Improving tuberculosis surveillance in Europe is key to controlling the disease.

As underlined by the joint ECDC and World Health Organization Regional Office for Europe TB report, launched on 18 March the importance of good surveillance to stem this trend cannot be underestimated. Where do we go with surveillance in Europe? Can we do more? How many MDR and XDR TB cases occur because of sub-optimal patient management? This issue of Eurosurveillance casts light on these important questions with four interesting articles. The results of the studies reported in this issue of Eurosurveillance allow us to point out some key topics: \u2022The completeness of reporting information (including treatment outcomes), the proportion of culture-confirmed TB cases reported as well as the proportion of strains on which DST for both first- and second-line drugs is performed and reported are still sub-optimal overall in Europe. The relevance of these pitfalls goes beyond the \u201csimple\u201d surveillance limitation, having the potential to affect other important TB control pillars, e.g. infection control and case-management. \u2022MDR and XDR TB still persist in Europe. The high proportion of MDR TB identified among new TB cases reported by certain countries indicates that sub-optimal infection control practices are likely to occur, while the high percentage of MDR TB notified among retreatment cases is probably the result of sub-optimal case management in the past decade

Multiresistentse tuberkuloosi ravi kulutulusus ja ravitulemused erinevate ravistrateegiate rakendamisel

Järjest laialdasemalt rakendatakse multiresistentse tuberkuloosi haigete raviks DOTS-Plus strateegiat, kasutades teise rea ravimeid, kuid teadmised nende efektiivsuse ja kulutulususe kohta on vähesed. Uuringus hinnati alates 2001. a augustist Eestis rakendatud DOTS-Plus strateegia tõhusust, maksumust ja kulutulusust võrreldes 3 alternatiivset ravi strateegiat: DOTS-Plus strateegia, pre-DOTS-plus strateegia ja DOTS-strateegia. Kulud arvutati 2002. a kehtinud hindades, tõhususe näitajateks olid tuberkuloosist põhjustatud surmade arv, kaotatud haiguskoormus ja kulutulususe näitajaks säästetud haiguskoormuse maksumus. Saadud andmete alusel võib väita, et kasutades DOTS-Plus strateegiat, on võimalik oluliselt paran dada multiresistentse tuberkuloosi haigete ravitulemusi ning võrreldes teiste võimalustega on see kulutulusaim. Eesti Arst 2006; 85 (3): 148–15

controlling the disease

Surveillance and outbreak reports Surveillance of extensively drug-resistant tuberculosis in Europe, 2003-2007 15 by I Devaux, D Manissero, K Fernandez de la Hoz, K Kremer, D van Soolingen, on behalf of the EuroTB network Analysis of tuberculosis treatment outcomes in the European Union and European Economic Area: efforts needed towards optimal case management and control 21 by D Manissero, V Hollo, E Huitric, C Ködmön, A Amato-Gauci Risk of developing tuberculosis from a school contact: retrospective cohort study

Multidrug- and extensively drug-resistant tuberculosis

We evaluated risk factors and treatment outcomes associated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) in Germany in 2004–2006. In 177 (4%) of 4,557 culture-positive TB cases, Mycobacterium tuberculosis isolates were identified as MDR TB; an additional 7 (0.15%) met criteria for XDR TB. Of these 184 patients, 148 (80%) were born in countries of the former Soviet Union. In patients with XDR TB, hospitalization was longer (mean ± SD 202 ± 130 vs. 123 ± 81 days; p = 0.015) and resistance to all first-line drugs was more frequent (36% vs. 86%; p = 0.013) than in patients with MDR TB. Seventy-four (40%) of these 184 patients received treatment with linezolid. Treatment success rates ranged from 59% for the entire cohort (59% for MDR TB and 57% for XDR TB) to 87% for those with a definitive outcome (n = 125; 89% for MDR TB and 80% for XDR TB). Extensive drug susceptibility testing and availability of second- and third-line drugs under inpatient management conditions permit relatively high treatment success rates in MDR- and XDR TB

Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients.

Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB

A Comprehensive Characterization of the TI-LGAD Technology

Pixelated low-gain avalanche diodes (LGADs) can provide both precision spatial and temporal measurements for charged particle detection; however, electrical termination between the pixels yields a no-gain region, such that the active area or fill factor is not sufficient for small pixel sizes. Trench-isolated LGADs (TI-LGADs) are a strong candidate for solving the fill-factor problem, as the p-stop termination structure is replaced by isolated trenches etched in the silicon itself. In the TI-LGAD process, the p-stop termination structure, typical of LGADs, is replaced by isolating trenches etched in the silicon itself. This modification substantially reduces the size of the no-gain region, thus enabling the implementation of small pixels with an adequate fill factor value. In this article, a systematic characterization of the TI-RD50 production, the first of its kind entirely dedicated to the TI-LGAD technology, is presented. Designs are ranked according to their measured inter-pixel distance, and the time resolution is compared against the regular LGAD technology

The CMS trigger system

Peer reviewe

Search for light bosons in decays of the 125 GeV Higgs boson in proton-proton collisions at root s=8 TeV

Peer reviewe

Test beam performance measurements for the Phase I upgrade of the CMS pixel detector

A new pixel detector for the CMS experiment was built in order to cope with the instantaneous luminosities anticipated for the Phase I Upgrade of the LHC. The new CMS pixel detector provides four-hit tracking with a reduced material budget as well as new cooling and powering schemes. A new front-end readout chip mitigates buffering and bandwidth limitations, and allows operation at low comparator thresholds. In this paper, comprehensive test beam studies are presented, which have been conducted to verify the design and to quantify the performance of the new detector assemblies in terms of tracking efficiency and spatial resolution. Under optimal conditions, the tracking efficiency is (99.95 ± 0.05) %, while the intrinsic spatial resolutions are (4.80 ± 0.25) μm and (7.99 ± 0.21) μm along the 100 μm and 150 μm pixel pitch, respectively. The findings are compared to a detailed Monte Carlo simulation of the pixel detector and good agreement is found.Peer reviewe

Bedaquiline in MDR/XDR-TB cases: first experience on compassionate use

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