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1.
Int J Tuberc Lung Dis ; 28(5): 217-224, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38659144

RESUMO

BACKGROUNDDespite the high morbidity and mortality globally, standard microbiologic diagnosis for TB requires laboratory infrastructure inaccessible in many resource-limited areas and may be insufficient for identifying extrapulmonary disease. Point-of-care (POC) ultrasound facilitates visualization of extrapulmonary manifestations, permitting laboratory-independent diagnosis, but its diagnostic utility remains unclear.METHODSWe conducted a systematic review of five online databases for studies reporting ultrasound findings among cases with and without extrapulmonary TB (EPTB). A minimum of two authors independently screened and reviewed each article, and extracted data elements of interest. We conducted a series of univariate meta-analyses using a random-effects model to calculate the pooled effect estimate and 95% confidence interval (CI) for each outcome: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).RESULTSOf 279 articles identified, 6 were included. There were 699 cases of EPTB among 1,633 participants. The pooled sensitivity estimate was 0.72 (95% CI 0.57-0.88). The pooled specificity estimate was 0.77 (95% CI 0.63-0.90). The pooled PPV and NPV estimates were respectively 0.67 (95% CI 0.47-0.87) and 0.85 (95% CI 0.77-0.93).CONCLUSIONPOC ultrasound showed modest test characteristics for diagnosing EPTB, which may constitute an improvement over some currently available diagnostics..


Assuntos
Sistemas Automatizados de Assistência Junto ao Leito , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Tuberculose , Ultrassonografia , Humanos , Tuberculose/diagnóstico por imagem , Tuberculose/diagnóstico
2.
J Asthma ; 56(4): 360-368, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29693462

RESUMO

OBJECTIVE: Asthma prevalence in Costa Rica is among the highest worldwide. We aimed to determine the prevalence of asthma among school-age children in the Central Highland Area of Costa Rica. METHODS: Cross-sectional study using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was performed. Parents or guardians of children aged 6-13 years completed written questionnaires. RESULTS: Total of 2817 school-aged children returned these questionnaires (74.1% return rate). The prevalence of asthma, rhinitis, and eczema was 21.9%, 42.6%, and 19.2%, respectively. The co-existence of the 3 diseases was seen in 22.6% of children with asthma. Boys had a slightly higher prevalence of these conditions, and younger children had higher prevalence of asthma and eczema, but lower prevalence of rhinitis than older children. The use of acetaminophen and antibiotics in the first 12 months of life showed a significant association with the prevalence of asthma, rhinitis, and eczema. Wheezing with exercise, dry cough at night, and ever rhinitis was highly associated with asthma symptoms in the last 12 months. In contrast, no association was found between children exposed to smoking at home. Frequent traffic next to the house was reported more frequently by the parents of children with asthma, although no significant association was found. CONCLUSION: The prevalence of asthma showed a significant decrease compared to previous studies. However, there was an unexpected high prevalence of rhinitis. Exposure to acetaminophen and antibiotic during the first year of life was highly associated with asthma symptoms.


Assuntos
Asma/epidemiologia , Eczema/epidemiologia , Rinite Alérgica/epidemiologia , Inquéritos e Questionários , Adolescente , Distribuição por Idade , Asma/diagnóstico , Asma/imunologia , Criança , Costa Rica , Estudos Transversais , Países em Desenvolvimento , Eczema/diagnóstico , Eczema/imunologia , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Prevalência , Prognóstico , Rinite Alérgica/diagnóstico , Índice de Gravidade de Doença , Distribuição por Sexo
3.
Aust J Physiother ; 37(3): 163-8, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-25026480

RESUMO

Eight therapists each examined 16 subjects (14 with documented ACL pathology, two normal subjects) in a single session. Instrumented anterior laxity measurements were performed bilaterally on all subjects prior to testing. Therapists assessed the degree of anterior tibial translation on a visual analogue scale, and indicated whether the nominated knee tested positive or negative using the Lachman test. Intertester reliability in assessing anterior translation was low. Correlation between the overall therapists' translation measurements and the arthrometer was moderate. Intertester reliability in indicating whether the nominated knee tested positive or negative was low. These findings suggest that greater expertise is necessary for therapists to reliably use the Lachman test as an assessment procedure in evaluation of the injured knee.

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