Antiandrogen Withdrawal Alone or in CombinationWith Ketoconazole in Androgen-Independent ProstateCancer Patients: A Phase III Trial (CALGB 9583) Eric J. Small, Susan Halabi, Nancy A. Dawson, Walter M. Stadler, Brian I. Rini, Joel Picus,Preston Gable, Frank M. Torti, Ellen Kaplan, and Nicholas J. Vogelzang Antiandrogen withdrawal (AAWD) results in a prostate-specific antigen (PSA) response (declin
What is tuberculosisTB EDUCATIONAL PROGRAM FOR THE MULTICULTURAL COMMUNITIES OF ISTANBUL
What is Tuberculosis?
Tuberculosis commonly known, as TB, is a disease spread by the microbe tuberculosis. About 1/3 of the world is infected with TB. Approximately 8 million people a year are infected with TB and 2 million people die each year from TB. In Turkey each year approximately 25,000 people are infected and approximately 1,000 people die from this disease.
How do you catch TB?
TB is caught through the air. The TB microbe forms as droplets, which without sun, can live for days in darkness and humidity. TB can be caught if an infected person talks too close, coughs or sneezes. If you have been infected with ACTIVE TB you can get sick again. But TB can also live secretly in the lung for years, in fact for a whole life, but the microbe can become active if you get very sick. In your lifetime, there is a 10% chance that you have or you will be in contact with some one who has active TB. What are the other forms of TB?
The most common form of TB is Pulmonary TB (Lung TB), but TB can be found together with Lung TB in other organs too. Outside of the lungs, TB can be found in bone and joint, internal organs, reproductive, and urinary systems. The treatment for all of these other forms of TB is the same as the treatment for Lung TB.
How will you not catch TB?
You cannot catch TB from a person with active TB by using a fork, knife, or glass that they used, or by touching them or kissing them. TB is not caught through sexual contact, though it is not recommend in the first 2 months, because the TB microbe is still active.
More than 2 weeks of coughing, or coughing with lots of flem or blood, night sweats, sweating, lose of appetite and lose of weight - these are all important symptoms of TB. Coughing for a long time is absolutely one of the most suspicious signs of TB.
If you have these symptoms what must you do?
If you think that you have TB or have any of these symptoms you should to go to the nearest Verem Savas to be tested as quickly as possible. The earlier you discover you have TB, the easier it for you is to treat.
Where do I go to be tested for TB?
In every city in Turkey there is TB dispensaries where both diagnosis and treatment are given free of charge. For example in Istanbul there are 4 Anti-TB clinics in Taksim, Sehremini Capa Hospital, Sisli and Zeytinburnu that you can go to be examined and tested. You do not need to show any residence paper or passport to be tested. If your test result is positive for active TB, every one who lives in your house in your shelter must also be tested. If you have active TB the medicines are free and given by Verem Savas Dispensary that you have already applied. And if there are any other sicknesses found in the lung, which are not TB, the doctor at the clinic will write a prescription for drugs to treat it. But you need to buy drugs for the illness other than TB. How are TB diagnoses?
When you go to the clinic, after telling your complaints to doctor, an X-ray of your lungs and a sample of your spit will be taken to do a bacterial test.
Is TB treatable?
TB EDUCATIONAL PROGRAM FOR THE MULTICULTURAL COMMUNITIES OF ISTANBUL Yes, in general TB is treatable but some strains of the disease may be antibiotics resistant and harder to treat. If you have a TB disease, you must remember that TB germs die very slowly. Even if you feel better after a few weeks even in 7-10 days of treatment taking TB medicines, it does not mean that all the TB germs are dead. TB treatment takes 6 to 9 months and taking your medicine prescribed by a physician in Verem Savas Dispensary every day without a break is the only way to cure TB. The best system for following the 6-month treatment program is Direct Observation Treatment (DOT). Is TB a shameful disease?
Absolutely not! This disease is found in every educational and socio-economic group. Because it is a disease which spreads through the respiratory system, anyone can be exposed. The fear of TB may come from the fact that until 50 years ago there was no medicine to treat TB. If some one had TB, he/she used to be put away not to infect the rest of the population. Nowadays TB is not a disease to be scared as it is curable. To be cured you only need to be treated taking medicines prescribed by your doctor continuously. To break the shame from this disease, please share information about the disease with everyone.
What is the treatment?
TB treatment is given on an outpatient basis. Only in very special situations will you have to be hospitalized: • Heart & respiratory system problem. Based on your physician’s decision, you may be hospitalized for 10 to 30 days. After being discharged from the hospital, TB treatment will continue as an outpatient basis. Once the clinic is sure that you have TB, you will take 4 medicines to kill the TB germs in your body, for a total of 12 pills for the first 2 months and 2 or 3 pills for the next 4 months. Like all medicines, TB medicines can have side effects. However, most people can take their TB medicines without any problem. The names of the pills are: • Isoniazid (i-so-ni-a-zid), also called INH • Rifampin (ri-fam-pin) • Ethambutol (eth-am-byoo-tol) At the end of the second month of your treatment, another sample of your spit will be taken to see if the medication is working. If it is not working, the treatment can go longer. If it is working, you will stop 2 drugs, and you will continue to take the other 2 antibiotics for the next 4 months. Take your pills until your doctor tells you to stop. If you stop taking medicines for TB disease early or do not take them the right way: • You can become sick again and stay sick for a longer time. • You can pass TB germ on to others again. TB EDUCATIONAL PROGRAM FOR THE MULTICULTURAL COMMUNITIES OF ISTANBUL • You can get MDR-TB and the new medicines which are extremely expensive! may not work to cure the TB and you may have to take different medicines that have even worse side effects.
Are there side effects to the TB medication?
Generally you will not have any extreme side effects to the pills. But if you are being treated for TB, tell your doctor right away if you have: • Changes in your hearing ringing in your ears. • Less appetite or no appetite for food. • Tingling or numbness around the mouth. • Changes in your eyesight blurred vision. If you have any of these symptoms go tell the nurse at the VSD clinic immediately as you can be helped.
When you suspect that you might be exposed to TB or before you start treatment or the first days of treatment you should: • Cover your mouth with a wet handkerchief while These simple things are very important to stop others from catching TB. To protect yourself against sickness, you should try to eat well, get fresh air and sun, and try to stay to a place that has good circulation of air and light. For children there is a vaccination, BCG injections, for the most dangerous forms like meningitis and miliar tuberculosis. And it is enough to take the injection only once, at the second month of the newborn. Verem Savas Dispensary gives injections for free. What is DOT Direct Observation Therapy?
Because the treatment for TB is long, DOT (Direct Observation Therapy) helps you take your medicine everyday. Someone will bring you your pills regularly. This can help you stay with your medicine plan. He/she will also watch that you take your TB pills and writes down the day and time when the medications were taken. Any problem with the medication, or any condition that may make it difficult for you to take your medicine daily will also be recorded. The person who follows a TB patient does not have to be a nurse or in the medical profession. He/she can be anyone that you trust, a friend or member of the family, who is willing to take responsibility for your medication. TB EDUCATIONAL PROGRAM FOR THE MULTICULTURAL COMMUNITIES OF ISTANBUL Why DOT?
DOT is a program prepared by The World Health Organization to make sure that the patient is taking and swallowing his/her medication every day. In practice, many countries have agreed that DOT is the best way to fight the spread of TB. While TB is treatable, the 6 to 9 treatment may be long and hard, and the medications can have side effects. So it is difficult to keep on the treatment program, especially if the patient faces the poverty. The best way to make sure that a sick person takes his/her medicines regularly is to watch the patient taking his/her pills every day. This is very important, because even after 10 days after starting to take drugs a sick person with TB may feel better, and may want to stop taking the medication, especially if the patient is suffering from side effects. To stop taking the medication before the doctor tells you to do so is very dangerous because TB microbe can become resistant to the TB drugs. Consequently, you can get another kind of TB that cannot be treated so easily called Multi-drug Resistant TB. What is Multi-drug Resistant TB?
Multi-drug Resistant TB (MDR-TB) happens because the patient took the wrong medications or not enough medication or did not finish the full 6 months of treatment. If the patient stops the medication half way or does not take the medication on a regular basis, the medication will have no curative effect on TB microbe. Especially and most importantly if the resistance to anti-TB medications grows, stronger forms of MDR-TB can grow too. MDR-TB is the dangerous form of TB because the medicines for MDR-TB have very strong uncomfortable side- effects, allergies. There is only a 50% chance that the patient will get better. The treatment for MDR TB is 2 years, and sometimes an operation may be necessary as part of the treatment. The minimum cost for treating a MDT-TB patient can be up 100,000 USD. If an MDR-TB patient infects another person, that person will get MDR-TB as well. For this reason it is important that MDR-TB patient is treated under the direct supervision of a doctor. HIV/ AIDS and TB
In the last years there has been a growing connection between HIV/AIDS and TB. TB takes advantage of the weak immunity system of a person who is AIDS. A person can be sick both with HIV and TB for years without having any symptoms. For this reason a person who suspects to be infected by HIV should take the ELIZA test informing and applying a HIV counselor.
Safety Data Sheet Tetracycline 1. PRODUCT AND COMPANY IDENTIFICATION Product Name: Tetracycline Synonyms/Generic Names: 4-(Dimethylamino)-1,4,4a,5,5a,6,11,12aoctahydro-3,6,10,12,12a- pentahydroxy-6-methyl-1,11-dioxo-2-naphthacenecarboxamide hydrochloride SDS Number: 753.00 Product Use: For Educational Use Only Manufacturer: Columbus Chemical Industries, Inc.