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Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

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Defining the role for Mycobacterium tuberculosis PCR testing from stool samples 确定粪便样本结核分枝杆菌PCR检测的作用
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-07-11 DOI: 10.1016/j.jctube.2025.100551
James T. Gaensbauer , Seanne P. Buckwalter , Juan Antonio Solon , Jaime Montoya , Concepcion F. Ang , Vera S. Antonios , Nancy L. Wengenack , Irene Sia
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引用次数: 0
A method for purifying and concentrating Mycobacterium tuberculosis in sputum specimens: The double-membrane filtration and concentration method (DMFCM) 一种痰标本中结核分枝杆菌纯化浓缩方法:双膜过滤浓缩法(DMFCM)
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-07-04 DOI: 10.1016/j.jctube.2025.100548
Dingyi Liu , Wenjing Wang , Yue Hou , Xiaoyi Gao , Wenzhao Xu , Tong Liang , Zhaogang Sun

Background

Tuberculosis (TB) is an infectious disease that poses a global hazard to public health. Clinically, the small number and low concentration of Mycobacterium tuberculosis (M.tb) in some specimens make TB difficult to detect in the laboratory and affect the sensitivity of diagnosis.

Methods

M.tb in clinical sputum specimens was purified and concentrated using the double membrane filtration concentration method (DMFCM), which was compared with existing methods and evaluated for application.

Results

DMFCM removes 40–80% of impurities from 80.53% of specimens while concentrating M.tb by up to 3.366 times. In microscopy examination, compared with the direct smear method (DSM), the sensitivity with DMFCM of the test was increased from 58.33% to 73.61%. For quantitative real-time PCR (qPCR), the positive rate of the sputum specimens treated with the DMFCM (37/42) was higher than that treated with centrifugation (35/42). In terms of cultures, treatment of sputum specimens with DMFCM reduced the time required to determine a positive result to 75% of the time required compared to the MGIT 960 liquid cultures, and increased the rate of positivity.

Conclusions

The M.tb in the culture solution after DMFCM treatment is purer and more concentrated, which can effectively improve the positive rate of detection.
结核病(TB)是一种对公众健康构成全球性危害的传染病。临床部分标本中结核分枝杆菌(Mycobacterium tuberculosis, M.tb)数量少、浓度低,难以在实验室检测,影响诊断的敏感性。方法采用双膜过滤浓缩法(DMFCM)对临床痰标本中的结核分枝杆菌进行纯化浓缩,并与现有方法进行比较,评价其应用价值。结果dmfcm对80.53%的样品杂质去除率达40 ~ 80%,对mtb的富集率可达3.366倍。镜检中,与直接涂片法(DSM)相比,DMFCM检测的灵敏度由58.33%提高到73.61%。实时荧光定量PCR (qPCR)结果显示,DMFCM处理的痰标本阳性率(37/42)高于离心处理的痰标本阳性率(35/42)。在培养方面,与MGIT 960液体培养相比,DMFCM处理痰标本将确定阳性结果所需的时间减少到所需时间的75%,并提高了阳性率。结论DMFCM处理后培养液中结核分枝杆菌纯度更高,浓度更浓,可有效提高检出率。
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引用次数: 0
Diagnostic and therapeutic challenges in disseminated tuberculosis with bone marrow involvement and hemophagocytic lymphohistiocytosis: A case report and literature review 弥散性结核伴骨髓浸润和噬血细胞淋巴组织细胞增多症的诊断和治疗挑战:1例报告和文献复习
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-07-03 DOI: 10.1016/j.jctube.2025.100550
Seulki Kim , A Reum Kim , Seungjin Lim , Su Jin Lee , Moonsuk Bae

Background

Tuberculosis (TB)-associated hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal condition characterized by a hyperinflammatory response. Bone marrow TB poses unique diagnostic and therapeutic challenges, often leading to delayed diagnosis and treatment. Here, we report a case of disseminated TB with bone marrow involvement, characterized by unexplained fever, pancytopenia, liver dysfunction, and associated hemophagocytosis.

Case presentation

A 37-year-old woman with a history of diabetes, hypertension, and end-stage renal disease presented with unexplained fever, pancytopenia, and liver dysfunction. A diagnosis of disseminated TB with bone marrow involvement associated with HLH was established based on findings of bone marrow aspiration and biopsy, along with transjugular liver biopsy. Three months after anti-TB treatment, she developed a paradoxical upgrading reaction, for which she was treated with steroids for 5 weeks. The patient was successfully treated with anti-TB drugs and steroids. However, the pancytopenia persisted. A bone marrow biopsy was performed 14 months after the diagnosis. Nonetheless, there was no evidence of TB or any hematological abnormalities. Through our literature review, we summarized diagnostic findings, treatment, and clinical outcomes for 42 patients diagnosed with bone marrow tuberculosis with or without HLH.

Conclusions

The diagnosis and treatment of disseminated TB-associated HLH are challenging. Early recognition, use of all available diagnostic approaches, and individualized treatment are crucial for improving patient outcomes.
结核病(TB)相关的噬血细胞性淋巴组织细胞增多症(HLH)是一种罕见且可能致命的疾病,其特征是高炎症反应。骨髓结核带来了独特的诊断和治疗挑战,往往导致诊断和治疗延迟。在此,我们报告一例弥散性结核伴骨髓受累,以不明原因发热、全血细胞减少、肝功能障碍和相关的噬血细胞症为特征。37岁女性,有糖尿病、高血压和终末期肾病史,表现为不明原因发热、全血细胞减少症和肝功能障碍。根据骨髓穿刺和活检以及经颈静脉肝活检的结果,确定了弥散性结核伴骨髓累及与HLH相关的诊断。在抗结核治疗3个月后,她出现了矛盾的升级反应,为此她接受了5周的类固醇治疗。用抗结核药物和类固醇成功地治疗了病人。然而,全血细胞减少症持续存在。诊断后14个月行骨髓活检。尽管如此,没有结核或任何血液学异常的证据。通过我们的文献回顾,我们总结了42例诊断为骨髓结核伴或不伴HLH的患者的诊断结果、治疗和临床结果。结论弥散性结核相关HLH的诊断和治疗具有挑战性。早期识别、使用所有可用的诊断方法和个性化治疗对改善患者预后至关重要。
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引用次数: 0
Factors influencing the risk of developing multidrug-resistant pulmonary tuberculosis in Northeast Thailand 影响泰国东北部发生耐多药肺结核风险的因素
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-07-02 DOI: 10.1016/j.jctube.2025.100549
Nion Leeka , Wongsa Laohasiriwong , Roshan Kumar Mahato , Kittiporn Amprarat , Seksan Chaisuksant

Background

This study aimed to identify the factors influencing Multidrug-Resistant Pulmonary Tuberculosis (MDR-TB) in Northeast Thailand.

Methods

A case-control study was conducted by reviewing medical record and collecting primary data using a structured questionnaire. The study population comprised the case group of patients with MDR-TB and the control group consisted of other pulmonary tuberculosis patients aged 18 years and over with ratio 1 case: 3 controls. The factors influencing MDR-TB in the Northeast of Thailand were identified by multivariable analysis.

Results

The results revealed that the majority of the cases and controls were males (73.79 % and 59.87 %, respectively) with mean ages of 50.50 years and 56.30 years. Cases had more moderate self-care behaviors (40.78 %) compared with controls (17.15 %). Nearly half (48.54 %) of the cases had a limited level of health literacy. Multivariable analysis demonstrated that education level (Adjusted Odd Ratio (AOR) = 1.12; 95 % CI = 1.14–1.96, p = 0.04), average monthly family income (AOR = 1.78; 95 % CI = 1.19–2.97, p = 0.01), number of windows (AOR = 2.03; 95 % CI = 1.34–3.91, p = 0.001), being diagnosed with tuberculosis two or more times (AOR = 4.63; 95 % CI = 2.51–12.35, p < 0.001), poor attitude towards tuberculosis illness (AOR = 1.32; 95 % CI = 1.05–2.48, p = 0.03), mild to moderate self-care behavior levels (AOR = 1.47; 95 % CI = 1.14–3.05, p < 0.001), and inadequate to problematic levels of health literacy (AOR = 2.11; 95 % CI = 1.36–3.63, p < 0.001) were significant determinants of MDR-TB.

Conclusions

This study concluded that education level, monthly family income, number of windows, recurrence of TB diagnosis, attitude towards TB illness, self-care behavior level and limited health literacy level were risk factors of MDR-TB. Inadequate health literacy was particularly associated with a high risk of developing MDR-TB. In order to increase treatment success rates, the results from this study should be used to improve targeted interventions and health education strategies.
本研究旨在确定泰国东北部地区耐多药肺结核(MDR-TB)的影响因素。方法采用病例对照研究方法,查阅病案资料,采用结构化问卷收集原始资料。研究人群包括耐多药结核病患者病例组和其他18岁及以上肺结核患者的对照组,1例:3例对照。通过多变量分析确定泰国东北部耐多药结核病的影响因素。结果本组病例以男性居多,分别为73.79%和59.87%,平均年龄为50.50岁和56.30岁。患者有较多的中度自我护理行为(40.78%),对照组为17.15%。近一半(48.54%)的病例卫生知识水平有限。多变量分析表明,受教育程度(调整奇数比(AOR) = 1.12;95% CI = 1.14-1.96, p = 0.04),家庭月平均收入(AOR = 1.78;95%可信区间-2.97 = 1.19,p = 0.01), windows(优势比= 2.03;95% CI = 1.34-3.91, p = 0.001),两次或两次以上被诊断为结核病(AOR = 4.63;95% CI = 2.51-12.35, p <;0.001),对结核病的态度差(AOR = 1.32;95% CI = 1.05-2.48, p = 0.03),轻至中度自我照顾行为水平(AOR = 1.47;95% CI = 1.14-3.05, p <;0.001),健康素养水平不足(AOR = 2.11;95% CI = 1.36-3.63, p <;0.001)是耐多药结核病的重要决定因素。结论受教育程度、家庭月收入、窗口数、结核病诊断复发率、结核病态度、自我保健行为水平和有限健康素养水平是耐多药结核病的危险因素。卫生知识普及不足与发生耐多药结核病的高风险特别相关。为了提高治疗成功率,本研究的结果应用于改进有针对性的干预措施和健康教育策略。
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引用次数: 0
Efficacy of mindful meditation in adjunct to a pulmonary rehabilitation program in improving functional capacity and quality of life in post-treated pulmonary tuberculosis patients: A randomized controlled trial (Study Protocol) 正念冥想辅助肺康复计划在改善肺结核治疗后患者功能能力和生活质量方面的疗效:一项随机对照试验(研究方案)
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-06-26 DOI: 10.1016/j.jctube.2025.100547
Bhakti Chavhan, Lajwanti Lalwani

Background

Post-treated pulmonary tuberculosis (PTB) frequently leads to long-term impairments in lung function, endurance, and mental well-being. Pulmonary rehabilitation (PR) programs aim to restore functional capacity but may not sufficiently address psychological distress. Mindful meditation, when integrated with PR, may offer enhanced recovery by addressing both physical and emotional deficits [1,2].

Methods

We plan to conduct this study at a single hospital, where 51 people who recently completed TB treatment will be invited to participate. Each person will be randomly placed into one of two groups. One group will follow a regular rehab program, while the other will follow the same program with added daily meditation sessions. The rehab will last for four weeks. We’ll check each person’s walking ability and quality of life [5,6], and also note changes in their breathing, oxygen levels, and vital signs [7].
Expected Results: People who do both meditation and rehab are likely to feel and function better than those who only do rehab. We hope this combined approach gives more balanced physical and mental recovery [1,2].

Conclusion

If adding meditation works well, it could become part of rehab for others recovering from TB. This might help patients feel more energetic and positive after their illness [3,4].
背景:治疗后肺结核(PTB)经常导致肺功能、耐力和精神健康的长期损害。肺康复(PR)计划旨在恢复功能能力,但可能不足以解决心理困扰。正念冥想,当与公关相结合时,可以通过解决身体和情感缺陷来促进康复[1,2]。方法我们计划在一家医院进行这项研究,将邀请51名最近完成结核病治疗的患者参加。每个人将被随机分为两组。一组将遵循常规的康复计划,而另一组将遵循相同的计划,每天增加冥想课程。康复治疗将持续四周。我们将检查每个人的行走能力和生活质量[5,6],并注意他们呼吸、含氧量和生命体征的变化。预期结果:既做冥想又做康复治疗的人可能比只做康复治疗的人感觉和功能更好。我们希望这种结合的方法能使身体和精神的恢复更加平衡[1,2]。结论如果加入冥想效果良好,可以成为其他结核病患者康复的一部分。这可能会帮助患者在病后感到更有活力和积极[3,4]。
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引用次数: 0
Extrapulmonary tuberculosis in The Netherlands, an epidemiologic overview, 1993–2022 荷兰1993-2022年肺外结核流行病学综述
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-06-26 DOI: 10.1016/j.jctube.2025.100546
Frouke A. Procee , Jizzo R. Bosdriesz , Frank G.J. Cobelens , Maria Prins , Sabine M. Hermans , Anton E. Kunst

Background

Extrapulmonary tuberculosis (EPTB) poses significant diagnostic and therapeutic challenges in low-incidence settings like the Netherlands. Despite declining overall tuberculosis (TB) incidence, the proportion of EPTB has risen, especially among migrant populations. This study examines sociodemographic, migration-related, and clinical factors associated with EPTB from 1993 to 2022 to inform TB diagnostics and care.

Methods

A retrospective quantitative analysis of 34,048 TB patients reported to the Netherlands Tuberculosis Registry (1993–2022) was conducted. Logistic regression was used to identify associations with EPTB. Temporal trends in EPTB and pulmonary TB (PTB) were evaluated, including stratification by age, country of birth, and duration of residency.

Results

Over the study period, the proportion of EPTB rose from 37 % to 50 %. EPTB was more common in women (adjusted odds ratio (aOR) 1.53; 95 % CI 1.45–1.62) and children under 14 years (aOR 2.83; 95 % CI 2.46–3.24). Foreign-born individuals, particularly from India, Somalia, Eritrea, Ethiopia and Pakistan, had higher odds of EPTB compared to Dutch-born individuals (aOR range: 2.33–3.86). EPTB was also associated with HIV infection (aOR 1.73; 95 % CI 1.43–2.11) but inversely related to social risk factors like homelessness and problem substance use. TB was notably frequently diagnosed among individuals residing in the Netherlands for over 10 years, more often EPTB than PTB.

Conclusion

The rising proportion of EPTB underscores the need for targeted interventions, particularly for high-risk groups such as women, children and migrants. Enhanced screening, early detection, and preventive strategies, especially for tuberculosis infection (TBI) are critical to reducing EPTB morbidity and mortality.
背景:在荷兰等低发病率地区,肺痨(EPTB)的诊断和治疗面临重大挑战。尽管结核病的总发病率有所下降,但EPTB的比例却有所上升,尤其是在移民人群中。本研究调查了1993年至2022年与EPTB相关的社会人口统计学、移民相关和临床因素,为结核病诊断和治疗提供信息。方法对荷兰结核病登记处1993-2022年报告的34048例结核病患者进行回顾性定量分析。使用逻辑回归来确定与EPTB的关联。对EPTB和肺结核(PTB)的时间趋势进行了评估,包括年龄、出生国家和居住时间的分层。结果在研究期间,EPTB的比例从37%上升到50%。EPTB在女性中更为常见(调整优势比(aOR) 1.53;95% CI 1.45-1.62)和14岁以下儿童(aOR 2.83;95% ci 2.46-3.24)。外国出生的人,特别是来自印度、索马里、厄立特里亚、埃塞俄比亚和巴基斯坦的人,与荷兰出生的人相比,患EPTB的几率更高(aOR范围:2.33-3.86)。EPTB还与HIV感染相关(aOR 1.73;95% CI 1.43-2.11),但与无家可归和问题物质使用等社会风险因素呈负相关。结核病在荷兰居住10年以上的人群中被诊断出来的频率很高,EPTB比PTB更常见。结论EPTB比例的上升强调了有针对性干预的必要性,特别是对妇女、儿童和移民等高危人群。加强筛查、早期发现和预防策略,特别是结核病感染(TBI),对于降低EPTB发病率和死亡率至关重要。
{"title":"Extrapulmonary tuberculosis in The Netherlands, an epidemiologic overview, 1993–2022","authors":"Frouke A. Procee ,&nbsp;Jizzo R. Bosdriesz ,&nbsp;Frank G.J. Cobelens ,&nbsp;Maria Prins ,&nbsp;Sabine M. Hermans ,&nbsp;Anton E. Kunst","doi":"10.1016/j.jctube.2025.100546","DOIUrl":"10.1016/j.jctube.2025.100546","url":null,"abstract":"<div><h3>Background</h3><div>Extrapulmonary tuberculosis (EPTB) poses significant diagnostic and therapeutic challenges in low-incidence settings like the Netherlands. Despite declining overall tuberculosis (TB) incidence, the proportion of EPTB has risen, especially among migrant populations. This study examines sociodemographic, migration-related, and clinical factors associated with EPTB from 1993 to 2022 to inform TB diagnostics and care.</div></div><div><h3>Methods</h3><div>A retrospective quantitative analysis of 34,048 TB patients reported to the Netherlands Tuberculosis Registry (1993–2022) was conducted. Logistic regression was used to identify associations with EPTB. Temporal trends in EPTB and pulmonary TB (PTB) were evaluated, including stratification by age, country of birth, and duration of residency.</div></div><div><h3>Results</h3><div>Over the study period, the proportion of EPTB rose from 37 % to 50 %. EPTB was more common in women (adjusted odds ratio (aOR) 1.53; 95 % CI 1.45–1.62) and children under 14 years (aOR 2.83; 95 % CI 2.46–3.24). Foreign-born individuals, particularly from India, Somalia, Eritrea, Ethiopia and Pakistan, had higher odds of EPTB compared to Dutch-born individuals (aOR range: 2.33–3.86). EPTB was also associated with HIV infection (aOR 1.73; 95 % CI 1.43–2.11) but inversely related to social risk factors like homelessness and problem substance use. TB was notably frequently diagnosed among individuals residing in the Netherlands for over 10 years, more often EPTB than PTB.</div></div><div><h3>Conclusion</h3><div>The rising proportion of EPTB underscores the need for targeted interventions, particularly for high-risk groups such as women, children and migrants. Enhanced screening, early detection, and preventive strategies, especially for tuberculosis infection (TBI) are critical to reducing EPTB morbidity and mortality.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100546"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multi-month dispensing of tuberculosis medications in sub-Saharan Africa: A feasible, person-centered care model 在撒哈拉以南非洲,每月分发结核病药物:一种可行的、以人为本的护理模式
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-06-20 DOI: 10.1016/j.jctube.2025.100541
Jonathan Izudi , Adithya Cattamanchi , Francis Bajunirwe
The treatment success rate among people with tuberculosis in sub-Saharan Africa is suboptimal despite the availability of shortened and efficacious TB regimens. Barriers such as long travel distances and frequent clinic visits for medication refills hinder access to care and compromise treatment adherence and completion. Multi-month dispensing of anti-retroviral drugs has proved successful in improving treatment adherence and viral load suppression among people living with human immunodeficiency virus. The strategy could be adapted for tuberculosis care to address treatment access and adherence barriers to optimize treatment success. In this perspective, we discuss the key considerations for the multi-month dispensing of tuberculosis drugs in sub-Saharan Africa. In particular, we highlight treatment monitoring, strengthening of logistics and supply chain systems, multi-month dispensing protocols, healthcare provider capacity building, community engagement, and monitoring and evaluation framework. We call for research, policy reforms, and pilot programs to evaluate and scale up multi-month dispensing of tuberculosis medications to end the epidemic by 2035.
在撒哈拉以南非洲,尽管有缩短和有效的结核病治疗方案,但结核病患者的治疗成功率并不理想。长途旅行和频繁去诊所补药等障碍阻碍了获得护理,影响了治疗的坚持和完成。事实证明,数月分发抗逆转录病毒药物在改善人类免疫缺陷病毒感染者的治疗依从性和抑制病毒载量方面取得了成功。该战略可适用于结核病护理,以解决治疗可及性和依从性障碍,以优化治疗成功。从这个角度来看,我们讨论了在撒哈拉以南非洲数月分发结核病药物的关键考虑因素。我们特别强调了治疗监测、加强物流和供应链系统、多月配药协议、医疗保健提供者能力建设、社区参与以及监测和评估框架。我们呼吁开展研究、政策改革和试点项目,以评估和扩大每月发放结核病药物的规模,到2035年终结这一流行病。
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引用次数: 0
Medication adherence in patients with nontuberculous mycobacterial disease 非结核分枝杆菌病患者的药物依从性
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-06-18 DOI: 10.1016/j.jctube.2025.100544
Arthur Lemson , Fleur Dijkhuizen , Ralf Stemkens , Arjan van Laarhoven , Reinout van Crevel , Jakko van Ingen , Rob Aarnoutse , Wouter Hoefsloot

Objectives

We aimed to measure and understand medication adherence in patients with nontuberculous mycobacterial (NTM) disease.

Methods

We enrolled adults with NTM disease receiving antimycobacterial treatment at Radboudumc, the Netherlands. Demographics and treatment outcomes were recorded, and medication adherence was assessed repeatedly. Adherence was measured using the Proportion of Days Covered (PDC) at 6 and 12 months, calculated from pharmacy records, and the 5-item Medication Adherence Report Scale (MARS-5). The Beliefs about Medicines Questionnaire (BMQ) explored reasons for (non)adherence.

Results

Sixty-one participants were enrolled, with a mean age of 63.2 (±12.9) years. Forty-one (67 %) had pulmonary, and 20 (33 %) extrapulmonary NTM disease, with M. avium complex being the most prevalent species (n = 38; 62 %). One or more adverse effects occurred in 56/61 (92 %) participants. A favorable response was seen in 34/49 (69 %) and 25/29 (86 %) participants at 6 and 12 months, respectively. The median PDC was 100 % (IQR, 99–100 %) at both timepoints, and the MARS-5 remained 5 out of 5 throughout treatment, indicating high adherence. Participants’ beliefs about the necessity of NTM treatment, as assessed in the BMQ, consistently outweighed concerns.

Conclusions

Medication adherence was high throughout the first year of NTM treatment, likely due to the perceived necessity of treatment and regular follow-up at our reference clinic.
目的我们旨在测量和了解非结核分枝杆菌(NTM)疾病患者的药物依从性。方法:我们招募了在荷兰Radboudumc接受抗真菌治疗的NTM成人患者。记录人口统计数据和治疗结果,并反复评估药物依从性。根据药房记录计算6个月和12个月的覆盖天数比例(PDC)和5项药物依从性报告量表(MARS-5)来衡量依从性。对药物的信念问卷(BMQ)探讨了(不)遵守的原因。结果入组61例,平均年龄63.2(±12.9)岁。41例(67%)为肺部NTM疾病,20例(33%)为肺外NTM疾病,其中鸟分枝杆菌复群是最常见的物种(n = 38;62%)。56/61(92%)的参与者发生了一种或多种不良反应。在6个月和12个月时,分别有34/49(69%)和25/29(86%)的参与者有良好的反应。两个时间点的中位PDC均为100% (IQR, 99 - 100%), MARS-5在整个治疗过程中保持5分,表明高依从性。正如BMQ评估的那样,参与者对NTM治疗必要性的信念始终超过了担忧。结论在NTM治疗的第一年,药物依从性很高,可能是由于我们认为治疗的必要性和在参考诊所的定期随访。
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引用次数: 0
The exacerbating effects of stable pulmonary tuberculosis on the deterioration of inflammatory response, coagulation function, and pulmonary function in COPD: A propensity score-matched retrospective study 稳定性肺结核对慢性阻塞性肺病患者炎症反应、凝血功能和肺功能恶化的加重作用:一项倾向评分匹配的回顾性研究
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-06-18 DOI: 10.1016/j.jctube.2025.100545
Jiangbo Li , Mei Ye , Haiyue Wang , Aidibai Ainiwaier , Ayididar Jumahan , Feng Sun
Chronic obstructive pulmonary disease (COPD) and tuberculosis pose significant public health challenges, particularly in tuberculosis-endemic developing regions where their co-prevalence may exacerbate the disease burden of chronic airflow obstruction. This study aimed to investigate the impact of stable pulmonary tuberculosis on inflammatory status, coagulation function, and pulmonary function in COPD patients during acute exacerbations.We conducted a retrospective analysis of 68 COPD patients with acute exacerbation and stable pulmonary tuberculosis (observation group) admitted between December 2019 and December 2023. Using propensity score matching based on age and gender, we selected 68 COPD patients without stable pulmonary tuberculosis as the control group. Comparative analysis of laboratory tests and pulmonary function parameters revealed that the observation group had significantly elevated levels of erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), lymphocyte count, platelet count (PLT), and D-dimer, along with significantly reduced pulmonary function parameters including forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) and forced expiratory flow between 25 %-75 % of vital capacity (FEF25-FEF75) (all P < 0.05). Correlation analysis demonstrated positive associations between ESR/IL-6 levels and D-dimer, PLT, and fibrin(ogen) degradation product (FDP) levels (P < 0.05).Binary logistic regression analysis of 14 significantly different variables identified IL-6 (OR = 1.056), ESR (OR = 1.022), PLT (OR = 1.005), D-Dimer (OR = 1.002), FEV1/FVC (OR = 0.962), FEF50 (OR = 0.534), and FEF75 (OR = 0.089) as independent factors associated with acute exacerbation in COPD patients with stable pulmonary tuberculosis (all P < 0.05). Our findings indicate that elevated IL-6, ESR, PLT, and D-Dimer levels coupled with decreased FEV1/FVC, FEF50, and FEF75 levels represent distinctive clinical characteristics of these patients.This study demonstrates that COPD patients with stable pulmonary tuberculosis exhibit enhanced inflammatory responses, prothrombotic tendencies, and more severe pulmonary function impairment, providing a scientific basis for developing individualized treatment strategies for this patient population.
慢性阻塞性肺疾病(COPD)和结核病构成了重大的公共卫生挑战,特别是在结核病流行的发展中地区,它们的共同流行可能加剧慢性气流阻塞的疾病负担。本研究旨在探讨稳定期肺结核对COPD患者急性加重期炎症状态、凝血功能和肺功能的影响。回顾性分析2019年12月至2023年12月收治的68例COPD急性加重合并稳定期肺结核患者(观察组)。采用基于年龄和性别的倾向评分匹配,选择68例无稳定期肺结核的COPD患者作为对照组。对比分析实验室检查和肺功能参数显示,观察组患者红细胞沉降率(ESR)、白细胞介素-6 (IL-6)、淋巴细胞计数、血小板计数(PLT)和d -二聚体水平显著升高,肺功能参数显著降低,包括1 s用力呼气容积/用力肺活量(FEV1/FVC)和用力呼气流量(FEF25-FEF75)在25% - 75%之间(P <;0.05)。相关分析显示ESR/IL-6水平与d -二聚体、PLT和纤维蛋白(原)降解产物(FDP)水平呈正相关(P <;0.05)。对14个具有显著差异的变量进行二元logistic回归分析,发现IL-6 (OR = 1.056)、ESR (OR = 1.022)、PLT (OR = 1.005)、d -二聚体(OR = 1.002)、FEV1/FVC (OR = 0.962)、FEF50 (OR = 0.534)和FEF75 (OR = 0.089)是COPD合并稳定型肺结核患者急性加重的独立因素(均P <;0.05)。我们的研究结果表明,IL-6、ESR、PLT和d -二聚体水平升高,同时FEV1/FVC、FEF50和FEF75水平下降,代表了这些患者独特的临床特征。本研究表明,COPD合并稳定期肺结核的患者炎症反应增强,有血栓形成倾向,肺功能损害更严重,为该患者群体制定个体化治疗策略提供了科学依据。
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引用次数: 0
Effect of home-based pulmonary rehabilitation on ventilation dynamics and small airway dysfunction in people with post-tuberculosis lung disease 家庭肺康复对结核后肺病患者通气动力学和小气道功能障碍的影响
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-06-14 DOI: 10.1016/j.jctube.2025.100542
Iasmim Maria Pereira Pinto Fonseca , Samantha Gomes de Alegria , Jéssica Gabriela Messias Oliveira , Thaís Souza Rodrigues , Carolina Alves Osório da Silva Chagas , Alícia Sales Carneiro , Walter Costa , Ana Paula Santos , Thiago Thomaz Mafort , Agnaldo José Lopes

Background

As the world moves toward eliminating tuberculosis (TB), there is a large population of TB survivors who still face a significant burden of TB complications. However, basic pulmonary rehabilitation program (PRP) packages for this population are currently lacking. This study aimed to evaluate the effect of home-based PRP (HBPRP) on lung mechanics, exercise capacity, and quality of life (QoL) in people with PTLD (pwPTLD).

Methods

This is a quasi-experimental study in pwPTLD who underwent HBPRP for 3 months. Before and after HBPRP, the following assessments were performed: QoL using the St George’s Respiratory Questionnaire (SGRQ), general fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), handgrip strength (HGS), pulmonary function, and functional exercise capacity using the Glittre-ADL test (TGlittre) coupled with measurement of dynamic ventilation.

Results

When comparing pre- and post-HBPRP values, there was a significant increase in TGlittre time [208 (194–249) vs. 184 (153–211) seconds, P = 0.004] and breathing reserve [56 (34–71) vs. 58 (39–73) %, P = 0.032], and a reduction in end-of-test inspiratory capacity [1.4 (0.9–2.3) vs. 1.6 (1.1–2.6) L, P = 0.030]. Although no increase in spirometric parameters was observed, there was an improvement in small airway dysfunction (SAD) as measured by respiratory oscillometry. Improvements were observed in the Activity and Impacts domains of the SGRQ. However, no significant changes were noted in FACIT-F or HGS after HBPRP.

Conclusions

In pwPTLD, HBPRP improves exercise tolerance, QoL, and SAD, with no effect on general fatigue and HGS. Therefore, TB programs should ensure the availability of PRP for pwPTLD, including HBPRP.
随着世界朝着消除结核病的方向发展,仍有大量结核病幸存者面临结核病并发症的沉重负担。然而,目前缺乏针对这一人群的基本肺康复计划(PRP)。本研究旨在评估家庭PRP (HBPRP)对PTLD (pwPTLD)患者肺力学、运动能力和生活质量(QoL)的影响。方法对行HBPRP治疗3个月的pwPTLD患者进行准实验研究。在HBPRP之前和之后,进行以下评估:生活质量使用圣乔治呼吸问卷(SGRQ),一般疲劳使用慢性疾病治疗疲劳功能评估(fact - f),握力(HGS),肺功能和功能运动能力使用Glittre-ADL测试(TGlittre)结合动态通气测量。结果hbprp前后比较,呼吸储备时间[208 (194-249)vs. 184(153-211)秒,P = 0.004]和呼吸储备时间[56 (34-71)vs. 58 (39-73) %, P = 0.032]显著增加,试验结束吸气量降低[1.4 (0.9-2.3)vs. 1.6 (1.1-2.6) L, P = 0.030]。虽然没有观察到肺量参数的增加,但呼吸振荡测量法测量的小气道功能障碍(SAD)有所改善。在SGRQ的活动域和影响域中观察到改进。然而,HBPRP后FACIT-F HGS未见明显变化。结论HBPRP可改善pwPTLD患者的运动耐量、生活质量和SAD,但对全身疲劳和HGS无影响。因此,结核病规划应确保为pwPTLD提供PRP,包括HBPRP。
{"title":"Effect of home-based pulmonary rehabilitation on ventilation dynamics and small airway dysfunction in people with post-tuberculosis lung disease","authors":"Iasmim Maria Pereira Pinto Fonseca ,&nbsp;Samantha Gomes de Alegria ,&nbsp;Jéssica Gabriela Messias Oliveira ,&nbsp;Thaís Souza Rodrigues ,&nbsp;Carolina Alves Osório da Silva Chagas ,&nbsp;Alícia Sales Carneiro ,&nbsp;Walter Costa ,&nbsp;Ana Paula Santos ,&nbsp;Thiago Thomaz Mafort ,&nbsp;Agnaldo José Lopes","doi":"10.1016/j.jctube.2025.100542","DOIUrl":"10.1016/j.jctube.2025.100542","url":null,"abstract":"<div><h3>Background</h3><div>As the world moves toward eliminating tuberculosis (TB), there is a large population of TB survivors who still face a significant burden of TB complications. However, basic pulmonary rehabilitation program (PRP) packages for this population are currently lacking. This study aimed to evaluate the effect of home-based PRP (HBPRP) on lung mechanics, exercise capacity, and quality of life (QoL) in people with PTLD (pwPTLD).</div></div><div><h3>Methods</h3><div>This is a quasi-experimental study in pwPTLD who underwent HBPRP for 3 months. Before and after HBPRP, the following assessments were performed: QoL using the St George’s Respiratory Questionnaire (SGRQ), general fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), handgrip strength (HGS), pulmonary function, and functional exercise capacity using the Glittre-ADL test (TGlittre) coupled with measurement of dynamic ventilation.</div></div><div><h3>Results</h3><div>When comparing pre- and post-HBPRP values, there was a significant increase in TGlittre time [208 (194–249) vs. 184 (153–211) seconds, <em>P</em> = 0.004] and breathing reserve [56 (34–71) vs. 58 (39–73) %, <em>P</em> = 0.032], and a reduction in end-of-test inspiratory capacity [1.4 (0.9–2.3) vs. 1.6 (1.1–2.6) L, <em>P</em> = 0.030]. Although no increase in spirometric parameters was observed, there was an improvement in small airway dysfunction (SAD) as measured by respiratory oscillometry. Improvements were observed in the Activity and Impacts domains of the SGRQ. However, no significant changes were noted in FACIT-F or HGS after HBPRP.</div></div><div><h3>Conclusions</h3><div>In pwPTLD, HBPRP improves exercise tolerance, QoL, and SAD, with no effect on general fatigue and HGS. Therefore, TB programs should ensure the availability of PRP for pwPTLD, including HBPRP.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100542"},"PeriodicalIF":1.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
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