BackgroundTuberculosis (TB) is a major public health problem. The Airin district of Osaka City has a large population of homeless persons and caregivers and is estimated to be the largest TB-endemic area in the intermediate-prevalence country, Japan. However, there have been few studies of homeless persons and caregivers. The objective of this study is to detect active TB and to assess the prevalence and risk factors for latent TB infection among homeless persons and caregivers.MethodsWe conducted a cross-sectional study for screening TB infection (active and latent TB infections) using questionnaire, chest X-ray (CXR), newly available assay for latent TB infection (QuantiFERON-TB Gold In-Tube; QFT) and clinical evaluation by physicians at the Osaka Socio-Medical Center Hospital between July 2007 and March 2008. Homeless persons and caregivers, aged 30-74 years old, who had not received CXR examination within one year, were recruited. As for risk factors of latent TB infection, the odds ratios (OR) and 95% confidence intervals (95% CI) for QFT-positivity were calculated using logistic regression model.ResultsComplete responses were available from 436 individuals (263 homeless persons and 173 caregivers). Four active TB cases (1.5%) among homeless persons were found, while there were no cases among caregivers. Out of these four, three had positive QFT results. One hundred and thirty-three (50.6%) homeless persons and 42 (24.3%) caregivers had positive QFT results. In multivariate analysis, QFT-positivity was independently associated with a long time spent in the Airin district: ≥10 years versus <10 years for homeless (OR = 2.53; 95% CI, 1.39-4.61) and for caregivers (OR = 2.32; 95% CI, 1.05-5.13), and the past exposure to TB patients for caregivers (OR = 3.21; 95% CI, 1.30-7.91) but not for homeless persons (OR = 1.51; 95% CI, 0.71-3.21).ConclusionsAlthough no active TB was found for caregivers, one-quarter of them had latent TB infection. In addition to homeless persons, caregivers need examinations for latent TB infection as well as active TB and careful follow-up, especially when they have spent a long time in a TB-endemic area and/or have been exposed to TB patients.

No abstract

No abstract

Objective: Using a thrombus model prepared by ligation of the inferior vena cava (IVC), the influences of the glycoside, glycyrrhizin, on plasma antithrombin levels and antithrombin mRNA expression levels in the liver and IVC with the inhibition of venous thrombosis were investigated. Materials and Methods: The rat IVC was exposed and ligated for 24 h immediately after the intravenous administration of 300 mg/kg glycyrrhizin. Among antithrombotic drugs, the Xa inhibitor, fondaparinux sodium, was used as a control drug. Results: The mean thrombus weight was significantly smaller in the glycyrrhizin-treated group (18.3 mg) than in the salinetreated group (34.3 mg). In contrast, the inhibition of thrombosis was not observed in the fondaparinux-treated group. Antithrombin mRNA expression levels in the liver were significantly higher in the ligated groups than in the baseline control group. The mean plasma antithrombin level was significantly lower in the glycyrrhizin group (96.6%) than in the saline group (114.4%), but was not significantly different from that in the baseline control group (102.4%). Conclusion:The pretreatment with glycyrrhizin inhibited venous thrombosis, and antithrombin mRNA expression levels in the liver and IVC as well as plasma antithrombin levels were significantly lower than those in the saline group.Keywords: glycyrrhizin, antithrombin, DVT targets being thrombin, factor Xa, and factor IXa. A sequence-specific pentasaccharide present in only a fraction of heparin molecules mediates the high-affinity binding and anticoagulant activation of antithrombin by this polysaccharide. 1) Antithrombin has lysine binding sites to which heparin binds at a molar ratio of 1:1. The half-life of thrombin is reduced to 20 ms in the presence of a high concentration of heparin, which is an approximately 2000-fold acceleration of this reaction. 2) Griffith previously identified thrombin-heparin binding as the most important factor for efficient thrombin inhibition by antithrombin. 3) P-and E-selectins have been known to mediate the linkage of endothelial cells to neutrophils through the binding to sialyl-Lewis X glycoproteins, which are expressed on the surface of neutrophils. 4,5) Neutrophils adherent to the endothelium also undergo transendothelial migration, leading to endothelial cell sloughing and exposure of the underlying basement membrane to the accelerated formation of deep vein thrombosis (DVT). 6) Glycyrrhizin, which is a natural triterpenoid saponin with a molecular mass of 840 Daltons, has been approved for useful drug for the treatment of allergic disorders and chronic hepatitis in Japan. We previously showed that glycyrrhizin was effective on the prevention of the tissue damage caused by ischemia-reperfusion in the rabbit hind limb. 7) were the first to demonstrate that glycyrrhizin exhibits antithrombotic activity in vivo and, it has, thus, been characterized as a potential thrombin inhibitor. Assafim et al. 9) showed that glycyrrhizin was effective in preventing venom-induced thrombus formati...

No abstract