Tuberculosis, malnutrition and wasting

Schwenk, Achim; Macallan, Derek C.

doi:10.1097/00075197-200007000-00008

Cited by 102 publications

(88 citation statements)

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“…Tuberculosis causes severe metabolic disturbances (cytokine activation, abnormal protein metabolism, and hormonal unbalance) causing 'consumption' (Macallan, 1999;Schwenk and Macallan, 2000;del Rey et al, 2007). In addition, spinal TB is expected to reduce normal activity (and in some cases leads to immobilization) because of symptoms such as weakness or numbness of the lower limbs (due to spinal nerve damage), severe pain, and signs such as an unsteady or abnormal gait (Luk, 1999), and a psoas abscess (Chandler and Page, 1940;Resnick and Niwayama, 1995), respiratory dysfunction (Aufderheide and Rodríguez Martin 1998), and paraplegia with flaccid paralysis (Turgut, 2001;Spiegel et al, 2005).…”

Section: Rationale Of the Studymentioning

confidence: 99%

“…In addition to the physical impairments due to Pott's spine, it is well known that TB leads to macro-and micronutrient malnutrition by interfering with protein and vitamin metabolism (Macallan, 1999;Schwenk and Macallan, 2000;van Lettow et al, 2004;del Rey et al, 2007;Wilbur et al, 2008). It is therefore reasonable to infer that the pattern of robusticity for AC5 is due to the slow progression of TB.…”

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confidence: 99%

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Insights on the paleoepidemiology of ancient tuberculosis from the structural analysis of postcranial remains from the Ligurian Neolithic (northwestern Italy)

Sparacello

Roberts

Canci

et al. 2016

International Journal of Paleopathology

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Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. Abstract: The aim of this research was to gain insights on the timeline of progression of osteoarticular tuberculosis (TB) in people from the Neolithic period by using skeletal traits that are independent of the bony lesions. The body proportions and postcranial mechanical strength of bones from two individuals from Liguria in northwestern Italy (Arene Candide 5, adolescent, and Arma dell'Aquila 1, adult), were compared with the rest of the Ligurian Neolithic skeletal series (45 individuals). If TB led to wasting of the skeleton and lack of normal function which endured for years, as often happens today, a clear signature of postcranial gracility and disruption of development should be apparent. Conversely, rapid progress of the disease would leave little systemic macroscopic change in the skeleton, except for the bony lesions directly caused by the TB pathogen, suggesting a different level of bacterial virulence in the past. The extreme biomechanical gracility observed in the lower limb of Arene Candide 5 suggests a period of compromised diaphyseal periosteal apposition during ontogeny due to metabolic disturbances likely linked to TB. Results suggest that, in Neolithic Liguria, TB in humans saw a slow, chronic progression, which is characteristic of diseases with long histories of host-pathogen coevolution. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64

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Section: Rationale Of the Studymentioning

confidence: 99%

mentioning

confidence: 99%

Insights on the paleoepidemiology of ancient tuberculosis from the structural analysis of postcranial remains from the Ligurian Neolithic (northwestern Italy)

Sparacello

Roberts

Canci

et al. 2016

International Journal of Paleopathology

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“…In another study conducted in Brazil, (16) weight loss was found in 74.5% of the patients. One group of authors (17) reported that malnutrition is related to tuberculosis, meaning that malnutrition is a risk factor for tuberculosis and a consequence of the disease. The consumptive nature of tuberculosis is related to anorexia and inflammatory cytokines, which induce a catabolic state.…”

Section: Resultsmentioning

confidence: 99%

“…(16)(17)(18) The possibility of association with other opportunistic infections, such as pneumocystosis, cannot be completely ruled out. Although the presence of opportunistic infections, as registered in the medical records, constituted an exclusion criterion, no tests were performed in order to identify such infections.…”

Section: Discussionmentioning

confidence: 99%

Manifestações clínicas, radiológicas e laboratoriais em indivíduos com tuberculose pulmonar: estudo comparativo entre indivíduos HIV positivos e HIV negativos internados em um hospital de referência

2011

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Objective: To compare clinical, radiological, and laboratory characteristics of individuals with pulmonary tuberculosis co-infected or not with HIV. Methods: A cross-sectional study, in which signs and symptoms were assessed by anamnesis and physical examination in patients hospitalized with pulmonary tuberculosis. The results of sputum smear microscopy and culture for Mycobacterium tuberculosis, as well as hemoglobin levels and CD4 + T-cell counts, were obtained from medical records, and chest X-ray reports were consulted. Results: We included 50 pulmonary tuberculosis patients, who were divided into two groups (HIV-positive and HIV-negative; n = 25 per group). The mean age of the participants was 38.4 ± 10.5 years; 46 (92%) were males; and 27 (54%) were White. Expectoration was presented by 21 (84%) and 13 (52%) of the patients in the HIV-negative and HIV-positive groups, respectively (p = 0.016). Radiological findings of cavitation were present in 10 (43%) and 2 (10%) of the patients in the HIV-negative and HIV-positive groups, respectively (p = 0.016), whereas an interstitial pattern was observed in 18 (78%) and 8 (40%), respectively (p = 0.012). The mean hemoglobin level was 11.1 ± 2.9 g/ dL and 9.3 ± 2.2 g/dL in the HIV-negative and HIV-positive groups, respectively (p = 0.015). Conclusions: In our sample of tuberculosis patients, expectoration was less prevalent, hemoglobin levels were lower, and cavitation was less common, as was an interstitial pattern, among those co-infected with HIV than among those without HIV co-infection.Keywords: HIV; Tuberculosis; Acquired immunodeficiency syndrome. ResumoObjetivo: Comparar as manifestações clínicas, radiológicas e laboratoriais de indivíduos com tuberculose pulmonar coinfectados com HIV com aqueles sem a coinfecção. Métodos: Estudo transversal, no qual sinais e sintomas foram analisados por meio de anamnese e exame físico em pacientes internados com tuberculose pulmonar. A baciloscopia, a cultura para Mycobacterium tuberculosis, a dosagem de hemoglobina e a contagem de células T CD4 + foram obtidas de registros dos prontuários, assim como os laudos das radiografias de tórax. Resultados: Foram incluídos 50 pacientes com tuberculose pulmonar, que foram divididos em dois grupos (HIV positivo e HIV negativo; n = 25 por grupo). A média de idade dos participantes foi de 38,4 ± 10,5 anos, 46 (92%) eram do sexo masculino, e 27 (54%) eram caucasianos. Apresentaram expectoração 21 (84%) e 13 (52%) dos pacientes nos grupos HIV negativo e HIV positivo, respectivamente (p = 0,016). Achados radiológicos de cavitação estavam presentes em 10 (43%) e 2 (10%) dos pacientes nos grupos HIV negativo e HIV positivo, respectivamente (p = 0,016), ao passo que padrão intersticial estava presente em 18 (78%) e 8 (40%) dos pacientes nesses grupos (p = 0,012). O nível médio de hemoglobina foi de 11,1 ± 2,9 g/dL e 9,3 ± 2,2 g/dL nos grupos HIV negativo e HIV positivo, respectivamente (p = 0,015). Conclusões: Entre pacientes coinfectados com tuberculose e HIV desta amostra, houve me...

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“…Por otra parte, otras entidades como la Diabetes Mellitus (DM) 22 , la adicción a drogas 23 , el alcoholismo 24 , la anemia 25 o la desnutrición 26 que condicionan una inmunodepresión 7 , son las que más se asocian con el diagnóstico de TB al alta hospitalaria. Hay que destacar el pequeñísimo número de pacientes diagnosticados de TB que además padecían SIDA y/o VIH, durante el periodo de estudio, aunque el porcentaje es parecido a lo encontrado en zonas similares a la nuestra 2,15 .…”

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Patología tuberculosa atendida en urgencias a través del análisis del CMBD de hospitalización en el área de Valladolid Oeste (2002-2006)

López-Izquierdo¹,

Villahoz²,

Vírseda³

et al. 2009

Rev. Esp. Salud Publica

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RESUMENFundamento: La Tuberculosis (TB) sigue siendo un problema de salud importante, en muchos casos los servicios de urgencias hospitalarios (SUH) constituyen el primer contacto de los pacientes con el sistema sanitario. Se desconoce el impacto de esta enfermedad en dichos servicios. Los objetivos de este estudio son conocer la importancia de la TB en los SUH y describir las altas hospitalarias (CMBD) con diagnós-tico de TB, y cuáles ya habían sido diagnosticadas en el SUH.Métodos: Estudio descriptivo retrospectivo de las altas con TB en hospitalización y en el SUH de un hospital terciario universitario entre [2002][2003][2004][2005][2006]. Estudio de concordancia diagnósti-ca y análisis de variables según dos grupos: Coincidentes (Alta con TB en el SUH y en el CMBD) y Sólo en el CMBD. Se calculan estadísticos de tendencia central y dispersión para las variables cuantitativas, y proporciones y elaboración de tablas de contingencia con aplicación del test chi 2 para las cualitativas.Resultados: De las 172 (0,26%) urgencias ingresadas que fueron altas hospitalarias con TB, 61 (35,5%) procedían del SUH. La concordancia diagnóstica fue 0,43 (43,46%). Las altas hospitalarias con TB (coincidentes) pasaron de 47 (17) Conclusiones: Las altas con TB descendieron durante el periodo estudiado. La concordancia diagnostica en el SUH fue moderada. Habría que incidir más en personas de mayor edad, y en aquéllas con factores de riesgo conocidos. En el SUH la TB respiratoria es también la más frecuente siendo la baciloscopia el método diagnóstico principal.Palabras claves: Tuberculosis. Servicio de Urgencias hospitalaria. Factores de riesgo. ABSTRACT Tuberculosis Pathology Attended in Emergency through the Analysis of the Hospital Discharges MBDS in the West Valladolid Area, Spain (2002-2006)Background: Tuberculosis (TB) continues to be an important health problem, in many cases the Hospital Emergency Services (HES) are the first contact of the patients with the sanitary system, there is not known the impact of this disease in the above mentioned services. The objectives of this study are to know the importance of TB in HES and to describe hospital discharges (MBDS) with TB diagnosis and if they had already been diagnosed in the HES.Methods: A retrospective descriptive study of discharges with TB diagnosis in the hospital ward and in the HES of a tertiary care university hospital from 2002 to 2006. The Diagnostic concordance study and analysis of variables according to two groups: Coincidens (discharge with TB diagnosis in the HES and in the MBDS) and Only in the MBDS. Calculate statisticals of central tendency and dispersal for the quantitative variables and proportions and tables of contingency with application of the test chi 2 for the qualitative ones.Results: Of the 172 (0.26%) emergencies admitted which were hospital discharges with Tb diagnosis, 61(35.5%) came in HES. The diagnostic concordance was 0.43(43.66%). The hospital discharges with Tb diagnosis (coincidents) changed from 47 (17) Conclusions: The discharges wi...

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Tuberculosis, malnutrition and wasting

Cited by 102 publications

References 56 publications

Insights on the paleoepidemiology of ancient tuberculosis from the structural analysis of postcranial remains from the Ligurian Neolithic (northwestern Italy)

Insights on the paleoepidemiology of ancient tuberculosis from the structural analysis of postcranial remains from the Ligurian Neolithic (northwestern Italy)

Manifestações clínicas, radiológicas e laboratoriais em indivíduos com tuberculose pulmonar: estudo comparativo entre indivíduos HIV positivos e HIV negativos internados em um hospital de referência

Patología tuberculosa atendida en urgencias a través del análisis del CMBD de hospitalización en el área de Valladolid Oeste (2002-2006)

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