Treatment responses in multidrug-resistant tuberculosis in Germany.

BACKGROUND: Excellent treatment outcomes have recently been reported for patients with multi/extensively drug-resistant tuberculosis (M/XDR-TB) in settings where optimal resources for individualised therapy are available. OBJECTIVE: To ascertain whether differences remain in treatment responses between patients with M/XDR-TB and those with non-M/XDR-TB. METHOD: Patients with TB were prospectively enrolled between March 2013 and March 2016 at five hospitals in Germany. Treatment was conducted following current guidelines and individualised on the basis of drug susceptibility testing. Two-month and 6-month sputum smear and sputum culture conversion rates were assessed. A clinical and radiological score were used to assess response to anti-tuberculosis treatment. RESULTS: Non-M/XDR-TB (n = 29) and M/XDR-TB (n = 46) patients showed similar rates of microbiological conversion: 2-month smear conversion rate, 90% vs. 78%; culture conversion rate, 67% vs. 61%; time to smear conversion, 19 days (IQR 10-32) vs. 31 days (IQR 14-56) (P = 0.066); time to culture conversion, 39 days (IQR 17-67) vs. 39 days (IQR 6-85) (P = 0.191). Both clinical and radiological scores decreased after the introduction of anti-tuberculosis treatment. CONCLUSION: There were no significant differences in scores between the two groups until 6 months of treatment. Under optimal clinical conditions, with the availability of novel diagnostics and a wide range of therapeutic options for individualised treatment, patients with M/XDR-TB achieved 6-month culture conversion rates that were compatible with those in patients with non-M/XDR-TB

Observation of double-charge discrete vortex solitons in hexagonal photonic lattices

We report on the experimental observation of stable double-charge discrete vortex solitons generated in hexagonal photonic lattices created optically in self-focusing nonlinear media and show that single-charge vortex solitons are unstable in analogous conditions. Subsequently, we study, both theoretically and experimentally, the existence and stability of spatial vortex solitons in two-dimensional hexagonal photonic lattices. We demonstrate that the stability of the double-charge vortices is a consequence of the intersite power exchange in the vortex soliton, and we provide a simple stability criterion on the basis of the analysis of the corresponding discrete nonlinear model. We extend our analysis to the case of defocusing nonlinearity and show the inversion of the vortex stability properties resulting in the fact that single-charge vortices become stable while their double-charge counterparts are unstable

Relapse-free cure from multidrug-resistant tuberculosis in Germany

Multidrug-resistant (MDR) tuberculosis (TB), defined by bacillary resistance against rifampicin and isoniazid, has been identified as a global threat to mankind [1]. According to the latest report by the European Centres for Disease Prevention and Control, and World Health Organization (WHO) regional office for Europe, only approximately 50% of MDR-TB patients in Europe reach favourable treatment outcomes [2]. Successful treatment outcomes are achieved for less than 25% of patients with extensively drug-resistant (XDR)-TB (MDR plus resistance against a least one fluoroquinolone and one second-line injectable drug) in the European Union/European Economic Area Countries [2]

On the groups SL2(ℤ[x]) and SL2(k[x, y])

Grunewald F, Mennicke J, Vaserstein L. On the groups SL2(ℤ[x]) and SL2(k[x, y]). Israel Journal of Mathematics. 1994;86(1-3):157-193.This paper studies free quotients of the groups SL(2)(Z[x]) and SL(2)(k[x, y]), k a finite field. These quotients give information about the relation of the above groups to their subgroups generated by elementary or unipotent elements