Comparison of isoniazid monoresistant tuberculosis with drug-susceptible tuberculosis and multidrug-resistant tuberculosis.

Limited data exist about the clinical characteristics of Mycobacterium tuberculosis (TB) isolates with resistance to isoniazid (IZN). We describe the demographic and clinical characteristics and risk factor information for persons with IZN monoresistant (resistant to isoniazid) TB compared with drug-susceptible TB and multidrug-resistant (MDR) TB. From 2002 to 2009, 590 cases of TB were diagnosed. Of these, 44 (7.5%) developed MDR-TB and 38 (6.4%) had IZN monoresistant TB. Among the IZN monoresistant TB patients, more common demographic characteristics were former resident of the Soviet Union immigrant, smoker, and previous history of TB (p = 0.005, 0.025, and 0.005, respectively), while HIV, weight loss, and hemoptysis were less common (p = 0.005 for all parameters). The mean length of treatment was 24 ± 4 months for MDR-TB, 10 ± 3 months for IZN monoresistant TB cases, and 8 ± 2 months for all other TB cases. The directly observed therapy (DOT) rate was similar in all three groups. However, treatment failure, completion of TB treatment, and mortality were all similar in drug-susceptible TB and higher in MDR-TB. In multivariate analysis, only a history of previous TB (odds ratio [OR] 1.4; 95% confidence interval [CI]: 1.2-1.6) was significantly associated with IZN monoresistant TB. IZN monoresistant TB has distinct characteristics. However, the length of treatment and outcome are similar to drug-susceptible TB cases.

[Epidemiologic profile of transtelephonic electrocardiography in El Salvador during 1994]. / Perfil epidemiológico de la electrocardiografía transtelefónica en El Salvador durante 1994.

UNLABELLED: A total of 3,787 electrocardiograms were obtained with transtelephonic monitors (TT-ECG) during 1994 in CardioTel of Central America, Nueva San Salvador, El Salvador. Each case was evaluated in terms of patient's risk and classified as high or low risk on basis of its clinical profile. There were 3,441 traces of low risk patients and 346 of high risk one. Female patients accounts for 64.7% of cases, with 35.3% corresponding to males. Of all the TT-ECG's a 52.3% were normal. Subjects older than 60 years (independently of risk had a greater probability of an abnormal TT-ECG; in the same way there was an statistically significative increase in the incidence of abnormal TT-ECG in high risk subjects compared with low risk ones. In respect to specific TT-ECG abnormalities against cardiovascular risk, a high risk condition implied a greater incidence of bundle branch blocks, signs of myocardial lesion/necrosis, left ventricular hypertrophy, sinus tachycardia and bradycardia, atrial fibrillation and premature ventricular and supraventricular complexes, with a p value of 0.05 of 0.001. CONCLUSIONS: TT-ECG is useful in the search of cardiovascular disease, regardless the presence or absence of symptoms. Age greater than 60 years and high cardiovascular risk implies a greater probability of abnormal TT-ECG.