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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introdução: Os inibidores de checkpoints imunológicos (ICI) são uma classe de medicamentos cada vez mais utilizados para tratar o câncer. No entanto, eles têm sido associados a um risco aumentado de reativação da tuberculose (TB) em pacientes com infecção tuberculosa latente (ILTB). Relato do caso: Mulher, 61 anos, com câncer de orofaringe desenvolveu reativação de TB pulmonar enquanto recebia nivolumabe. Acredita-se que a reativação da TB em pacientes em ICI seja em virtude da inibição da via PD-1 que desempenha um papel no controle da ILTB. A incidência de reativação da TB em pacientes em ICI é maior do que na população geral. Conclusão: O uso crescente de ICI provavelmente levará a um aumento no número de casos de reativação da TB. Sugere-se proceder ao rastreamento rotineiro para ILTB nos pacientes que estão sendo considerados para tratamento com ICI, especialmente em países com alta incidência de TB.

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Correlacionar mediadores inflamatórios e parâmetros bioquímicos em pacientes com tuberculose (TB) pulmonar ativa atendidos em um hospital público, em São Luís, MA. Métodos: Trata-se um caso-controle de pacientes com diagnóstico positivo para TB pulmonar ativa. Amostras de soro dos pacientes e grupo controle foram coletadas para os experimentos clínicos e os dados epidemiológicos foram coletados por meio de prontuários e entrevistas. O grupo controle foi formado por voluntários saudáveis sem contato prévio com casos de TB, pareados com idade e sexo ao grupo clínico. Para dosar citocinas inflamatórias, utilizaram-se os kits Human IL-6 ELISA Set e Human IFN-γ ELISA Set. Mediu-se o estresse oxidativo pela quantificação das espécies reativas do ácido tiobarbitúrico (TBARS) e óxido nítrico (ON). Na bioquímica, mediram-se os níveis de ácido úrico, anti-estreptolisina-O (AEO), alanina aminotransferase (ALT), amilase, aspartato aminotransferase (AST), cálcio, colesterol total, gama glutamil transferase (Gama GT), glicose, fosfatase alcalina, lipoproteína de alta densidade (HDL), proteína C reativa (PCR) e triglicerídeos. A análise estatística foi realizada pelo software GraphPad Prism 8, com p

Objective: to describe the social construction of the social concept of pulmonary tuberculosis that, from the perspective of nurses, emerges from concepts based on stigma. Method: descriptive study, qualitative approach, with 12 nurses from centers of pneumological diagnosis in northern Portugal. Data collected in November 2020 and January 2021 by semi-structured interview, subsequently analyzed by content analysis methodology. Results: from the participants' discourses, the concept of pulmonary tuberculosis emerges. The understanding of the disease is surrounded by myths and taboos, with a bleak prognosis, causes fear of contagion, death, fear, shame, estrangement, social isolation and denial of the disease. Among nurses, talking about tuberculosis is a topic to avoid, it is an area that causes confusion and fear. Final considerations: the concept of the word tuberculosis persists rooted in concepts and prejudices. Social stigma remains at its core and perpetuates its negative concept to the present day. [ABSTRACT FROM AUTHOR]

Objetivo: Analisar a vulnerabilidade à tuberculose pulmonar em pessoas em situação de rua no município de Passos – MG. Metodologia: Estudo do tipo transversal observacional, descritivo com abordagem quantitativa que visa levantar variáveis para analisar a vulnerabilidade à tuberculose pulmonar em pessoas em situação de rua no município de Passos – MG. Foram entrevistadas 78 pessoas. A coleta de dados foi realizada de junho a outubro de 2019 através de entrevista. Os sujeitos pesquisados foram escolhidos pelo critério de acessibilidade. Para a análise, os dados foram lançados no programa Excel (Microsoft). Resultados: Do total de entrevistados (78), têm-se: indivíduos do sexo masculino (90%), da faixa etária adulta de 20 a 59 anos (91%), se alimentam 2 vezes ou menos por dia (52,5%); cerca de 40% dos entrevistados não possuíam acesso à higiene completa (acesso aos 3 itens: sanitário, banho e escovação dentária), 5 (6,4%) indivíduos já apresentaram tuberculose em algum momento da vida e 15 (19,2%) foram identificados com queixa de sintomas respiratórios. Além disso, foram estabelecidas relações entre consumo de álcool, tabaco e drogas ilícitas na população entrevistada. Conclusão: Os dados demonstram a vulnerabilidade das pessoas em situação de rua para a tuberculose a partir de análise de fatores como acesso à higiene, qualidade da alimentação, uso de álcool, tabaco e outras drogas.

Introduction: Pulmonary tuberculosis is considered one of the major public health issues in Peru, thus understanding its real condition from different points of view will allow choosing the most appropriate therapeutic approach and patient care. Objective: To determine the relationship between social support and self-care in patients in the Lima Este Hospital, Peru. Materials and Methods: A quantitative correlational cross-sectional study was conducted with 114 patients participating in the NTCP program. Non-probability purposive sampling was built with 100 patients for which inclusion and exclusion criteria were applied. The MOS Social Support Survey and Self-Care Questionnaire were administered. Ethical considerations were considered for data collection. Data was processed using SPSS-24 software and later analyzed using descriptive statistics with frequencies and percentages. The chi-squared test was used for inferential analysis. Results: Sex, age, educational level and marital status had no relationship (p>0.05) with self-care in TB patients. Inappropriate self-care was found in 69.2% of patients receiving MDR-TB treatment. 100% of patients receiving drug-susceptible TB treatment showed appropriate self-care with a significant relationship (p-value of 0.000). 83.3% of patients who perceived appropriate support showed appropriate self-care, 76.9% of patients who perceived poor support rated their self-care as inappropriate with a significant relationship (p-value of 0.000). Similar findings were found for the social support dimension with a p-value of <0.05. Conclusions: Patients were characterized as young, male and single under drug-susceptible TB treatment. A significant relationship was found between appropriate social support and appropriate self-care. A schedule for drug-susceptible TB treatment is related to inappropriate self-care. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess whether the Primary Health Care coverage, in different models, interfered with the number of reported cases of pulmonary tuberculosis, deaths and cure of the disease, in the state of São Paulo, from 2008 to 2016. This was an ecological study, with secondary data, statistically analyzed by Poisson regression. A higher prevalence of the disease was found in municipalities with a larger population, higher poverty rate and lower coverage of the Family Health Strategy. There were more deaths in municipalities with a larger population, better economic indicators, lower coverage of community health agents and with traditional Primary Health Care. Higher cure rates were observed in municipalities with worse economic and human development indicators, with higher coverage of community health agents and the Primary Health Care. The coverage of Primary Health Care, especially in models composed with community health agents, is associated with better indicators of pulmonary tuberculosis. [ABSTRACT FROM AUTHOR]

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Introdução: Em Pediatria, o diagnóstico de tuberculose constitui um desafio, pois a doença pode frequentemente manifestar-se através de formas graves e extrapulmonares. O objetivo deste estudo foi avaliar e refletir sobre a tuberculose grave com necessidade de internamento, em idade pediátrica, numa área metropolitana de Lisboa. Material e Métodos: Estudo descritivo de doentes com idade inferior a 18 anos, internados com o diagnóstico de tuberculose num hospital pediátrico terciário, de 2008 a 2019 (12 anos). Resultados: Identificados 145 doentes, numa média de 12 casos por ano, e um aumento do número de casos nos últimos três anos. A mediana de idades dos doentes era de 12,9 anos, 42,8% nascidos em países africanos de língua oficial portuguesa e 20% tinham doença crónica. Diagnosticou-se tuberculose pulmonar em 52,4% (n = 76) e tuberculose extrapulmonar em 47,6%: ganglionar (n = 26), óssea (n = 15), miliar (n = 8), meníngea (n = 7), peritoneal/intestinal (n = 6), pleural (n = 4), renal (n = 1), cutânea (n = 1), da parede torácica (n = 1) e glândulas salivares (n = 1). A prova tuberculínica foi positiva em 78/99 (78,8%) e o Interferon Gamma Release Assay em 61/90 (67,8%). Em 20,7% (n = 30) identificaram-se bacilos ácido-álcool resistentes no exame direto do suco gástrico/expetoração e o agente foi identificado em 59,3% (n = 86). A tuberculose resistente ocorreu em 11% (n = 16). Os doentes com tuberculose extrapulmonar eram mais jovens (p = 0,006) e fizeram tratamentos mais prolongados (p < 0,001). Ocorreram complicações da terapêutica em 11% (n = 16). Registou-se um óbito numa doente com neoplasia avançada. Conclusão: Este estudo alerta para a necessidade do rastreio da infeção em crianças de países endémicos, imunossuprimidos e com doença crónica.

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: analisar as evidências disponíveis na literatura sobre os fatores relacionados à não adesão ao tratamento diretamente observado por pessoas com tuberculose pulmonar. Métodos: trata-se de uma revisão integrativa da literatura. A busca ocorreu entre os meses de agosto de 2019 e maio de 2020, por acesso às bases de dados MEDLINE, LILACS, BDENF, BINACIS, IBECS, PUBMED, SCOPUS, e WEB OF SCIENCE, bem como via biblioteca virtual SCIELO, selecionando artigos publicados entre 2009 e 2019. Resultado: dos 1664 estudos pré-analisados foram identificados e selecionados 57 artigos que atenderam à pergunta de pesquisa. Após a extração dos dados, os fatores de não adesão foram estratificados em cinco categorias: fatores relacionados ao paciente, aspectos socioeconômicos, fatores referentes ao tratamento, fatores relacionados aos profissionais/serviço de saúde e aspectos de conhecimento, os quais apresentaram uma correspondência de 49, 33, 41, 23 e 20 artigos, respectivamente. Conclusão: Este estudo possibilitou analisar as evidências científicas relacionadas aos fatores da não adesão ao tratamento diretamente observado por pessoas com tuberculose pulmonar. Conclui-se que a multifacetada gama de aspectos associados a tal problema de pesquisa pode ser sintetizada em fatores relacionados ao paciente, a aspectos socioeconômicos, a fatores referentes ao tratamento, fatores relacionados aos profissionais/serviço de saúde e a aspectos inerentes ao conhecimento.

A tuberculose é uma doença infecciosa cuja prevalência tem vindo a diminuir significativamente em Portugal. Dos doentes infetados, apenas 10% desenvolverão a doença, sendo este risco superior em populações imunocomprometidas. Os autores descrevem um caso de uma grávida, previamente saudável e sem contexto epidemiológico, cujo diagnóstico de tuberculose foi estabelecido às 32 semanas de gestação, após ter iniciado um quadro clínico inespecífico. A confirmação diagnóstica e a instituição da terapêutica anti-bacilar foram céleres permitindo um desfecho materno-fetal favorável. O parto decorreu às 36 semanas sem intercorrências. O recém-nascido iniciou de imediato quimioprofilaxia que manteve até confirmação de ausência de doença. A mãe manteve seguimento em consulta de Pneumologia no Centro de Doenças Pneumológico, com boa evolução clínica, radiológica e laboratorial, tendo tido alta sem doença ativa. A abordagem de uma grávida com suspeita de tuberculose deverá seguir a marcha diagnóstica habitual, nomeadamente com os exames imagiológicos necessários e com a instituição da terapêutica o mais precocemente possível.

O trabalho teve como objetivo realizar revisão de literatura sobre a abordagem da Fisioterapia no contexto da tuberculose pulmonar, proporcionando maior conhecimento acerca da influência da tuberculose na função pulmonar, além de chamar a atenção para a amplitude da atuação da Fisioterapia sobre o diagnóstico, tratamento e sequelas da doença. Trata-se de um estudo narrativo, tipo revisão integrativa de literatura entre os anos 2000 e 2019, com a busca de 237 artigos, dos quais sete referentes ao SciELO, 62 ao BVS, 94 ao PubMed, sete ao PEDro e 67 ao SCOPUS. Inicialmente, foram excluídos 63 artigos por estarem duplicados, e, três por serem de revisão de literatura. Após a leitura dos títulos e resumos foram excluídos 160 artigos. Assim, restaram 16 artigos que foram analisados na íntegra, e, dez foram utilizados para análise, considerando os critérios de inclusão e exclusão. Analisando os artigos selecionados, podemos concluir que, a Fisioterapia respiratória, em termos de reabilitação pulmonar, é um importante instrumento no tratamento adjuvante da tuberculose pulmonar e de suas sequelas, bem como no diagnóstico das possíveis disfunções pulmonares. Entretanto, são necessárias mais pesquisas na área, com amostras maiores e mais representativas, avaliando os efeitos a médio e longo prazo da abordagem fisioterapêutica, para corroborar tais achados, além de avaliar outros recursos fisioterapêuticos que possam ser eficazes no manejo da tuberculose e de suas sequelas.

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To analyze occurrences of drug-related adverse effects in treatment of tuberculosis and its association with clinical variables and outcome. Method: Cross-sectional study with 63 cases of tuberculosis treated at Tuberculosis and Leprosy Outpatient Clinic of São José do Rio Preto, São Paulo, from 2010 to 2015. We used frequency analysis and chi-square test with Monte Carlo correction. Results: Adverse effects started before the third month of treatment; effects were more frequent, with predominance of gastric irritation. There was association between medical conduct and adverse effects (p=0.009). Conclusion: Adverse effects caused by medications may impair the clinical outcome due to risk of treatment withdrawal. Health professionals should be alert to signs and symptoms related to adverse effects, implementing the necessary behaviors to neutralize or reduce complaints, aiming adherence to treatment and cure of the disease. [ABSTRACT FROM AUTHOR]

Cavitation is a common finding in lung images, secondary to infectious, inflammatory, tumor, and autoimmune conditions, the former being the most common cause in all levels of care and geography. The diagnostic approach must be judicious, integrating the image, with the patient's medical history, personal history, and exposures, as well as the time of evolution of the symptoms; which are key elements for the approach. It is always essential to integrate the clinical findings with the laboratory and the pathology in order to reach an accurate diagnosis and timely treatment, since the isolated image is not enough, given the multiple etiologies described and variety of presentation that make this radiological sign only a premise to the confirmation of an underlying disease. [ABSTRACT FROM AUTHOR]

Objective: to identify the cost of the Gene Xpert MTB/Rif® technology and analyze its contribution to the rapid diagnosis of tuberculosis. Method: quantitative and retrospective study, carried out in the period from 2014 to 2016. Data search was performed on the Information System of Disease Notification and on the Laboratory Environment Manager. The data were analyzed based on the techniques of descriptive statistics through distribution of absolute and relative frequency. Results: 196 cases were studied, and the average time to perform the test for diagnosis of tuberculosis through Gene Xpert MTB/Rif® was two days, with a cost of 35.20R$ per test performed. Conclusion: the costs of Gene Technology Xpert MTB/Rif® are relatively higher than that of sputum smear microscopy, but have great advantages in time to release the test result and higher sensitivity and specificity offered by the rapid molecular assay. [ABSTRACT FROM AUTHOR]

This article presents a study on the prevalence of malnutrition among individuals with tuberculosis in the United States. Malnutrition and tuberculosis are problems that tend to interact with each other, as malnutrition can lead to secondary immunodeficiency, increasing susceptibility to infection. Demographic, anthropometric, laboratory, and functional capacity data were used for non-institutionalized individuals with tuberculosis. The results showed that 19% of the sample had malnutrition. The prevalence of malnutrition was high, even among non-active individuals with tuberculosis. [Extracted from the article]

This article discusses the association between diabetes mellitus (DM) and tuberculosis (TB). The study used demographic, anthropometric, laboratory, and clinical data from individuals over 20 years old from the American NHANES database. A moderate correlation between DM and TB was found. Further studies are needed to investigate this relationship, including other laboratory tests and lifestyle factors. [Extracted from the article]

Copyright of Enfermagem Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe the chest computed tomography (CT) findings in immunocompetent children under 36 months of age with pulmonary tuberculosis. Materials and Methods: This was a descriptive case series conducted in the city of Rio de Janeiro, Brazil, between January 2004 and July 2013, involving 20 young children who underwent CT after undergoing chest X-rays that did not provide a definitive diagnosis. Results: All of the participants had lymph node enlargement and consolidations. In 15 cases (75%), the consolidations were accompanied by atelectasis. Pulmonary cavitation was seen in 10 cases (50%), and cavitation within consolidations was seen in 7 (35%). The areas of cavitation and parenchymal destruction were not seen on conventional chest X-rays. Conclusion: The radiological presentation of pulmonary tuberculosis in young children differs from that described in older children and adults. CT is an effective method for the early diagnosis of pulmonary tuberculosis in immunocompetent infants, allowing the rapid institution of specific treatment, which is crucial for halting disease progression, as well as for preventing local and systemic complications. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Avaliar a prevalência de tuberculose pulmonar (TBP) bacilífera e sintomáticos respiratórios (SR) em um hospital psiquiátrico público de referência em Alagoas, Brasil. Métodos: Pesquisa transversal quantitativa conduzida nas alas de internação do Hospital Escola Portugal Ramalho por meio de questionários contendo dados demográficos, epidemiológicos e sociais, de março a abril de 2013. Grupos estabelecidos: SR, submetidos às coletas para baciloscopia, e assintomáticos (AR). Resultados: Participaram do estudo 143 pacientes, sendo 61,5% (n=88) homens, 51,7% (n=74) adultos jovens, 30,8% (n=44) analfabetos e 41,3% (n=59) com alguma condição debilitante associada. A prevalência de TBP bacilífera encontrada foi de 0,69% (n=1). Os SR representaram 14,7% (n=21) da amostra e foram associados ao grupo de pacientes internados há mais de dois anos e sem perspectiva de alta (p=0,01), e ao hábito de fumar (p=0,02). Conclusão: Encontrou-se nesse grupo uma alta prevalência de TBP bacilífera, se comparada à da população brasileira, sendo os SR associados ao maior tempo de internação hospitalar e ao hábito de fumar.

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of lung disease, and its use is increasing worldwide. It has been used as a means of diagnosing lung cancer in its initial stages, and there are data supporting its use for the diagnosis of benign lung disease. The aim of this study was to share our experience with EBUS-TBNA and discuss its diagnostic value. Methods: We retrospectively analyzed the results related to 159 patients who underwent EBUS-TBNA at our pulmonary medicine clinic between 2010 and 2013. We recorded the location and size of lymph nodes seen during EBUS. Lymph nodes that appeared to be affected on EBUS were sampled at least twice. We recorded the diagnostic results of EBUS-TBNA and (for cases in which EBUS-TBNA yielded an inconclusive diagnosis) the final diagnoses after further investigation and follow-up. Results: We evaluated 159 patients, of whom 89 (56%) were male and 70 (44%) were female. The mean age was 54.6 ± 14.2 years among the male patients and 51.9 ± 11.3 years among the female patients. Of the 159 patients evaluated, 115 (84%) were correctly diagnosed by EBUS. The diagnostic accuracy of EBUS-TBNA was 83% for benign granulomatous diseases and 77% for malignant diseases. Conclusions: The diagnostic value of EBUS-TBNA is also high for benign pathologies, such as sarcoidosis and tuberculosis. In patients with mediastinal disorders, the use of EBUS-TBNA should be encouraged, primarily because it markedly reduces the need for mediastinoscopy.

Objetivo: Avaliar a prevalência de casos bacilíferos de tuberculose pulmonar entre usuários de uma unidade de atenção básica. Métodos: Estudo observacional, de corte transversal, realizado entre fevereiro e agosto de 2011 com 1.873 indivíduos maiores de 18 anos atendidos na Unidade Básica de Saúde (UBS), localizada na zona norte do município do Rio de Janeiro-RJ (Brasil), selecionados por conveniência de forma não probabilística. Inicialmente, aplicou-se instrumento para o diagnóstico presuntivo de tuberculose pulmonar. Os indivíduos com escore positivo foram submetidos ao teste bacilífero. Realizou-se estatística descritiva com frequência simples e percentual, bem como teste exato de Fisher para avaliar a associação com sexo, idade e os resultados da baciloscopia de escarro. Resultados: Entre os indivíduos atendidos na UBS estudada, 157 (8,4%) apresentaram escore positivo para diagnóstico presuntivo de tuberculose. Nesses, os sintomas mais frequentes foram tosse (76,5%, n=13) e dor torácica (70,6%, n=12). Não houve associação significativa entre baciloscopia positiva com sexo (p=0,477) e idade (p=0,186). Conclusão: A ocorrência de casos bacilíferos de tuberculose pulmonar entre indivíduo com escore positivo de presunção dessa doença mostrou-se alta na unidade de saúde estudada.

Este estudo analisou a magnitude da tuberculose pulmonar no período de 2007 a 2010 em municípios sul-mato-grossenses fronteiriços ao Paraguai e à Bolívia. Na região de fronteira, as taxas de incidência (49,1/100 mil habitantes), de mortalidade (4,0/100 mil) e de abandono do tratamento (11,3%) foram 1,6, 1,8 e 1,5 vez maiores do que na região não fronteiriça. Entre indígenas da fronteira, as taxas de incidência (253,4/100 mil habitantes), mortalidade (11,6/100 mil) e coinfecção por HIV (1,9/100 mil) foram, respectivamente, 6,4, 3,2 vezes e 1,9 vez maiores do que entre os não indígenas nesta região. Estar na região de fronteira revelou-se fator de proteção contra coinfecção por HIV. Constatou-se associação entre ser indígena e não abandonar o tratamento. Conclui-se que a população residente nesses municípios de fronteira vivencia elevado risco de adoecimento, de morte e de abandono do tratamento de tuberculose pulmonar, o que requer ações diferenciadas de vigilância em saúde.

Introduction:Tuberculosis promotes an acute phase response with an increase of blood reactants, such as C-reactive protein (CRP), among others, which are associated with increased erythrocyte sedimentation rate (ESR).Objective:Evaluate the ESR and the CRP as markers for diagnosis and monitoring cases of pulmonary tuberculosis.Method:Research on patients with clinical, laboratory, and imaging diagnosis of pulmonary tuberculosis, from Itajaí-SC; in which CRP and ESR were analyzed in three different times: at diagnosis, before starting treatment (T0), after three months of treatment (T1), and at the end of treatment (T2).Results:51 patients were studied at T0 (100%), 43 (84.31%) at T1, and 32 (62.74%) at T2. ESR and CRP values presented significant differences in the three different times (p < 0.0001***). When analyzing the relationship between negative/positive sputum and altered/normal ESR and CRP at T0, ESR (p = 0.0691), CRP (p = 0.0166*). For chest imaging and sputum smear variables it was observed the following: CRP versus smear (p = 0.0002***), ESR versus smear (p = 0.3810), CRP versus chest imaging (p = 0.0097**), and ESR versus chest imaging (p = 0.0766). The correlation between ESR and CRP was: T0 (p = 0.0033**), T1 (p < 0.0001***) and T2 (p = 0.0015**).Conclusion:ESR and CRP proved to be good markers in the diagnosis and monitoring of tuberculosis cases, however, CRP achieve more significant results than ESR.

This is a literature review together with a field research, exploratory-descriptive, with a quantitative approach that sought to analyze the knowledge of the nursing team related to prevention actions through the care of patients in the treatment of pulmonary tuberculosis, starting of the assumption that they are most likely to become infected in this trade exposition. To compose the literature review, a bibliographic survey of scientific publications from online journals was carried out. For data collection, a questionnaire pre-established by Cavalcante (2013) was used, composed of 18 questions, covering sociodemographic profile, health conditions of the respondents, exposure to occupational risks, knowledge about the disease in question; protection measures against the risks inherent in work and participation in lectures / courses where the subject was tuberculosis. The results of the research revealed that the studied population was comprised of mostly female individuals between the ages of 20 and 35, who were singles with an expressive sample of nursing technicians. Most of the interviewees have been working for more than 5 years, dedicating 6 hours a day to the care of patients and TB suspects. Most professionals are out of date for courses on TB; did not undergo tuberculin sensitivity test. and regarding EPI's, Mascara; gloves, mask N95 and capes prevail as necessary EPI's in the judgment of the professionals. It is expected that the issue will not be exhausted with the present study, considering the importance of having a survey to verify if there is infection index of these professionals and the contingency proposal through tuberculosis. [ABSTRACT FROM AUTHOR]

Objective: To analyze the predictors of pulmonary tuberculosis treatment refusal. Methods: cross-sectional study from the analysis of 1110 patients 18 years or older enrolled in the Tuberculosis Control Program of Cuiabá / MT, Brazil, from 2013 to 2014. Data were obtained from the SINAN database of the Epidemiological Surveillance Coordination of Mato Grosso State Health Secretariat. Bivariate analysis was performed, prevalence ratio, significance level of 5% (p <0.05); taking as variable outcome the abandonment of treatment. Associations with p <0:20 were selected for the Poisson regression Multiple Robusta (RPa). [ABSTRACT FROM AUTHOR]

Copyright of Revista de Pesquisa: Cuidado é Fundamental is the property of Revista de Pesquisa: Cuidado e Fundamental Online and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Brazilian Journal of Pulmonology / Jornal Brasileiro de Pneumologia is the property of Sociedade Brasileira de Pneumologia e Tisiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Tuberculosis is a disease of great social impact in the world. Although there is a tendency to decrease its indices in Brazil, there are structural and management weaknesses in the services. Health information is considered essential to improve this scenario. Objective: To identify the profile of the pulmonary tuberculosis patients in the city of Divinópolis from 2010 to 2015. Materials and Methods: Descriptive, epidemiological, quantitative and historical study. Data collection was performed through consultation of the notification sheets contained in the Notifiable Diseases Information System. The eligible population was new cases of pulmonary tuberculosis among residents of Divinópolis, notified between 2010 and 2015. Results: 104 new cases of pulmonary tuberculosis were reported in residents of the municipality. The incidence rate ranged from 6.04 to 10.06 cases per 100,000 inhabitants. The highest number of reports occurred in males (67.3%), adults over 50 years (57.7%) and subjects with elementary school degree (37.5%). For the first sputum smear, 51.9% of patients had positive results. As for sputum culture, the clear majority (70.2%) did not take the exam. As an associated disease, HIV positive was present in 9 reports (8.7%). Regarding the outcome situation, data indicated that 69 cases were completed as cured and 8 dropped the treatment out. Conclusion: It is expected that the knowledge of the profile of the cases may help in planning actions aimed at the diagnosis, treatment and prevention of the disease. [ABSTRACT FROM AUTHOR]

Objective. To estimate the rate of drug resistance among pulmonary tuberculosis (PTB) cases in the state of Mato Grosso do Sul, Brazil, and specifically in the border areas with Paraguay and Bolivia, as well as to identify associated risk factors. Method. The present cross-sectional, epidemiological study focused on PTB cases recorded between January 2007 and December 2010 in the State Reportable Disease Information System with results of susceptibility tests to rifampicin, isoniazid, ethambutol, and streptomycin. Dependent variables were development of resistance to a single drug or any combination of drugs. Independent variables were being a new or treated case, living in border areas, presence/absence of diabetes, and history of alcoholism. Results. There were 789 TBP cases with susceptibility testing. The following characteristics were associated with resistance: treated case (P=0.0001), border region (P=0.0142), alcoholism (P=0.0451), and diabetes (P=0.0708). The rates of combined, primary, and acquired resistance for the state were 16.3%, 10.6%, and 39.0%, vs. 22.3%, 19.2%, and 37.5% for the border region. The rates of combined, primary, and acquired multidrug resistance for the state were 1.8%, 0.6%, and 6.3%, vs. 3.1%, 1.2%, and 12.5% for the border region. Conclusions. In the border region, the state should investigate drug resistance in all patients with respiratory symptoms, determine the pattern of resistance in confirmed cases, adopt directly observed treatment for cases of PTB, and develop health actions together with neighboring countries. Across the state, the levels of acquired resistance should be monitored, with investigation of resistance in all treated cases and implementation of directly observed treatment especially among patients with diabetes or alcoholism. [ABSTRACT FROM AUTHOR]

We aimed at analyzing the discourse of matrix support workers about tuberculosis (TB) control related to the model of municipal management. A qualitative study involving interviews with 16 matrix support workers, who worked with health management in the municipality of João Pessoa, state of Paraíba, Brazil. Data analysis was conducted according to the theoretical-analytical framework of the French school of Discourse Analysis. The results indicate contradictions between the municipality’s healthcare plan proposal and the discourse of managers regarding actions for tuberculosis control. Above all, there is a lack of knowledge regarding the disease and DOTS (Directly Observed Treatment, Short-Course). We conclude that the gap between the view of matrix support workers and the intentions of the municipal health care plan weakens TB control and prevents the constitution of a new healthcare model. doi: 10.5216/ree.v16i3.22164.

OBJECTIVE: To describe the prevalence of anemia and of its types in hospitalized patients with pulmonary tuberculosis. METHODS: This was a descriptive, longitudinal study involving pulmonary tuberculosis inpatients at one of two tuberculosis referral hospitals in the city of Rio de Janeiro, Brazil. We evaluated body mass index (BMI), triceps skinfold thickness (TST), arm muscle area (AMA), ESR, mean corpuscular volume, and red blood cell distribution width (RDW), as well as the levels of C-reactive protein, hemoglobin, transferrin, and ferritin. RESULTS: We included 166 patients, 126 (75.9%) of whom were male. The mean age was 39.0 ± 10.7 years. Not all data were available for all patients: 18.7% were HIV positive; 64.7% were alcoholic; the prevalences of anemia of chronic disease and iron deficiency anemia were, respectively, 75.9% and 2.4%; and 68.7% had low body weight (mean BMI = 18.21 kg/m2). On the basis of TST and AMA, 126 (78.7%) of 160 patients and 138 (87.9%) of 157 patients, respectively, were considered malnourished. Anemia was found to be associated with the following: male gender (p = 0.03); low weight (p = 0.0004); low mean corpuscular volume (p = 0.03);high RDW (p = 0; 0003); high ferritin (p = 0.0005); and high ESR (p = 0.004). We also found significant differences between anemic and non-anemic patients in terms of BMI (p = 0.04), DCT (p = 0.003), and ESR (p < 0.001). CONCLUSIONS: In this sample, high proportions of pulmonary tuberculosis patients were classified as underweight and malnourished, and there was a high prevalence of anemia of chronic disease. In addition, anemia was associated with high ESR and malnutrition.

Bronchial stenosis can impair regional lung ventilation by causing abnormal, asymmetric airflow limitation. Electrical impedance tomography (EIT) is an imaging technique that allows the assessment of regional lung ventilation and therefore complements the functional assessment of the lungs. We report the case of a patient with left unilateral bronchial stenosis and a history of tuberculosis, in whom regional lung ventilation was assessed by EIT. The EIT results were compared with those obtained by ventilation/perfusion radionuclide imaging. The patient was using nasal continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea syndrome. Therefore, we studied the effects of postural changes and of the use of nasal CPAP. The EIT revealed heterogeneous distribution of regional lung ventilation, the ventilation being higher in the right lung, and this distribution was influenced by postural changes and CPAP use. The EIT assessment of regional lung ventilation produced results similar to those obtained with the radionuclide imaging technique and had the advantage of providing a dynamic evaluation without radiation exposure.

Copyright of Avances en Enfermería is the property of Editorial Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Brazilian Journal of Pulmonology / Jornal Brasileiro de Pneumologia is the property of Sociedade Brasileira de Pneumologia e Tisiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tuberculosis and cryptococcosis are infectious diseases that can result in the formation of single or multiple nodules in immunocompetent patients. Exposure to silica is known to raise the risk of infection with Mycobacterium tuberculosis. We report the case of an elderly man with no history of opportunistic infections and no clinical evidence of immunodeficiency but with a six-month history of dry cough and nocturnal wheezing. A chest X-ray revealed a mass measuring 5.0 × 3.5 cm in the right upper lobe. The diagnostic approach of the mass revealed tuberculosis. The histopathological analysis of the surrounding parenchyma reveled silicosis and cryptococcosis. Cryptococcosis was also found in masses identified in the mediastinal lymph nodes. The surgical approach was indicated because of the degree of pleuropulmonary involvement, the inconclusive results obtained with the invasive and noninvasive methods applied, and the possibility of malignancy. This case illustrates the difficulty inherent to the assessment of infectious or inflammatory pulmonary pseudotumors, the differential diagnosis of which occasionally requires a radical surgical approach. Despite the presence of respiratory symptoms for six months, the first chest X-ray was performed only at the end of that period. We discuss the possible pathogenic mechanisms that might have led to the combination of three types of granulomatous lesions in the same lobe, and we emphasize the need for greater awareness of atypical presentations of pulmonary tuberculosis.

OBJETIVO: Avaliar o processo diagnóstico da tuberculose pulmonar em indígenas menores de 15 anos, por meio do Sistema de Pontuação do Ministério da Saúde Modificado (SP-MSm), em crianças e adolescentes com resultados negativos na baciloscopia. MÉTODOS: Estudo descritivo retrospectivo de 49 casos de tuberculose em indígenas menores de 15 anos no estado do Mato Grosso do Sul entre 2007 e 2010. RESULTADOS: Dos 49 pacientes, 27 (56%) eram menores de 5 anos, 33 (67%) apresentavam sintomas sugestivos de tuberculose, 24 (49%) tinham baixo peso, e 36 (73,5%) haviam sido vacinados com BCG. O teste tuberculínico foi reator em 28 pacientes (57%). Dentre esses, 18 (64%) apresentaram enduração > 10 mm. Foram realizadas radiografias de tórax em 37 pacientes (76%), sendo que 31 (84%) fizeram apenas um exame. Desses 37 pacientes, os achados radiológicos eram sugestivos de tuberculose em 16 (43%), de infiltrado/condensação em 10 (27%) e normais em 4 (11%). As Equipes de Saúde Indígena foram responsáveis pelo diagnóstico em 31 (63%) dos casos, mas o SP-MS original só foi utilizado em 14 (45%). Os escores do SP-MSm foram determinados em 30 pacientes (61%). Dos 30 casos pontuados, os resultados dos escores indicaram diagnóstico de tuberculose muito provável, possível e pouco provável em 16 (53%), 11 (37%) e 3 (10%), respectivamente. CONCLUSÕES: A proporção de diagnóstico muito provável e possível foi concordante com o diagnóstico padrão do serviço (90%), evidenciando a aplicabilidade epidemiológica do SP-MSm para o diagnóstico da tuberculose pulmonar em indígenas, de forma compatível com a realidade do serviço de saúde prestado.OBJECTIVE: To evaluate the process of diagnosing pulmonary tuberculosis in smear-negative indigenous children and adolescents under 15 years of age with the modified Brazilian National Ministry of Health Scoring System (mBNMH-SS). METHODS: This was a retrospective descriptive study involving 49 indigenous patients under 15 years of age with tuberculosis, treated between 2007 and 2010 in the state of Mato Grosso do Sul, Brazil. RESULTS: Of the 49 patients, 27 (56%) were under 5 years of age, 33 (67%) had symptoms suggestive of tuberculosis, 24 (49%) were underweight, and 36 (73.5%) had been BCG vaccinated. The tuberculin skin test was positive in 28 patients (57%), 18 (64%) of whom had an induration > 10 mm. Chest X-rays were performed in 37 (76%) of the patients, 31 (84%) of whom had only one chest X-ray taken. Among those 37 patients, the radiological findings were suggestive of tuberculosis in 16 (43%), infiltration/condensation in 10 (27%), and normal in 4 (11%). The Indigenous Health Care Teams made the diagnosis in 31 (63%) of the cases, using the original BNMH-SS in only 14 (45%). We calculated the mBNMH-SS scores for 30 (61%) of the 49 patients. Among the 30 cases scored, a diagnosis of tuberculosis was found to be highly likely, possible, and unlikely in 16 (53%), 11 (37%), and 3 (10%), respectively. CONCLUSIONS: The proportion of highly likely and possible diagnoses was consistent with the standard proportion of cases diagnosed by the teams (90%), demonstrating the epidemiological applicability of the mBNMH-SS for the diagnosis of pulmonary tuberculosis in the indigenous population, within the scenario of the health care provided.

OBJETIVO: Estimar a prevalência de resistência primária aos medicamentos do esquema básico de tratamento antituberculose em pacientes com tuberculose pulmonar virgens de tratamento sem fatores de risco conhecidos para resistência primária, e identificar os possíveis fatores associados à resistência medicamentosa. MÉTODOS: Estudo transversal exploratório com a análise de prontuários de pacientes que participaram de dois ensaios clínicos de tuberculose sensível entre 1&º de novembro de 2004 e 31 de março de 2011 no Ambulatório Prof. Newton Bethlem do Instituto de Doenças do Tórax da Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ). Os critérios de inclusão foram ter idade > 18 anos, ter pesquisa direta de BAAR positiva na primeira amostra de escarro, ter cultura positiva para Mycobacterium tuberculosis, ter realizado testes de sensibilidade aos fármacos, ser virgem de tratamento para tuberculose e não ter história de prisão, hospitalização ou contato com caso de tuberculose resistente. RESULTADOS: Foram incluídos 209 pacientes. A prevalência de resistência primária geral foi de 16,3%. A prevalência geral de resistência à isoniazida e à estreptomicina foi, respectivamente, 9,6% e 9,1%, enquanto a prevalência de monorresistência à isoniazida e à estreptomicina foi de, respectivamente, 5,8% e 6,8%. A prevalência de resistência a dois ou mais fármacos foi de 3,8%, e a prevalência de tuberculose multirresistente foi de 0,5%. Não foram observadas associações estatisticamente significativas entre as variáveis estudadas e resultados do teste de sensibilidade aos fármacos. CONCLUSÕES: Na amostra estudada, a prevalência de resistência primária foi elevada apesar da ausência de fatores de risco conhecidos.OBJECTIVE: To estimate the prevalence of primary resistance to the drugs in the basic treatment regimen for tuberculosis in treatment-naïve patients with pulmonary tuberculosis and no known risk factors for such resistance, as well as to identify factors potentially associated with drug resistance. METHODS: This was an exploratory cross-sectional study. We analyzed the medical records of the subjects enrolled in two clinical trials of treatments for drug-susceptible tuberculosis between November 1, 2004 and March 31, 2011 at the Prof. Newton Bethlem Outpatient Clinic of the Federal University of Rio de Janeiro Thoracic Diseases Institute, located in the city of Rio de Janeiro, Brazil. The inclusion criteria were being > 18 years of age, testing positive for AFB in the first sputum sample, having a positive culture for Mycobacterium tuberculosis, having undergone drug susceptibility testing, and being treatment-naïve. Patients with a history of imprisonment or hospitalization were excluded, as were those who had been in contact with drug-resistant tuberculosis patients. RESULTS: We included 209 patients. The overall prevalence of primary drug resistance was 16.3%. The overall prevalence of resistance to isoniazid and streptomycin was, respectively, 9.6% and 9.1%, compared with 5.8% and 6.8% for single-drug resistance to isoniazid and streptomycin, respectively. The prevalence of resistance to two or more drugs was 3.8%, and the prevalence of multidrug resistance was 0.5%. No statistically significant associations were found between the variables studied and drug susceptibility testing results. CONCLUSIONS: In this sample, the prevalence of primary drug resistance was high despite the absence of known risk factors.

Avaliamos o rendimento diagnóstico da fibrobroncoscopia óptica no diagnóstico de tuberculose pulmonar com baciloscopia negativa em pacientes atendidos em um hospital de referência em Lima, Peru. Dos 611 pacientes submetidos ao procedimento, 140 (23%) foram diagnosticados com tuberculose com base nas amostras de LBA. Ser mais jovem e do sexo masculino foi associado a culturas positivas. Além disso, 287 pacientes realizaram baciloscopia de escarro após a broncoscopia, e os resultados aumentaram o rendimento diagnóstico em 22% em relação às amostras de LBA. Concluímos que amostras de LBA e de escarro pós-broncoscopia tiveram um bom rendimento diagnóstico nos pacientes com suspeita de tuberculose pulmonar com baciloscopia negativa.We evaluated the diagnostic yield of fiberoptic bronchoscopy for the diagnosis of smear-negative pulmonary tuberculosis in patients treated at a referral hospital in Lima, Peru. Of the 611 patients who underwent the procedure, 140 (23%) were diagnosed with tuberculosis based on the analysis of BAL samples. Being young and being male were significantly associated with positive cultures. In addition, 287 patients underwent post-bronchoscopic sputum smear testing for AFB, the results of which increased the diagnostic yield by 22% over that obtained through the analysis of BAL samples alone. We conclude that the analysis of BAL samples and post-bronchoscopic sputum samples provides a high diagnostic yield in smear-negative patients suspected of having pulmonary tuberculosis.