969 resultados para MDR-TB


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Tuberculosis (TB), an infection caused by human pathogen Mycobacterium tuberculosis, continues to kill millions each year and is as prevalent as it was in the pre-antimicrobial era. With the emergence of continuously-evolving multi-drug resistant strains (MDR) and the implications of the HIV epidemic, it is crucial that new drugs with better efficacy and affordable cost are developed to treat TB. With this in mind, the first part of this thesis discusses the synthesis of libraries of derivatives of pyridine carboxamidrazones, along with cyclised (1,2,4-triazole and 1,2,4-oxadiazole) and fluorinated analogues. Microbiological screening against M. tuberculosis was carried out at the TAACF, NIAID and IDRI (USA). This confirmed the earlier findings that 2-pyridyl-substituted carboxamidrazones were more active than the 4-pyridyl-substituted carboxamidrazones. Another important observation was that upon cyclisation of these carboxamidrazones, a small number of the triazoles retained their activity while in most of the remaining compounds the activity was diminished. This might be attributed to the significant increase in logP value caused by cyclisation of these linear carboxamidrazones, resulting in high lipophilicity and decreased permeability. Another reason might be that the rigidity conferred upon the compound due to cyclisation, results in failure of the compound to fit into the active site of the putative target enzyme. In order to investigate the potential change to the compounds’ metabolism in the organism and/or host, the most active compounds were selected and a fluorine atom was introduced in the pyridine ring. The microbiological results shows a drastic improvement in the activity of the fluorinated carboxamidrazone amides as compared to their non fluorinated counterpart. This improvement in the activity could possibly be the result of the increased cell permeability caused by the fluorine. In a subsidiary strand, a selection of long-chain , -unsaturated carboxylic esters, -keto, -hydroxy carboxylic esters and -keto, -hydroxy carboxylic esters, structurally similar to mycolic acids, were synthesised. The microbiological data revealed that one of the open chain compound was active against the Mycobacterium tuberculosis H37Rv strain and some resistant isolates. The possible compound activity could be its potential to disrupt mycobacterial cell wall synthesis by interfering with the FAS-II pathway.

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Transmission of a 73.7 Tb/s (96x3x256-Gb/s) DP-16QAM mode-division- multiplexed signal over 119km of few-mode fiber transmission line incorporating an inline multi mode EDFA and a phase plate based mode (de-)multiplexer is demonstrated. Data-aided 6x6 MIMO digital signal processing was used to demodulate the signal. The total demonstrated net capacity, taking into account 20% of FEC-overhead and 7.5% additional overhead (Ethernet and training sequences), is 57.6 Tb/s, corresponding to a spectral efficiency of 12 bits/s/Hz. © 2012 Optical Society of America.

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In this paper, we experimentally demonstrate the benefit of polarization insensitive dual-band optical phase conjugation for up to ten 400 Gb/s optical super-channels using a Raman amplified transmission link with a realistic span length of 75 km. We demonstrate that the resultant increase in transmission distance may be predicted analytically if the detrimental impacts of power asymmetry and polarization mode dispersion are taken into account.

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Tuberculosis (TB) is an infectious disease and nonadherence to medication can lead to new cases, multi-drug resistant TB, or potential death. Additionally, healthcare professionals and individuals with TB’s knowledge of the disease and medication adherence are crucial for successful completion of medication therapy. Patient education is one of the most important aspects of care provided in healthcare settings (CDC, 1994). TB tends to disproportionately affect minority and economically disadvantaged patient populations. The purpose of this mixed method study was to explore the relationship between spirituality, knowledge, and TB medication adherence among African Americans and Haitians. The primary research question was: What is the relationship between spirituality, knowledge and TB medication adherence among African Americans and Haitians? Quantitative data were gathered from 33 questionnaires and analyzed by two ANOVAs and four chi square analyses. The null hypothesis was not rejected; there was not a statistically significant relationship between spirituality and TB medication adherence (p =.208) among the study’s African Americans and Haitians. Qualitative data concerning participants’ knowledge of TB, gathered from 16 individual interviews further informed this analysis. Secondary research questions examined the role of spirituality, knowledge of TB and medication adherence among African Americans and Haitians. Four common themes emerged across both groups to answer the secondary research questions. Interviews revealed the themes: (a) God is in control, (b) stigmatization of TB, (c) lack of knowledge, and (d) fear of death. The theme lack of knowledge about TB was found to contribute to stigmatization of TB patients. However, in this study stigma and lack of knowledge were related to initial denial of symptoms and delayed diagnosis, but not found to be related to TB medication adherence. This study could help adult educators and health educators enhance their educational interventions, develop a better understanding of adult learning, resulting in early diagnosis and treatment ultimately decreasing transmission of TB, drug resistance, and potential death. Educators should be aware that TB patients’ spirituality may be an important part of how they cope with having TB. A larger scale study, conducted at multiple locations should be conducted to extend the findings of this small scale exploratory study. Further studies should be done to better determine what patient, healthcare provider and health care system factors might mediate relationships that may exist between lack of knowledge of TB, stigma and TB medication adherence.

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Nonadherence to medication for tuberculosis (TB) can lead to new cases of TB and death. Interest in spirituality in healthcare has grown among adult educators, health educators and healthcare workers (Tisdell, 2003). This mixed-method study will explore spirituality and TB medication adherence among African American and Haitian populations.

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Geometric frustration occurs in the rare earth pyrochlores due to magnetic rare earth ions occupying the vertices of the network of corner-sharing tetrahedra. In this research, we have two parts. In the first one we study the phase transition to the magnetically ordered state at low temperature in the pyrochlore Er₂Ti₂O₇. The molecular field method was used to solve this problem. In the second part, we analyse the crystal electric field Hamiltonian for the rare earth sites. The rather large degeneracy of the angular momentum J of the rare earth ion is lifted by the crystal electric field due to the neighboring ions in the crystal. By rewriting the Stevens operators in the crystal electric field Hamiltonian ᴴCEF in terms of charge quadruple operators, we can identify unstable order parameters in ᴴCEF . These may be related to lattice instabilities in Tb₂Ti₂O₇.

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We present the results of electrical resistivity, magnetic susceptibility, specific heat and x-ray absorption spectroscopy measurements in Tb1−xYxRhIn5 (x = 0.00, 0.15, 0.4.0, 0.50 e 0.70) single crystals. Tb1−xYxRhIn5 is an antiferromagnetic AFM compound with ordering temperature TN ≈ 46 K, the higher TN within the RRhIn5 serie (R : rare earth). We evaluate the physical properties evolution and the supression of the AFM state considering doping and Crystalline Electric Field (CEF) effects on magnetic exchange interaction between Tb3+ magnetic ions. CEF acts like a perturbation potential, breaking the (2J + 1) multiplet s degeneracy. Also, we studied linear-polarization-dependent soft x-ray absorption at Tb M4 and M5 edges to validate X-ray Absorption Spectroscopy as a complementary technique in determining the rare earth CEF ground state. Samples were grown by the indium excess flux and the experimental data (magnetic susceptibility and specific heat) were adjusted with a mean field model that takes account magnetic exchange interaction between first neighbors and CEF effects. XAS experiments were carried on Total Electron Yield mode at Laborat´onio Nacional de Luz S´ıncrotron, Campinas. We measured X-ray absorption at Tb M4,5 edges with incident polarized X-ray beam parallel and perpendicular to c-axis (E || c e E ⊥ c). The mean field model simulates the mean behavior of the whole system and, due to many independent parameters, gives a non unique CEF scheme. XAS is site- and elemental- specific technique and gained the scientific community s attention as complementary technique in determining CEF ground state in rare earth based compounds. In this work we wil discuss the non conclusive results of XAS technique in TbRhIn5 compounds.

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In this paper, we experimentally demonstrate the benefit of polarization insensitive dual-band optical phase conjugation for up to ten 400 Gb/s optical super-channels using a Raman amplified transmission link with a realistic span length of 75 km. We demonstrate that the resultant increase in transmission distance may be predicted analytically if the detrimental impacts of power asymmetry and polarization mode dispersion are taken into account.

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OBJECTIVES: Inhibitors of uridine diphosphate-3-O-(R-3-hydroxymyristoyl)-N-acetylglucosamine deacetylase (LpxC, which catalyses the first, irreversible step in lipid A biosynthesis) are a promising new class of antibiotics against Gram-negative bacteria. The objectives of the present study were to: (i) compare the antibiotic activities of three LpxC inhibitors (LPC-058, LPC-011 and LPC-087) and the reference inhibitor CHIR-090 against Gram-negative bacilli (including MDR and XDR isolates); and (ii) investigate the effect of combining these inhibitors with conventional antibiotics. METHODS: MICs were determined for 369 clinical isolates (234 Enterobacteriaceae and 135 non-fermentative Gram-negative bacilli). Time-kill assays with LPC-058 were performed on four MDR/XDR strains, including Escherichia coli producing CTX-M-15 ESBL and Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii producing KPC-2, VIM-1 and OXA-23 carbapenemases, respectively. RESULTS: LPC-058 was the most potent antibiotic and displayed the broadest spectrum of antimicrobial activity, with MIC90 values for Enterobacteriaceae, P. aeruginosa, Burkholderia cepacia and A. baumannii of 0.12, 0.5, 1 and 1 mg/L, respectively. LPC-058 was bactericidal at 1× or 2× MIC against CTX-M-15, KPC-2 and VIM-1 carbapenemase-producing strains and bacteriostatic at ≤4× MIC against OXA-23 carbapenemase-producing A. baumannii. Combinations of LPC-058 with β-lactams, amikacin and ciprofloxacin were synergistic against these strains, albeit in a species-dependent manner. LPC-058's high efficacy was attributed to the presence of the difluoromethyl-allo-threonyl head group and a linear biphenyl-diacetylene tail group. CONCLUSIONS: These in vitro data highlight the therapeutic potential of the new LpxC inhibitor LPC-058 against MDR/XDR strains and set the stage for subsequent in vivo studies.

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ASA (acetylsalicylic acid) is an NSAID (non-steroidal anti-inflammatory drug). ASA has gained attention as a potential chemopreventive and chemotherapeutic agent for several neoplasms. The aim of this study was to analyse the possible antitumoural effects of ASA in two erythroleukaemic cell lines, with or without the MDR (multidrug resistance) phenotype. The mechanism of action of different concentrations of ASA were compared in K562 (non-MDR) and Lucena (MDR) cells by analysing cell viability, apoptosis and necrosis, intracellular ROS (reactive oxygen species) formation and bcl-2, p53 and cox-2 gene expression. ASA inhibited the cellular proliferation or induced toxicity in K562 and Lucena cell lines, irrespective of the MDR phenotype. The ASA treatment provoked death by apoptosis and necrosis in K562 cells and only by necrosis in Lucena cells. ASA also showed antioxidant activity in both cell lines. The bcl-2, p53 and cox-2 genes in both cell lines treated with ASA seem to exhibit different patterns of expression. However, normal lymphocytes treated with the same ASA concentrations were more resistant than tumoral cells. The results of this work show that both cell lines responded to treatment with ASA, demonstrating a possible antitumoral and anti-MDR role for this drug.

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O fator de transcrição OCT4 é um importante marcador de células tronco e tem sido relacionado com o conceito de células tronco tumorais (CTTs). Recentemente, ele tem sido também relacionado ao fenótipo de resistência a múltiplas drogas (MDR). O objetivo deste trabalho foi testar se o OCT4 está ligado ao fenótipo MDR em células eritroleucêmicas derivadas da linhagem LMC-K562. Para isso, foi realizada a análise de expressão de genes associados à superfamília de transportadores ABC (ATP Binding Cassette) e, também, de fatores de transcrição relacionados a células tronco. Os primeiros resultados apontaram uma relação direta entre OCT4 e transportadores ABC na linhagem MDR derivada de K562 (Lucena). O sequenciamento de promotores ABC não revelou qualquer mutação que pudesse explicar a expressão diferenciada do OCT4 na linhagem MDR. Posteriormente, o sequenciamento da região contendo o domínio homeobox do gene OCT4 de ambas as linhagens celulares evidenciou, pela primeira vez, que este fator de transcrição é alvo de mutações que podem estar relacionados com o fenótipo MDR. As mutações encontradas implicam substituições de vários aminoácidos em ambas as linhagens celulares. K562 teve sete substituições (três exclusivas), enquanto Lucena teve 13 (nove exclusivas). Além disso, um busca in silico por motivos de fosforilação dentro da sequência de aminoácidos comparada, revelou que o OCT4 humano normal possui sete motivos potenciais de fosforilação. Entretanto, K562 perdeu um motivo e Lucena dois deles. Moléculas com diferentes padrões de fosforilação podem ter sua função modificada. Estes resultados indicam o OCT4 com uma alvo potencial para o tratamento do câncer, especialmente aqueles resistentes à quimioterapia.

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Este artículo resume el proceso de implementación del Laboratorio de Televisión Digital (DTV) de la Universidad de Cuenca, que surge como un entorno confiable de experimentación e investigación que hace uso de las características asociadas al estándar ISDB-Tb adoptado por Ecuador en el año 2010 para la transmisión de señales de televisión abierta. El objetivo de este artículo es documentar los aspectos que se han considerado para simular un escenario real en el que un Transport Stream (TS) formado por contenido audiovisual y aplicaciones interactivas, primero se genera, para luego transmitirse a través del canal de comunicaciones, y finalmente ser recibido en una televisión con receptor ISDB-Tb. Así, se facilita el desarrollo y la experimentación de nuevos servicios aprovechando el nuevo formato de DTV.