Pregnancy in patients with tuberculosis: A TBNET cross-sectional survey

BACKGROUND: Objectives: To determine whether the incidence of tuberculosis with pregnancy is more common than would be expected from the crude birth rate; to see whether there is significant delay in the diagnosis of tuberculosis during pregnancy. METHOD: Design: A cross-sectional survey. SETTING: 13 tuberculosis clinics within different European countries and the USA. POPULATION/SAMPLE: All patients with tuberculosis seen at these clinics for a period\u2009>\u20091 year. INSTRUMENT: Questionnaire survey based on continuous data collection. MAIN OUTCOME MEASURES: number and proportion of women with tuberculosis who were pregnant; timing of diagnosis in relation to pregnancy, including those who were pregnant or delivered in the 3 months prior to the diagnosis of TB and those who developed TB within 3 months after delivery. RESULTS: Pregnancy occurred in 224 (1.5 %) of 15,217 TB patients and followed the expected rate predicted from the crude birth rate for the clinic populations. TB was diagnosed more commonly in the 3 months after delivery (n\u2009=\u2009103) than during pregnancy (n\u2009=\u200968; \u3c7 2\u2009=\u200925.1, P\u2009<\u20090.001). CONCLUSIONS: TB is diagnosed more frequently after delivery, despite variations in local TB incidence and healthcare systems

Multidrug-Resistant Tuberculosis in Europe, 2010-2011

This study (TBNET #30) was supported by the European Commission Seventh Framework Programme (FP7/2007-2013) under grant agreement FP7-223681 and was part of the EU FP7–funded TBPANNET project (http://www.tbpannet.org). C.L. is supported by the German Center for Infection Research

Tuberculose en Belgique :Quoi de neuf pour le praticien ?

Tuberculosis is still an important disease in Belgium, mainly in big agglomerations. For this reason, knowledge of this entity by a general practitioner is very important. Genetic tests able to identify the species of Mycobacterium tuberculosis have been developed in recent years, but also identification of resistance to 1st and 2nd line treatment through genetic methods has been developed. The quick availability of results of this tests compared to the standard tests is a big advantage. Treatment of drug-susceptible tuberculosis hasn't changed recently. In contrast a lot has changed in the landscape of multidrug resistant tuberculosis with the development of 2nd line drugs and shortening of treatment duration in specific cases of multidrug resistant tuberculosis.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Endobronchial ultrasound in the management of nonsmall cell lung cancer

Flexible bronchoscopy plays a major role in the diagnosis and staging of lung cancer. One of the most important advances in this field is the development of endobronchial ultrasound (EBUS), which has extended the view of the bronchoscopist. These techniques are safe and allow assessment of the depth of tumour invasion in the central airways, detection of peripheral tumours before sampling, localisation of the central tumour in the lung parenchyma close to the central airways for real-time guided sampling, and staging of lymph nodes within the mediastinum. Progress in handling and analyses of the small samples obtained during EBUS procedures also allow modern pathological and molecular studies to be performed. This article reviews the data currently available in the field of convex and radial probe EBUS for the diagnosis and staging of nonsmall cell lung cancer and highlights the strengths but also the weaknesses of these new techniques

Severe pulmonary infections complicating nivolumab treatment for lung cancer: a report of two cases

Background: Immunotherapy represents a recent milestone in the treatment of lung cancer, particularly with the rapidly expanding development of monoclonal antibodies targeting checkpoint inhibitors in the programmed cell death-1 (PD-1) pathway, such as nivolumab and pembrolizumab. Classical auto-immune side effects of these treatments, often called immune-related adverse events (irAEs), can affect multiple organs, including the lungs in which potentially life-threatening pneumonitis may require rapid treatment with high doses of corticosteroids. Nevertheless, the occurrence of severe infections in cancer patients treated with nivolumab, outside the context of immunosuppressive therapy, is a complication that has rarely been reported in the literature. Clinical cases: We report two cases of severe pulmonary infection with unusual microbes, Mycobacterium tuberculosis and Aspergillus fumigatus, in patients treated with nivolumab for non-small cell lung cancer. Conclusion: Ruling out pulmonary infections may require extensive investigation, as these may have an atypical presentation due to immunomodulation. Furthermore, treating the patient with corticosteroids for immune-related pneumonia could lead to a fatal outcome in this context. This report highlights the importance of excluding the presence of opportunistic infections and tuberculosis before considering immune-related pulmonary toxicity with or without a history of prior corticosteroid use. These cases also emphasize the potential value of tuberculosis screening in patients treated with PD-1 checkpoint inhibitors.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Le staging endoscopique

Mediastinal staging of non-small cell lung cancer has major therapeutic and prognostic implications. Invasive surgical staging remains the gold standard but two recent endoscopic techniques have been introduced and have challenged the surgical techniques. Endoscopic ultrasound (EUS) and endobronchial ultrasound (EBUS) are minimally invasive techniques that can be performed ambulatory under local anesthesia and are safe. These techniques allow real-time guided aspiration of mediastinal (hilar) lymph nodes with excellent accuracy and should be considered as alternatives to surgical staging. Surgical assessment remains indicated when the prevalence of lymph node involvement is low or when EBUS or EUS show negative results. © 2012 Elsevier Masson SAS.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

L'endoscopie de staging

Mediastinal staging of non-small cell lung cancer has major therapeutical and prognostic implications. Invasive surgical staging remains the gold standard but two recent endoscopic techniques have been introduced and have challenged the surgical techniques. Endoscopic ultrasound (EUS) and endobronchial ultrasound (EBUS) are minimally invasive techniques that can be performed ambulatory under local anesthesia and are safe. These techniques allow real-time guided aspiration of mediastinal (hilar) lymph nodes with excellent accuracy and should be considered as alternatives to surgical staging. Surgical assessment remains indicated when the prevalence of lymph node involvement is low or when EBUS or EUS show negative results. © 2011 Société de Pneumologie de Langue Française (SPLF).SCOPUS: ar.jinfo:eu-repo/semantics/publishe

La stadification (« staging ») endoscopique

Precise determination of mediastinal involvement in non-small-cell lung cancer has major therapeutic and prognostic implications. Although surgery remains the reference invasive technique, two new endoscopic techniques have been developed and have radically modified today's practices. Esophageal ultrasound (EUS) and endobronchial ultrasound (EBUS) are minimally invasive techniques that can be carried out under local anesthesia in an outpatient setting with no significant complications. It can guide needle aspiration of the mediastinal (hilar) lymph nodes in real time with excellent results, which positions these techniques as alternatives to surgery. Surgical mediastinal exploration remains indicated when the prevalence of mediastinal lymph node involvement is low or when EBUS and/or EUS is noninformative. © 2010 Société de Pneumologie de Langue Française (SPLF).SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Le long fleuve tranquille de l'écho-endoscopie bronchique

SCOPUS: ed.jinfo:eu-repo/semantics/publishe

Driver oncogenes in sub-Saharan African patients with non-small cell lung cancer

Non-small cell lung cancer can exhibit driver oncogenes, including epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), that are possible targets for therapy. The prevalence of these rearranged driver oncogenes is influenced by race, smoking habits, and gender. Most data come from Caucasian and Asian populations. To our knowledge, there is no literature available about the prevalence of driver oncogenes in Sub-Saharan Africa, where the tobacco epidemic is still in the early stage. In this small case series, 6 patients of Sub-Saharan African ethnicity with stage IV lung adenocarcinoma are described. EGFR mutation was present in 3/6 patients and ALK rearrangement in 1/6 patients. This incidence seems high but interestingly, all patients were non-smokers or light smokers. In this series, the high prevalence of driver oncogene was probably related to low smoking habits and these initial data in Sub-Saharan Africans suggest high prevalence of driver mutations for this reason.SCOPUS: ar.jinfo:eu-repo/semantics/publishe