 0.19). There were significant differences in the combined effect of each value between the two groups (P<0.05).
 CONCLUSION The intervention efficacy of lamivudine on liver dysfunction in patients undergoing anti-tuberculosis treatment for pulmonary tuberculosis complicated with chronic hepatitis B patients was good, which can reduce hepatitis B viral load levels.
Antitubercular Agents ; therapeutic use ; Antiviral Agents ; therapeutic use ; China ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Tuberculosis, Pulmonary ; complications ; drug therapy ; Viral Load

Abscess ; diagnosis ; etiology ; therapy ; Antitubercular Agents ; therapeutic use ; DNA, Bacterial ; analysis ; Debridement ; methods ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Metacarpus ; Middle Aged ; Mycobacterium tuberculosis ; genetics ; isolation & purification ; Tuberculosis, Pulmonary ; complications ; drug therapy ; microbiology

BACKGROUND: Treatment outcome with only chemotherapy for multi-drug resistant tuberculosis is usually considered not to be satisfactory. However, the combined therapy of chemotherapy with surgical treatment has been producing higher sputum AFB negative conversion and longer survival rates, and this treatment strategy is expected to be a set-up for the patients with multi-drug resistant tuberculosis. MATERIAL AND METHOD: A retrospective review was performed with the medical records and laboratory findings in 49 patients with multi-drug resistant tuberculosis of 130 patients who underwent pulmonary resection for pulmonary tuberculosis between January 1995 and December 1999 at National Masan Tuberculosis Hospital. RESULT: A mean number of the resistant drugs was 4.5 with a mean age of 35 years. Cavitary lesions on plain chest x-ray were shown in 43 patients of 49(87.8%). Thirty one had positive sputum cultures preoperatively(63.3%). Operative techniques were as follows; 12 pneumonectomies, 28 lobectomies, 7 lobectomies with segmentectomies or wedge resections, one wedge resection and a cavernoplasty. Sputum AFB negative conversion rate was 93.5 % with continuous postoperative chemotherapy. There was no death after operation. Air leakage over a week, postoperative bleeding and wound disruption were developed as postoperative complications. CONCLUSION: We experienced the higher effectiveness of postoperative chemotherapy with pulmonary resection on multi-drug resistant tuberculosis. Although there are several different ideas about operative indications, postoperative drug regimens and length of postoperative medications, pulmonary resection should be considered actively as a effective combination measure with chemotherapy to give a treatment for multi-drug resistant pulmonary tuberculosis.
Drug Therapy ; Hemorrhage ; Hospitals, Chronic Disease ; Humans ; Mastectomy, Segmental ; Medical Records ; Pneumonectomy ; Postoperative Complications ; Retrospective Studies ; Sputum ; Survival Rate ; Thorax ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant* ; Tuberculosis, Pulmonary ; Wounds and Injuries

Mycobacterium celatum is a nontuberculous mycobacterium that rarely causes pulmonary disease in immunocompetent subjects. We describe the successful treatment of M. celatum lung disease with antimicobacterial chemotherapy and combined pulmonary resection. A 33-year-old woman was referred to our hospital with a 3-month history of a productive cough. Her medical history included pulmonary tuberculosis 14 years earlier. Her chest X-ray revealed a large cavitary lesion in the left upper lobe. The sputum smear was positive for acid-fast bacilli, and M. celatum was subsequently identified in more than three sputum cultures, using molecular methods. After 1 year of therapy with clarithromycin, ethambutol, and ciprofloxacin, the patient underwent a pulmonary resection for a persistent cavitary lesion. The patient was considered cured after receiving 12 months of postoperative antimycobacterial chemotherapy. There has been no recurrence of disease for 18 months after treatment completion. In summary, M. celatum is an infrequent cause of potentially treatable pulmonary disease in immunocompetent subjects. Patients with M. celatum pulmonary disease who can tolerate resectional surgery might be considered for surgery, especially in cases of persistent cavitary lesions despite antimycobacterial chemotherapy.
Adult ; Anti-Infective Agents/*therapeutic use ; Female ; Humans ; Lung/*surgery ; Lung Diseases/*drug therapy/*microbiology/*surgery ; Mycobacterium/*metabolism ; Mycobacterium Infections/*drug therapy ; Radiography, Thoracic/methods ; Treatment Outcome ; Tuberculosis, Pulmonary/complications