Biomedical subjects

Antonino Catanzaro

Publications and source records attributed to Antonino Catanzaro.

8 recordsLinked to original sources

PubMed2006

Factors related to response to intermittent treatment of Mycobacterium avium complex lung disease.

RATIONALE: Mycobacterium avium complex pulmonary disease (MAC-PD) is associated with substantial morbidity, and standard daily multidrug therapy is difficult to tolerate. OBJECTIVES: To characterize response to a three-times-weekly (TIW) regimen of clarithromycin, ethambutol, and rifampin. METHODS: A 1-yr prospective noncomparative trial of TIW treatment was conducted during 2000-2003 in 17 U.S. cities. Participants were 91 HIV-negative adults, diagnosed with moderate to severe MAC-PD, who originally participated in a trial of an inhaled IFN-gamma treatment. Improvement in sputum culture, high-resolution computed tomography (HRCT), and symptoms were assessed. RESULTS: Treatment response rates (and median response times) were 44% (2 mo or longer) for culture, 60% (5.5-11.5 mo) for HRCT, and 53% (8.5 mo) for symptoms. Having noncavitary, compared with cavitary, disease increased culture response by 4.0 times (95% confidence interval [CI], 1.7-9.2) and HRCT response by 4.9 times (95% CI, 1.9-13.0). Culture response was 1.5 times (95% CI, 1.1-2.2) higher for older subjects and 2.2 times (95% CI, 1.0-4.7) higher for previously untreated subjects. Being smear-negative increased culture response by 2.3 times (95% CI, 1.1-5.2) but decreased HRCT response by 4.4 times (95% CI, 1.7-11.5). Increasing ethambutol use by 5 mo increased culture response by 1.5 times (95% CI, 1.0-2.1) but decreased symptom response. Not having chronic obstructive pulmonary disease, bronchiectasis, or poor lung function increased symptom response by 1.9 to 3.9 times. CONCLUSIONS: TIW therapy was less effective for MAC-PD patients with cavitary disease and a history of chronic obstructive pulmonary disease, bronchiectasis, or previous treatment for MAC-PD. Further research is needed to study the long-term outcomes of TIW treatment.

Aged↗

PubMed2005

Coccidioidomycosis.

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Coccidioidomycosis↗

PubMed2004

Coccidioidomycosis.

Coccidioidomycosis is a fungal infection caused by Coccidiodes. The fungus has a limited geographic distribution but the disease can be seen anywhere. Primary infection is usually self-limited; however, when a large dose of fungus is inhaled or in an immunosuppressed host, the patient may develop overwhelming infection, including ARDS, in a brief period. While serodiagnosis can help to suspect the diagnosis, particularly in the setting of overwhelming disease, diagnostic efforts should focus on identifying the organism in body fluids or tissues. Several treatment options are available. Amphotericin B was the drug of choice for decades when there were no alternatives. Triazoles, fluconazole and itraconazole, are very effective and much less toxic.

Journal Article↗

PubMed2003

Predictors of adherence to treatment for latent tuberculosis infection in high-risk Latino adolescents: a behavioral epidemiological analysis.

The objective was to test whether theoretical variables predict adherence to treatment for latent tuberculosis infection in high-risk Latino adolescents. 286 Latino adolescents, age 13-18 years, were recruited from 10 middle/high schools in San Diego County, San Diego, USA. Participants completed a baseline interview and up to 9 monthly interviews. The cumulative number of pills consumed in 9 months was regressed on 16 independent variables, entered hierarchically in seven blocks. The final model accounted for 25% of the variance in adherence to isoniazid (INH), F (16, 230)=4.69, p<0.001. Adherence counseling (+), age (-), grades (+), being bicultural (+), and risk behaviors (-) were significantly related to adherence. Learning theories presume that adherence to medical regimens requires social support and freedom from physical and social barriers. Results support these theories. Future studies should explore additional precepts in order to identify additional predictors and to maximize adherence to INH among Latino adolescents and other high-risk populations. Doing so should decrease the risk of active TB among high-risk racial/ethnic and foreign-born populations.

Acculturation↗

PubMed2003

Costs of implementing and maintaining a tuberculin skin test program in hospitals and health departments.

OBJECTIVE: To determine (1) the annual costs of implementing and maintaining tuberculin skin test (TST) programs at participating study sites, (2) the cost of the TST program per healthcare worker (HCW), and (3) the outcomes of the TST programs, including the proportion of HCWs with a documented TST conversion and the proportion who accepted and completed treatment for latent TB infection, before and after the implementation of staffTRAK-TB software (Centers for Disease Control and Prevention, Atlanta, GA). DESIGN: Cost analysis in which costs for salaries, training, supplies, radiography, and data analysis were collected for two 12-month periods (before and after the implementation of staffTRAK-TB). SETTING: Four hospitals (two university and two city) and two health departments (one small county and one big city). RESULTS: The annual cost of implementing and maintaining a TST program ranged from dollars 66,564 to dollars 332,728 for hospitals and dollars 92,886 to dollars 291,248 for health departments. The cost of the TST program per HCW ranged from dollars 41 to dollars 362 for hospitals and dollars 176 to dollars 264 for health departments. CONCLUSIONS: Costs associated with implementing and maintaining a TST program varied widely among the participating study sites, both before and after the implementation of staffTRAK-TB. Compliance with the TB infection control guidelines of the Centers for Disease Control and Prevention may require a substantial investment in personnel time, effort, and commitment.

Academic Medical Centers↗

PubMed2002

Identification of a chemotactic, MCP-1-like protein from Mycobacterium avium.

In the immunocompetent host, Mycobacterium avium is responsible for chronic localized pulmonary disease, which is characterized by the presence of increased numbers of activated T cells and macrophages in the lungs. M. avium organisms as well as sonic extracts of M. avium were found to act as chemoattractants for THP-1 cells as well as monocytes, monocyte-derived macrophages and alveolar macrophages obtained from normal human donors in an in vitro chemotaxis assay, where a significantly higher number of cells were found in wells containing M. avium compared to control wells. Proteolytic treatment of M. avium sonicate resulted in significant loss (50%) of chemotactic activity. Monoclonal antibodies against recombinant human monocyte chemoattractant protein-1 (MCP-1) were found to cross-react with a 34-kDa protein of M. avium sonicate on Western blot and inhibit M. avium sonicate-mediated chemotaxis of THP-1 cells (47%). These data suggest the presence of an 'MCP-1 like' molecule on M. avium. Recruitment of host immune regulatory cells to the site of infection by pathogens may be involved in generating a local immune response or may be a bacterial strategy for survival within the host by recruiting the cells that they infect, i.e. macrophages.

Cells, Cultured↗

PubMed2002

Diagnosis, differentiating colonization, infection, and disease.

Nontuberculous mycobacteria (NTM) are found commonly in respiratory specimens. In many clinical laboratories, the majority of mycobacteria recovered from respiratory samples are NTM. Perhaps this is because NTM are common in the environment. The water that we drink or shower in often contains NTM; consequently, we often find NTM in respiratory secretions. The term colonization has been used when NTM are recovered more than once even though a specific disease cannot be demonstrated. Under these circumstances, it is never quite clear whether a low-grade infection exists or if secretions are simply contaminated by environmental organisms; however, colonization can be discerned from infection by focusing on the elements of making the diagnosis of an NTM-related disease, rather than simply finding the organism in respiratory samples.

Diagnosis, Differential↗

PubMed2002

Urine testing to monitor adherence to TB preventive therapy.

This study examined the validity of the Arkansas urine test. One hundred ninety-four adolescents submitted an unannounced urine specimen monthly (for 6 to 8 months). Duplicate specimens were blindly tested with high agreement (kappa >90%). Sensitivity and specificity were estimated. In 68% of test runs, adolescents recalled taking INH within 24 hr of specimen collection. For recall intervals of 24, 48, and 72 hr, sensitivity was 87, 85, and 83%, respectively. Females were less likely to test positive when INH was taken within the previous 24 hr (sensitivity 84 versus 92% males). Specificity was 57, 91, and 95% at 24, 48, and 72 hr, respectively. The Arkansas urine test was practical to use, and results correlated well with self-reported adherence to INH for treatment of latent tuberculosis infection (LTBI), over several months of follow-up. The test may be useful as part of an adherence-monitoring program when used in conjunction with self-reported measures.

Adolescent↗