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1.
Rev. Soc. Bras. Med. Trop ; 54: e01032021, 2021. tab, graf
Article in English | LILACS | ID: biblio-1288067

ABSTRACT

Abstract INTRODUCTION: The concomitant use of antituberculosis and antiretroviral drugs, as well as drugs to treat other diseases, can cause drug-drug interactions. This study aimed to describe potential drug-drug interactions (pDDI) in patients with TB and HIV/AIDS co-infection, as well as to analyze possible associated factors. METHODS: This study was performed in a reference hospital for infectious and contagious diseases in the southeastern region of Brazil and evaluated adult patients co-infected with tuberculosis and HIV/AIDS. A cross-sectional study was conducted in which sociodemographic, clinical, and pharmacotherapeutic characteristics were assessed. The pDDI were identified using the Drug-Reax software. Association analysis was performed using either a chi-squared test or a Fisher's exact test. Correlation analysis was performed using the Spearman's coefficient. RESULTS: The study included 81 patients, of whom 77 (95.1%) were exposed to pDDI. The most frequent interactions were between antituberculosis and antiretroviral drugs, which can cause therapeutic ineffectiveness and major adverse reactions. A positive correlation was established between the number of associated diseases, the number of drugs used, and the number of pDDI. An association was identified between contraindicated and moderate pDDI with excessive polypharmacy and hospitalization. CONCLUSIONS: We found a high frequency of pDDI, especially among those hospitalized and those with excessive polypharmacy. These findings highlight the importance of pharmacists in the pharmacotherapeutic monitoring in these patients.


Subject(s)
Tuberculosis/complications , Tuberculosis/drug therapy , Pharmaceutical Preparations , HIV Infections/complications , HIV Infections/drug therapy , Acquired Immunodeficiency Syndrome , Brazil , Cross-Sectional Studies , Drug Interactions
3.
Washington; Organización Panamericana de la Salud; mar. 19 2020. 5 p.
Non-conventional in Spanish | LILACS | ID: biblio-1096599

ABSTRACT

A medida que el mundo se une para hacer frente a la pandemia del COVID-19, es importante garantizar que los servicios y operaciones esenciales para hacer frente a los problemas de salud prevalentes, continúen protegiendo la vida de las personas con TB y otras enfermedades o condiciones de salud. Los servicios de salud, incluidos los programas nacionales para combatir la TB, deben involucrarse activamente para garantizar una respuesta efectiva y rápida al COVID-19.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Tuberculosis/complications , Tuberculosis/prevention & control , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Betacoronavirus
4.
Arch. argent. pediatr ; 118(1): e39-e42, 2020-02-00. ilus, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1095862

ABSTRACT

La tuberculosis es una enfermedad muy frecuente en nuestro medio. A pesar de que la detección precoz y el tratamiento adecuado logran la curación en la mayoría de los pacientes, la dificultad en el diagnóstico, el abandono del tratamiento y la aparición de resistencia a los fármacos tradicionales generan que, en la actualidad, continúe siendo un importante problema de salud pública. En la Argentina, la tasa de morbilidad es de 25/100 000 habitantes, con un leve aumento en la mortalidad.Se presenta el caso de una paciente pediátrica con tuberculosis, que tuvo múltiples complicaciones asociadas a la enfermedad y a su tratamiento, entre las cuales se incluye el síndrome in-flamatorio de reconstitución inmunológica, también conocido como reacción paradojal al tratamiento antituberculoso. Este representa una consecuencia clínica adversa al restablecimien-to de la inmunidad en el paciente que padece una infección sistémica grave, como la tuberculosis miliar.


Tuberculosis is a very frequent disease in our environment. Although early detection and adequate treatment achieve cure in most patients, the difficulty in diagnosis, the abandonment of treatment and the appearance of resistance to traditional drugs generate that at present it continues to represent an im-portant public health problem. In Argentina, the morbidity rate is 25/100,000 inhabitants, with a slight increase in mortality.We present the case of a pediatric patient with tuberculosis and multiple complications associated with the disease and its treatment. One of these complications was the immune re-constitution inflammatory syndrome or paradoxical reaction to antituberculosis treatment. It represents an adverse clinical con-sequence of the restoration of immunity in the patient suffering from a serious systemic infection such as miliary tuberculosis.


Subject(s)
Humans , Female , Child , Tuberculosis/complications , Tuberculosis, Miliary/diagnosis , Immune Reconstitution Inflammatory Syndrome , Tuberculosis, Meningeal , Tuberculosis, Miliary/drug therapy
5.
Rev. bras. epidemiol ; 23: e200009, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1092617

ABSTRACT

RESUMO: Introdução: A comorbidade tuberculose e diabetes ainda continua um desafio para a saúde pública mundial. Objetivo: Analisar o perfil sociodemográfico e as características do diagnóstico e tratamento dos casos de tuberculose com e sem diabetes no Brasil. Métodos: Estudo transversal, com dados do Sistema de Informação de Agravos de Notificação e do Sistema de Gestão Clínica de Hipertensão Arterial e Diabetes Mellitus da Atenção Básica, no período de 2007 a 2011. Modelo de regressão de Poisson com variância robusta foi utilizado para estimar a razão de prevalência (RP) e seus respectivos intervalos de confiança. Resultados: A comorbidade estudada foi encontrada em 7,2% dos casos. Modelo hierárquico mostrou maior RP entre indivíduos do sexo feminino (RP = 1,31; intervalo de confiança de 95% - IC95% 1,27 - 1,35); maior associação nas faixas etárias 40-59 anos e ≥ 60 anos (RP = 11,70; IC95% 10,21 - 13,39 e RP = 17,49; IC95% 15,26-20,05) e com resultado positivo da baciloscopia - primeira amostra (RP = 1,40; IC95% 1,35 - 1,47). Reingresso após abandono e abandono foram inversamente associados na comorbidade (RP = 0,66; IC95% 0,57 - 0,76 e RP = 0,79; IC95% 0,72 - 0,87). Conclusão: Os achados, como a relação inversa do abandono ao tratamento da tuberculose no grupo das pessoas com comorbidade, reforçam a importância de ações integradas nos serviços para mudar o cenário dessa desafiadora comorbidade.


ABSTRACT: Introduction: Tuberculosis and diabetes comorbidity remains a challenge for global public health. Objective: To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil. Methods: This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals. Results: We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87). Conclusion: The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Tuberculosis/complications , Tuberculosis/epidemiology , Diabetes Complications/epidemiology , Socioeconomic Factors , Tuberculosis/diagnosis , Tuberculosis/therapy , Brazil/epidemiology , Comorbidity , Prevalence , Cross-Sectional Studies , Sex Distribution , Age Distribution , Diabetes Complications/diagnosis , Diabetes Complications/therapy , Middle Aged
6.
Rev. bras. enferm ; 72(5): 1271-1278, Sep.-Oct. 2019. tab
Article in English | LILACS, BDENF | ID: biblio-1042153

ABSTRACT

ABSTRACT Objective: To analyze the clinical and epidemiological features of tuberculosis in children and adolescents in an infectious diseases reference hospital. Method: A documental and retrospective study was carried out with 88 medical files in an infectious diseases reference hospital in the state of Ceará. Data were analyzed by univariate, bivariate and multivariate approaches. Results: It was found that, depending on the tuberculosis type, its manifestations may vary. The logistic regression model considered only pulmonary tuberculosis due to a number of observations and included female sex (95% CI: 1.4-16.3), weight loss (95% CI: 1.8-26.3), bacilloscopic screening (95% CI: 1.5-16.6) and sputum collected (95% CI: 1.4-19.4) as possible predictors. Conclusions: Children and adolescents present different manifestations of the disease depending on the tuberculosis type that affects them. Knowing the most common features of each condition could enhance early diagnosis and, consequently, result in adequate treatment and care.


RESUMO Objetivo: Analisar as características clínicas e epidemiológicas da tuberculose em crianças e adolescentes de um hospital de referência em doenças infecciosas. Método: Foi realizado um estudo documental e retrospectivo com 88 prontuários médicos em um hospital de referência em doenças infecciosas no estado do Ceará. Os dados foram analisados através das abordagens univariada, bivariada e multivariada. Resultados: Verificou-se que, dependendo do tipo de tuberculose, suas manifestações podem variar. O modelo de regressão logística considerou apenas a tuberculose pulmonar devido a um número de observações e incluiu sexo feminino (IC 95%: 1,4-16,3), perda de peso (IC 95%: 1,8-26,3) e baciloscopia (IC 95%: 1,5-16,6) com coleta de escarro (IC95%: 1,4-19,4) como possíveis preditores. Conclusão: Crianças e adolescentes apresentam diferentes manifestações da doença dependendo do tipo de tuberculose que os afeta. Conhecer as características mais comuns de cada condição pode melhorar o diagnóstico precoce e, consequentemente, levar a tratamentos e cuidados adequados.


RESUMEN Objetivo: Analizar las características clínicas y epidemiológicas de la tuberculosis en niños y adolescentes en un hospital de referencia de enfermedades infecciosas. Método: Se realizó un estudio documental y retrospectivo con 88 archivos médicos en un hospital de referencia de enfermedades infecciosas en el estado de Ceará. Se analizaron los datos por enfoques univariados, bivariados y multivariados. Resultados: Se encontró que, dependiendo del tipo de tuberculosis, sus manifestaciones pueden variar. El modelo de regresión logística consideró solo la tuberculosis pulmonar, debido a varias, observaciones e incluyó el género femenino (IC 95%: 1,4-16,3), la pérdida de peso (IC 95%: 1,8-26,3), la revisión baciloscopia (95 % CI: 1,5-16,6) y el esputo recolectado (95% CI: 1,4-19,4) como posibles predictores. Conclusiones: Los niños y adolescentes presentan diferentes manifestaciones de la enfermedad en función del tipo de tuberculosis que los afecta. Conocer las características más comunes de cada afección podría mejorar el diagnóstico temprano y, en consecuencia, resultar en un tratamiento y atención adecuados.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Tuberculosis/classification , Tuberculosis/complications , Tuberculosis/epidemiology , Brazil/epidemiology , Logistic Models , Retrospective Studies , Risk Factors , Hospitals/statistics & numerical data
7.
Rev. Soc. Bras. Clín. Méd ; 17(2): 81-84, abr.-jun. 2019. graf.
Article in Portuguese | LILACS | ID: biblio-1026509

ABSTRACT

Objetivo: Trazer um panorama dos últimos 5 anos acerca das internações e mortalidade por sequelas da tuberculose em pacientes com mais de 60 anos. Métodos: Utilização de dados disponibilizados pelo DATASUS, com as seguintes variáveis: sequelas de tuberculose (B90 do CID-10); sexo; faixa etária ≥60 anos; de janeiro de 2012 a dezembro de 2016; nas regiões brasileiras. Resultados: De 349 idosos internados por sequelas de tuberculose, 137 (39,25%) foram na Região Nordeste, 100 (28,65%) na Sudeste, 73 (20,91%) na Sul, 32 (9,16%) na Centro-Oeste e 7 (2,0%) na Norte, sendo 79 casos em 2012, 80 em 2013, 42 em 2014, 70 em 2015 e 78 em 2016. A maioria dos pacientes (216) era do sexo masculino, bem como 66,76% dos casos encontravam-se na faixa dos 60 aos 69 anos. A taxa nacional de mortalidade foi de 8,02, com 17,81 na Região Sul, 14,29 na Norte, 6,0 na Sudeste, 5,11 na Nordeste e 3,13 na Centro-Oeste. O maior número se deu em 2013 (11,25) e o menor em 2012 (5,06). A faixa etária com maior mortalidade foi a de acima de 80 anos, com 24,0, e o sexo mais predominante, o masculino, com 9,72. Conclusão: A análise dos dados epidemiológicos supracitados é essencial para um melhor manejo dos pacientes idosos, de maneira a diminuir cada vez mais os índices de complicações, tratando de maneira eficaz e monitorando atentamente quaisquer eventos durante a internação desses pacientes. (AU)


Objective: To provide an overview of the last 5 years on hospitalizations and mortality from tuberculosis sequelae in patients over 60 years of age. Methods: Use of data provided by DATASUS, with the following variables: tuberculosis sequelae (B90 of ICD- 10); gender; age range ≥60 years; from January / 2012 to December / 2016; in the Brazilian regions. Results: Of 349 elderly people hospitalized for TB sequelae, 137 (39.25%) were from the Northeast region, 100 (28.65%) from the Southeast, 73 (20.91%) from the South, 32 (9.16%) from the In the Central West, and 7 (2.0%) from the North, with 79 cases in 2012, 80 in 2013, 42 in 2014, 70 in 2015 and 78 in 2016. Most patients (216) were male, and 66.76% of the cases were in the range of 60 to 69 years. The national mortality rate was 8.02, with 17.81 in the South region, 14.29 in the North, 6.0 in the Southeast, 5.11 in the Northeast, and 3.13 in the Midwest. The highest number occurred in 2013 (11.25), and the lowest in 2012 (5.06). The age group with the highest mortality was over 80 years old, with 24.0, and male gender was the most predominant, with 9.72. Conclusion: The analysis of the abovementioned epidemiological data is essential for a better management of the elderly patients, in order to reduce the complication rates, treating effectively, and closely monitoring any events during these patients hospitalization. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Tuberculosis/mortality , Brazil/epidemiology , Hospitalization/statistics & numerical data , Tuberculosis/complications , Tuberculosis/epidemiology , Sex Factors , Demography/statistics & numerical data , Indicators of Morbidity and Mortality , Incidence , Prevalence , Cross-Sectional Studies , Data Interpretation, Statistical , Age Factors , Age and Sex Distribution
8.
Gac. méd. Méx ; 155(3): 266-275, may.-jun. 2019. tab, graf
Article in English, Spanish | LILACS | ID: biblio-1286502

ABSTRACT

Resumen Los granulomas son lesiones circunscritas compuestas principalmente por células mononucleares que surgen en respuesta a estímulos antigénicos pobremente degradables. Se encuentran en 2 a 15 % de las biopsias hepáticas; su hallazgo puede significar desde un fenómeno incidental, hasta la manifestación de una enfermedad sistémica de origen infeccioso, autoinmune o neoplásico. El cuadro clínico suele apuntar a la patología subyacente, sin embargo, la lista de condiciones asociadas es amplia y difiere con base en los antecedentes epidemiológicos y a las características basales del paciente. El elemento de mayor utilidad para su estudio es la historia clínica exhaustiva, con énfasis en viajes recientes, exposición de riesgo y consumo de fármacos o alimentos crudos o exóticos. El análisis histopatológico detallado puede auxiliar en la identificación de la etiología, por ejemplo, la presencia de granulomas epitelioides con necrosis caseosa indica tuberculosis y su ausencia, sarcoidosis; la abundancia de eosinófilos es señal de reacciones farmacológicas o infecciones parasitarias; la presencia de cuerpos extraños puede ser la causa de la enfermedad granulomatosa hepática. En este artículo describimos los aspectos clínico-patológicos básicos de esta enfermedad y proveemos un breve resumen de las etiologías más comunes, principalmente en la región de Latinoamérica.


Abstract Granulomas are circumscribed lesions mainly composed of mononuclear cells that arise in response to poorly degradable antigenic stimuli. They are found in 2-15 % of liver biopsies and the meaning of their finding can range from an incidental phenomenon to the manifestation of a systemic disease of infectious, autoimmune or neoplastic origin. Clinical presentation usually points at the underlying pathology; however, the list of associated conditions is extensive, and differs based on patient epidemiological history and baseline characteristics. The most useful element for their study is a thorough medical history, with an emphasis on recent trips, exposures and consumption of drugs or raw or exotic foods. Detailed histopathological analysis may help identify the etiology. For example, the presence of epithelioid granulomas with caseous necrosis indicates tuberculosis and, its absence, sarcoidosis; eosinophil abundance can be associated with drug reactions or parasitic infections; and the presence of foreign bodies can be the cause of granulomatous liver disease (GLD). In this article, we describe the basic clinical-pathological aspects of GLD, and provide a brief summary of the most common etiologies, with an emphasis on the Latin-American region.


Subject(s)
Humans , Animals , Granuloma/diagnosis , Liver Diseases/diagnosis , Sarcoidosis/complications , Sarcoidosis/diagnosis , Tuberculosis/complications , Tuberculosis/diagnosis , Biopsy/methods , Diagnosis, Differential , Granuloma/physiopathology , Liver Diseases/physiopathology
11.
Rev. gaúch. enferm ; 40: e20190050, 2019. tab
Article in English | LILACS, BDENF | ID: biblio-1043028

ABSTRACT

Abstract Objective: analyzing the aspects associated with case outcomes and the international border situation when it comes to patients with tuberculosis (TB) associated with comorbidities. Method: exploratory descriptive epidemiological study, analyzing all new cases of TB with comorbidities reported in 2013 on SISNAN in the cities at the border of the state of Paraná and Paraguay. The variables used were: sociodemographic, clinical and operational. To analyze the data, descriptive analysis and the chi-square test were applied. Results: 227 cases of tuberculosis associated with comorbidities were reported and 70.9% were from cities bordering Paraguay. Alcoholism (22.0%) and AIDS (13.7%) were the most common comorbidities. The chi-square test presented a statistical association of border cities with negative outcomes and not performing directly observed treatments. Conclusion: Through the study, it was possible to find that the location of border cities can be determinant for a negative outcome.


Resumen Objetivo: Analizar los aspectos asociados al cierre del caso y a la situación de frontera internacional entre enfermos de tuberculosis con comorbilidad. Método: Estudios epidemiológico, descriptivo exploratorio, analizando todos los casos nuevos de TB con comorbilidad notificados en el año 2013 en SISNAN en municipio de frontera del Estado de Paraná con Paraguay. Las variables utilizadas fueron: sociodermográficas, clínicas y operacionales. Para analizar los datos se aplicó análisis descriptiva y el test qui-cuadrado. Resultados: De los 227 casos de tuberculosis con comorbilidades, el 70,9% eran de municipios que hacían frontera con Paraguay. El alcoholismo (22,0%) y el sida (13,7%) fueron las comorbilidades más frecuentes. La prueba que qui-cuadrado presentó asociación estadística para los municipios de frontera con desenlace desfavorable y que no realizan el tratamiento directamente observado. Conclusión: Por el estudio, es posible identificar que la localización de los municipios de frontera puede ser determinante para un desempeño desfavorable.


Resumo Objetivo Analisar os aspectos associados ao desfecho do caso e à situação de fronteira internacional entre doentes de tuberculose com comorbidades. Método: Estudo epidemiológico, descritivo exploratório, analisando todos os casos novos de Tuberculose com comorbidades notificados no ano 2013 no Sistema de Informação de Agravos de Notificação em municípios de fronteira do estado do Paraná com o Paraguai. As variáveis utilizadas foram: sociodemográficas, clínicas e operacionais. Para analisar os dados aplicou-se análise descritiva e o teste qui-quadrado. Resultados: Dos 227 casos de tuberculose com comorbidades, 70,9% eram de municípios que faziam fronteira com o Paraguai. O alcoolismo (22,0%) e a aids (13,7%) foram as comorbidades mais frequentes. O teste que qui-quadrado apresentou associação estatística para os municípios de fronteira com desfecho desfavorável e que não realizam o tratamento diretamente observado. Conclusão Pelo estudo, é possível identificar que a localização dos municípios de fronteira pode ser determinante para um desempenho desfavorável.


Subject(s)
Humans , Male , Pregnancy , Adult , Young Adult , Tuberculosis/complications , Tuberculosis/drug therapy , Paraguay , Brazil , Epidemiologic Studies , Urban Health , Treatment Outcome , Internationality , Middle Aged
12.
Rev. Soc. Bras. Med. Trop ; 52: e20180188, 2019. graf
Article in English | LILACS | ID: biblio-1041591

ABSTRACT

Abstract Reports of simultaneous infections and neoplasms in patients with acquired immune deficiency syndrome (AIDS) are occasionally seen in the literature. However, coexistent lymphoma with tuberculosis, and Kaposi sarcoma (KS) with tuberculosis occurring in the same lymph node is rare. Coexistent lesions pose diagnostic difficulties. In this article, we report two HIV-positive patients from Zimbabwe who displayed KS and tuberculosis; KS and diffuse large B-cell lymphoma in the same lymph node. We found only one similar case presentation in the literature, which was reported in India.


Subject(s)
Humans , Male , Female , Adult , Sarcoma, Kaposi/complications , Tuberculosis/complications , HIV Infections/complications , Lymphoma, Large B-Cell, Diffuse/complications , Lymph Nodes/pathology , Sarcoma, Kaposi/pathology , Tuberculosis/pathology , Zimbabwe , HIV Infections/pathology , Lymphoma, Large B-Cell, Diffuse/pathology
13.
Med. interna (Caracas) ; 35(3): 107-117, 2019. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1052940

ABSTRACT

Analizar las características epidemiológicas, clínicas y efectividad del diagnóstico de derrame pleural. Métodos: estudio descriptivo, retroprospectivo transversal, con una muestra constituida por pacientes atendidos en el período enero 2013 a junio 2018 en los que se demostrase compromiso pleural, parenquimatoso pulmonar o de otro órgano y cuyo motivo de ingreso fue el estudio de derrame pleural en el Servicio de Medicina interna en el Hospital General del Oeste "Dr. José Gregorio Hernández". Tratamiento estadístico: análisis estadístico descriptivo basado en medidas de tendencia central (media y desvia- ción estándar) para las variables cuantitativas y de proporción (moda, porcentaje) en la variables categóricas y/o cualitativas. Se midió el índice Kappa entre la sospecha diagnóstica y el diagnós- tico realizado, para la valoración del grado de concordancia diagnóstica. Resultados: de 261 pacientes con derrame pleural, el 64,2% se encontraba en edad productiva, predominó el sexo mas- culino, y el nivel socioeconómico Graffar IV. La causa más frecuente de derrame pleural fue la tuberculosis pleural. La concordancia diagnóstica promedio fue de 0,70. Conclusión:Se evidenció un incremento del tiempo diagnóstico, relacionado al tiempo de obtención de resultados en los estudios paraclínicos. El cálculo del índice de concordancia entre el diagnóstico presuntivo y el definitivo fue importante(AU)


Pleural effusion is a frequent cause of admission to internal medicine wards worldwide, and is frequently secondary to clinical entities that are among the leading causes of mortality. Objective: To analyze the epidemiological, clinical characteristics and effectiveness in the diagnosis of pleural effusion. Methods:descriptive, retroprospective, transversal study, with a sample of patients treated from the period January 2013 to June 2018 in which pleural, parenchymal or pulmonary involvement of another organ were demonstrated when the reason for admission was the study of pleural effusion in the Internal Medicine Department at the Hospital General del Oeste "Dr. José Gregorio Hernández". Statistical analysis: Consisted of a descriptive statistical analysis based on measures of central tendency for the quantitative variables and proportion in the categorical and/or qualitative variables. The Kappa index was measured between the diagnostic suspicion and the diagnosis made, for the assessment of the degree of diagnostic agreement. Results: Of 261 patients with pleural effusion, 64.2% were of productive age, the male sex predominated, and the Graffar IV socioeconomic level. Pleural tuberculosis was the most common cause of pleural effusion. The average diagnostic concordance was 0.70. Conclusion:There was an increase in the diagnostic time, related to the time of obtaining results in the complementary studies. The calculation of the concordance index between the presumptive and definitive diagnosis was important(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pleural Effusion/etiology , Pleural Effusion/pathology , Bacterial Infections/etiology , Tuberculosis/complications , Biopsy , Heart Failure , Internal Medicine
14.
Rev. cuba. pediatr ; 90(4): e630, set.-dic. 2018. graf
Article in Spanish | LILACS, CUMED | ID: biblio-978473

ABSTRACT

Introducción: Colagenosis y tuberculosis comparten síntomas y signos, pero además, el trastorno autoinmune y los tratamientos inmunosupresores que reciben los pacientes con colagenosis, los hacen más vulnerables a esta infección, lo que puede constituir un dilema diagnóstico. Objetivo: Contribuir al conocimiento de la relación entre tuberculosis y colagenosis. Presentación de casos: Se presentan tres adolescentes con tuberculosis, atendidos en el Centro de Referencia Nacional para la Tuberculosis Infantil. Dos enfermos tenían diagnóstico previo de colagenosis (artritis idiopática juvenil y polimiositis) con tratamiento esteroideo en exacerbaciones o continuo desde hacía un año, respectivamente. El tercero presentó un síndrome febril prolongado con pleuresía y pericarditis, con sospecha de lupus eritematoso diseminado. Se diagnosticó tuberculosis por test de mantoux hiperérgico. El tratamiento fue prolongado con esteroides, drogas antituberculosas y pericardiotomía al inicio del proceso, con evolución tórpida y fallo de tratamiento. Todo el tiempo se trató de descartar una enfermedad del colágeno. Se confirmó por cultivo la tuberculosis en los tres pacientes y la evolución final fue satisfactoria. Se exponen las características de cada enfermo y se analiza la relación entre ambas entidades. Conclusiones: Se presentan tres casos que ejemplifican la relación entre tuberculosis y colagenosis(AU)


Introduction: Collagenosis and tuberculosis share similar symptoms and manifestations; and in addition, the autoimmune disorder and inmunosuppressive treatments that patients with collagenosis receive make them more vulnerable to this infection which can constitute a diagnostic dylemma. Objective: To contribute to a better knowledge on the relation among tuberculosis and collagenosis. Cases presentation: Three adolescents suffering collagenosis are presented. They were attended in the National Reference Center for Children Tuberculosis. Two of the patients had previous diagnostic of collagenosis (juvenile idiopatic arthritis and polymyositis) with steroids treatment in exacerbations or continuous since a year ago. The third patient presented a prolonged febrile syndrome with pleurisy and pericarditis, with suspicions of disseminated lupus erythematosus. Tuberculosis was diagnosed by the test of hyperergic Mantoux. The treatment was prolonged with steroids, antiturberculosis drugs and pericardiotomy at the beginning of the process, with bad evolution and failure of the treatment. All the time it was intended to rule out collagen disease. Tuberculosis was confirmed by culturing in the three patients and final evolution was satisfactorily. Characteristics of each patient were exposed and it was analyzed the relation among both diseases. Conclusions: Three cases that exemplify the relation among tuberculosis and collagenosis(AU)


Subject(s)
Humans , Male , Female , Adolescent , Tuberculosis/complications , Tuberculosis/diagnosis , Collagen Diseases/complications , Collagen Diseases/epidemiology , Isoniazid/therapeutic use , Case Reports
15.
Enferm. actual Costa Rica (Online) ; (35): 85-102, Jul.-Dez. 2018. tab, graf
Article in Spanish | LILACS, BDENF | ID: biblio-953203

ABSTRACT

Resumen 17. Este estudio tuvo por objetivo identificar los factores de riesgo asociados a la aparición de tuberculosis en Rincón Grande, Pavas. Se trata de una investigación cuantitativa realizada en dos fases: la primera correspondió a una descripción de los casos de tuberculosis en toda el área de estudio y la segunda, a un estudio de casos y controles con la población de Rincón Grande. En ambas fases se utilizó la totalidad de casos registrados de tuberculosis pulmonar entre 2010 y 2016. La fuente de datos fue el Sistema de Información Integrado de Salud y el libro de registro de casos. La selección de los controles fue aleatoria simple, con el total de sintomáticos respiratorios y el reporte del ELISA. Entre los resultados se denota que la incidencia en Pavas (periodo 2010-2016), osciló entre 10.2 y 22.2 casos por cada 100 000 habitantes. El 70,4% de los casos tenía entre 20 y 64 años de edad, el 59,0% correspondió a hombres; el 29,6%, a extranjeros. El 18,8% presentó antecedentes de consumo de drogas y el 51,1% tenían estudios con escolaridad primaria o menor. Los factores asociados son hacinamiento crítico, sexo (OR=1.9, IC=0.1-3.6), co-infección con VIH (OR=9.7, IC=2.3-39.6) y estado nutricional. Los hombres presentan 1.9 más veces la posibilidad de desarrollar tuberculosis y las personas con VIH presentan 9.7 veces dicha posibilidad. Se concluye que la seropositividad por VIH, las condiciones de hacinamiento, la desnutrición y el sexo masculino son factores de riesgo para la incidencia de tuberculosis en Rincón Grande.


Abstract 21. The objective of this study was to identify the risk factors associated with the appearance of tuberculosis in Rincón Grande, Pavas. This is a quantitative investigation carried out in two phases: the first corresponded to a description of the cases of tuberculosis in the entire study area and the second, to a case-control study with the population of Rincón Grande. In both phases, the totality of registered cases of pulmonary tuberculosis between 2010 and 2016 was used. The source of data was the Integrated Health Information System and the case record book. The selection of controls was simple random, with the total of respiratory symptoms and the ELISA report. Among the results it is noted that the incidence in Pavas (period 2010-2016), ranged between 10.2 and 22.2 cases per 100 000 inhabitants. 70,4% of the cases were between 20 and 64 years of age, 59,0% corresponded to men; 29,6%, to foreigners. 18,8% had a history of drug use and 51,1% had studies with primary or lower education. The associated factors are critical overcrowding, sex (OR = 1.9, CI = 0.1-3.6), co-infection with HIV (OR = 9.7, CI = 2.3-39.6) and nutritional status. Men present 1.9 times more the possibility of developing tuberculosis and people with HIV present 9.7 times that possibility. It is concluded that HIV seropositivity, crowded conditions, malnutrition and male sex are risk factors for the incidence of tuberculosis in Rincón Grande.


Resumo 25. O objetivo deste estudo foi identificar os fatores de risco associados ao aparecimento da tuberculose em Rincón Grande, Pavas. Trata-se de uma investigação quantitativa realizada em duas fases: a primeira correspondeu a uma descrição dos casos de tuberculose em toda a área de estudo e a segunda, a um estudo caso-controle com a população de Rincón Grande. Em ambas as fases, utilizou-se a totalidade dos casos registrados de tuberculose pulmonar entre 2010 e 2016. A fonte de dados foi o Sistema Integrado de Informação em Saúde e o livro de registro de casos. A seleção dos controles foi aleatória simples, com o total de sintomas respiratórios e o laudo ELISA. Entre os resultados, observa-se que a incidência em Pavas (período 2010-2016) variou entre 10,2 e 22,2 casos por 100 mil habitantes. 70,4% dos casos tinham entre 20 e 64 anos de idade, 59,0% correspondiam a homens; 29,6% para estrangeiros. 18,8% tinham histórico de uso de drogas e 51,1% tinham estudos com ensino primário ou inferior. Os fatores associados são superlotação crítica, sexo (OR = 1,9, IC = 0,1-3,6), co-infecção por HIV (OR = 9,7, IC = 2,3-39,6) e estado nutricional. Os homens apresentam 1,9 vezes mais a possibilidade de desenvolver tuberculose e as pessoas com HIV apresentam 9,7 vezes essa possibilidade. Conclui-se que a soropositividade ao HIV, condições de superlotação, desnutrição e sexo masculino são fatores de risco para a incidência de tuberculose em Rincón Grande.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Tuberculosis/complications , HIV , Costa Rica , Vulnerable Populations , Malnutrition
16.
Buenos Aires; GCBA. Gerencia Operativa de Epidemiología; 20 jul. 2018. a) f: 21 l:25 p. graf, tab.(Boletín Epidemiológico Semanal: Ciudad Autónoma de Buenos Aires, 3, 100).
Monography in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1116498

ABSTRACT

El área programática del Hospital Parmenio Piñero (AP-HGAPP) se localiza en el sur de la ciudad, e incluye parte de las comunas 7, 8, 9, 10, 6 y 4. Según datos provenientes del Censo 20105, se registraron 324.179 personas viviendo en este territorio, con un porcentaje de población con Necesidades Básicas Insatisfechas de 10,4% (superior al valor promedio de CABA de 7%). Se presenta en este informe un análisis de situación de tuberculosis, tomando como eje el territorio y la población a cargo del hospital y sus centros de salud y acción comunitaria. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Tuberculosis/classification , Tuberculosis/complications , Tuberculosis/ethnology , Tuberculosis/mortality , Tuberculosis/prevention & control , Tuberculosis/transmission , Tuberculosis/epidemiology , Catchment Area, Health/statistics & numerical data , Epidemiologic Studies , Hospitals, Municipal/statistics & numerical data
17.
Biomédica (Bogotá) ; 38(2): 180-188, ene.-jun. 2018. tab
Article in English | LILACS | ID: biblio-950936

ABSTRACT

ABSTRACT Introduction: Tuberculosis continues to be a major health problem in the world with an incidence of more than 10 million cases in 2015. There are factors that change the risk of developing the disease after infection, as well as the presentation of the disease. Objective: To determine the main comorbidities and demographic, clinical and microbiological characteristics of tuberculosis adult patients in Argentina from a gender and age perspective. Materials and methods: We conducted a cross-sectional study in urban referral hospitals for patients with tuberculosis. We included tuberculosis patients of 15 years or more of age who were hospitalized or treated in outpatient clinics with bacteriologically confirmed pulmonary or extrapulmonary forms of the disease, as well as those who, although not bacteriologically confirmed, had clinical and radiological characteristics consistent with tuberculosis. The study period was from August 1st, 2015 to August 31st, 2016. Results: We included 378 patients. The median age was 37 years. Male gender was associated with extrapulmonary tuberculosis, hospitalization, smoking, drug addiction and alcoholism. Tuberculosis and aids (22.6%) was related to drug use, admission into hospital, extrapulmonary tuberculosis, non-addiction to tobacco, non-pathological radiology, absence of cavitation, and negative sputum smear microscopy. Patients less than 40 years of age had a higher rate of drug addiction and low weight, while those aged 40 or over had a higher proportion of diabetes, alcoholism and chronic obstructive pulmonary disease (COPD). Conclusions: This study will help recognize tuberculosis patients' characteristics and comorbidities influencing the development and evolution of the disease from an age and gender perspective to enable the development of social and community-based strategies.


RESUMEN Introducción. La tuberculosis continúa siendo un importante problema de salud en el mundo, con una incidencia de más de 10 millones de casos en el 2015. Hay factores que modifican el riesgo de desarrollar la enfermedad luego de contraer la infección, así como su forma de presentación. Objetivo. Determinar las principales comorbilidades y características demográficas, clínicas y microbiológicas de pacientes adultos con tuberculosis en Argentina, mediante un análisis desde la perspectiva de sexo y edad. Materiales y métodos. Se llevó a cabo un estudio transversal en hospitales de referencia para pacientes de áreas urbanas con tuberculosis. Se incluyeron pacientes de 15 años o más con tuberculosis pulmonar o extrapulmonar, confirmada bacteriológicamente y en tratamiento hospitalario o ambulatorio, y también, pacientes sin confirmación bacteriológica, pero con características clínicas y radiológicas indicativas de tuberculosis. El período de estudio fue del 1ºde agosto de 2015 al 31 de agosto de 2016. Resultados. Se incluyeron 378 pacientes. La mediana de edad fue de 37 años. El sexo masculino estuvo asociado con tuberculosis extrapulmonar, hospitalización, tabaquismo, adicción a drogas y alcoholismo. Los menores de 40 años presentaron adicción a drogas y bajo peso con mayor frecuencia, en tanto que los de 40 años o más presentaron, en mayor proporción, diabetes, alcoholismo y enfermedad pulmonar obstructiva crónica (EPOC). Se observaron más casos de sida en el sexo masculino, y en edades de 40 años y más. Conclusiones. Este trabajo permitió conocer las características y las comorbilidades de enfermos de tuberculosis, que influyen en el desarrollo y la evolución de la enfermedad, desde una perspectiva de edad y sexo, con el objetivo de facilitar enfoques de manejo que incorporan aspectos sociales y comunitarios.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Tuberculosis/complications , Argentina/epidemiology , Tuberculosis/diagnosis , Tuberculosis/microbiology , Tuberculosis/epidemiology , Urban Health , Cross-Sectional Studies , Sex Distribution , Age Distribution
18.
Rev. argent. radiol ; 82(1): 28-35, mar. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1041865

ABSTRACT

La Tuberculosis (TBC) es una patología infecto-contagiosa de alta morbimortalidad en Chile y en el mundo, siendo la segunda causa de muerte por cuestión infecciosa y es considerada una patología de alta relevancia a nivel de salud pública. Es causada por una bacteria de alta virulencia y contagio llamada mycobacterium tuberculosis. En la actualidad contamos con protocolos de detección y tratamiento muy eficaces, que la convierten en una enfermedad prevenible y curable. El diagnóstico se realiza con estudios bacteriológicos específicos frente a una sospecha clínica-epidemiológica sugerente. Sin embargo, el uso de imágenes forma parte casi obligatoria de su estudio y control. Debido a que el órgano diana de la TBC es el pulmón, es habitual utilizar como apoyo diagnóstico una radiografía de tórax, la cual es útil, en caso de TBC pulmonar, al presentar hallazgos característicos y orientadores para su diagnóstico. Es importante destacar que el mycobacterium tuberculosis tiene alto potencial de diseminación por contigüidad, vía linfática y/o hematógena, siendo esa última vía la causante de la mayoría de las TBC extrapulmonares, las cuales se presentan en un 20% de pacientes inmunocompetentes y hasta en un 60% de inmunocomprometidos. La principal localización de una TBC extrapulmonar es a nivel pleural, seguida del compromiso ganglionar, urogenital y osteoarticular, siendo el resto de las localizaciones muy infrecuentes. Para esos casos la tomografía computada (TC) es el estudio por imágenes de elección para el diagnóstico y control, además de ser una herramienta muy útil para la detección de complicaciones.


Tuberculosis (TB) is an infectious disease of high morbility and mortality in Chile and in the world. It is the second cause of death due to infectious causes in the world, and is considered of high relevance to public health. TB is caused by a highly pathogenic and virulent bacterium denominated mycobacterium tuberculosis. Nowadays, there are effective protocols for detection and treatment of this disease, which make it preventable and curable. Diagnosis is reached by specific bacteriological studies in the presence of a clinical epidemiological suspicion. Nevertheless, imagining methods are almost an obligatory part of tuberculosis study and control. Since the lung is the target organ of TB, chest X-ray is commonly used as a support for diagnosis, which is very useful in case of pulmonary TB because it provides characteristic findings to guide diagnosis. It is important to highlight that the mycobacterium tuberculosis has a high potential for dissemination by contiguity, via lymphatic and/or haematogenous, the latter being the cause of the majority of extrapulmonary TB, which are presented in 20% of immunocompetent patients and by up to 60% of immunocompromised. The main site of extrapulmonary TB is into the pleural space, followed by the lymph node, urogenital and osteoarticular involvement, the remainder being infrequent localizations. In these cases, a computed tomography (CT) study based on the selection of images, is the tool used for diagnosis and control, which is also useful for the detection of complications.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Tuberculosis/classification , Tuberculosis/complications , Tuberculosis/diagnostic imaging , Tuberculosis, Lymph Node/diagnostic imaging , Tuberculosis, Miliary/diagnostic imaging , Tuberculosis, Osteoarticular/diagnostic imaging , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/diagnostic imaging , Tuberculosis, Urogenital/diagnostic imaging , Radiography, Thoracic/methods , Tomography, X-Ray Computed/methods , Lung/pathology
19.
Rev. ANACEM (Impresa) ; 12(1): 17-20, feb. 2018. ilus
Article in Spanish | LILACS | ID: biblio-981416

ABSTRACT

INTRODUCCIÓN: Dentro de las micobacterias atípicas destaca el Complejo Micobacterium Avium, cuyo nicho principal en humanos son los pacientes con inmunodeficencia. PRESENTACIÓN DEL CASO: Paciente masculino, 30 años, con antecedentes de infección por Virus de Inmonudeficiencia Humana en terapia antirretroviral y por virus Hepatitis B. Hospitalizado por cuadro de dolor abdominal asociado a síndrome consuntivo. Durante hospitalización se realizó Tomografía Computarizada que mostró múltiples adenopatías. Luego se realizó biopsia ganglionar que concluyó Tuberculosis ganglionar, comenzando con tratamiento antituberculoso. En el transcurso del tratamiento el paciente inició con sintomatología respiratoria y sus baciloscopías de esputo persistieron positivas, manteniéndose con dicho cuadro hasta confirmar la presencia de Micobacterium Avium en el cultivo, comenzando su tratamiento específico, con positivos resultados. DISCUSIÓN: El Complejo Micobacterium Avium corresponde a la causa más común de enfermedad por micobacteria no tuberculosa en inmunosuprimidos. Por lo tanto, es un patógeno que merece ser considerado al menos como diagnóstico diferencial en dicho tipo de pacientes. En el presente caso se evidencia tanto una sospecha como un diagnóstico tardío, lo que llevó a una demora en el inicio del tratamiento y a complicaciones sintomáticas del paciente. Es necesario para la pesquisa precoz, realizar cultivos tanto para M. tuberculosis como para micobacterias atípicas para mejorar pronóstico y a su vez disminuir el riesgo de complicaciones.


INTRODUCTION: Among the atypical mycobacteria, the Micobacterium Avium Complex stands out. Its main niche in humans is immunodeficient patients. CASE REPORT: 30 years old male patient, with a history of infection by Human Immunodeficiency Virus on antiretroviral therapy, and Hepatitis B virus. Hospitalized for abdominal pain associated with consumptive syndrome. During his hospitalization, a computerized tomography was performed, showing multiple adenopathies. Then, a lymph node biopsy was performed that concluded nodal tuberculosis, beginning with antituberculous treatment. During the course of this treatment, patient presented respiratory symptoms and sputum bacilloscopy persisted positive, maintaining this condition until the presence of Mycobacterium Avium was confirmed in the culture, beginning with specific treatment, with positive results. DISCUSSION: The Mycobacterium Avium Complex is the most common cause of nontuberculous mycobacterial disease in immunosuppressed patients. Therefore, its a pathogen that has to be considered at least as a differential diagnosis in such patients. In the present case, suspicion and a late diagnosis are evidenced, which lead to a delay in the initiation of treatment and complications for the patient. It is necessary for early screening, culture for both M. tuberculosis and atypical mycobacteria to improve prognosis and to reduce the risk of complications.


Subject(s)
Humans , Male , Adult , Tuberculosis/complications , Mycobacterium avium-intracellulare Infection/drug therapy , HIV Infections/complications , Mycobacterium avium Complex
20.
Biomédica (Bogotá) ; 38(1): 7-16, ene.-mar. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-888541

ABSTRACT

Resumen El factor de necrosis tumoral alfa (FNTα) es una citocina fundamental en la reacción inmunitaria frente al cáncer y a infecciones tales como la tuberculosis. Esta molécula también desempeña un papel fundamental en la patogenia de enfermedades complejas y de difícil tratamiento, como la artritis reumatoidea, la espondilitis anquilosante, la enfermedad de Crohn, la psoriasis y la colitis ulcerativa, condiciones que suelen requerir el uso de medicamentos que antagonizan la función del factor de necrosis tumoral alfa, el cual se ha relacionado con un incremento del riesgo de desarrollar tuberculosis, micosis y otras infecciones graves. Se reporta el caso de un hombre de 68 años de edad con diagnóstico de enfermedad de Crohn, a quien se le administró tratamiento con antagonistas del FNTα, debido a lo cual desarrolló tuberculosis diseminada. El diagnóstico se hizo con base en los hallazgos histológicos y mediante pruebas de biología molecular. Se discuten la presentación clínica y el manejo del caso, y se hace un análisis comparativo de los casos de tuberculosis asociados al tratamiento con antagonistas del FNTα reportados en Colombia durante los últimos diez años, con especial énfasisen la detección y el tratamiento de la tuberculosis latente.


Abstract Tumor necrosis factor-α (TNF-α) is an important fundamental cytokine during the immune response against cancer and infections such as tuberculosis. This molecule also plays a key pathogenic role in complex and difficult-to-treat diseases such as rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, psoriasis and ulcerative colitis. The treatment of these diseases frequently needs TNF-αantagonists, which has been related to an increased risk of developing tuberculosis, mycoses, and other severe infections. We report the case of a 68-year-old man with Crohn's disease, who developed disseminated tuberculosis due to anti-TNF-α immunosuppressive therapy. The diagnosis was based on the histopathological findings and molecular biology assays. We discuss the clinical presentation and workup of this case, and we present a comparative analysis of tuberculosis cases associated with anti-TNF-α reported in Colombia during the last 10 years emphasizing on the diagnosis and treatment of latent tuberculosis.


Subject(s)
Aged , Humans , Male , Arthritis, Rheumatoid/complications , Tuberculosis/complications , Crohn Disease/drug therapy , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Immunosuppressive Agents/adverse effects , Spondylitis, Ankylosing , Colombia , Immunosuppressive Agents/chemistry
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