Tuberculin skin testing in inflammatory bowel disease patients from an endemic area of Brazil

Objective: Inflammatory bowel disease (IBD) is a chronic disorder involving the gastrointestinal tract. Immunosuppressive drugs are usually prescribed to treat IBD patients, and this treatment can lead to tuberculosis reactivation. This paper aimed to analyze tuberculin skin test (TST) results in IBD patients at a reference center in Brazil. Methods: We evaluated TST results in IBD patients using a cross-sectional study. We also analyzed the medical records of patients treated at a reference IBD outpatient unit where TST is routinely performed. Results: We reviewed 119 medical records of 57 (47.9%) Crohn's disease (CD), 57 (47.9%) ulcerative colitis (UC) and 5 (4.2%) indeterminate colitis (IC) patients. The mean (SD) age was 43.5 (13.7) years old. TST was positive in 24 (20.2%) of the patients. TST was positive in 16/57 (28.1%) UC and 6/57 (10.5%) CD patients (prevalence ratio [PR] 2.7). Forty-one patients (34.5%) were taking immunosuppressive drugs (azathioprine or prednisone) at the time of the TST, and six of these patients (14.6%) had positive test results. Two patients using infliximab had negative TST results. Thirty-five of the 41 patients (85.4%) on immunosuppressive treatment were anergic compared with 73.1% (57/78) of the untreated patients (PR 1.2). Conclusions: Patients with IBD have TST results similar to the general Brazilian population. Within the IBD population, CD patients have a lower frequency of TST positivity than UC patients. .

Qualidade de vida e transplante hepático: avaliação comparativa em diferentes fases pré e pós cirurgia / Quality of life and liver transplantation: assessment before and after surgery

O transplante hepático é definido como a terapêutica de escolha para a doença hepática em estágio terminal. O uso de instrumentos genéricos e instrumentos específicos na avaliação da qualidade de vida dos pacientes cirróticos previamente ao transplante evidencia comprometimento da qualidade de vida proporcional à gravidade da doença hepática e mais pronunciado nos portadores de cirrose pelo VHC, especialmente em seus aspectos cognitivos. O transplante hepático é capaz não apenas de prolongar a sobrevida destes pacientes, como também de melhorar sua qualidade de vida, em todos os seus aspectos. Neste grupo de pacientes a recidiva da hepatite C determina comprometimento do funcionamento do enxerto, bem como da sua qualidade de vida...

Liver transplantation is defined as the standard treatment for end-stage liver disease. The use of generic and specific instruments for evaluation of quality of life in cirrhotic patients before transplantation can show that quality of life is severely impaired in this group of patients and it’s related to the degree of liver disease severity. Hepatitis C also determines worse quality of life when compared to other etiologies, especially due to cognitive dysfunction. Liver transplantation enhances quality of life in cirrhotic patients, but since hepatitis C recurs in the allograft, deterioration of their quality of life is observed...