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Diagnosis, treatment and prevention of tuberculosis in children.

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Diagnosis, treatment and prevention of tuberculosis in children.

N S W Public Health Bull. 2013 Jul;24(-1):15-21

Authors: Britton P, Perez-Velez CM, Marais BJ

Abstract
In Australia, tuberculosis notification rates have plateaued at a low level and disease is highly concentrated in immigrant communities where children may be affected. Many clinicians regard tuberculosis as an adult disease, hence it is rarely considered in the differential diagnosis of sick children. This paper provides a brief overview of the natural history of the disease in children to demonstrate the importance of taking a careful tuberculosis exposure history. It also provides guidance regarding the diagnosis, treatment and prevention of tuberculosis in children. The management of paediatric cases is not difficult if important differences with adult disease are carefully considered; these differences are discussed in detail.

PMID: 23849022 [PubMed - in process]

Biosensor technology: recent advances in threat agent detection and medicine.

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Biosensor technology: recent advances in threat agent detection and medicine.

Chem Soc Rev. 2013 Jul 15;

Authors: Kirsch J, Siltanen C, Zhou Q, Revzin A, Simonian A

Abstract
Biosensors are of great significance because of their capability to resolve a potentially large number of analytical problems and challenges in very diverse areas such as defense, homeland security, agriculture and food safety, environmental monitoring, medicine, pharmacology, industry, etc. The expanding role of biosensing in society and a real-world environment has led to an exponential growth of the R&D efforts around the world. The world market for biosensor devices, according to Global Industry Analysts, Inc., is expected to reach $12 billion by 2015. Such expedient growth is driven by several factors including medical and health problems, such as a growing population with a high risk of diabetes and obesity, and the rising incidence of chronic diseases such as heart disease, stroke, cancer, chronic respiratory diseases, tuberculosis, etc.; significant problems with environmental monitoring; and of course serious challenges in security and military applications and agriculture/food safety. A review paper in the biosensor technology area may be structured based on (i) the principles of detection, such as the type of transducer platform, bioanalytical principles (affinity or kinetic), and biorecognition elements origin/properties (i.e. antibodies, enzymes, cells, aptamers, etc.), and (ii) the application area. This review follows the latter strategy and focuses on the applications. This allows discussion on how different sensing strategies are brought to bear on the same problem and highlights advantages/disadvantages of these sensing strategies. Given the broad range of biosensor related applications, several particularly relevant areas of application were selected for review: biological threat agents, chemical threat agents, and medicine.

PMID: 23852443 [PubMed - as supplied by publisher]

Uptake of neonatal BCG vaccination in England: performance of the current policy recommendations.

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Uptake of neonatal BCG vaccination in England: performance of the current policy recommendations.

Thorax. 2013 Jul 13;

Authors: Nguipdop-Djomo P, Mangtani P, Pedrazzoli D, Rodrigues LC, Abubakar I

Abstract
BCG uptake among infants in England has not been measured since targeted infant vaccination replaced universal schoolchildren vaccination in 2005, mainly because of the challenges in defining denominators. We estimated uptake between 2006 and 2008 by dividing number of BCG doses administered to infants by number of all live births (where BCG vaccination is universal) or ethnic minority/Eastern Europeans live births (where infant-BCG vaccination is selective). Weighted average uptake was 68% (95% CI 65% to 71%), slightly higher in primary care trusts with universal (72% (95% CI 64% to 80%)) than selective (66% (95% CI 61% to 70%)) policy; and also 13% higher in areas vaccinating in postnatal wards compared with community settings.

PMID: 23853248 [PubMed - as supplied by publisher]

Tuberculosis infection during Hajj pilgrimage. The risk to pilgrims and their communities.

Millions of Muslims travel to Makkah every year to perform Hajj. Many pilgrims come from countries with a high incidence of tuberculosis (TB). Over-crowding, physical exhaustion, heat, and co-morbid conditions of mostly middle-aged and elderly pilgrims make them susceptible to infection, or reactivation of latent TB. Evidence from previous reports indicated a significant risk of acquiring infection during Hajj.

Pilgrims infected in Makkah may spread the infection to contacts in their countries. Spread of multi-drug resistant TB is a real concern. Control efforts are required to reduce the risk of infection and transmission. Screening of pilgrims from high burden countries before travel with chest x-ray will help to detect and treat active TB, and prevent infection of others.

Low incidence countries may consider carrying out tuberculin skin test or Quanti-FERON TB assay for pilgrims before and after Hajj, to identify and treat recent converters.
National and international coordinated efforts are essential for successful implementation of control measures to prevent the spread of the disease.

Tuberculosis Clinical Trial Update And The Current Anti-Tuberculosis Drug Portfolio.

Tuberculosis (TB), an ongoing public health threat, is worsened by the emergence of drug resistance. With an estimated 630000 cases per year of multidrug resistant (MDR)-TB, and 9% of those being extensively drug resistant (XDR)-TB, there is an urgent need for new and more effective anti-TB drugs.

New TB treatment regimens should be able to shorten the duration of therapy that currently takes at least six months. The non-compliance with this long treatment duration is one of the reasons for the development of drug resistance. In spite of the difficulties and alleged lack of interest from the pharmaceutical industry for the discovery and development of new antibiotics, several new or repurposed drugs are being evaluated in clinical trials.

This review article summarizes the information available and presents an update on the drugs currently in clinical trials for TB and briefly introduces some new compounds in pre-clinical development.

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