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Volume 80, Issue 10
Displaying 1-5 of 5 articles from this issue
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Ayako MIKAMI, Emiko TOYOTA, Naoki ISHIZUKA, Eriko MORINO, Go NAKA, Ats ...2005 Volume 80 Issue 10 Pages 631-636
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objectives] The criteria for discharge from TB ward was changed from sputum culture negative to smear negative since January 2003 and the duration of hospitalization and the applicability of each criteria were analyzed.
[Methods] Cases hospitalized from Jan. to De c.2003 (Group I) were compared with those hospitalized from Jan.2000 to Dec.2002 (Group II). In group I, we investigated which criteria was applied for each case.
[Results] Shifting criteria from culture negative to smear negative, the median duration of hospitalization was shortened from 83 to 70 days, in particular in 20s, 30s and 70s. No effect however were found in patients with initially high grade excreter of AFB or extensive cavitary lesions. Although 44%of patients were discharged according to smear conversion to negative, this criteria could not be applied in 17% due to some reasons.
[Conclusions] Conversion to culture negative has been conventionally used for discharge criteria in Japan considering not only contagiousness of the disease but to maintain patients adherence to treatment. After the introduction of new criteria to shorten the hospitalization periods, Japanese style DOTS after discharge would be more important to maintain patients adherence to treatment. We will continue to evaluate the treatment completion rate.View full abstractDownload PDF (1010K) -
Yuka SASAKI, Fumio YAMAGISHI, Takenori YAGI2005 Volume 80 Issue 10 Pages 637-642
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Purpose] To evaluate the current situation of contacts examination and chemoprophylaxis for those who were exposed to multi-drug resistant tuberculosis (MDR-TB) in Japan.
[Object and method] The questionnaire survey was conducted about the MDR-TB patients and their contacts examination enforced in the ordinance-designated cities in Japan from 1998 to 2002.
[Result] Ni ne cities out of total 13 ordinance-designated cities replied to the questionnaire (69.2%). The cases newly diagnosed as MDR-pulmonary tuberculosis were 189 cases from 1998 to 2002. Out of 189 cases, 34 MDR pulmonary tuberculosis patients were the source of MDR-TB infection. Among 659 individuals who were exposed to 34 MDR-TB, 58persons (8.8 %) were diagnosed as the contacts who were infected with MDR-TB. Out of 58 persons, 41 had chemoprophylaxis; 18 with isoniazid (INH), 3 with Ethionamide (TH), 2 with INH + Rifampin (RFP)+ Ethambutol (EB), and each one with EB + Pyrazinamide (PZA) + TH, PZA + TH, PZA + Levofloxacin, PZA + EB. In 6 persons, INH was changed to other medicines, and 8 persons were treated with unknown prescription. Thirteen contacts developed MDR-TB, and out of them, 9 cases had several problems when they developed MDR-TB. Those problems were the delay in detecti on, infection from hospitalization refused cases, infection at the time of bacteriological relapse, and no use of chemoprophylaxis.
[Conclusion] MDR-TB bacilli prod uce the tuberculosis infection similarly as the sensitive tubercle bacilli, and it is necessary to re-examine the action plan of contacts examination including chemoprophylaxis.View full abstractDownload PDF (1196K) -
Hirokazu TANIGUCH, Saburo IZUMI2005 Volume 80 Issue 10 Pages 643-646
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 66-year-old woman was referred to our hospital because of lochiorrhea. Uterus MRI and ultrasonography showed hydrometra. Endometrium biopsy revealed epithelioid cell granuloma, and vaginal discharge and endometrium culture was positive for M. tuberculosis. She was diagnosed as endometrial tuberculosis. After treatment with INH, RFP, and EB for 9 months, she recoverd.View full abstractDownload PDF (3133K) -
Fumio YAMAGISHI2005 Volume 80 Issue 10 Pages 647-653
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSIn Japan, a person who is 29 or younger, contacted a tuberculosis patient recently and judged to have received infection is the object of the chemoprophylaxis by the public expenditure. On the other hand, in ATS/CDC, they call chemoprophylaxis as the treatment of latent tuberculosis infection, and if there is a strong possibility that a person may appear tuberculosis, they start chemoprophylaxis, regardless of age. We usually prescribe isoniazid for latent tubercular infection. The period of prescription is at least 6 months, which is effective, but 9 months is more desirable. Recently, in the West, tuberculosis are frequent among patients who are administered Infliximab, anti-tumor necrosis factor- α. In Japan, after 6 months' evaluation period for Infliximab medication to rheumatoid arthritis, 11 out of 2, 000 became tuberculosis (100, 000 to 550). As for the tuberculin reaction before Infliximab medication, 2 were un-carrying out and 4 were negative. Moreover, even in positive examples, many of them were small redness. From this result, the Japanese Society for Tuberculosis and the Japan College of Rheumatology advised jointly. Those who are using immunosuppressant drugs and a doctor judged that they need chemoprophylaxis are supposed to the start medication if they are positive in tuberculin reaction, or there are some proof of tubercular infection on chest X-ray film, or there are high possibility of having received tubercular infection. By carrying out active chemoprophylaxis regardless of age, tuberculosis from high risk group is expected to decrease.View full abstractDownload PDF (1321K) -
2005 Volume 80 Issue 10 Pages 655-674
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (4247K)
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