Patients with drug-susceptible tuberculosis (TB) show good tolerance of the medications used and have few side effects. However, medications used to treat multidrug-resistant tuberculosis (MDR-TB) have many known side effects. Here, we studied the occurrence of side effects due to treatment of patients with MDR-TB.We conducted a retrospective and consecutive review of the medical records of 256 patients who received treatment for MDR-TB between January 2006 and December 2011.One or more side effects were observed in 95 (37.1%) of the 256 patients. These side effects led to the suspension of the use of 1 or more drugs from the regimen of individualized treatment prescribed for 44 of the patients (17.2%). The side effects observed most frequently included gastrointestinal disturbance (18.4%), psychiatric disorder (5.5%), arthralgia (4.7%), hepatitis (3.9%), peripheral neuropathy (3.1%), hypothyroidism (2.3%), epileptic seizures (2%), dermatological effects (2%), ototoxicity (1.6%), and nephrotoxicity (1.2%). The treatment was successful in 220 (85.9%) patients with MDR-TB.Our study may help in formulating strategies for the timely and aggressive management of drug side effects. This may reduce the suspension of therapy and increase the rate of clinical success.

Early estimation of mortality risk in patients with trauma is essential. In this study, we evaluate the validity of the Emergency Trauma Score (EMTRAS) and Rapid Emergency Medicine Score (REMS) for predicting in-hospital mortality in patients with trauma. Furthermore, we compared the REMS and the EMTRAS with 2 other scoring systems: the Revised Trauma Score (RTS) and Injury Severity score (ISS).We performed a retrospective chart review of 6905 patients with trauma reported between July 2011 and June 2016 at a large national university hospital in South Korea. We analyzed the associations between patient characteristics, treatment course, and injury severity scoring systems (ISS, RTS, EMTRAS, and REMS) with in-hospital mortality. Discriminating power was compared between scoring systems using the areas under the curve (AUC) of receiver operating characteristic (ROC) curves.The overall in-hospital mortality rate was 3.1%. Higher EMTRAS and REMS scores were associated with hospital mortality (P < .001). The ROC curve demonstrated adequate discrimination (AUC = 0.957 for EMTRAS and 0.9 for REMS). After performing AUC analysis followed by Bonferroni correction for multiple comparisons, EMTRAS was significantly superior to REMS and ISS in predicting in-hospital mortality (P < .001), but not significantly different from the RTS (P = .057). The other scoring systems were not significantly different from each other.The EMTRAS and the REMS are simple, accurate predictors of in-hospital mortality in patients with trauma.

BackgroundMultidrug-resistant tuberculosis (MDR-TB) is an important global health problem. Furthermore, the time to identify a positive sputum culture is an important risk factor for the spread of tuberculosis, and several factors can predict a prolonged time to culture conversion. Moreover, the relationship between poor nutritional status and infectious disease is clearly established. Therefore, the present study aimed to investigate the association between body mass index (BMI) and sputum culture conversion within 3 months among patients with MDR-TB.Materials and MethodsWe retrospectively evaluated 218 patients with MDR-TB who were treated at a large tuberculosis referral hospital in South Korea between January 2005 and December 2010. The outcome of interest was defined as sputum culture conversion within 3 months, and we analyzed the association between BMI and this outcome.ResultsAmong the 218 patients, 53 patients (24.3%) had a low BMI (<18.5 kg/m2). In the multivariate Cox proportional-hazards regression analysis, failure to achieve sputum culture conversion within 3 months was independently associated with having a low BMI (hazard ratio [HR]: 1.741, 95% confidence interval [CI]: 1.006–3.013; P = 0.047) and a positive sputum smear at the initiation of therapy (HR: 8.440, 95% CI: 1.146–62.138, P = 0.036).ConclusionLow BMI (<18.5 kg/m2) was an independent risk factor for failure to achieve sputum culture conversion within 3 months among patients with MDR-TB.