994 results on '"Gilman RH"'
Search Results
2. An acidic microenvironment in Tuberculosis increases extracellular matrix degradation by regulating macrophage inflammatory responses
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Whittington, AM, Turner, FS, Baark, F, Templeman, S, Kirwan, DE, Roufosse, C, Krishnan, N, Robertson, BD, Chong, DLW, Porter, JC, Gilman, RH, and Friedland, JS
- Abstract
Mycobacterium tuberculosis (M.tb) infection causes marked tissue inflammation leading to lung destruction and morbidity. The inflammatory extracellular microenvironment is acidic, however the effect of this acidosis on the immune response to M.tb is unknown. Using RNA-seq we show that acidosis produces system level transcriptional change in M.tb infected human macrophages regulating almost 4000 genes. Acidosis specifically upregulated extracellular matrix (ECM) degradation pathways with increased expression of Matrix metalloproteinases (MMPs) which mediate lung destruction in Tuberculosis. Macrophage MMP-1 and -3 secretion was increased by acidosis in a cellular model. Acidosis markedly suppresses several cytokines central to control of M.tb infection including TNF-α and IFN-γ. Murine studies demonstrated expression of known acidosis signaling G-protein coupled receptors OGR-1 and TDAG-8 in Tuberculosis which are shown to mediate the immune effects of decreased pH. Receptors were then demonstrated to be expressed in patients with TB lymphadenitis. Collectively, our findings show that an acidic microenvironment modulates immune function to reduce protective inflammatory responses and increase extracellular matrix degradation in Tuberculosis. Acidosis receptors are therefore potential targets for host directed therapy in patients.
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- 2023
3. S85 Leucine-rich 2 glycoprotein-1 upregulation in plasma of patients with active tuberculosis
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Kutschenreuter, J, primary, Loader, MC, additional, Kirwan, DE, additional, Gilman, RH, additional, Friedland, JS, additional, and Chong, DLW, additional
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- 2022
- Full Text
- View/download PDF
4. Impact of urbanisation and altitude on the incidence of, and risk factors for, hypertension
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Bernabe-Ortiz, A, Carrillo-Larco, RM, Gilman, RH, Checkley, W, Smeeth, L, and Jaime Miranda, J
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Adult ,Male ,Rural Population ,Cardiac & Cardiovascular Systems ,ALCOHOL-CONSUMPTION ,TYPE-2 DIABETES-MELLITUS ,BLOOD-PRESSURE ,Blood Pressure ,1102 Cardiovascular Medicine And Haematology ,Risk Assessment ,DISEASE ,Hypertension/epidemiology ,Risk Factors ,Peru ,Prevalence ,Humans ,purl.org/pe-repo/ocde/ford#3.02.04 [https] ,Urbanization/trends ,Prospective Studies ,Risk Assessment/methods ,Aged ,Science & Technology ,NUTRITION TRANSITION ,Incidence ,CRONICAS Cohort Study Group ,Urbanization ,MEN ,Middle Aged ,PREVENTION ,Special Populations ,Cross-Sectional Studies ,Cardiovascular System & Hematology ,OBESITY ,Hypertension ,Cardiovascular System & Cardiology ,Disease Progression ,Female ,HEALTH ,Self Report ,Life Sciences & Biomedicine ,Peru/epidemiology ,Follow-Up Studies - Abstract
BACKGROUND: Most of the data regarding the burden of hypertension in low-income and middle-income countries comes from cross-sectional surveys instead of longitudinal studies. We estimated the incidence of, and risk factors for, hypertension in four study sites with different degree of urbanisation and altitude. METHODS: Data from the CRONICAS Cohort Study, conducted in urban, semiurban and rural areas in Peru, was used. An age-stratified and sex-stratified random sample of participants was taken from the most updated census available in each site. Hypertension was defined as systolic blood pressure >/=140 mm Hg, or diastolic blood pressure >/=90 mm Hg, or self-report physician diagnosis and current treatment. The exposures were study site and altitude as well as modifiable risk factors. Incidence, incidence rate ratios (IRRs), 95% CIs and population-attributable fractions (PAFs) were estimated using generalised linear models. RESULTS: Information from 3237 participants, mean age 55.8 (SD+/-12.7) years, 48.4% males, was analysed. Overall baseline prevalence of hypertension was 19.7% (95% CI 18.4% to 21.1%). A total of 375 new cases of hypertension were recorded, including 5266 person-years of follow-up, with an incidence of 7.12 (95% CI 6.44 to 7.88) per 100 person-years. Individuals from semiurban site were at higher risk of hypertension compared with highly urbanised areas (IRR=1.76; 95% CI 1.39 to 2.23); however, those from high-altitude sites had a reduced risk (IRR=0.74; 95% CI 0.58 to 0.95). Obesity was the leading risk factor for hypertension with a great variation according to study site with PAF ranging from 12.5% to 42.4%. CONCLUSIONS: Our results suggest heterogeneity in the progression towards hypertension depending on urbanisation and site altitude.
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- 2017
5. Geographical variation in the progression of type 2 diabetes in Peru: The CRONICAS Cohort Study
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Bernabe-Ortiz, A, Carrillo-Larco, RM, Gilman, RH, Miele, CH, Checkley, W, Wells, JC, Smeeth, L, and Jaime Miranda, J
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Rural Population ,Adult ,Male ,Urban Population ,Endocrinology, Diabetes and Metabolism ,DISEASE ,Endocrinology & Metabolism ,Endocrinology ,CARDIOMETABOLIC RISK ,Peru ,SYSTEMATIC ANALYSIS ,Prevalence ,Internal Medicine ,Humans ,Obesity ,Prospective Studies ,21 REGIONS ,Aged ,INSULIN-RESISTANCE ,Science & Technology ,HIGH-ALTITUDE ,purl.org/pe-repo/ocde/ford#3.02.18 [https] ,Altitude ,Incidence ,CRONICAS Cohort Study Group ,1103 Clinical Sciences ,Type 2 diabetes ,GLOBAL BURDEN ,Middle Aged ,BODY-MASS INDEX ,Diabetes Mellitus, Type 2 ,Diabetes Mellitus, Type 2/epidemiology ,Risk factors ,RISK-FACTORS ,Disease Progression ,Female ,Life Sciences & Biomedicine ,Peru/epidemiology ,Follow-Up Studies - Abstract
BACKGROUND: The study aims were to estimate the incidence and risk factors for T2D in four settings with different degree of urbanization and altitude in Peru. METHODS: Prospective cohort study conducted in urban, semi-urban, and rural areas in Peru. An age- and sex-stratified random sample of participants was taken from the most updated census. T2D was defined as fasting blood glucose 7.0mmol/L or taking anti-diabetes medication. Exposures were divided into two groups: geographical variables (urbanization and altitude), and modifiable risk factors. Incidence, relative risks (RR), 95% confidence intervals (95%CI), and population attributable fractions (PAF) were estimated. RESULTS: Data from 3135 participants, 48.8% males, mean age 55.6years, was analyzed. Overall baseline prevalence of T2D was 7.1% (95%CI 6.2-8.0%). At follow-up, including 6207 person-years of follow-up, a total of 121 new T2D cases were accrued, equating to an incidence of 1.95 (95%CI 1.63-2.33) per 100 person-years. There was no urban to rural gradient in the T2D incidence; however, compared to sea level sites, participants living in high altitude had a higher incidence of diabetes (RR=1.58; 95%CI 1.01-2.48). Obesity had the highest attributable risk for developing T2D, although results varied by setting, ranging from 14% to 80% depending on urbanization and altitude. CONCLUSIONS: Our results suggest that the incidence of T2D was greater in high altitude sites. New cases of diabetes were largely attributed to obesity, but with substantial variation in the contribution of obesity depending on the environment. These findings can inform appropriate context-specific strategies to reduce the incidence of diabetes.
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- 2016
- Full Text
- View/download PDF
6. A household-level score to predict the risk of tuberculosis among contacts of patients with tuberculosis: derivation and external validation prospective cohort study
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Saunders, MJ, Wingfield, T, Datta, S, Montoya, R, Ramos, E, Baldwin, MR, Tovar, MA, Evans, BEW, Gilman, RH, Evans, CA, Wellcome Trust, Medical Research Council (MRC), and Imperial Health Charity
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Adult ,Male ,Adolescent ,TRANSMISSION ,DIAGNOSIS ,Microbiology ,1117 Public Health and Health Services ,Young Adult ,Risk Factors ,1108 Medical Microbiology ,Surveys and Questionnaires ,Peru ,Humans ,Prospective Studies ,Child ,Tuberculosis, Pulmonary ,Family Characteristics ,Science & Technology ,Illicit Drugs ,Infant, Newborn ,Sputum ,Infant ,Reproducibility of Results ,1103 Clinical Sciences ,Middle Aged ,SOCIAL DETERMINANTS ,Infectious Diseases ,Cough ,Child, Preschool ,Female ,MYCOBACTERIUM-TUBERCULOSIS ,HEALTH ,Contact Tracing ,Life Sciences & Biomedicine - Abstract
Background The epidemiological impact and cost-effectiveness of social protection and biomedical interventions for tuberculosis-affected households might be improved by risk stratification. We therefore derived and externally validated a household-level risk score to predict tuberculosis among contacts of patients with tuberculosis. Methods In this prospective cohort study, we recruited tuberculosis-affected households from 15 desert shanty towns in Ventanilla and 17 urban communities in Callao, Lima, Peru. Tuberculosis-affected households included index patients with a new diagnosis of tuberculosis and their contacts who reported being in the same house as the index patient for more than 6 h per week in the 2 weeks preceding index patient diagnosis. Tuberculosis-affected households were not included if the index patient had no eligible contacts or lived alone. We followed contacts until 2018 and defined household tuberculosis, the primary outcome, as any contact having any form of tuberculosis within 3 years. We used logistic regression to identify characteristics of index patients, contacts, and households that were predictive of household tuberculosis, and used these to derive and externally validate a household-level score. Findings Between Dec 12, 2007, and Dec 31, 2015, 16 505 contacts from 3 301 households in Ventanilla were included in a derivation cohort. During the 3-year follow-up, tuberculosis occurred in contacts of index patients in 430 (13%, 95% CI 12–14) households. Index patient predictors were pulmonary tuberculosis and sputum smear grade, age, and the maximum number of hours any contact had spent with the index patient while they had any cough. Household predictors were drug use, schooling of the female head of a household, and lower food spending. Contact predictors were if any of the contacts were children, number of lower-weight (body-mass index [BMI]
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- 2019
7. Urbanization and Altitude Are Associated with Low Kidney Function in Peru
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Carrillo Larco, R, Miranda, JJ, Gilman, RH, Narvaez-Guerra, O, Herrera-Enriquez, K, Medina-Lezama, J, Smeeth, L, Checkley, W, Bernabe-Ortiz, A, and Wellcome Trust
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RENAL-FUNCTION ,estimated glomerular filtration rate ,purl.org/pe-repo/ocde/ford#3.03.05 [https] ,Physiology ,kidney dysfunction ,Biophysics ,PROGRESSION ,rural area ,urbanization ,sea level ,THERAPY ,DISEASE ,Article ,male ,Peru ,INJURY ,glomerular filtration ,cross-sectional study ,controlled study ,human ,kidney function ,HEMOGLOBIN ,POPULATION ,Public, Environmental & Occupational Health ,Science & Technology ,purl.org/pe-repo/ocde/ford#3.01.08 [https] ,adult ,Altitude ,CRONICAS Cohort Study Group ,ERYTHROPOIESIS-STIMULATING AGENTS ,hemoglobin ,major clinical study ,purl.org/pe-repo/ocde/ford#3.03.11 [https] ,aged ,female ,priority journal ,1116 Medical Physiology ,Life Sciences & Biomedicine ,Sport Sciences ,chronic kidney disease ,altitude ,urban area - Abstract
Background: Kidney health needs to be studied in low- and middle-income countries with populations living at high altitude and undergoing urbanization. We studied whether greater level of urbanization was associated with worse kidney function and higher hemoglobin was associated with worse kidney function at high altitude. Methods: Cross-sectional analysis of population-based studies in Peru including five sites at different altitude above the sea level and urbanization level (in decreasing order of urbanization): Lima (sea level), Arequipa (2335 m), urban Puno (3825 m), Tumbes (sea level), and rural Puno (3825 m). The exposures were urbanization and altitude as per study site, and hemoglobin (g/dL). The outcome was the estimated glomerular filtration rate (eGFR). Results: Four thousand two hundred eight people were studied: mean age was 57.4 years (standard deviation: 12.4) and 51.9% were women. In comparison to rural Puno, eGFR was similar in Lima; in comparison to rural Puno, Arequipa, urban Puno, and Tumbes had worse eGFR, for example, in Arequipa, beta = -8.07 (95% confidence interval [CI]: -10.90 to -5.24). Intermediate (beta = -8.60; 95% CI: -10.55 to -6.66) and high (beta = -11.21; 95% CI: -14.19 to -8.24) altitude were negatively correlated with eGFR when only urban places were analyzed. At high altitude, there was a trend for a negative association between hemoglobin and eGFR: beta = -1.09 (95% CI: -2.22 to 0.04). Conclusions: Apparently, higher altitude and level of urbanization, except for one highly urbanized site, were associated with worse kidney function. Our findings suggest that some of the adverse impact of high altitude on kidney function has been balanced by the lower risk conferred by rural environments.
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- 2019
8. The HOMA-IR performance to identify new diabetes cases by degree of urbanization and altitude in Peru: The CRONICAS Cohort Study
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Carrillo-Larco, RM, Jaime Miranda, J, Gilman, RH, Checkley, W, Smeeth, L, and Bernabe-Ortiz, A
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Science & Technology ,endocrine system diseases ,INSULIN SENSITIVITY ,nutritional and metabolic diseases ,HOMEOSTASIS MODEL ASSESSMENT ,Research & Experimental Medicine ,DIAGNOSIS ,Endocrinology & Metabolism ,TYPE-2 ,Medicine, Research & Experimental ,HBA(1C) ,GLYCEMIA ,SECRETION ,TRAJECTORIES ,Life Sciences & Biomedicine ,RESISTANCE - Abstract
Aims. Prognostic thresholds to identify new type 2 diabetes mellitus (T2DM) cases using the HOMA-IR have not been defined. We studied the HOMA-IR performance to identify incident T2DM cases and to assess if the thresholds varied according to urbanization and altitude in Peru. Methods. Longitudinal analysis. The outcome was incident T2DM cases: self-report diagnosis and fasting glucose. The exposure was the HOMA-IR. Receiver operating characteristic (ROC) curves were plotted, and the area under the ROC curve (AUC) was estimated with 95% confidence intervals (95% CIs). Results are presented overall and stratified by study site (Lima, Tumbes, urban Puno, and rural Puno), rurality (urban, semiurban, and rural), and altitude (low and high). Results. A total of 3120 participants (mean age: 55.6 years, 51.2% females) contributed data to this analysis. The median baseline HOMA-IR was 1.7 (IQR 1.0–2.9), with median values ranging from 1.1 in rural Puno to 2.0 in Lima and Tumbes (). Overall for incident T2DM, the AUC was 0.69 (95% CI: 0.64–0.74) with an empirical threshold of 2.8 yielding a positive likelihood ratio of 2.30 and a negative one of 0.61; the positive and negative predictive values were 14.6% and 95.7%, respectively. The empirical thresholds varied within the variables of interest, for example, from 0.9 in urban Puno to 2.9 in Lima. Conclusions. Using the HOMA-IR to identify incident T2DM cases seems to yield moderate accuracy. The HOMA-IR could help improve identifying people at high risk of T2DM.
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- 2018
9. Microscopic Observation Drug Susceptibility Assay for Rapid Diagnosis of Lymph Node Tuberculosis and Detection of Drug Resistance
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Kirwan, D, Ugarte-Gil, C, Gilman, RH, Caviedes, L, Hasan Rizvi, SM, Ticona, E, Chavez, G, Cabrera, JL, Matos, ED, Evans, CA, Moore, DAJ, Friedland, JS, Wellcome Trust, and Imperial College Healthcare NHS Trust- BRC Funding
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Adult ,Aged, 80 and over ,Male ,Bacteriological Techniques ,Microscopy ,Time Factors ,Adolescent ,Mycobacteriology and Aerobic Actinomycetes ,11 Medical And Health Sciences ,06 Biological Sciences ,Middle Aged ,Tuberculosis, Lymph Node ,Microbiology ,Sensitivity and Specificity ,Young Adult ,Tuberculosis, Multidrug-Resistant ,Humans ,Female ,07 Agricultural And Veterinary Sciences ,Aged - Abstract
In this study, 132 patients with lymphadenopathy were investigated. Fifty-two (39.4%) were diagnosed with tuberculosis (TB). The microscopic observation drug susceptibility (MODS) assay provided rapid (13 days), accurate diagnosis (sensitivity, 65.4%) and reliable drug susceptibility testing (DST). Despite its lower sensitivity than that of other methods, its faster results and simultaneous DST are advantageous in resource-poor settings, supporting the incorporation of MODS into diagnostic algorithms for extrapulmonary TB.
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- 2015
10. Cough Frequency During Treatment Associated With Baseline Cavitary Volume and Proximity to the Airway in Pulmonary TB
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Proaño, A, Bui, DP, López, JW, Vu, NM, Bravard, MA, Lee, GO, Tracey, BH, Xu, Z, Comina, G, Ticona, E, Mollura, DJ, Friedland, JS, Moore, DAJ, Evans, CA, Caligiuri, P, Gilman, RH, and Tuberculosis Working Group in Peru
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respiratory tract diseases - Abstract
BACKGROUND: Cough frequency, and its duration, is a biomarker that can be used in low-resource settings without the need of laboratory culture and has been associated with transmission and treatment response. Radiologic characteristics associated with increased cough frequency may be important in understanding transmission. The relationship between cough frequency and cavitary lung disease has not been studied. METHODS: We analyzed data in 41 adults who were HIV negative and had culture-confirmed, drug-susceptible pulmonary TB throughout treatment. Cough recordings were based on the Cayetano Cough Monitor, and sputum samples were evaluated using microscopic observation drug susceptibility broth culture; among culture-positive samples, bacillary burden was assessed by means of time to positivity. CT scans were analyzed by a US-board-certified radiologist and a computer-automated algorithm. The algorithm evaluated cavity volume and cavitary proximity to the airway. CT scans were obtained within 1 month of treatment initiation. We compared small cavities (≤ 7 mL) and large cavities (> 7 mL) and cavities located closer to (≤ 10 mm) and farther from (> 10 mm) the airway to cough frequency and cough cessation until treatment day 60. RESULTS: Cough frequency during treatment was twofold higher in participants with large cavity volumes (rate ratio [RR], 1.98; P = .01) and cavities located closer to the airway (RR, 2.44; P = .001). Comparably, cough ceased three times faster in participants with smaller cavities (adjusted hazard ratio [HR], 2.89; P = .06) and those farther from the airway (adjusted HR, 3.61;, P = .02). Similar results were found for bacillary burden and culture conversion during treatment. CONCLUSIONS: Cough frequency during treatment is greater and lasts longer in patients with larger cavities, especially those closer to the airway.
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- 2018
11. MPT64 patch test for the diagnosis of active pulmonary tuberculosis: a randomised controlled trial in Peru
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Pope, V, Sacksteder, KA, Hererra, J Coronel, Gilman, RH, Vargas-Prada, S, Lopez Romero, S, Yafac, J, Sanchez Rios, E, and Moore, DAJ
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TB ,purl.org/pe-repo/ocde/ford#3.02.07 [https] ,MPT64 ,diagnostic ,purl.org/pe-repo/ocde/ford#3.03.08 [https] ,patch test - Abstract
SETTING: There remains a lack of effective and inexpensive diagnostic tools for active tuberculosis (TB) disease. Testing immune responses to proteins secreted by Mycobacterium tuberculosis, such as MPT64, may be a diagnostic option. OBJECTIVE: To evaluate the sensitivity and specificity of a patch test using MPT64 for the diagnosis of active TB disease. DESIGN: This randomised, double-blind, placebo-controlled, prospective study in Lima, Peru, involved 55 healthy controls and 457 symptomatic individuals referred for routine TB testing by the National TB Control Programme. All subjects underwent a comprehensive diagnostic workup, and received an active patch on one arm and a placebo patch on the opposite arm, which were read after 4 days. RESULTS: Eighty-one (18%) of the symptomatic participants were classified as having definite TB, while an additional 98 (21%) had probable TB. The patch tests performed the same in both groups, with a sensitivity of 27% and specificity of 74%. The area under the receiver operating characteristic curve was 0.495 (95%CI 0.425-0.565). CONCLUSIONS: Contrary to existing literature, the MPT64 patch was not sensitive and specific to detect active TB. Given the potential of the test, understanding possible differences in the protein source or underlying genetic factors should be explored further.
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- 2018
12. Sodium and Potassium Consumption in a Semi-Urban Area in Peru: Evaluation of a Population-Based 24-Hour Urine Collection
- Author
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Carrillo-Larco, RM, Saavedra-Garcia, L, Miranda, JJ, Sacksteder, KA, Diez-Canseco, F, Gilman, RH, and Bernabe-Ortiz, A
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Adult ,Male ,Time Factors ,Adolescent ,purl.org/pe-repo/ocde/ford#3.03.04 [https] ,Nutritional Status ,Blood Pressure ,Urinalysis ,dietary potassium ,Recommended Dietary Allowances ,Young Adult ,Peru ,Humans ,dietary sodium ,sodium ,Randomized Controlled Trials as Topic ,purl.org/pe-repo/ocde/ford#4.04.01 [https] ,potassium ,Urban Health ,blood pressure ,Potassium, Dietary ,Sodium, Dietary ,Middle Aged ,Cross-Sectional Studies ,sodium chloride ,1111 Nutrition And Dietetics ,Female ,Biomarkers - Abstract
Despite the negative effects of high sodium and low potassium consumption on cardiovascular health, their consumption has not been quantified in sites undergoing urbanization. We aimed to determine the sodium and potassium consumption in a semi-urban area in Peru with a cross-sectional study. 24-h urine samples were collected. The outcomes were mean consumption of sodium and potassium, as well as adherence to their consumption recommendation
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- 2018
13. Risk score for first-screening of prevalent undiagnosed chronic kidney disease in Peru: the CRONICAS-CKD risk score
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Carrillo Larco, RM, Miranda, JJ, Gilman, RH, Medina-Lezama, J, Chirinos-Pacheco, JA, Muñoz-Retamozo, PV, Smeeth, L, Checkley, W, Bernabe-Ortiz, A, and CRONICAS Cohort Study Group
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Adult ,Male ,1103 Clinical Sciences ,Urology & Nephrology ,Middle Aged ,Kidney ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,Severity of Illness Index ,Cohort Studies ,Renal Insufficiency, Chronic/diagnosis/epidemiology/physiopathology ,purl.org/pe-repo/ocde/ford#3.02.20 [https] ,Cross-Sectional Studies ,Latin America ,Risk Factors ,Chronic kidney disease ,Hypertension/diagnosis/epidemiology/physiopathology ,Prevalence ,Humans ,Female ,Peru/epidemiology ,Aged ,Follow-Up Studies ,Risk assessment - Abstract
Background Chronic Kidney Disease (CKD) represents a great burden for the patient and the health system, particularly if diagnosed at late stages. Consequently, tools to identify patients at high risk of having CKD are needed, particularly in limited-resources settings where laboratory facilities are scarce. This study aimed to develop a risk score for prevalent undiagnosed CKD using data from four settings in Peru: a complete risk score including all associated risk factors and another excluding laboratory-based variables. Methods Cross-sectional study. We used two population-based studies: one for developing and internal validation (CRONICAS), and another (PREVENCION) for external validation. Risk factors included clinical- and laboratory-based variables, among others: sex, age, hypertension and obesity; and lipid profile, anemia and glucose metabolism. The outcome was undiagnosed CKD: eGFR
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- 2017
14. Comparing sputum collection methods for tuberculosis diagnosis: a systematic review, pairwise and network meta-analysis
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Datta, S, Shah, L, Gilman, RH, Evans, CA, Medical Research Council (MRC), Wellcome Trust, and Imperial College London, Wellcome Trust
- Abstract
Background The performance of laboratory tests to diagnose pulmonary tuberculosis is dependent on the quality of the sputum sample tested. The relative merits of sputum collection methods to improve tuberculosis diagnosis are poorly characterised. We therefore aimed to investigate the effects of sputum collection methods on tuberculosis diagnosis. Methods We did a systematic review and meta-analysis to investigate whether non-invasive sputum collection methods in people aged at least 12 years improve the diagnostic performance of laboratory testing for pulmonary tuberculosis. We searched PubMed, Google Scholar, ProQuest, Web of Science, CINAHL, and Embase up to April 14, 2017, to identify relevant experimental, case-control, or cohort studies. We analysed data by pairwise meta-analyses with a random-effects model and by network meta-analysis. All diagnostic performance data were calculated at the sputum-sample level, except where authors only reported data at the individual patient-level. Heterogeneity was assessed, with potential causes identified by logistic meta-regression. Findings We identified 23 eligible studies published between 1959 and 2017, involving 8967 participants who provided 19 252 sputum samples. Brief, on-demand spot sputum collection was the main reference standard. Pooled sputum collection increased tuberculosis diagnosis by microscopy (odds ratio [OR] 1·6, 95% CI 1·3–1·9, p
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- 2017
15. Towards improving early diagnosis of congenital Chagas disease in an endemic setting
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Messenger, LA, Gilman, RH, Verastegui, M, Galdos-Cardenas, G, Sanchez, G, Valencia, E, Sanchez, L, Malaga, E, Rendell, VR, Jois, M, Shah, V, Santos, N, Del Carmen Abastoflor, M, LaFuente, C, Colanzi, R, Bozo, R, Bern, C, and Working Group on Chagas disease in Bolivia and Peru
- Abstract
Congenital Trypanosoma cruzi transmission is now estimated to account for 22% of new infections, representing a significant public health problem across Latin America and internationally. Treatment during infancy is highly efficacious and well tolerated, but current assays for early detection fail to detect >50% of infected neonates and 9 month follow-up is low. : Women presenting for delivery in two urban hospitals in Santa Cruz department, Bolivia were screened by rapid test. Specimens from infants of infected women were tested by microscopy (micromethod), quantitative PCR (qPCR) and IgM trypomastigote excreted-secreted antigen (TESA)-blots at birth and 1 month, and by IgG serology at 6 and 9 months. : Among 487 infants of 476 seropositive women, congenital T. cruzi infection was detected in 38 infants of 35 mothers (7.8%). In cord blood, qPCR, TESA-blot and micromethod sensitivities/specificities were 68.6%/99.1%, 58.3%/99.1% and 16.7%/100%, respectively. When birth and 1 month results were combined, cumulative sensitivities reached 84.2%, 73.7% and 34.2%, respectively. Low birth weight and/or respiratory distress were reported in 11 (29%) infected infants. Infants with clinical signs had higher parasite loads and were significantly more likely to be detected by micromethod. : The proportion of T. cruzi infected infants with clinical signs has fallen from the 1990s, but symptomatic congenital Chagas disease still represents a significant, albeit increasingly challenging to detect, public health problem. Molecular methods could facilitate earlier diagnosis and circumvent loss to follow-up but remain logistically and economically prohibitive for routine screening in resource-limited settings.
- Published
- 2017
16. Dynamics of Cough Frequency in Adults Undergoing Treatment for Pulmonary Tuberculosis
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Proaño, A, Bravard, MA, López, JW, Lee, GO, Bui, D, Datta, S, Comina, G, Zimic, M, Coronel, J, Caviedes, L, Cabrera, JL, Salas, A, Ticona, E, Vu, NM, Kirwan, DE, Loader, M-CI, Friedland, JS, Moore, DAJ, Evans, CA, Tracey, BH, Gilman, RH, and Tuberculosis Working Group in Peru
- Subjects
respiratory tract diseases - Abstract
Background: Cough is the major determinant of tuberculosis transmission. Despite this, there is a paucity of information regarding characteristics of cough frequency throughout the day and in response to tuberculosis therapy. Here we evaluate the circadian cycle of cough, cough frequency risk factors, and the impact of appropriate treatment on cough and bacillary load. Methods: We prospectively evaluated human immunodeficiency virus-negative adults (n = 64) with a new diagnosis of culture-proven, drug-susceptible pulmonary tuberculosis immediately prior to treatment and repeatedly until treatment day 62. At each time point, participant cough was recorded (n = 670) and analyzed using the Cayetano Cough Monitor. Consecutive coughs at least 2 seconds apart were counted as separate cough episodes. Sputum samples (n = 426) were tested with microscopic-observation drug susceptibility broth culture, and in culture-positive samples (n = 252), the time to culture positivity was used to estimate bacillary load. Results: The highest cough frequency occurred from 1 pm to 2 pm, and the lowest from 1 am to 2 am (2.4 vs 1.1 cough episodes/hour, respectively). Cough frequency was higher among participants who had higher sputum bacillary load (P < .01). Pretreatment median cough episodes/hour was 2.3 (interquartile range [IQR], 1.2-4.1), which at 14 treatment days decreased to 0.48 (IQR, 0.0-1.4) and at the end of the study decreased to 0.18 (IQR, 0.0-0.59) (both reductions P < .001). By 14 treatment days, the probability of culture conversion was 29% (95% confidence interval, 19%-41%). Conclusions: Coughs were most frequent during daytime. Two weeks of appropriate treatment significantly reduced cough frequency and resulted in one-third of participants achieving culture conversion. Thus, treatment by 2 weeks considerably diminishes, but does not eliminate, the potential for airborne tuberculosis transmission.
- Published
- 2017
17. Rationing tests for drug-resistant tuberculosis - who are we prepared to miss?
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Martin, LJ, Roper, MH, Grandjean, L, Gilman, RH, Coronel, J, Caviedes, L, Friedland, JS, and Moore, DAJ
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Adult ,Male ,Health Care Rationing/standards ,STRATEGIES ,Drug Susceptibility Testing ,Mycobacterium tuberculosis/isolation & purification ,Microbial Sensitivity Tests/statistics & numerical data ,Sputum/microbiology ,DIAGNOSIS ,COST-EFFECTIVENESS ,Medicine, General & Internal ,Multidrug-resistant tuberculosis ,Risk Factors ,General & Internal Medicine ,SUSCEPTIBILITY ASSAY ,Humans ,Tuberculosis ,Medicine(all) ,Science & Technology ,Mass Screening/methods/standards ,Tuberculosis, Multidrug-Resistant/diagnosis/epidemiology ,Diagnostic Tests, Routine/statistics & numerical data ,11 Medical And Health Sciences ,Health Status Disparities ,Middle Aged ,Health Services Accessibility/standards ,purl.org/pe-repo/ocde/ford#3.02.00 [https] ,Treatment Outcome ,PERU ,Health Resources ,Female ,MYCOBACTERIUM-TUBERCULOSIS ,Life Sciences & Biomedicine ,Microscopic-observation drug-susceptibility assay - Abstract
Background: Early identification of patients with drug-resistant tuberculosis (DR-TB) increases the likelihood of treatment success and interrupts transmission. Resource-constrained settings use risk profiling to ration the use of drug susceptibility testing (DST). Nevertheless, no studies have yet quantified how many patients with DR-TB this strategy will miss. Methods: A total of 1,545 subjects, who presented to Lima health centres with possible TB symptoms, completed a clinic-epidemiological questionnaire and provided sputum samples for TB culture and DST. The proportion of drug resistance in this population was calculated and the data was analysed to demonstrate the effect of rationing tests to patients with multidrug-resistant TB (MDR-TB) risk factors on the number of tests needed and corresponding proportion of missed patients with DR-TB. Results: Overall, 147/1,545 (9.5 %) subjects had culture-positive TB, of which 32 (21.8 %) had DR-TB (MDR, 13.6 %; isoniazid mono-resistant, 7.5 %; rifampicin mono-resistant, 0.7 %). A total of 553 subjects (35.8 %) reported one or more MDR-TB risk factors; of these, 506 (91.5 %; 95 % CI, 88.9–93.7 %) did not have TB, 32/553 (5.8 %; 95 % CI, 3.4–8.1 %) had drug-susceptible TB, and only 15/553 (2.7 %; 95 % CI, 1.5–4.4 %) had DR-TB. Rationing DST to those with an MDR-TB risk factor would have missed more than half of the DR-TB population (17/32, 53.2 %; 95 % CI, 34.7–70.9). Conclusions: Rationing DST based on known MDR-TB risk factors misses an unacceptable proportion of patients with drug-resistance in settings with ongoing DR-TB transmission. Investment in diagnostic services to allow universal DST for people with presumptive TB should be a high priority.
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- 2016
18. Helicobacter pylori infection in infants and toddlers in South America: concordance between [¹³C] urea breath test and monoclonal H. pylori stool antigen test
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Queiroz, DMM, Saito, M, Rocha, GA, Rocha, AMC, Melo, FF, Checkley, W, Braga, LL, Silva, IS, Gilman, RH, and Crabtree, JE
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Accurate noninvasive tests for diagnosing Helicobacter pylori infection in very young children are strongly required. We investigated the agreement between the [¹³C] urea breath test ([¹³C]UBT) and a monoclonal ELISA (HpSA) for detection of H. pylori antigen in stool. From October 2007 to July 2011, we enrolled 414 infants (123 from Brazil and 291 from Peru) of ages 6 to 30 months. Breath and stool samples were obtained at intervals of at least 3 months from Brazilian (n = 415) and Peruvian (n = 908) infants. [¹³C]UBT and stool test results concurred with each other in 1,255 (94.86%) cases (kappa coefficient = 0.90; 95% confidence interval [CI] = 0.87 to 0.92). In the H. pylori-positive group, delta-over-baseline (DOB) and optical density (OD) values were positively correlated (r = 0.62; P < 0.001). The positivity of the tests was higher (P < 0.001; odds ratio [OR] = 6.01; 95% CI = 4.50 to 8.04) in Peru (546/878; 62.2%) than in Brazil (81/377; 21.5%) and increased with increasing age in Brazil (P = 0.02), whereas in Peru it decreased with increasing age (P < 0.001). The disagreement between the test results was associated with birth in Brazil and female gender but not with age and diarrhea. Our results suggest that both [¹³C]UBT and the stool monoclonal test are reliable for diagnosing H. pylori infection in very young children, which will facilitate robust epidemiological studies in infants and toddlers.
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- 2013
19. Der Single Nucleotide Polymorphismus von IL-1B-511 erhöht das Risiko von atrophischer Gastritis und intestinalem Magenkarzinom bei H. pylori infizierten Patienten in Peru
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Gehmert, S, Meyer, F, Velapatino, B, Herrera, P, Cok, J, Vasquez, G, Combe, J, Wen, S, and Gilman, RH
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ddc: 610 - Published
- 2008
20. Plectrancthus Diterpenes Against Mycobacterium Tuberculosis
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Rijo, P, Simões, MF, Francisco, AP, Rojas, R, Gilman, RH, Vaisberg, AJ, Moiteiro, C, Rodríguez, B, and Repositório da Universidade de Lisboa
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Made available in DSpace on 2015-12-30T10:18:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2008
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- 2008
21. Serological responses in porcine cysticercosis: A link with the parasitological outcome of infection
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Deckers, Nynke, KANOBANA, K, SILVA, M, GONZALEZ, AE, GARCIA, HH, GILMAN, RH, and Dorny, Pierre
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Medicine and Health Sciences - Published
- 2008
22. MODS assay for the diagnosis of TB
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Moore, DAJ, Gilman, RH, and Friedland, JS
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- 2007
23. Antimycobacterial activity of sesquiterpenes isolated from Celastrus vulcanicola (Celastraceae)
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Torres, DF, primary, Osorio, AA, additional, Jiménez, IA, additional, Rojas, RD, additional, Gilman, RH, additional, and Bazzocchi, IL, additional
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- 2008
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24. Helicobacter pylori in the drinking water in Peru
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Hulten, K, primary, Han, SW, additional, Enroth, H, additional, Klein, PD, additional, Opekun, AR, additional, Gilman, RH, additional, Evans, DG, additional, Engstrand, L, additional, Graham, DY, additional, and El-Zaatari, FA, additional
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- 1996
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25. Differences in cardiovascular risk factors in rural, urban and rural-to-urban migrants in Peru.
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Miranda JJ, Gilman RH, Smeeth L, Miranda, J Jaime, Gilman, Robert H, and Smeeth, Liam
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Objectives: To assess differences in cardiovascular risk profiles among rural-to-urban migrants and non-migrant groups.Methods: Cross-sectional study in Ayacucho and Lima, Peru. Participants were: rural (n=201); rural-to-urban migrants (n=589); and urban (n=199). Cardiovascular risk factors were assessed according to migrant status (migrants vs non-migrants), age at first migration, length of residency in an urban area and lifetime exposure to an urban area.Results: For most risk factors, the migrant group had intermediate levels of risk between those observed for the rural and urban groups. Prevalence for rural, migrant and urban groups was 3%, 20% and 33%, respectively, for obesity, and 0.8%, 3% and 6% for type-2 diabetes. This gradient of risk was not observed uniformly across all risk factors. Blood pressure did not show a clear gradient of difference between groups. The migrant group had similar systolic blood pressure but lower diastolic blood pressure than the rural group. The urban group had higher systolic blood pressure but similar diastolic blood pressure than rural group. Hypertension was more prevalent among the urban (29%) than both the rural and migrant groups (11% and 16%, respectively). For HbA(1c), although the urban group had higher levels, the migrant and rural groups were similar to each other. No differences were observed in triglycerides between the three groups. Within migrants, those who migrated when aged older than 12 years had higher odds of diabetes, impaired fasting glucose and metabolic syndrome compared to people who migrated at younger ages. Adjustment for age, sex and socioeconomic indicators had little impact on the patterns observed.Conclusions: The impact of rural-to-urban migration on cardiovascular risk profile is not uniform across different risk factors, and is further influenced by the age at which migration occurs. A gradient in levels was observed for some risk factors across study groups. This observation indicates that urbanisation is indeed detrimental to cardiovascular health. [ABSTRACT FROM AUTHOR]- Published
- 2011
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26. Neurocysticercosis: unraveling the nature of the single cysticercal granuloma.
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García HH, Gonzalez AE, Rodriguez S, Tsang VC, Pretell EJ, Gonzales I, Gilman RH, Cysticercosis Working Group in Peru, García, H H, Gonzalez, A E, Rodriguez, S, Tsang, V C W, Pretell, E J, Gonzales, I, and Gilman, R H
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- 2010
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27. Frequency of diarrhoea as a predictor of elevated blood pressure in children.
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Miranda JJ, Davies AR, Smith GD, Smeeth L, Cabrera L, Gilman RH, García HH, Ortega YR, Cama VA, Miranda, Juan Jaime, Davies, Alisha R, Smith, George Davey, Smeeth, Liam, Cabrera, Lilia, Gilman, Robert H, García, Héctor H, Ortega, Ynes R, and Cama, Vitaliano A
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- 2009
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28. Evaluation and treatment of chagas disease in the United States: a systematic review.
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Bern C, Montgomery SP, Herwaldt BL, Rassi A Jr, Marin-Neto JA, Dantas RO, Maguire JH, Acquatella H, Morillo C, Kirchhoff LV, Gilman RH, Reyes PA, Salvatella R, Moore AC, Bern, Caryn, Montgomery, Susan P, Herwaldt, Barbara L, Rassi, Anis Jr, Marin-Neto, Jose Antonio, and Dantas, Roberto O
- Abstract
Context: Because of population migration from endemic areas and newly instituted blood bank screening, US clinicians are likely to see an increasing number of patients with suspected or confirmed chronic Trypanosoma cruzi infection (Chagas disease).Objective: To examine the evidence base and provide practical recommendations for evaluation, counseling, and etiologic treatment of patients with chronic T cruzi infection. Evidence Acquisition Literature review conducted based on a systematic MEDLINE search for all available years through 2007; review of additional articles, reports, and book chapters; and input from experts in the field.Evidence Synthesis: The patient newly diagnosed with Chagas disease should undergo a medical history, physical examination, and resting 12-lead electrocardiogram (ECG) with a 30-second lead II rhythm strip. If this evaluation is normal, no further testing is indicated; history, physical examination, and ECG should be repeated annually. If findings suggest Chagas heart disease, a comprehensive cardiac evaluation, including 24-hour ambulatory ECG monitoring, echocardiography, and exercise testing, is recommended. If gastrointestinal tract symptoms are present, barium contrast studies should be performed. Antitrypanosomal treatment is recommended for all cases of acute and congenital Chagas disease, reactivated infection, and chronic T cruzi infection in individuals 18 years or younger. In adults aged 19 to 50 years without advanced heart disease, etiologic treatment may slow development and progression of cardiomyopathy and should generally be offered; treatment is considered optional for those older than 50 years. Individualized treatment decisions for adults should balance the potential benefit, prolonged course, and frequent adverse effects of the drugs. Strong consideration should be given to treatment of previously untreated patients with human immunodeficiency virus infection or those expecting to undergo organ transplantation.Conclusions: Chagas disease presents an increasing challenge for clinicians in the United States. Despite gaps in the evidence base, current knowledge is sufficient to make practical recommendations to guide appropriate evaluation, management, and etiologic treatment of Chagas disease. [ABSTRACT FROM AUTHOR]- Published
- 2007
29. Treatment of neurocysticercosis: current status and future research needs.
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Nash TE, Singh G, White AC, Rajshekhar V, Loeb JA, Proaño JV, Takayanagui OM, Gonzalez AE, Butman JA, DeGiorgio C, Del Brutto OH, Delgado-Escueta A, Evans CA, Gilman RH, Martinez SM, Medina MT, Pretell EJ, Teale J, Garcia HH, and Nash, T E
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- 2006
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30. Neurocysticercosis: some of the essentials.
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Garcia HH, Gonzalez AE, Tsang VCW, Gilman RH, and Cysticerosis Working Group in Peru
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- 2006
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31. Neurocysticercosis: association between seizures, serology, and brain CT in rural Peru.
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Montano SM, Villaran MV, Ylquimiche L, Figueroa JJ, Rodriguez S, Bautista CT, Gonzalez AE, Tsang VCW, Gilman RH, Garcia HH, Cysticercosis Working Group in Peru, Montano, S M, Villaran, M V, Ylquimiche, L, Figueroa, J J, Rodriguez, S, Bautista, C T, Gonzalez, A E, Tsang, V C W, and Gilman, R H
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- 2005
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32. Helicobacter pylori reinfection is common in Peruvian adults after antibiotic eradication therapy.
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Soto G, Bautista CT, Roth DE, Gilman RH, Velapatiño B, Ogura M, Dailide G, Razuri M, Meza R, Katz U, Monath TP, Berg DE, Taylor DN, and Gastrointestinal Physiology Working Group in Peru
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To characterize posttreatment recurrence of Helicobacter pylori in Peru, 192 adults with H. pylori-positive gastric biopsy specimens were monitored by (14)C-Urea breath test, after eradication of H. pylori by use of amoxicillin, clarithromycin, and omeprazole. The cumulative risk of recurrence at 18 months was 30.3% (95% confidence interval, 21.4%-39.3%). Randomly amplified polymorphic DNA patterns and DNA sequence data established that, among 28 pairs of H. pylori isolates from pretreatment and recurrent infections, 6 (21%) were genetically similar, suggesting recrudescence of the previous infection, and 22 (79%) were different, suggesting reinfection with a new strain that differed from that involved in the initial infection. Eating mainly outside of the home was a risk factor for infection with a new strain (adjusted relative risk [RR], 5.07), whereas older age was a protective factor (adjusted RR, 0.20). Although an increase in the anti-H. pylori IgG antibody titer corresponded to recurrence, pretreatment and recurrent infections were similar with respect to quantitative culture colony counts and histologic characteristics, suggesting that neither prior eradication nor the memory immune response measurably alters the risk or burden of recurrent infection. Although eradication with antibiotics was successful, the high rate of reinfection suggests that treatment is unlikely to have a lasting public health effect in this setting. Copyright © 2003 The University of Chicago [ABSTRACT FROM AUTHOR]
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- 2003
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33. No association between Helicobacter pylori and Mycobacterium tuberculosis infections among gastrointestinal clinic attendees in Lima, Peru.
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Torres MA, Passaro DJ, Watanabe J, Parsonnet J, Small P, Miyagui J, Rodriquez C, Astete M, Gilman RH, Torres, M A, Passaro, D J, Watanabe, J, Parsonnet, J, Small, P, Miyagu, J, Rodriquez, C, Astete, M, and Gilman, R H
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- 2003
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34. Risk factors for burns in children: crowding, poverty, and poor maternal education.
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Delgado J, Ramírez-Cardich ME, Gilman RH, Lavarello R, Dahodwala N, Bazán A, Rodríguez V, Cama RI, Tovar M, and Lescano A
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OBJECTIVE: To characterize the presentation of burns in children and risk factors associated with their occurrence in a developing country as a basis for future prevention programs. DESIGN: Case-control study. Setting: Burn unit of the National Institute of Child Health (Instituto Nacional de Salud del Nino) in Lima, Peru. METHODS: A questionnaire was administered to all consenting guardians of children admitted to the burns (cases) and general medicine (controls) units during a period of 14 months. Guardians of patients were questioned regarding etiology of the injury, demographic and socioeconomic data. RESULTS: 740 cases and controls were enrolled. Altogether 77.5% of the cases burns occurred in the patient's home, with 67.8% in the kitchen; 74% were due to scalding. Most involved children younger than 5 years. Lack of water supply (odds ratio (OR) 5.2, 95% confidence interval (CI) 2.1 to 1 2.3), low income (OR 2.8, 95% CI 2.0 to 3.9), and crowding (OR 2.5, 95%CI 1.7 to 3.6) were associated with an increased risk. The presence of a living room (OR 0.6, 95% CI 0.4 to 0.8) and better maternal education (OR 0.6, 95% CI 0.5 to 0.9) were protective factors. CONCLUSIONS: To prevent burns interventions should be directed to low socioeconomic status groups; these interventions should be designed accordingly to local risk factors. [ABSTRACT FROM AUTHOR]
- Published
- 2002
35. Sexually transmitted diseases in a family planning and an antenatal clinic in Peru: limitations of current practices and analysis of the use of potential markers, pH testing, and Whiff testing.
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Thompson DA, Tsai YK, Gilman RH, Vivar A, Calderon M, Thompson, D A, Tsai, Y K, Gilman, R H, Vivar, A, and Calderon, M
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- 2000
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36. Community infection ratio as an indicator for tuberculosis control.
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Madico G, Gilman RH, Checkley W, Cabrera L, Kohlstadt I, Kacena K, Diaz JF, Black R, Madico, G, Gilman, R H, Checkley, W, Cabrera, L, Kohlstadt, I, Kacena, K, Díaz, J F, and Black, R
- Abstract
The epidemiology of tuberculosis remains poorly understood. We investigated the relative importance of within-household and community transmission of infection among children aged 6 months to 14 years living in a Peruvian shanty-town. The prevalence of Mycobacterium tuberculosis exposure among 175 contact children (sharing a household with a person who had confirmed pulmonary tuberculosis) and 382 control children (living in nearby households free of active tuberculosis) was defined as the proportion of children with a positive purified protein derivative (PPD) skin-test. 97 (55%) contact children and 129 (34%) controls were PPD positive. Living in a contact household (odds ratio 1.74, 95% CI 1.11-2.73) and age (1.11, 1.06-1.18) were significant risk factors for PPD positivity. We calculated the community infection ratio (CIR) as the odds ratio of PPD-positive controls to PPD-positive contacts: CIR = [formula: see text] A low CIR therefore suggests mainly household spread of infection, whereas a high value suggests frequent transmission outside the household. The adjusted odds ratio (for age, sex, within-household correlation, and household size) was 0.40 (95% CI 0.26-0.64), compared with values of 0.18-0.37 in studies elsewhere. Currently recommended tuberculosis control strategies are suitable for areas with low CIRs. Different strategies may be needed for areas, such as that we studied, with high values. [ABSTRACT FROM AUTHOR]
- Published
- 1995
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37. Reference values for pulse oximetry at high altitude.
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Gamponia MJ, Babaali H, Yugar F, Gilman RH, Gamponia, M J, Babaali, H, Yugar, F, and Gilman, R H
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Objective: To determine reference values for oxygen saturation (Sao2) in healthy children younger than 5 years living at high altitude.Design: One hundred and sixty eight children were examined for Sao2 at 4018 m during well child visits. Physiological state was also noted during the examination.Results: The mean Sao2 was 87.3% (95% confidence intervals (CI) 86.7%, 87.9%) with a median value of 87.7%. A significant difference was observed in Sao2 between children younger than 1 year compared with older children, although the difference was no longer demonstrable when sleeping children were excluded.Conclusions: This study has provided a reference range of Sao2 values for healthy children under 5 years old so that pulse oximetry may be used as an adjunct in diagnosing acute respiratory infections. Younger children were also shown to have a lower mean Sao2 than older children living at high altitude, which suggests physiological adaptation to high altitude over time. In addition, sleep had a lowering effect on Sao2, although the clinical importance of this remains undetermined. [ABSTRACT FROM AUTHOR]- Published
- 1998
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38. Cytotoxic and anti-infective sesquiterpenes present in Plagiochila disticha (Plagiochilaceae) and Ambrosia peruviana (Asteraceae)
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Aponte JC, Yang H, Vaisberg AJ, Castillo D, Málaga E, Verástegui M, Casson LK, Stivers N, Bates PJ, Rojas R, Fernandez I, Lewis WH, Sarasara C, Sauvain M, Gilman RH, and Hammond GB
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- 2010
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39. Amebic colitis: correlation of proctoscopy before treatment and barium enema after treatment
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Martinez, CR, primary, Gilman, RH, additional, Rabbani, GH, additional, and Koster, F, additional
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- 1982
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40. Species identification after treatment for human taeniasis.
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Jeri C, Gilman RH, Lescano AG, Mayta H, Ramirez ME, Gonzalez AE, Nazerali R, and Garcia HH
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- 2004
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41. Epidemiology of highly endemic multiply antibiotic-resistant shigellosis in children in the Peruvian Amazon [corrected] [published erratum appears in PEDIATRICS 2008 Nov;122(5):1163-4].
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Kosek M, Peñataro Yori P, Pan WK, Paredes Olortegui M, Gilman RH, Perez J, Banda Chavez C, Meza Sanchez G, Burga R, and Hall E
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- 2008
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42. Improved recovery of Mycobacterium tuberculosis from children using the microscopic observation drug susceptibility method.
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Oberhelman RA, Soto-Castellares G, Caviedes L, Castillo ME, Kissinger P, Moore DAJ, Evans C, and Gilman RH
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- 2006
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43. A prospective study of bacillus Calmette-Guérin scar formation and tuberculin skin test reactivity in infants in Lima, Peru.
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Santiago EM, Lawson E, Gillenwater K, Kalangi S, Lescano AG, Du Quella G, Cummings K, Cabrera L, Torres C, and Gilman RH
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- 2003
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44. Microscopic-observation drug-susceptibility assay for the diagnosis of TB.
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Moore DAJ, Evans CAW, Gilman RH, Caviedes L, Coronel J, Vivar A, Sanchez E, Piñedo Y, Saravia JC, Salazar C, Oberhelman R, Hollm-Delgado M, LaChira D, Escombe AR, Friedland JS, Moore, David A J, Evans, Carlton A W, Gilman, Robert H, Caviedes, Luz, and Coronel, Jorge
- Abstract
Background: New diagnostic tools are urgently needed to interrupt the transmission of tuberculosis and multidrug-resistant tuberculosis. Rapid, sensitive detection of tuberculosis and multidrug-resistant tuberculosis in sputum has been demonstrated in proof-of-principle studies of the microscopic-observation drug-susceptibility (MODS) assay, in which broth cultures are examined microscopically to detect characteristic growth.Methods: In an operational setting in Peru, we investigated the performance of the MODS assay for culture and drug-susceptibility testing in three target groups: unselected patients with suspected tuberculosis, prescreened patients at high risk for tuberculosis or multidrug-resistant tuberculosis, and unselected hospitalized patients infected with the human immunodeficiency virus. We compared the MODS assay head-to-head with two reference methods: automated mycobacterial culture and culture on Löwenstein-Jensen medium with the proportion method.Results: Of 3760 sputum samples, 401 (10.7%) yielded cultures positive for Mycobacterium tuberculosis. Sensitivity of detection was 97.8% for MODS culture, 89.0% for automated mycobacterial culture, and 84.0% for Löwenstein-Jensen culture (P<0.001); the median time to culture positivity was 7 days, 13 days, and 26 days, respectively (P<0.001), and the median time to the results of susceptibility tests was 7 days, 22 days, and 68 days, respectively. The incremental benefit of a second MODS culture was minimal, particularly in patients at high risk for tuberculosis or multidrug-resistant tuberculosis. Agreement between MODS and the reference standard for susceptibility was 100% for rifampin, 97% for isoniazid, 99% for rifampin and isoniazid (combined results for multidrug resistance), 95% for ethambutol, and 92% for streptomycin (kappa values, 1.0, 0.89, 0.93, 0.71, and 0.72, respectively).Conclusions: A single MODS culture of a sputum sample offers more rapid and sensitive detection of tuberculosis and multidrug-resistant tuberculosis than the existing gold-standard methods used. [ABSTRACT FROM AUTHOR]- Published
- 2006
45. A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis.
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Garcia HH, Pretell EJ, Gilman RH, Martinez SM, Moulton LH, Del Brutto OH, Herrera G, Evans CAW, Gonzalez AE, and Cysticercosis Working Group in Peru
- Published
- 2004
46. Diagnosis of sputum-scarce HIV-associated pulmonary tuberculosis in Lima, Peru.
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Vargas D, García L, Gilman RH, Evans C, Ticona E, Ñavincopa M, Luo RF, Caviedes L, Hong C, Escombe R, Moore DAJ, Vargas, Daniel, García, Luis, Gilman, Robert H, Evans, Carlton, Ticona, Eduardo, Navincopa, Marcos, Luo, Robert F, Caviedes, Luz, and Hong, Clemens
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Sputum induction, bronchoalveolar lavage, or gastric aspiration are often needed to produce adequate diagnostic respiratory samples from people with HIV in whom tuberculosis is suspected. Since these procedures are rarely appropriate in less-developed countries, we compared the performances of a simple string test and the gold-standard sputum induction. 160 HIV-positive adults under investigation for tuberculosis, and 52 asymptomatic HIV-positive control patients underwent the string test followed by sputum induction. The string test detected tuberculosis in 14 patients in whom this disease was suspected; sputum induction detected only eight of them (McNemar's test, p=0.03). These preliminary data suggest that the string test is safe and effective for retrieval of useful clinical specimens for diagnosis of pulmonary tuberculosis, and is at least as sensitive as sputum induction. [ABSTRACT FROM AUTHOR]
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- 2005
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47. Links between sex-related expectations about alcohol, heavy episodic drinking and sexual risk among young men in a shantytown in Lima, Peru.
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Gálvez-Buccollini JA, Paz-Soldan V, Herrera P, DeLea S, Gilman RH, and Anthony JC
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CONTEXT: Alcohol use is frequently identified as a contributor to risky sexual behaviors; however, research results are mixed. Given the conflicting evidence, researchers have focused on other factors, such as expectations about alcohol's effects that might help explain the relationship of alcohol use and risky sexual behaviors. METHODS: Cross-sectional data from 312 sexually experienced males aged 18-30 in a shanty town in Lima, Peru, were used in logistic regression models to identify associations of heavy episodic drinking and sex-related expectations about alcohol with sexual risk behaviors. RESULTS: Heavy episodic drinking was associated with having had two or more sexual partners and having had sex with a casual partner in the past year (odds ratios, 2.8 and 2.5, respectively). After controlling for alcohol consumption, sex-related expectations about alcohol were associated with these high-risk sexual behaviors,as well as with not using a condom at last sex (1.2) and not using a condom at last sex with a casual partner (1.3). CONCLUSION: Beliefs about the effect of alcohol on sexual performance could help explain links between alcohol consumption and risky sexual behavior not completely accounted for by the pharmacological effects of alcohol. International Family Planning Perspectives, 2008, 34(1):15-20 [ABSTRACT FROM AUTHOR]
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- 2008
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48. Taenia solium cysticercosis.
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García HH, Gonzalez AE, Evans CAW, Gilman RH, Cysticercosis Working Group in Peru, García, Héctor H, Gonzalez, Armando E, Evans, Carlton A W, and Gilman, Robert H
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The larval stage of the pork tapeworm (Taenia solium) infects the human nervous system, causing neurocysticercosis. This disease is one of the main causes of epileptic seizures in many less developed countries and is also increasingly seen in more developed countries because of immigration from endemic areas. Little information is available on the natural evolution of taeniasis or cysticercosis. Available therapeutic measures include steroids, treatments for symptoms, surgery, and, more controversially, antiparasitic drugs to kill brain parasites. Efforts to control and eliminate this disease are underway through antiparasitic treatment of endemic populations, development of pig vaccines, and other measures. [ABSTRACT FROM AUTHOR]
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- 2003
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49. Gender differences in sex-related alcohol expectancies in young adults from a peri-urban area in Lima, Peru.
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Gálvez-Buccollini JA, Paz-Soldán VA, Herrera PM, DeLea S, and Gilman RH
- Abstract
OBJECTIVES: To estimate the effect of sex-related alcohol expectancies (SRAE) on hazardous drinking prevalence and examine gender differences in reporting SRAE. METHODS: Trained research assistants administered part of a questionnaire to 393 men and 400 women between 18 and 30 years old from a peri-urban shantytown in Lima, Peru. The remaining questions were self-administered. Two measuring instruments-one testing for hazardous drinking and one for SRAE-were used. Multivariate data analysis was performed using logistic regression. RESULTS: Based on odds ratios adjusted for socio-demographic variables (age, marital status, education, and employment status) (n = 793), men with one or two SRAE and men with three or more SRAE were 2.3 (95% confidence interval (CI) = 1.4-3.8; p = 0.001) and 3.9 (95% CI = 2.1-7.3; p < 0.001) times more likely than men with no SRAE, respectively, to be hazardous drinkers. Reporting of SRAE was significantly higher in men versus women. CONCLUSION: In a shantytown in Lima, SRAE is associated with hazardous drinking among men, but not among women, and reporting of SRAE differs by gender. [ABSTRACT FROM AUTHOR]
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- 2009
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50. Analysis of nucleotide diversity of NAT2 coding region reveals homogeneity across Native American populations and high intra-population diversity
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Damian Labuda, G. F. De Stefano, Robert H. Gilman, Eduardo Tarazona-Santos, Antti Sajantila, Gustavo Adolfo Vallejo, Silvia Fuselli, Stephen J. Chanock, Sandro L. Bonatto, Carlton A. Evans, Davide Pettener, Donata Luiselli, Giselle Soto, Francisco M. Salzano, Fuselli S, Gilman RH, Chanock SJ, Bonatto SL, De Stefano G, Evans CA, Labuda D, Luiselli D, Salzano FM, Soto G, Vallejo G, Sajantila A, Pettener D, and Tarazona-Santos E.
- Subjects
single nucleotide ,haplotype ,haplotypes ,sequence analysis ,acetylator phenotype ,Native American ,Latin-American populations ,drug-metabolizing enzyme ,admixture ,genotype ,population ,arylamine N-acetyltransferase ,Nucleotide diversity ,polymorphism ,arylamine acetyltransferase ,American Indian ,article ,gene locus ,gene sequence ,genetic isolation by distance ,genetic variability ,geographical variation (species) ,human ,nucleotide sequence ,pharmacogenetics ,phenotype ,population genetics ,priority journal ,promoter region ,russian federation ,western hemisphere ,acetylation ,americas ,DNA mutational analysis ,evolution, molecular ,gene frequency ,genetics, population ,humans ,Indians, North American ,mutation ,open reading frames ,polymorphism, single nucleotide ,0302 clinical medicine ,Indians ,Genotype ,Coding region ,genetics ,Genetics ,0303 health sciences ,Settore BIO/14 ,3. Good health ,030220 oncology & carcinogenesis ,Molecular Medicine ,North American ,Biology ,Polymorphism, Single Nucleotide ,Evolution, Molecular ,03 medical and health sciences ,Genetic variation ,evolution ,molecular ,Allele frequency ,030304 developmental biology ,Pharmacology ,Genetic diversity ,Haplotype ,Genetic Variation ,Siberia ,Genetics, Population ,Pharmacogenetics - Abstract
N-acetyltransferase 2 (NAT2), an important enzyme in clinical pharmacology, metabolizes antibiotics such as isoniazid and sulfamethoxazole, and catalyzes the transformation of aromatic and heterocyclic amines from the environment and diet into carcinogenic intermediates. Polymorphisms in NAT2 account for variability in the acetylator phenotype and the pharmacokinetics of metabolized drugs. Native Americans, settled in rural areas and large cities of Latin America, are under-represented in pharmacogenetics studies; therefore, we sequenced the coding region of NAT2 in 456 chromosomes from 13 populations from the Americas, and two from Siberia, detecting nine substitutions and 11 haplotypes. Variants *4 (37%), *5B (23%) and *7B (24%) showed high frequencies. Average frequencies of fast, intermediate and slow acetylators across Native Americans were 18, 56 and 25%, respectively. NAT2 intra-population genetic diversity for Native Americans is higher than East Asians and similar to the rest of the world, and NAT2 variants are homogeneously distributed across native populations of the continent.
- Published
- 2007
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