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Background People coinfected with tuberculosis (TB) and human immunodeficiency virus (HIV) are 20–37 times more likely to develop active TB disease than non-HIV-infected people. Syndemic interaction between HIV and TB epidemics has made testing for TB a must for HIV-infected people and vice versa. We present the case of a young male diagnosed with HIV infection, due to mandatory HIV testing for all TB cases in Romania. Case presentation A 30-year-old man was hospitalized for fever, chills and productive cough not influenced by previous antibiotic home treatment. He was admitted with tachycardia and bilateral presence of coarse crackles in lower pulmonary areas. Chest X-ray suggested bilateral bronchopneumonia; the results from blood tests showed inflammation, leukocytosis and anaemia. Hemocultures were negative. Under wide-spectrum antibiotic treatment, his general condition partially improved, but on the seventh day, chest X-ray revealed abscess in the left inferior lobe and the progression of previous lesions. Chest computed tomography revealed multiple large consolidation areas in both lung areas, a 13 cm diameter abscess and multiple mediastinal adenopathy of 2–4 cm in diameter. Acid fast bacilli smear from sputum was positive. After the diagnosis of pulmonary TB, anti-TB treatment was started; the patient was subsequently diagnosed with HIV infection. He received specific anti-TB treatment, and 3 weeks later, retroviral treatment was initiated. Clinical evolution was favourable and radiological appearance improved. In addition, he did not present any adverse effects of therapy. Conclusions HIV testing for all TB cases is a must because HIV-TB coinfection raises important diagnostic and treatment problems.

Background Tuberculosis (TB) remains a major public health problem in Romania, which has the highest TB incidence in the European Union. Methods We undertook a retrospective study to describe changing trends in the main epidemiological indicators of TB in Romania from 1995 to 2016. Data were obtained from the Marius Nasta Institute of Pneumology, Bucharest, official data published by the National Center for Public Health Statistics and Informatics in Health Statistics Yearbooks, the European Health For All database and the World Health Organization 2017 global TB report. Results Overall TB notifications in Romania declined after 2002, from 142.2 to 74/100 000 in 2016. For new TB cases, the incidence declined after 2002, from 118.9 to 54.5/100 000 in 2016. After peaking in 2002, at 23.3/100 000, the notification rate of relapses declined to 11.8/100 000 in 2014, but almost doubled the following year. The number of multidrug-resistant TB cases decreased from 624 in 2009 to 530 in 2012, but then increased to 670 in 2015. The number of extensively drug-resistant TB cases tripled between 2012 and 2015, from 22 to 68 cases. Conclusion Although the decline in TB nationwide after 2002 confirms the effectiveness of control measures, the current TB burden in Romania remains very high by European standards.

Contains fulltext : 202938.pdf (Publisher’s version ) (Closed access) BACKGROUND: Diabetes mellitus (DM) is common among tuberculosis (TB) patients and often undiagnosed or poorly controlled. We compared point of care (POC) with laboratory glycated haemoglobin (HbA1c) testing among newly diagnosed TB patients to assess POC test accuracy, safety and acceptability in settings in which immediate access to DM services may be difficult. METHODS: We measured POC and accredited laboratory HbA1c (using high-performance liquid chromatography) in 1942 TB patients aged 18 years recruited from Peru, Romania, Indonesia and South Africa. We calculated overall agreement and individual variation (mean +/- 2 standard deviations) stratified by country, age, sex, body mass index (BMI), HbA1c level and comorbidities (anaemia, human immunodeficiency virus [HIV]). We used an error grid approach to identify disagreement that could raise significant concerns. RESULTS: Overall mean POC HbA1c values were modestly higher than laboratory HbA1c levels by 0.1% units (95%CI 0.1-0.2); however, there was a substantial discrepancy for those with severe anaemia (1.1% HbA1c, 95%CI 0.7-1.5). For 89.6% of 1942 patients, both values indicated the same DM status (no DM, HbA1c

Background People with diabetes have an increased risk of developing active tuberculosis (TB) and are more likely to have poor TB-treatment outcomes, which may impact on control of TB as the prevalence of diabetes is increasing worldwide. Blood transcriptomes are altered in patients with active TB relative to healthy individuals. The effects of diabetes and intermediate hyperglycemia (IH) on this transcriptomic signature were investigated to enhance understanding of immunological susceptibility in diabetes-TB comorbidity. Methods Whole blood samples were collected from active TB patients with diabetes (glycated hemoglobin [HbA1c] ≥6.5%) or IH (HbA1c = 5.7% to, Our study shows that people with diabetes and tuberculosis have altered peripheral immune profiles compared to people with only tuberculosis, and that these differences also exist in patients with intermediate hyperglycemia.

Additional file 1. Patient Information Leaflet.pdf on HIV testing for TB patients, distributed in the TB clinic in Romania.

The apparent faecal digestibility of the essential amino acids from Ω3 PUFA layer diets and feeding solutions to avoid possible adverse effects of such diets were investigated in two experiments conducted on Lohmann Brown laying hens. Experiment 1 used 72 layers assigned to three groups (C1, E1-1, E2), while experiment 2 used 96 layers assigned to four groups (C2, E1-2, E3, E4). All experimental diets have been enriched in Ω 3 PUFA by supplementing a conventional diet (C1, C2) with 5% flaxseed meal and 2% camelina meal. Diets E2 and E4 had an increased level of Cu (150 mg/kg), diets E3 and E4 were supplemented with 0.0125% enzyme mix, while diets E1-1 and E1-2 were only supplemented with 5% flaxseed meal and 2% camelina meal. The digestibility coefficients of the studied essential amino acids (threonine, valine, phenylalanine, isoleucine, leucine, lysine, cystine, methionine) were lower (p≤0.05) in groups E1-1 and E2 from experiment 1, than in the control group (C1). In experiment 2, the supplemental enzyme mix (E3) increased (p≤0.05) the digestibility coefficients of phenylalanine, lysine, cystine and methionine, compared to the diet with camelina and flaxseed meals (E1-2). The simultaneous inclusion of copper and enzyme mix in the E4 diet increased (p≤0.05) lysine digestibility compared to group E1-2 and sulphur amino acids digestibility, compared to the other groups (C2, E1-2 and E3). In both experiments, only the feed conversion ratio was different (p≤0.05) in favour of the control groups (C1 and C2), compared to the other groups.

Introduction: Tuberculosis (TB) is the commonest and the deadliest opportunistic infection in patients living with HIV/ AIDS. Purpose: The paper aims to assess patients with and without TB-HIV coinfection in Dolj county registered in Regional and National database in order to identify risk factors for progression to active TB for immunodepresive patients. Material and method: We performed a retrospective descriptive study using records of 336 patients infected with HIV (PIH)-data from medical charts between 2005-2015 and we compared with the data for 1120 patients without HIV between 2005-2012. Results: 64,1% were females and 35,89% were males. Most cases were from rural areas (61,54%) most of them graduating primary (17,94%) and secondary school (48,71%). Most of them don’t have a job (87%) and are supported by state with a monthly miminum income. Majority is born between 1980-1990 (64,1%), with predominance of Romanians (92.31%) compared to the Roma. Regarding all TB diagnoses (pulmonary and extrapulmonary) 117 had at least one episode of active TB. TB and HIV have been diagnosed almost at the same time in 25,64% cases. At the time of TB diagnosis 87% of patients had CD4+lymphocytes count

The present study aimed to investigate the effect of Artemisia (Artemisia annua) supplementation as essential oil and powder, in broiler diet on performance and intestinal microflora. One hundred and eighty Cobb 500 broiler chicks assigned to three experimental groups (six replicates with 10 broilers per replicate) were housed in an environment-controlled house. Compared to the control diet, the experimental diets included 0.05 g kg-1 Artemisia essential oil (E1), 0.05 g kg-1 essential oil plus 0.1 g kg-1 powder of Artemisia (E2), respectively. Growth performance was monitored throughout days 14-42. Artemisia supplementation (E1, E2) did not influence growth performance of the chicks. Compared to the C and E1, the chicks from E2 group had a lower count of Enterobacteriaceae in the intestinal and caecal content, both at 35 and at 42 days. The Artemisia supplements did not influence the staphylococci populations from the intestinal content of the chicks (42 days), but in the caecal content samples, this count was lower in E2 (8.836 log10 cfu g-1) than in C (8.876 log10 cfu g-1) and E1 (8.870 log10 cfu g-1). The count of lactobacilli increased in the intestinal and caecal contents of chickens fed the diet supplemented with Artemisia at the 35th and 42nd day. Diet supplementation with A. annua essential oil and powder could be an effective solution in maintaining the proper microflora balance in the chicks’ intestine.

The 7-week feeding trial evaluated the effect of 2% grapeseed meal used as natural antioxidant in the diets for slow-growing Hubbard broiler chicks, aged 14 days. The chicks were weighed individually and assigned to two groups (C and E), with 40 chicks per group, housed under conditions of temperature, humidity and light regimen according to the hybrid management guide. The basal ingredients of the conventional diet were corn, wheat, gluten, soybean meal and 2% flaxseed meal, which is rich in polyunsaturated fatty acids. Compared to the control formulation, the experimental formulation included 2% grapeseed meal, both in the growing and finishing stages. The broilers had free access to feed and water. In the end of the feeding trial, blood samples were collected for serum biochemical determinations and six broilers per group were slaughtered and samples of breast and thigh meat were collected. The meat samples were assayed for the basic chemical composition, fatty acids profile and cholesterol content using standardized methods. The content of total polyunsaturated fatty acids (PUFAs) was significantly higher (p

The 21 days feeding trial was conducted on 90, Cobb 500 broilers (aged 14 days), assigned to 3 groups (C, E1 and E2) housed in an experimental hall at 32° C constant temperature and 23 h light regimen. During the growth period (14-35 days), the conventional diet (C) had corn and soybean meal as basic ingredients. Unlike the conventional diet formulation (C), the diet formulations for the experimental groups also included 0.005% Artemisia annua oil (E1) and 0.005% Artemisia annua oil plus 1% Artemisia annua powder (E2). Six broilers per group were slaughtered at 35 days of age in order to measure the weight of the carcass and internal organs of broilers, and samples of intestinal and caecal content were collected for bacteriological assessment (Enterobacteriaceae, E. coli, staphylococci, Lactobacilli, Salmonella spp.).The following parameters were monitored during the experimental period: bodyweight (g); average daily feed intake (g feed/broiler/day); average daily weight gain (g/broiler/day); feed conversion ratio (g feed/g gain). Under heat stress (32 ºC), E2 broilers (mixture of A. annua oil and powder) had a significantly (p

International audience; El algoritmo de auto-organización (Self-Organizing Map, SOM), o Mapa de Kohonen, es un algoritmo muypopular, definido por Teuvo Kohonen al principio de los anõs 80. El actúa como un algoritmo de clasificación(clustering) no supervisado y almismo tiempo como una herramienta potente de visualización. El es ampliamenteusado para aplicaciones en muchos campos, tales como economía, industría, gestión, sociología,geografía, análisis de textos, etc. Muchas variantes han sido definidas para adaptar SOM al estudio de datoscomplejos, tales como series temporales, datos de categoría, datos nominales, datos de disimilaridades. Sinembargo, la convergencia y la estabilidad del algoritmo SOM no tienen pruebas rigurosas y completas hastaahora. Este papel presenta el estado-del-arte de los aspectos teoréticos de SOM, al mismo tiempo que algunasextensiones para datos no numéricos y ejemplos típicos de diferentes campos con datos reales.; The Self-Organizing Maps (SOM) is a very popular algorithm, introduced by Teuvo Kohonen in the early80s. It acts as a non supervised clustering algorithm as well as a powerful visualization tool. It is widelyused in many application domains, such as economy, industry, management, sociology, geography, textmining, etc. Many variants have been defined to adapt SOM to the processing of complex data, such astime series, categorical data, nominal data, dissimilarity or kernel data. However, so far, SOMhas sufferedfroma lack of rigorous results on its convergence and stability. This article presents the state-of-art on thetheoretical aspects of SOM, as well as several extensions to non numerical data and provides some typicalexamples of applications in different real-world fields.

The 4-week study was conducted with 180 Lohmann Brown layers (52 weeks of age). The layers were assigned to three groups (C, E1 and E2). The basal diet (group C) consisted mainly of corn, soybean meal and corn gluten, and contained 19% crude protein and 11.58 MJ/kg metabolizable energy. The diets for groups E1 and E2 differed from group C by the inclusion of 5% flax meal and of dietary antioxidants. The concentration of α-linolenic acid in the fat of E1 and E2 diets was almost 10 times higher than in group C. E1 diet was supplemented with vitamin E (100 mg/kg feed, DM), while E2 diet was supplemented with 2% grape seed meal (polyphenols: 630.890 µg gallic acid equivalents/g sample; flavonoids: 5.065 µg rutin equivalents/g sample; antioxidant capacity: 28.468 mM trolox equivalents/g sample). The antioxidant capacity of E2 was higher than in C, but lower than in E1. Haugh units of the eggs (18 eggs/group) harvested during the last experimental week were not significantly different among groups. The ω-6/ω-3 polyunsaturated fatty acids (PUFAs) ratio in the fat from the eggs was 4.46 ± 0.11 (E1) and 4.52 ± 0.21 (E2), three times lower (p

Introduction: Mutiple mieloma (MM) cells are rarely found in extramedullary sites. The sites of extramedullary dissemination reported in the literature are spleen, liver, lymph nodes, kidneys, thyroid gland, adrenal gland, ovary, tests, lung, pleura, pericardium, intestinal tract and skin. We report a case in which the myeloma was diagnosed after we discovered the presence of monoclonal plasma cells in the bronchoalveolar lavage fluid (BAL). Matherial and method: a case in which diagnosis was established from bronchoalveolar lavage (BAL) fluid demonstrating the presence of monoclonal plasma cells in Craiova Pneumology Departament. Results: Analysis of BAL fluid for the presence of plasma cells and for cytoplasmic immunoglobulin DNA provides a noninvasive means of establishing the diagnosis. Conclusions: Pulmonary parenchyma is an uncommon site of extramedullary involvement in multiple myeloma. Interstitial lung disease as pulmonary manifestation of multiple myeloma is even rarer; only isolated cases with histological proofs have been reported in the literature.