New approaches in the diagnosis and treatment of latent tuberculosis infection

With nearly 9 million new active disease cases and 2 million deaths occurring worldwide every year, tuberculosis continues to remain a major public health problem. Exposure to Mycobacterium tuberculosis leads to active disease in only ~10% people. An effective immune response in remaining individuals stops M. tuberculosis multiplication. However, the pathogen is completely eradicated in ~10% people while others only succeed in containment of infection as some bacilli escape killing and remain in non-replicating (dormant) state (latent tuberculosis infection) in old lesions. The dormant bacilli can resuscitate and cause active disease if a disruption of immune response occurs. Nearly one-third of world population is latently infected with M. tuberculosis and 5%-10% of infected individuals will develop active disease during their life time. However, the risk of developing active disease is greatly increased (5%-15% every year and ~50% over lifetime) by human immunodeficiency virus-coinfection. While active transmission is a significant contributor of active disease cases in high tuberculosis burden countries, most active disease cases in low tuberculosis incidence countries arise from this pool of latently infected individuals. A positive tuberculin skin test or a more recent and specific interferon-gamma release assay in a person without overt signs of active disease indicates latent tuberculosis infection. Two commercial interferon-gamma release assays, QFT-G-IT and T-SPOT.TB have been developed. The standard treatment for latent tuberculosis infection is daily therapy with isoniazid for nine months. Other options include therapy with rifampicin for 4 months or isoniazid + rifampicin for 3 months or rifampicin + pyrazinamide for 2 months or isoniazid + rifapentine for 3 months. Identification of latently infected individuals and their treatment has lowered tuberculosis incidence in rich, advanced countries. Similar approaches also hold great promise for other countries with low-intermediate rates of tuberculosis incidence

ICAR: endoscopic skull‐base surgery

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Niosomes of Nerium oleander extracts: In vitro assessment of bioactive nanovesicular structures

WOS: 000393626900019Niosomes are known as non-ionic surfactant-based vesicles and have been used quite a lot for medical applications as a novel drug delivery system in recent years. Herein we describe, the preparation and characterization of niosomes containing oleander (Nerium oleander) (ONs) extract as the herbal compound. In this context, niosomal formulations of two different extracts obtained from oleander roots were prepared by a thin film hydration technique using Tween 60 (non-ionic surfactant) with a cholesterol mixture at 1:1 M ratio. These vesicular structures were characterised by various techniques such as atomic force microscopy, zeta potential and dynamic light scattering size measurements. ONs vesicles are less than 100 nm in size with a good physical stability more than 50 days. Initially, total phenolic and flavonoid contents and antioxidant activities of the extracts were investigated. The methanol extract of oleander roots (MOE) showed higher polyphenolic content and exhibits a better antioxidant activity in compared to the hydro-methanol (20% methanol) extract (MOWE). Total phenolic contents in the MOE and MOWE were calculated as 64.51 +/- 0.945 mu g/mg and 65.05 +/- 0.37 mu g/mg gallic acid equivalents, respectively. Encapsulation efficiencies of the vesicles were found as 16.2% for MON (contain MOE) and 13.24% for MWON (contain MOWE). The significant linear correlation Was confirmed between the antioxidant activity and total phenolic content of extracts as well as ONs. Cell based cytotoxic activities of methanol extract and MON formulations were also assessed via KIT assay using Hela and A549 cell lines. (C) 2016 Elsevier B.V. All rights reserved.Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [2209/A]The project outlined in this paper was supported by The Scientific and Technological Research Council of Turkey (TUBITAK) 2209/A Research Projects Support Program for University Students