Background: Stress-Related Exhaustion (SE) has increased in the last 10 years. Examination is key for good care, but research on body examinations for SE is lacking. Clinically, autonomic stress response with affected respiratory patterns can be observed in SE.  Global Body Examination (GBE) can be used to evaluate autonomic stress responses. GBE has a respiratory domain (rGBE) that has been tested for validity, but not for its intra-rater reliability. Moreover, its’ association with SE symptom severity is unknown. Aim: To examine intra-rater reliability of rGBE in SE, and concurrent validity between rGBE and symptom severity in SE, measured with the self-reported outcome measure Shirom-Melamed Burnout Questionnaire (SMBQ). Method: Test-retest and cross-sectional design was used in the study, with a sample of convenience. Intra-rater reliability was analyzed with ICC, standard error of measurement (SEM) and agreement through a Bland-Altman plot. Spearman’s rho was used to analyze correlation between SMBQ and rGBE. Result: Sample size was 25. Intra-rater reliability was very high (ICC: 0.94, 95% CI: 0.86-0.97, p<0.01). Bland-Altman plot revealed no systematic errors. Mean of rGBE: 7.51 (SD2.14) with SEM: 0.56. Correlation between rGBE and SMBQ was low, Spearman’s rho=0.48,95% CI: 0.09-0.74, p=0,02, with 22% shared variance. Conclusion: rGBE shows good intra-rater reliability and seems suitable for examining SE symptoms. However, its use in diagnostic and to determinate symptom severity in SE remains uncertain due to the wide CI. Beyond SE, rGBE might be useful for other disorders affecting the autonomic balance, as well as diseases that affect respiration. / Bakgrund: Utmattningssyndrom har ökat i samhället de senaste 10 åren. Undersökning är viktig för god rehabilitering men forskning gällande kroppsundersökningar saknas på utmattningssyndrom. Kliniskt har bland annat påverkat respirationsmönster observerats, som ett kroppsligt uttryck på autonom uppvarvning. Global Body Examination (GBE) är en undersökningsmetod som kartlägger autonom uppvarvning. GBE har en respirationsdomän (rGBE) som har testats för validitet, men inte för intrabedömarreliabilitet. Om ett samband föreligger mellan rGBE och besvärsgrad vid utmattningssyndrom är också okänt. Syfte: Att undersöka intrabedömarreliabilitet hos rGBE, samt den samtidiga validiteten mellan rGBE och självskattad besvärsgrad enligt Shirom-Melamed Burnout Questionnaire (SMBQ) hos individer med utmattningssyndrom. Metod: Test-retestdesign och tvärsnittsdesign användes i studien. Bekvämlighetsurval utfördes. Intrabedömarreliabilitet analyserades med ICC, standardmätfel och överenstämmelse via en Bland-Altman analys. Korrelationen mellan rGBE och SMBQ analyserades med Spearman’s rho. Resultat: Deltagarantalet blev 25. Intrabedömarreliabiliteten var mycket hög; ICC=0.94, 95% konfidensintervall 0.86-0.97, p<0.01. Bland-Altman analys visade inga systematiska mätfel. Medelvärde av rGBE blev 7.51 (SD 2.14) med standardmätfel på 0.56. Sambandet mellan rGBE och SMBQ var lågt; Spearmans's rho=0.48, 95% konfidensintervall 0.09-0.74, p=0.02. Samvariationen blev 22%. Slutsats: rGBE visar god intrabedömarreliabilitet och kan vara en lämplig undersökningsmetod för att observera utmattningssymtom. Inga säkra slutsatser kan dras gällande rGBEs användbarhet vid diagnostik eller besvärsgradering av utmattningssyndrom då konfidensintervallet blev brett. Utöver utmattningssyndrom kan rGBE troligen vara användbar vid besvär som påverkar den autonoma balansen, såväl som besvär som påverkar respirationen.

Background: Parametrial tumor involvement is an important prognostic factor in cervical cancer and is used to guide management. Here, we investigate the diagnostic value of clinical examination under general anesthesia (EUA) and magnetic resonance imaging (MRI) in determining parametrial tumor spread. Methods: Post-operative pathological findings of 400 patients with primary cervical cancer were compared to the respective MRI data and the results from EUA. The gynecological oncologist had access to the MR images during clinical assessment (augmented EUA, aEUA). Results: Pathologically proven parametrial tumor invasion was present in 165 (41%) patients. aEUA exhibited a higher accuracy than MRI alone (83% vs. 76%; McNemar’s odds ratio [OR] = 2.0, 95%CI 1.25–3.27, p = 0.003). Although accuracy was not affected by tumor size in aEUA, MRI was associated with a lower accuracy in tumors ≥2.5 cm (OR for a correct diagnosis compared to smaller tumors 0.22, p < 0.001). There was also a decrease in specificity when evaluating parametrial invasion by MRI in tumors ≥2.5 cm in diameter (p < 0.0001) compared to smaller tumors (< 2.5 cm). Body mass index had no influence on performance of either method. Conclusions: aEUA has the potential to increase the diagnostic accuracy of MRI in determining parametrial tumor involvement in cervical cancer patients.

No description available.

Commercial and homemade diets are currently used to treat many canine patients with acquired disorders of the colon. Clinically, the efficacy of diets has been found to be unpredictable. Only one study to date has evaluated the effect of diet on the colonic mucosa. This study showed that diet did not observably alter the colonic mucosa of normal dogs, when biopsy samples were evaluated by light microscopy. The effect of diet on colonic ultrastructure in the dog, using transmission electron microscopy, has not previously been investigated. To determine the effect of diet on colonic ultrastructure, cell height, cell area, microvillus height, number of microvilli/apex width and basement membrane width were measured. Ten cells per animal were evaluated. Six dogs were assigned to the control group and fed the control diet for the duration of the study. Six dogs were fed each of the three test diets at four week intervals. The test diets used included a high fiber diet, a hypoallergenic diet and a highly digestible diet. These diets were selected because they are the diets most often recommended for the canine patient with colonic disorders. The value for cell height for the highly digestible group was significantly greater than the other groups, as measured by ANOV A and Duncan's multiple comparison test. No other significant differences were found. The biological relevance of a significantly different value for cell height alone is difficult to evaluate, as other parameters that would indicate an alteration in maturation or proliferation of the colonic epithelial cells did not change. value for cell height alone is difficult to evaluate, as other parameters that would indicate an alteration in maturation or proliferation of the colonic epithelial cells did not change. Therefore, we conclude that commercial diets do not have an effect on the colonic ultrastructure of normal dogs. Although no effect of diet was found, this study does provide morphologic measurements that can be used as a basis for future ultrastructural studies of the colonic mucosa. / Master of Science

Die proximale Tibiafraktur stellt eine seltene Fraktur der langen Röhrenknochen im Wachstumsalter dar, welche sich in mehrere Frakturtypen aufteilt. Diese werden zu typischen Altersgipfeln durch typische Unfallmechanismen verursacht. Eine nicht adäquate Therapie dieser Frakturen kann aufgrund des fehlgeleiteten Knochenwachstums zu Beinachsenabweichungen, Beinlängendifferenzen und funktionellen Einschränkungen des Kniegelenks führen. Ziel dieser Studie ist die Therapie und Nachsorge der Patient:innen, die in der Klinik und Poliklinik für Kinderchirurgie des Universitätsklinikums Dresden stattfand, zu bewerten. Dabei wurden die Patient:innen zu einer klinischen Nachuntersuchung und zur Beurteilung des Wohlbefindens eingeladen.:1. EINLEITUNG 1.1 DIE PROXIMALE TIBIAFRAKTUR IM KINDESALTER 1.1.1 Definition und Epidemiologie 1.2 Ätiologie und Klassifikation 1.1.2.1 Ausriss der Eminentia intercondylaris 1.1.2.2 Apophysenausriss der proximalen Tibia 1.1.2.3 Metaphysäre Frakturen der proximalen Tibia 1.1.3 Diagnostik 1.1.3.1 Ausriss der Eminentia intercondylaris 1.1.3.2 Apophysenausriss der proximalen Tibia 1.1.3.3 Metaphysäre Frakturen der proximalen Tibia 1.1.4 Therapie 1.1.4.1 Ausriss der Eminentia intercondylaris 1.1.4.2 Apophysenausriss der proximalen Tibia 1.1.4.3 Metaphysäre Frakturen der proximalen Tibia 1.1.5 Komplikationen und Folgeschäden 1.1.5.1 Ausriss der Eminentia intercondylaris 1.1.5.2 Apophysenausriss der proximalen Tibia 1.1.5.3 Metaphysäre Frakturen der proximalen Tibia 2. FRAGESTELLUNG 3. PATIENT:INNEN UND METHODEN 3.1 PATIENT:INNENGRUPPEN UND VERGLEICHSPOPULATION 3.2 DATENERHEBUNG 3.2.1 Klinische Untersuchung 3.2.1.1 Körpermaße, numerische Schmerzskala, Gangbild 3.2.1.2 Beinlängenmessung und Rotationsfehler 3.2.1.3 Beweglichkeit, Kraftprüfung 3.2.1.4 Interkondylärer und intermalleolärer Abstand 3.2.1.5 Tibiofemoraler Winkel 3.2.2 Fragebögen 3.2.2.1 Pedi-IKDC 3.2.2.2 PODCI 3.3 STATISTISCHE AUSWERTUNG 4. ERGEBNISSE 4.1 EPIDEMIOLOGISCHE DATEN 4.1.1 Alter und Geschlecht 4.1.2 Links-Rechts Verteilung 4.1.3 Frakturklassifikation 4.2 ALTERS-, GESCHLECHTER- UND FRAKTURSEITENVERTEILUNG DER SUBGRUPPEN 4.2.1 Alters- und Geschlechterverteilung der E-Gruppe 4.2.2 Alters- und Geschlechterverteilung der TU-Gruppe 4.2.3 Alters- und Geschlechterverteilung der T-Gruppe 4.3 UNFALLMECHANISMEN 4.3.1 Unfallmechanismen der E-Gruppe 4.3.2 Unfallmechanismen der TU-Gruppe 4.3.3 Unfallmechanismen der T-Gruppe 4.4 MEDIZINISCHE VERSORGUNG 4.5 ERGEBNISSE DER NACHUNTERSUCHUNG 4.5.1 Teilnahme an der Nachuntersuchung 4.6 ERGEBNISSE DER KLINISCHEN UNTERSUCHUNG 4.6.1 Schwellung und Schmerzen 4.6.2 BMI 4.6.3 Längenunterschied und Rotationsfehler der Beine 4.6.4 Beinachsen, interkondylärer- und intermalleolärer Abstand 4.6.5 Beweglichkeit des Kniegelenks und Kraftprüfung 4.7. ERGEBNISSE DER FRAGEBÖGEN 4.7.1 Ergebnisse aus dem Pedi-IKDC 4.7.2 Ergebnisse des PODCI 4.8 GEGENÜBERSTELLUNG DER KLINISCHEN UNTERSUCHUNGSERGEBNISSE UND DEN ERGEBNISSEN DER FRAGEBÖGEN 4.9 FALLBERICHTE 4.9.1 Fallbericht der E-Gruppe 4.9.2 Fallbericht der TU-Gruppe 4.9.3 Fallbericht der T-Gruppe 5. DISKUSSION 5.1 BEWERTUNG DER BASISDATEN 5.2 FRAGESTELLUNG: 1. AUFFÄLLIGKEITEN IN DER KLINISCHEN UNTERSUCHUNG 5.3 FRAGESTELLUNG: 2. AUSWIRKUNGEN AUF DEN FUNKTIONELLEN ZUSTAND DES KNIEGELENKS UND DAS WOHLBEFINDEN 5.4 FRAGESTELLUNG: 3. VERBESSERUNGSFÄHIGE ASPEKTE DES KLINISCHEN MANAGEMENTS VON PROXIMALEN TIBIAFRAKTUREN 5.5 FRAGESTELLUNG: 4. BEWERTUNG DES DIGITALEN VERFAHRENS DER BEINACHSENMESSUNG 5.6 LIMITATIONEN DER STUDIE 6. ZUSAMMENFASSUNG 7. SUMMARY 8. ANHANG 8.1 TABELLEN IM ANHANG 8.2 UNTERSUCHUNGSBOGEN 8.3 PEDI-IKDC FRAGEBOGEN 8.4 PODCI FRAGEBOGEN GRUPPE „2-10 JAHRE“ 8.5 PODCI FRAGEBOGEN GRUPPE „11-18 JAHRE ELTERN“ 8.6 PODCI FRAGEBOGEN GRUPPE „11-18 JAHRE PATIENT:INNEN“ LITERATURVERZEICHNIS

INTRODUCTION: This study explores the relationship between single motherhood during pregnancy and dental caries, considering factors like socioeconomic status and oral health practices. METHODS: This cross-sectional study utilized data from the NHANES cycles 2011-2018. Inclusion criteria were positive pregnancy status, age 20-44 years, complete survey response, and completion of the dental health component. Participants were analyzed based on the presence or absence of active decay. The key independent variable was relationship status (pregnant single mother (single/widowed/divorced) vs. pregnant partnered (married/living with partner). Variables included age, race/ethnicity, poverty income ratio, education level, history of high blood pressure, health insurance status, smoking status, sugar intake, and timing of the last dental visit. Statistical methods included descriptive analysis and crude and adjusted logistic regression models, utilizing SAS-9.4 to account for NHANES' sampling design. RESULTS: Crude analysis indicated that partnered pregnant individuals had a higher prevalence of untreated dental caries (OR = 1.22, 95% CI: 1.08, 1.39) compared to single pregnant individuals. However, this association was not statistically significant after adjusting for potential confounders (adjusted OR = 1.02, 95% CI: 0.83, 1.26). Significant predictors were lower income, education, and smoking status. DISCUSSION: After adjusting for confounders, single motherhood alone was not a statistically significant predictor of dental caries. However, lower income, lower education levels, smoking status, and infrequent dental visits were significant predictors. These findings highlight the need for targeted public health interventions that address socioeconomic determinants, improve educational opportunities, provide financial support, and integrate oral health education into prenatal care programs.

由於不同的行業，其工作內涵差別極大，而不同的工作，其特性更是相去甚遠，自然，對於工作所需之人員，其應具備之資格條件也就大不相同，例如社會各種職場之報考者常常面臨著體格檢查限制的壓力，日常的生活、人際交往、求學、就業、失業、等等問題無時無刻不在困擾著他們，甚至在人生的每一個階段，他們都必須在縫隙中尋求生存的空間。 有些人事用人機關認為體格檢查限制並非是一種歧視行為，而是基於公共利益的需要而給予的合理的差別待遇，所謂「歧視」一詞具有多義性，在此應從侵害「國民就業機會平等」理解之。針對體格檢查限制之問題，本文擬先就體格檢查之意涵予以說明，並舉例說明公務人員考試之體格檢查限制，例如對B型肝炎帶原者限制其報考各類國家考試，這樣一個涉及健康標準的問題，其所設限之體檢標準是否合理？其唯一標準是「醫學標準」，如果科學證明B型肝炎帶原者對他人不構成傳染或雖有傳染性但並不嚴重且可以採取措施加以預防，則上開有關體檢之資格限制標準，構成對B型肝炎帶原者平等競爭公職權利的侵犯，是違憲的，因大量的醫學證明，B型肝炎帶原者並不會對公眾的健康構成威脅。 本文係以有關人民參加需經國家考試公務人員就業體格檢查限制所涉及之基本權利之保障與限制（干預）為研究之課題，人民就業體格檢查是否可以予以差別待遇？而該差別待遇是否合理？合乎比例原則？手段與目的之間如不符比例原則，恐有違憲之虞，故國家於設定體格檢查限制條件時，必須有合理的限制標準，並能依據合理的判斷基準予以救濟，避免侵害人民之權利，且立法、司法及行政各部門，更應負起積極的責任，研擬相關配套措施，以保障人民憲法上的基本權利，全文共分6章：第一章緒論，旨在說明本文之研究動機並界定研究範圍，同時提出本文之研究目的和方法。第二章體格檢查之基本概念，先敘明體格檢查之意涵，包括體格檢查之概念、目的（功能）、意義及特點（執行機構），再加以整理公務人員體格檢查標準之法規依據。第三至第五章構成本文之本論。旨在依序探討公務人員就業體格檢查限制所涉之基本權利保障與限制（干預），並檢討相關行政救濟案例，各章內容以我國憲法所保障之就業基本權利探討為主，並以憲法對於限制人權之相關原則的討論為輔。第六章結論，則在將前述各章之研究結果作綜合性的簡要陳述，並嘗試提出檢討及建議作為本論文之歸結。 / Each career has unique requirements for employees due to the different entity of the career. Therefore the job applicants have to face the pressure of physical examination during application to a new job frequently. Some human resource organizations consider “the abridgement of physical examination” as a rational differential treatment based on the public interests, rather than a discriminative behavior. As the term “discrimination” has versatile meanings, it will be interpreted as an interference of “the equal opportunity for civil employment” in this thesis. In this article, the meaning of the abridgement of physical examination on employment will be illustrated, followed by an example from the abridgement of the physical examination on professional examination. For example, it should be scrutinized whether it is appropriate to abridge a hepatitis B carrier of attending the civil examination, which is concerned from a view of health judged by the medical standard. Some researchers argued that the scientific evidences showed hepatitis B will not be transmitted via carriers, or even can be transmitted but not severely and can be prevented. Then standards of the physical examination on employment would invade the right of equal competition for civil service. Those would be unconstitutional because hepatitis B carriers would not make any threat to public health, which were proved through lots of medical evidences. The main purpose of this thesis concentrated on the protection and interference of basic rights involved in the abridgement of physical examination on civil service. The study will scrutinize the appropriateness, rationality, equality of discriminative treatment in the physical examination on civil service. If the goal and the means of public deeds are not proportional, it would be unconstitutional. To set up the conditions for the abridgement of physical examination, the government should have reasonable standards of restriction and also reasonable judgment criteria of relief for the abridgement of physical examination to avoid invading civil rights. The organization of legislation, justice and administration should take the responsibility of drafting relevant integrated measures to guard the civil privilege. The thesis consists of six chapters. Chapter one (prolegomenon) includes the motive, scope, goal and methods of this study. Chapter two (introduction) elucidates the concept, goal (function), construction and characteristics (an executive body) of the physical examination, and regulations related to standards for the physical examination on the civil service. Chapter three to five (main body) center on the protection and abridgement (interference) of basic rights and the review of administrative relief cases involved in the physical examination of employment. We will study the protection of right of work in our constitution mainly, accompanied by discussion of the relative principles of interference of human rights as well. Chapter six (conclusion) summarizes the research results in previous chapters and make conclusions and suggestions.

This study explored and evaluated the prevalence of supplementary tuition in the teaching and learning of Mathematics/Mathematical Literacy in some high-performing schools of the East London district in the Eastern Cape. The study followed a descriptive survey design to address the research problem. Data were gathered using questionnaires for grade 11 learners and high school Mathematics/Mathematical Literacy teachers. The learners were the first group to be taught the Mathematics/Mathematical Literacy learning programme of the new National Curriculum Statement (NCS). The results showed that a fair number of learners (about 48%) were not satisfied with their performance in Mathematics/Mathematical Literacy and a large number of the learners (about 90%) considered a good pass in Mathematics/Mathematical Literacy as important, particularly for their future careers. A substantial proportion of learners (42%) expressed concern about the amount of school time allocated to Mathematics/Mathematical Literacy, and thought that this factor hampered the successful completion of the syllabus. Teachers who happened to be adequately qualified and experienced enough, struggled to complete the Grade 11 Mathematics syllabus in time and were concerned about misconceptions carried from lower classes. Teachers also expressed some concern about learners' lack of commitment to Mathematics/Mathematical Literacy. Learners seemingly took supplementary tuition as a way of overcoming their learning challenges. Of the three forms of supplementary tuition (i.e. private tuition, vacation classes and revising model/former examination papers) commonly available in the district, revising examination papers was preferred (about 83%) followed by private tuition at 81% and lastly vacation school. Learners spent 1.67 hours per week on average on supplementary tuition. More Mathematics learners (about 34%) than Mathematical Literacy learners (about 6%) make use of supplementary tuition. Based on these findings, it was concluded that supplementary tuition is not unique to schools that perform poorly, and even at high performing schools, factors exist which influence learners to take supplementary tuition. / MATH, SCIENCE & TECH EDU / MSC (MATHS,SCIENCE OR T/EDU)

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban University of Technology, 2010. / The aim of this study was to determine the inter-examiner reliability of motion palpation to detect joint dysfunction in hindfoot and midfoot joints of asymptomatic feet and feet with chronic ankle instability syndrome. The rationale for this study was that motion palpation is a commonly used assessment tool that is used by the chiropractic profession to detect the need for manipulation of the spine and extremities. Also until the reliability of motion palpation is known, other studies using motion palpation as an assessment tool to detect the need for manipulation in the hindfoot and midfoot are questionable. The study was conducted at Durban University of Technology (DUT). Patients that responded to the adverts were then screened via telephonic interview. The researcher performed a case history, physical examination and a foot and ankle regional examination on each patient. Three masters chiropractic students then independently assessed both the symptomatic and asymptomatic feet of each patient and recorded their results. The data was then statistically analysed using SPSS version 15. It was found that the inter-examiner reliability of motion palpation for detecting restrictions in feet with chronic ankle instability syndrome was fair and for detecting instability, there was moderate reliability. In the asymptomatic group the examiners showed to have poor reliability in detecting restrictions and moderate reliability in detecting instability. Inter-examiner reliability was better in the symptomatic group and in this group examiners had more agreement on detecting instability as opposed to restrictions. This study has showed that inter-examiner reliability ranged from poor to moderate in the symptomatic and asymptomatic group with the reliability ranging from poor to moderate. Therefore, one can conclude that motion palpation can be used as an assessment tool to detect joint dysfunction in hindfoot and midfoot joints. However, further studies are warranted to address other subjective and objective measurements such as tenderness and range of motion together with motion palpation.

Thesis (MScMedSc)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Setting This study was conducted in the Tygerberg district, Cape Town, in the Western Cape, South Africa Background The evaluation of early tuberculosis (TB) treatment response is based on month 2 sputum culture status. This method of evaluation has a number of limitations: the test requires relatively advanced laboratory infrastructure and procedures, it takes several weeks to obtain results and is a relatively a poor marker at predicting treatment response. The discovery of potential host markers which reflect the efficacy of early treatment would be of great importance for clinical management of individual patients. The treatment failure would be detectable earlier than at week 8 of treatment. The duration of clinical trials of new anti-tuberculosis drugs may also be substantially reduced by such markers if these would be measurable earlier than at week 8 of therapy. Objectives 1) To evaluate diluted, 7-day whole blood cultures stimulated with live Mycobacterium tuberculosis (M.tb) for the presence of host markers of early TB treatment response 2) To evaluate an overnight, undiluted, M.tb antigen stimulated whole blood culture Quantiferon Gold In Tube (QFT-GIT) supernatants for host markers of early TB treatment response The study designs were as follows: In study one, baseline samples and samples from week 1, week 2 and week 4 of treatment from 30 cured TB patients were selected from a larger biomarker study, in which whole blood was stimulated with live M.tb or left unstimulated. Fifty seven host markers were measured in supernatants by multiplex cytokine arrays. In study two, baseline samples and samples from week 2 and week 8 of treatment from 19 cured TB patients were randomly selected from the placebo group in a micronutrient supplement study. QFT-GIT supernatants from these participants were assessed through multiplex cytokine arrays for levels of fifty seven host markers. All of the participants in both studies were Human Immunodeficiency Virus (HIV) negative. Changes in marker expression over time and between fast and slow responders to treatment were evaluated. Comparability between the two culture methods was assessed for markers that were evaluated in both studies. Results In study one, the majority of host markers showed significant changes over time in the unstimulated supernatants. Only GRO and IL-1beta changed significantly in an antigen-specific manner (background levels subtracted). No significant changes were observed between fast and slow responders. In study two, the majority of host markers showed significant changes over time in the unstimulated supernatants whereas only MDC and IL-4 changed during the observation period in antigen stimulated levels. Significant differences were observed between fast and slow responders at pre-treatment for IL-13 Ag-Nil and IL-1betaAg-Nil . Conclusion This study revealed, antigen-specific responses showed only limited potential for early TB treatment response monitoring, but may have potential in differentiating between treatment outcomes. Future investigations may have to include later time points during treatment as these were not included in the present assessment. The QFT-GIT samples do not appear to be equivalent to live M.tb stimulated 7-day whole blood assays. / AFRIKAANSE OPSOMMING: Instelling Die studie is uitgevoer in die Tygerbergdistrik, Kaapstad, Wes-Kaap, Suid-Afrika. Agtergrond Die evaluering van die respons op vroeë tuberkulose (TB) behandeling word gebaseer op die status van maand 2 sputum kulture. Hierdie evalueringsmetode het ‘n paar beperkinge: die toets benodig relatief gevorderde laboratorium infrastruktuur en prosedures, die toetsuitslae is eers na ‘n paar weke beskikbaar en dit is n relatiewe swak merker om repons op behandeling te voorspel. Die ontdekking van potensiële selfmerkers wat die doeltreffendheid van vroeë behandeling weerspieël sal van groot belang wees vir die kliniese bestuur van individuele pasiënte. Mislukking van die behandeling sal sodoende voor week 8 van behandeling waargeneem kan word. Die tydsduur van kliniese proewe van nuwe anti-tuberkulose medikasie mag ook baie verkort word met sulke merkers as dit voor week 8 van behandeling gemeet kan word. Doelwitte 1) Om verdunde, 7-dae oue volbloedkulture, met lewende Mikobakterium tuberkulosis (M.tb) gestimuleer, te evalueer vir die teenwoordigheid van vroeë TB behandeling respons selfmerkers. 2) Om die supernatant van oornag, onverdunde, M.tb antigeen gestimuleerde volbloedkulture Quantiferon Gold In Tube (QFT-GIT) vir vroeë behandeling respons selfmerkers te evalueer. Die studie-ontwerpe was soos volg: Met studie een is basislynmonsters en monsters verkry na week 1, week 2 en week 4 van behandeling van 30 geneesde TB-pasiënte geselekteer uit ‘n groter biomerkerstudie waarin die volbloed met lewende M.tb gestimuleer is of ongestimuleer gelaat is. Sewe-en-vyftig selfmerkers is in die supernatante gemeet deur middel van multipleks sitokine arrays. Met studie twee is basislynmonsters en monsters verkry na week 2 en week 8 van behandeling van 19 geneesde TB-pasiënte lukraak uit die plasebo-groep in ‘n mikrovoedingstowwe-aanvullingstudie geselekteer. Vlakke van 57 selfmerkers is in die QFT-GIT supernatante van hierdie deelnemers, deur middel van die multipleks sitokine arrays, bepaal. Al die deelnemers van beide studies was HIV negatief. Veranderinge in merker-uitdrukking oor tyd, asook tussen vinnige en stadige respons tot behandeling, is ge-evalueer. Die vergelykbaarheid van die twee kultuurmetodes is geassesseer ten opsigte van die ge-evalueerde merkers in albei studies. Resultate Met studie een het die meerderheid van die selfmerkers in die ongestimuleerde supernatante kenmerkende verandering oor tyd gewys. Slegs GRO en IL-1beta het aansienlik verander in die antigeenspesifieke wyse (agtergrond vlakke afgetrek). Geen kenmerkende veranderinge was waargeneem tussen die vinnige en stadige respons pasiënte nie. Met studie twee het die meerderheid van die selfmerkers aansienlike veranderinge oor tyd in die ongestimuleerde supernatante gewys, in vergelyking waar net die MDC en IL-4 veranderinge gedurende die observasie periode in antigeen gestimuleerde vlakke getoon het. Kenmerkende verskille is tussen die vinnige en stadige respons pasiënte in voorbehandeling vir IL-13 Ag-Nil en IL-1betaAg-Nil waargeneem. Gevolgtrekking Die studie bewys dat antigeenspesifieke response slegs beperkte potensiaal vir vroeë TB behandeling respons monitering het, maar mag die potensiaall vir onderskeidende behandeling uitkomste hê. Toekomstige ondersoeke sal dalk latere tydpunte gedurende die behandeling moet insluit aangesien dit nie in hierdie evaluasie ingesluit is nie. Die QFT-IT monsters verskyn nie as gelykwaardig met die lewendig M.tb gestimuleerde 7-dae volbloed toetse nie.