Incidence of tuberculosis infection among New York State prison employees.

Steenland, Kyle; Levine, Aubrey J.; Sieber, Karl; Schulte, Paul A.; Aziz, David

doi:10.2105/ajph.87.12.2012

Cited by 38 publications

(28 citation statements)

References 2 publications

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“…111 who presented IPVD without hepatopulmonary syndrome, IPVD was scored as 1+. (14) In the present study, echocardiographydetermined IPVD score was found to correlate significantly with shunt fraction calculated using either of the two quantitative methods employed (blood gas analysis after pure oxygen breathing and scintigraphy).…”

Section: Resultssupporting

confidence: 49%

“…This value was defined as proposed in the literature, due to its acceptable sensitivity for the identification of gas exchange abnormalities in such patients. (7,10,14) Patients underwent perfusion scintigraphy with technetium-99m-labeled macroaggregated albumin ( 99m Tc-MAA). The radioactive drug (2-4 mCi) was injected into a peripheral vein, with the patient in the sitting position.…”

Section: Methodsmentioning

confidence: 99%

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Avaliação semiquantitativa ecocardiográfica de dilatações vasculares intrapulmonares em candidatos a transplante hepático: correlação com avaliação de shunt e parâmetros funcionais pulmonares

et al. 2009

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Objective: To correlate semiquantitative evaluation of intrapulmonary vascular dilatations (IPVD) with quantitative evaluation of shunt levels, as well as to describe clinical and pulmonary function findings in a sample of liver disease patients with IPVD. Methods: Patients presenting transthoracic echocardiography (TTE) positivity for IPVD underwent clinical evaluation, pulmonary function tests and pulmonary shunt quantification (scintigraphy with technetium-99m-labeled macroaggregated albumin and blood gas analysis after pure oxygen breathing). Results: A total of 28 liver cirrhosis patients were studied (mean age, 47.5 years; 60.7% were Child-Pugh class B). A 4-point, ascending scale was used as a measure of IPVD intensity, which was scored as 1, 2, 3 and 4, respectively, in 13 (46.4%), 9 (32.1%), 2 (7.1%) and 4 (14.3%) of the patients. Patients were divided into a low-intensity group (scores 1 and 2) and a high-intensity group (scores 3 and 4). The mean shunt assessed using scintigraphy was 14.9% in the sample as a whole and was lower in the low-intensity group (11.7% vs. 26.3%; p = 0.01). The mean shunt by blood gas analysis was higher in the high-intensity group (8.3% vs. 16.3%; p < 0.001). Mean PaO 2 was lower in the high-intensity group. There was a negative correlation between DLCO and IPVD severity (r = −0.406, p = 0.01). Conclusions: TTE is a safe, useful tool for assessing IPVD severity in liver disease patients. The IPVD intensity assessed using TTE correlated with the intrapulmonary shunt values obtained through the quantitative methods evaluated, as well as with pulmonary gas exchange abnormalities.Keywords: Anoxia; Liver cirrhosis; Hepatopulmonary syndrome; Echocardiography. ResumoObjetivo: Verificar a relação entre a avaliação semiquantitativa de dilatações vasculares intrapulmonares (DVIP) e a avaliação quantitativa de shunt, e descrever achados clínicos e funcionais pulmonares em uma amostra de hepatopatas com DVIP. Métodos: Pacientes com ecocardiografia transtorácica (ETT) positiva para DVIP foram submetidos à avaliação clínica e de função pulmonar assim como à quantificação de shunt intrapulmonar (cintilografia com macroagregados de albumina marcados com tecnécio-99m e por gasometria com oxigênio a 100%). Resultados: Foram estudados 28 pacientes cirróticos (média de idade, 47,5 anos; 60,7% dos casos classificados como Child-Pugh B). Uma escala de 4 pontos, em ordem ascendente, foi utilizada para medir a intensidade das DVIP, classificada de 1 a 4, respectivamente, em 13 (46,4%), 9 (32,1%), 2 (7,1%) e 4 (14,3%) dos pacientes. A amostra foi dividida em grupo baixa intensidade (escores 1 e 2) e grupo alta intensidade (escores 3 e 4). A média de shunt por cintilografia foi 14,9% na amostra total, sendo menor no grupo baixa intensidade (11,7% vs. 26,3%; p = 0,01). O grupo alta intensidade teve maiores valores de shunt através de gasometria (8,3% vs. 16,3%; p < 0.001). A PaO 2 média foi inferior no grupo alta intensidade. A intensidade de DVIP e a DLCO correlacionaram-se de forma inversa ...

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Section: Resultssupporting

confidence: 49%

Section: Methodsmentioning

confidence: 99%

Avaliação semiquantitativa ecocardiográfica de dilatações vasculares intrapulmonares em candidatos a transplante hepático: correlação com avaliação de shunt e parâmetros funcionais pulmonares

et al. 2009

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“…Transmission occurs among prisoners (10)(11)(12)(13) and among professionals working in the prison system. (14) Longer prison stays are significantly associated with an increased risk for latent and active TB. (15,16) A study conducted in prisons in the city of New York showed that one year of incarceration doubled the probability of developing active TB among inmates who were not infected before entering the prison system.…”

Section: Introductionmentioning

confidence: 99%

Prevalência de TB ativa e TB latente em internos de um hospital penal na Bahia

2009

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Objective: To determine the prevalence of latent and active TB among detainees in a prison hospital in Bahia, Brazil. Methods: A cross-sectional study with prospective data collection was carried out comprising 237 inmates in the Bahia State Prison Hospital between July 2003 and April 2004. A standardized questionnaire was applied and completed by medical students. The detainees were systematically submitted to the following tests: tuberculin skin test, chest X-ray (anteroposterior), sputum smear microscopy and culture for mycobacteria. The events of interest were active TB and latent TB. Results: The mean age of the participants was 36.6 years, and 89.9% were male. Smoking and alcohol consumption were reported by 70.0% and 43.9% of the inmates, respectively. A history of treatment for TB was reported by 11.3% of the inmates. Of the inmates evaluated, 36.3% reported cough and 31.4% reported expectoration. Other less common symptoms were asthenia (in 26.2%), weight loss (in 23.1%), loss of appetite (in 17.7%), fever (in 11.3%) and hemoptysis (in 6.7%). Of the 86 inmates tested, none presented positive HIV serology. The prevalence of latent TB was 61.5% (96 of the 156 inmates submitted to tuberculin skin tests), whereas that of active TB was 2.5% (6 of the 237 inmates evaluated). The presence of cough was a determinant of active TB (prevalence ratio = 8.8; 95% CI: 1.04-73.9; p = 0.025). Conclusions: Active and latent TB are highly prevalent among inmates hospitalized in the Bahia State Prison Hospital. Our findings justify the need to implement public policies specifically directed towards the control of TB in this population.Keywords: Tuberculosis; Prisons; Hospitals; Prevalence. ResumoObjetivo: Estimar as prevalências de TB latente e TB ativa entre custodiados de um hospital penal na Bahia. Métodos: Foram avaliados através de estudo de corte transversal com coleta prospectiva de dados 237 internos no Hospital Penal da Bahia entre julho de 2003 e abril de 2004. Um questionário padronizado foi preenchido por estudantes de medicina. Os indivíduos foram sistematicamente submetidos aos seguintes exames: teste tuberculínico, radiografia de tórax em incidência póstero-anterior, baciloscopia e cultura para micobactérias. Os eventos de interesse foram TB ativa e TB latente. Resultados: A média de idade foi de 36,6 anos, sendo 89,9% homens. Tabagismo e alcoolismo foram relatados por 70.0% e 43.9% dos internos, respectivamente. História de tratamento para TB foi relatada por 11,3% dos indivíduos. Dos internos avaliados, 36,3% relataram tosse e 31,4%, expectoração. Outros sintomas menos frequentemente referidos foram astenia (26,2%), perda de peso (23,1%), inapetência (17,7%), febre (11,3%) e hemoptise (6,7%). Nenhum dos 86 internos testados apresentou sorologia anti-HIV positiva. Entre os 156 submetidos ao teste tuberculínico, a prevalência de TB latente foi de 61,5% (146 casos). Do total, 6 casos de TB ativa foram detectados (prevalência de 2,5%). A presença de tosse foi um determinante de TB ativa (razão de preva...

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“…The M. tuberculosis complex is responsible for more disease worldwide than any other bacteria [1,2]. Although the United States is a low prevalence country (reporting 14,511 confirmed cases of tuberculosis in 2004 [3]), tuberculosis is a recognized occupational hazard in health care [4] and correctional facilities [5]. In addition, it is often necessary to differentiate between M. tuberculosis and ubiquitous nontuberculous mycobacterial infection.…”

Section: Introductionmentioning

confidence: 99%

Discrimination of intact mycobacteria at the strain level: A combined MALDI-TOF MS and biostatistical analysis

et al. 2006

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New methodologies for surveillance and identification of Mycobacterium tuberculosis are required to stem the spread of disease worldwide. In addition, the ability to discriminate mycobacteria at the strain level may be important to contact or source case investigations. To this end, we are developing MALDI-TOF MS methods for the identification of M. tuberculosis in culture. In this report, we describe the application of MALDI-TOF MS, as well as statistical analysis including linear discriminant and random forest analysis, to 16 medically relevant strains from four species of mycobacteria, M. tuberculosis, M. avium, M. intracellulare, and M. kansasii. Although species discrimination can be accomplished on the basis of unique m/z values observed in the MS fingerprint spectrum, discrimination at the strain level is predicted on the relative abundance of shared m/z values among strains within a species. For the 16 mycobacterial strains investigated in the present study, it is possible to unambiguously identify strains within a species on the basis of MALDI-TOF MS data. The error rate for classification of individual strains using linear discriminant analysis was 0.053 using 37 m/z variables, whereas the error rate for classification of individual strains using random forest analysis was 0.023 using only 18 m/z variables. In addition, using random forest analysis of MALDI-TOF MS data, it was possible to correctly classify bacterial strains as either M. tuberculosis or non-tuberculous with 100% accuracy.

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Incidence of tuberculosis infection among New York State prison employees.

Cited by 38 publications

References 2 publications

Avaliação semiquantitativa ecocardiográfica de dilatações vasculares intrapulmonares em candidatos a transplante hepático: correlação com avaliação de shunt e parâmetros funcionais pulmonares

Avaliação semiquantitativa ecocardiográfica de dilatações vasculares intrapulmonares em candidatos a transplante hepático: correlação com avaliação de shunt e parâmetros funcionais pulmonares

Prevalência de TB ativa e TB latente em internos de um hospital penal na Bahia

Discrimination of intact mycobacteria at the strain level: A combined MALDI-TOF MS and biostatistical analysis

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