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Romanowski K, Oravec A, Billingsley M, Shearer K, Gupte A, Huaman MA, Fox GJ, Golub JE, Johnston JC. A scoping review of interventions to mitigate common non-communicable diseases among people with TB. Int J Tuberc Lung Dis 2022; 26:1016-1022. [PMID: 36281048 DOI: 10.5588/ijtld.22.0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Recommendations have been made to integrate screening for common non-communicable diseases (NCDs) within TB programs. However, we must ensure screening is tied to evidence-based interventions before scale-up. We aimed to map the existing evidence regarding interventions that address NCDs that most commonly affect people with TB.METHODS: We systematically searched PubMed, Medline, and Embase for studies that evaluated interventions to mitigate respiratory disease, cardiovascular disease, alcohol and substance use disorder, and mental health disorders among people with TB. We excluded studies that only screened for comorbidity but resulted in no further intervention. We also excluded studies focusing on smoking cessation interventions for which evidence-based guidelines are well established.RESULTS: The search identified 20 studies that met our inclusion criteria. The most commonly evaluated intervention was referral for diabetes care (6 studies). Other interventions included pulmonary rehabilitation (5 studies), care programs for alcohol use disorder (4 studies), and psychosocial support or individual counselling (5 studies).CONCLUSION: There is limited robust evidence to support identified interventions in changing individual outcomes, and a significant knowledge gap remains on the long-term durability of the interventions´ clinical benefit, reach, and effectiveness. Implementation research demonstrating feasibility and effectiveness is needed before scaling up.
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Affiliation(s)
- K Romanowski
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada, Provincial TB Services, BC Centre for Disease Control, Vancouver, BC, Canada
| | - A Oravec
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - M Billingsley
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - K Shearer
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Gupte
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA, Center for Clinical Global Health Education, Johns Hopkins University School of Medicine, Baltimore, MD, USA, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M A Huaman
- Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - G J Fox
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia, Woolcock Institute of Medical Research, Glebe, NSW, Australia
| | - J E Golub
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J C Johnston
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada, Provincial TB Services, BC Centre for Disease Control, Vancouver, BC, Canada
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Shivakumar SVBY, Padmapriyadarsini C, Chavan A, Paradkar M, Shrinivasa BM, Gupte A, Dhanasekaran K, Thomas B, Suryavanshi N, Dolla CK, Selvaraju S, Kinikar A, Gaikwad S, Kohli R, Sivaramakrishnan GN, Pradhan N, Hanna LE, Kulkarni V, DeLuca A, Cox SR, Murali L, Thiruvengadam K, Raskar S, Ramachandran G, Golub JE, Gupte N, Mave V, Swaminathan S, Gupta A, Bollinger RC. Concomitant pulmonary disease is common among patients with extrapulmonary TB. Int J Tuberc Lung Dis 2022; 26:341-347. [PMID: 35351239 PMCID: PMC8982647 DOI: 10.5588/ijtld.21.0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND : Microbiologic screening of extrapulmonary TB (EPTB) patients could inform recommendations for aerosol precautions and close contact prophylaxis. However, this is currently not routinely recommended in India. Therefore, we estimated the proportion of Indian patients with EPTB with microbiologic evidence of pulmonary TB (PTB). METHODS : We characterized baseline clinical, radiological and sputum microbiologic data of 885 adult and pediatric TB patients in Chennai and Pune, India, between March 2014 and November 2018. RESULTS : Of 277 patients with EPTB, enhanced screening led to the identification of 124 (45%) with concomitant PTB, including 53 (19%) who reported a cough >2 weeks; 158 (63%) had an abnormal CXR and 51 (19%) had a positive sputum for TB. Of 70 participants with a normal CXR and without any cough, 14 (20%) had a positive sputum for TB. Overall, the incremental yield of enhanced screening of patients with EPTB to identify concomitant PTB disease was 14% (95% CI 12–16). CONCLUSIONS : A high proportion of patients classified as EPTB in India have concomitant PTB. Our results support the need for improved symptom and CXR screening, and recommends routine sputum TB microbiology screening of all Indian patients with EPTB.
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Affiliation(s)
| | - C Padmapriyadarsini
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - A Chavan
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - M Paradkar
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - B M Shrinivasa
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - A Gupte
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - K Dhanasekaran
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - B Thomas
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - N Suryavanshi
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - C K Dolla
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - S Selvaraju
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - A Kinikar
- Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - S Gaikwad
- Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - R Kohli
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - G N Sivaramakrishnan
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - N Pradhan
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - L E Hanna
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - V Kulkarni
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - A DeLuca
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - S R Cox
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - L Murali
- District Tuberculosis Office, Thiruvallur, India
| | - K Thiruvengadam
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - S Raskar
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - G Ramachandran
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - J E Golub
- Johns Hopkins School of Medicine, Baltimore, MD, USA, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - N Gupte
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - V Mave
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - A Gupta
- Johns Hopkins School of Medicine, Baltimore, MD, USA, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - R C Bollinger
- Johns Hopkins School of Medicine, Baltimore, MD, USA, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Gupte A, Sasidharan A, Kunheri B, Kumar A, Reddy S, Nair H, K U P, R A, Dutta D. PO-1645 Dosimetric comparison of radiotherapy techniques for left breast, axilla and supraclavicular fossa. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08096-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Dutta D, Reddy S, Sreenija Y, Nair H, Sasidharan A, Gupte A, Kannan R, Pottayil S, Edappattu A, S S. PO-1215 Indian experience of 100 HCC patients with portal vein thrombosis treated with robotic radiosurgery. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07666-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gupte A, Madhavan R, Nair H, Sasidharan A, K S, R Nair A, K u P, Kunheri B, Holla R, Dutta D. PO-1298: Early outcome & toxicity of 450 consecutive patients treated with CyberKnife: Indian experience. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01316-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shivakumar SVBY, Chandrasekaran P, Kumar AMV, Paradkar M, Dhanasekaran K, Suryavarshini N, Thomas B, Kohli R, Thiruvengadam K, Kulkarni V, Hannah LE, Sivaramakrishnan GN, Pradhan N, Dolla C, Gupte A, Ramachandran G, DeLuca A, Meshram S, Bhardawaj R, Bollinger RC, Golub J, Selvaraj K, Gupte N, Swaminathan S, Mave V, Gupta A. Diabetes and pre-diabetes among household contacts of tuberculosis patients in India: is it time to screen them all? Int J Tuberc Lung Dis 2019; 22:686-694. [PMID: 29862955 DOI: 10.5588/ijtld.17.0598] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Pre-diabetes mellitus (pre-DM) and DM increase the risk of developing tuberculosis (TB). Screening contacts of TB patients for pre-DM/DM and linking them to care may mitigate the risk of developing TB and improve DM management. OBJECTIVE To measure the prevalence of pre-DM/DM and associated factors among the adult household contacts (HHCs) of pulmonary TB patients. METHODS Between August 2014 and May 2017, adult HHCs of newly diagnosed adult PTB patients in Pune and Chennai, India, had single blood samples tested for glycosylated haemoglobin (HbA1c) at enrolment. DM was defined as previously diagnosed, self-reported DM or HbA1c 6.5%, and pre-DM as HbA1c between 5.7% and 6.4%. Latent tuberculous infection (LTBI) was defined as a positive tuberculin skin test (5 mm induration) or QuantiFERON® Gold In-Tube (0.35 international units/ml). RESULTS Of 652 adult HHCs, 175 (27%) had pre-DM and 64 (10%) had DM. Forty (64%) HHCs were newly diagnosed with DM and 48 (75%) had poor glycaemic control (HbA1c 7.0%). Sixty-eight (22%) pre-DM cases were aged 18-34 years. Age 35 years, body mass index 25 kg/m2, chronic disease and current tobacco smoking were significantly associated with DM among HHCs. CONCLUSIONS Adult HHCs of TB patients in India have a high prevalence of undiagnosed DM, pre-DM and LTBI, putting them at high risk for developing TB. Routine DM screening should be considered among all adult HHCs of TB.
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Affiliation(s)
| | - P Chandrasekaran
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - M Paradkar
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India
| | - K Dhanasekaran
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - N Suryavarshini
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India
| | - B Thomas
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - R Kohli
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India
| | - K Thiruvengadam
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - V Kulkarni
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India
| | - L E Hannah
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - N Pradhan
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India
| | - C Dolla
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - A Gupte
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - G Ramachandran
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - A DeLuca
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - S Meshram
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - R Bhardawaj
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - R C Bollinger
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - J Golub
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - K Selvaraj
- Pondicherry Institute of Medical Sciences (PIMS), Puducherry
| | - N Gupte
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - S Swaminathan
- Indian Council of Medical Research, New Delhi, India
| | - V Mave
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - A Gupta
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Mave V, Meshram S, Lokhande R, Kadam D, Dharmshale S, Bharadwaj R, Kagal A, Pradhan N, Deshmukh S, Atre S, Sahasrabudhe T, Barthwal M, Meshram S, Kakrani A, Kulkarni V, Raskar S, Suryavanshi N, Shivakoti R, Chon S, Selvin E, Gupte A, Gupta A, Gupte N, Golub JE. Prevalence of dysglycemia and clinical presentation of pulmonary tuberculosis in Western India. Int J Tuberc Lung Dis 2019; 21:1280-1287. [PMID: 29297449 DOI: 10.5588/ijtld.17.0474] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
SETTING Pune, India. OBJECTIVES To estimate the prevalence and risk factors of pre-diabetes mellitus (DM) and DM, and its associations with the clinical presentation of tuberculosis (TB). DESIGN Screening for DM was conducted among adults (age 18 years) with confirmed TB between December 2013 and January 2017. We used multinomial regression to evaluate the risk factors for pre-DM (glycated hemoglobin [HbA1c] 5.7-6.5% or fasting glucose 100-125 mg/dl) and DM (HbA1c 6.5% or fasting glucose 126 mg/dl or random blood glucose > 200 mg/dl or self-reported DM history/treatment) and the association of dysglycemia with the severity of TB disease. RESULTS Among 1793 participants screened, 890 (50%) had microbiologically confirmed TB. Of these, 33% had pre-DM and 18% had DM; 41% were newly diagnosed. The median HbA1c level among newly diagnosed DM was 7.0% vs. 10.3% among known DM (P < 0.001). DM (adjusted OR [aOR] 4.94, 95%CI 2.33-10.48) and each per cent increase in HbA1c (aOR 1.42, 95%CI 1.01-2.01) was associated with >1+ smear grade or 9 days to TB detection. CONCLUSION Over half of newly diagnosed TB patients had DM or pre-DM. DM and increasing dysglycemia was associated with higher bacterial burden at TB diagnosis, potentially indicating a higher risk of TB transmission to close contacts.
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Affiliation(s)
- V Mave
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - S Meshram
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India; Byramjee-Jeejeebhoy Government Medical College, Pune, India
| | - R Lokhande
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India; Byramjee-Jeejeebhoy Government Medical College, Pune, India
| | - D Kadam
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India; Byramjee-Jeejeebhoy Government Medical College, Pune, India
| | - S Dharmshale
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India; Byramjee-Jeejeebhoy Government Medical College, Pune, India
| | - R Bharadwaj
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India; Byramjee-Jeejeebhoy Government Medical College, Pune, India
| | - A Kagal
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India; Byramjee-Jeejeebhoy Government Medical College, Pune, India
| | - N Pradhan
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - S Deshmukh
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - S Atre
- Dr D Y Patil Medical College, Pune, India
| | | | - M Barthwal
- Dr D Y Patil Medical College, Pune, India
| | - S Meshram
- Dr D Y Patil Medical College, Pune, India
| | - A Kakrani
- Dr D Y Patil Medical College, Pune, India
| | - V Kulkarni
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - S Raskar
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - N Suryavanshi
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - R Shivakoti
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - S Chon
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - E Selvin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - A Gupte
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - A Gupta
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - N Gupte
- Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Pune, India; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - J E Golub
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Shaikh N, Gupte A, Dharmshale S, Pokkali S, Thakar M, Upadhye VJ, Ordonez AA, Kinikar A, Gupte N, Mave V, Kagal A, Gupta A, Lalvani A, Paranjpe R, Bharadwaj R, Jain SK. Novel interferon-gamma assays for diagnosing tuberculosis in young children in India. Int J Tuberc Lung Dis 2018; 21:412-419. [PMID: 28284256 DOI: 10.5588/ijtld.16.0428] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SETTING The tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) are used as supportive evidence to diagnose active tuberculosis (TB). Novel IGRAs could improve diagnosis, but data are lacking in young children. DESIGN Children (age 5 years) with suspected TB were prospectively screened at a tertiary hospital in Pune, India; the children underwent TST, and standard (early secretory antigenic target 6 and culture filtrate protein 10) and enhanced (five additional novel antigens) enzyme-linked immunospot (ELISpot) assays. RESULTS Of 313 children (median age 30 months) enrolled, 92% had received bacille Calmette-Guérin vaccination, 53% were malnourished and 9% were coinfected with the human immunodeficiency virus (HIV); 48 (15%) had TB, 128 (41%) did not, and TB could not be ruled out in 137 (44%). The sensitivity of enhanced (45%) and standard (42%) ELISpot assays for diagnosing TB was better than that of TST (20%) (P 0.03); however, enhanced ELISpot was not more sensitive than the standard ELISpot assay (P = 0.50). The specificity of enhanced ELISpot, standard ELISpot and TST was respectively 82% (95%CI 74-89), 88% (95%CI 81-94) and 98% (95%CI 93-100). Rv3879c and Rv3615c, previously reported to be promising antigens, failed to improve the diagnostic performance of the ELISpot assay. CONCLUSION The TST and the standard and novel ELISpot assays performed poorly in diagnosing active TB among young children in India.
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Affiliation(s)
- N Shaikh
- National AIDS Research Institute, Pune, India
| | - A Gupte
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - S Dharmshale
- Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - S Pokkali
- Department of Pediatrics, Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - M Thakar
- National AIDS Research Institute, Pune, India
| | | | - A A Ordonez
- Department of Pediatrics, Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A Kinikar
- Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - N Gupte
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - V Mave
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - A Kagal
- Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - A Gupta
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - R Paranjpe
- National AIDS Research Institute, Pune, India
| | - R Bharadwaj
- Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - S K Jain
- Department of Pediatrics, Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Kerensky T, Hasan A, Schain D, Trikha G, Liu C, Rand K, Soldevila-Pico C, Gupte A. Histopathologic resolution of adult liver transplantation adenovirus hepatitis with cidofovir and intravenous immunoglobulin: a case report. Transplant Proc 2012; 45:293-6. [PMID: 23267812 DOI: 10.1016/j.transproceed.2012.06.059] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 06/19/2012] [Indexed: 11/19/2022]
Abstract
Adenovirus (ADV) infections in adult solid organ transplant recipients, although rare, are associated with high mortality. There are no randomized controlled trials establishing the efficacy of specific treatment modalities. To our knowledge apparent response to treatment with combination therapy with intravenous cidofovir (CDV) and immunoglobulin (IVIG) has only been demonstrated in 2 adult renal transplant recipients in whom ADV was documented in body fluids only. We describe an adult liver transplant recipient diagnosed with ADV hepatitis based on positive immunohistochemical staining of a liver biopsy specimen, positive blood ADV DNA polymerase chain reaction (PCR), and treated with the combination of CDV and IVIG. We demonstrated both clearance of viremia and histopathologic resolution of the hepatitis despite the patient's fatal outcome. To our knowledge this is the only case documenting eradication of tissue-invasive ADV disease in any solid organ transplant recipient using CDV and IVIG. This case provides evidence to support the use of this drug combination, which has many potential toxicities that might discourage its use otherwise.
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Affiliation(s)
- T Kerensky
- Department of Medicine, University of Florida College of Medicine, Gainesville, Florida 32610-0277, USA
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Cordero-Reyes A, Gupte A, Youker K, Estep J, Loebe M, Hamilton D, Hsueh W, Torre-Amione G. 795 Evidence for Restoration of Glucose Metabolism in Failing Myocardium Following Prolonged Mechanical Circulatory Support. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Gupte S, Gupte A, Marathe K. O371 How significant is sub-clinical hypothyroidism in pregnancy outcome? Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60743-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dai J, Gupte A, Gates L, Mumper R. A comprehensive study of anthocyanin-containing extracts from selected blackberry cultivars: Extraction methods, stability, anticancer properties and mechanisms. Food Chem Toxicol 2009; 47:837-47. [DOI: 10.1016/j.fct.2009.01.016] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Roghmann M, Taylor KL, Gupte A, Zhan M, Johnson JA, Cross A, Edelman R, Fattom AI. Epidemiology of capsular and surface polysaccharide in Staphylococcus aureus infections complicated by bacteraemia. J Hosp Infect 2005; 59:27-32. [PMID: 15571850 DOI: 10.1016/j.jhin.2004.07.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2003] [Accepted: 07/09/2004] [Indexed: 10/26/2022]
Abstract
Staphylococcus aureus is a leading cause of serious hospital- and community-acquired infections. The discovery of serologically distinct capsular polysaccharides on the surface of clinical isolates has allowed the development of vaccines and passive protective immunity. We have studied patient characteristics, infection characteristics and the surface and capsular polysaccharide serotype distribution in patients with S. aureus infections complicated by bacteraemia admitted to VA hospitals in Maryland between 1995 and 2000. Nine hundred and ninety-three blood cultures from 331 patients were positive for S. aureus. Thirty-eight percent of patients had diabetes, 11% had end-stage renal failure, and 23% were injection drug users. Forty-two percent of infections were caused by methicillin-resistant strains (MRSA), and 60% were acquired during hospitalization. Serotyping of the first available isolate per patient (N=234 isolates) using polyclonal antibodies showed three major phenotypes--42%, type 8 (T8) capsule; 50%, type 5 (T5) capsule; and 8%, 336 polysaccharide. MRSA isolates were significantly more likely to be T5 than methicillin-susceptible isolates (66% vs. 39%, P<0.001). The proportion of T5 MRSA increased significantly (years 1-2: 41%; years 3-4: 65%; years 5-6: 90%, P<0.001). This large sample of patients with serious S. aureus infection confirms that capsular polysaccharides T5 and T8 cause most human infections, and together with serotype 336, account for nearly all those with bacteraemia.
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Affiliation(s)
- M Roghmann
- Epidemiology Section, Medical Care Clinical Center, VA Maryland Health Care System, Baltimore, MD, USA.
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Eriksson de Rezende CL, Mallinson ET, Gupte A, Joseph SW. Salmonella spp. are affected by different levels of water activity in closed microcosms. J Ind Microbiol Biotechnol 2001; 26:222-5. [PMID: 11464270 DOI: 10.1038/sj.jim.7000116] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2000] [Accepted: 01/24/2001] [Indexed: 11/09/2022]
Abstract
Controlling water activity (a(w)) can significantly impact the growth of Salmonella in poultry litter and manure - a phenomenon that was studied quantitatively using two common serotypes of Salmonella. The quantitative effect of changes in levels of a(w) on Salmonella populations was determined using inoculated, frosted glass rectangles placed in closed chambers (microcosms). Glass rectangles with known concentrations of Salmonella enteritidis and S. brandenburg were placed in microcosms maintained at an a(w) level of 0.893 for 24 h at room temperature (RT) and then transferred to other microcosms maintained at the same temperature but with higher a(w) levels (0.932 and 0.987). Salmonella populations on the slides were quantified at 4, 18, 24, and 48 h. Slightly elevated levels of a(w) (<0.1, i.e., 10% equilibrium relative humidity) for 24 h resulted in a 100-fold increase in counts of Salmonella. The data also suggested that in vitro adaptation to dry environments may occur when the organisms are exposed to alternating levels of relatively high and low (0.987 and 0.893) levels of a(w). Any increased tolerance of Salmonella to reduced levels of a(w) could be the result of physico-chemical changes in the organism due to selective environmental pressure, formation of a protective biofilm, and/or entry into a dormant state. Results from this study are compatible with those from previously reported on-farm surveys, reinforcing the contention that maintaining a(w) below 0.85 in and around litter/manure surfaces in poultry or livestock bedding areas may be a critical factor in safe production of food.
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Affiliation(s)
- C L Eriksson de Rezende
- Department of Cell Biology and Molecular Genetics, University of Maryland, College Park, MD 20742, USA
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Gupte S, Gupte A, Subramaniam U, Mulay A. Hay's obstetric forceps - safe instrument for forceps revival. Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)82687-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
A technique has been described for the stabilization of calcium alginate beads using radiation polymerized acrylamide. The technique involved dropping a mixture containing the cells (20%), sodium alginate (2%), acrylamide (2.5%) and N-N'-methylene-bis-acrylamide (0.1%) through a syringe needle into cold (-75 degrees C) toluene. The frozen beads obtained were exposed to 60Co gamma-rays (0.5 KGy) and were then thawed in 0.1 M CaCl2 solution. Unlike the calcium alginate beads the conjugate beads were not found to be dissolved when incubated in 3% trisodium citrate solution. Stabilized beads containing entrapped yeast cells could be reused for over 15 batches for the inversion of sucrose without loss in activity or chemical integrity of the beads.
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Affiliation(s)
- A Gupte
- Nuclear Agriculture and Biotechnology Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India
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Gupte A, Madamwar D. Solid State Fermentation of Lignocellulosic Waste for Cellulase and β-Glucosidase Production by Cocultivation of Aspergillus ellipticus and Aspergillus fumigatus. Biotechnol Prog 1997. [DOI: 10.1021/bp970004g] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mutalik S, Gupte A, Gupte S. Oral acyclovir therapy for varicella in pregnancy. Int J Dermatol 1997; 36:49-51. [PMID: 9071617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- S Mutalik
- Department of Skin and Sexually Transmitted Diseases, Joshi Hospital, Pune, India
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Ghate M, Pratinidhi A, Gupte A. Risk prediction charts for low birth weight. Indian Pediatr 1996; 33:15-8. [PMID: 8772945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To develop intrauterine fetal growth monitoring charts for prediction of babies with low birth weight (LBW). DESIGN Prospective study. SETTING Antenastal clinic of a government and a private hospital. SUBJECTS Two hundred and eighty one healthy pregnant women were enrolled before 28 weeks of pregnancy. MAIN OUTCOME MEASURES The uterine fundal height and abdominal girth were recorded fortnightly. Following delivery, the neonatal birth weight was correlated with these measurements. RESULTS Graphs were plotted for the mean fundal height and abdominal girth in relation to gestational age for neonatal weight categories of 2000 g, 2500 g and 3000 +/- 200 g. Measurement of the fundal height and abdominal girth predicted the neonatal weight category with a sensitivity of 87.5%, specificity of 90% and positive predictive value of 77.8%. CONCLUSIONS The uterine fundal height and abdominal girth, when related to the gestational age, can accurately predict the neonatal birth weight category. The charts prepared in this study can help in prediction of LBW babies and allow appropriate intervention to be undertaken in the antenatal period at grass root level.
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Affiliation(s)
- M Ghate
- Department Preventive and Social Medicine, B.J. Medical College, Pune
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Abstract
Block copolymers exhibit the phenomenon of microdomain formation in pure states as well as in solutions. The microdomains vest the block copolymer assemblies with the intriguing characteristics of microheterogeneous media. We demonstrate that this microheterogeneity in hydrophobic-hydrophilic block copolymer systems can be exploited for immobilizing enzymes and to carry out enzymatic reactions. Examples involving cholesterol oxidase and horseradish peroxidase are provided here. The observed changes in the enzymatic activity in block copolymer microdomains from that in the aqueous media are interpreted in terms of the hydrophobicity of the reaction microenvironment. The block copolymer microdomains are simple to generate, well defined, and easily reproducible. Therefore, they hold significant potential as media for enzymatic biosynthetic reactions when the substrates or the reaction products are water insoluble.
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Affiliation(s)
- A Gupte
- Department of Chemical Engineering, Pennsylvania State University, University Park 16802
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Abstract
Human umbilical vein endothelial cells at confluence were subjected to steady shear flow. The effect of flow on the synthesis of fibronectin, its release into the medium, and incorporation into the extracellular matrix were investigated. The total content of fibronectin in endothelial cells exposed to flow was found to be lower than that in static controls after periods of 12 to 48 h. In the presence of cycloheximide there was no difference in the fibronectin content of sheared and unsheared cells. Our results suggest that the synthesis of fibronectin is inhibited by the flow-induced perturbation of endothelial cells.
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Affiliation(s)
- A Gupte
- Department of Chemical Engineering, Pennsylvania State University, University Park 16802
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