5-mm thick sections were taken at 10-mm intervals. The images were prospectively reconstructed with the use of a high-resolution bone algorithm in diagnosing the lung lesions. The HRCT results were then compared with the results of clinical and para-clinical work-up on the patients. The analysis and comparison of rank values were performed using the chi-square P-values less than 0.05, and the sensitivity, specificity, positive and negative predictive value were likewise computed.
Results showed that 61 of the patients were negative for sputum smear and culture, 9 were positive for both, 5 negative for sputum smear and culture positive and 27 diagnosed according to BAL and TBLB results (Martin and Lazarus 2000, Karam). All of the patients had x-ray or chest radiographs suggesting active PTB through infiltration or cavitation in the upper lobes. HRCT findings concluded that 76 of the patients or 74.5% had active PTB who required work-up confirmation and established a strong positive correlation. The sensitivity of HRCT was placed at a high 96%. Binomial tests were also performed between the final diagnosis and each characteristic "tree-in-bud" and centrilobular appearances radiologic manifestation in determining the diagnostic yield of each characteristic radiologic manifestation obtained from the CT scan. Analysis revealed that neither was individually diagnostic, but their combination accurately confirmed a diagnosis of PTB (Martin and Lazarus, Karam).
Radiography or x-ray in conjunction with skin testing is the standard initial screening method not only when results seem unreliable, the skin test reading is impractical or when there are significant risks of transmission in undiagnosed cases as in institutional settings, like hospitals, jails and long-term facilities (Leung 1999).
Post-primary TB is usually a disease of adolescents and adults, the earliest findings being a heterogeneous, poorly marginated opacity in the apical or posterior portion of the upper lobes. In 40% of cases, chest x-rays revealed cavitation, particularly in cases complicated with extensive fibrosis and structural distortion (Martin and Lazarus 2000, Karam). The most common complication of tuberculous cavitation is endobronchial spread, which is radiographically detectable at 19% but up to 98% by HRCT. In some cases, HRCT may detect indicators of active disease not intercepted or captured by chest radiographs. The higher level of sensitivity of the HRCT may lead to prompt and accurate diagnosis even while microbiology results are pending.
Treatment - Latent tuberculosis infection is usually indicated, whatever the patient's age and for patients who belong to the high-risk groups. There are no standard recommendations for patients in the lower-risk groups but health care workers weigh the benefits against the risks, especially for patients older than 35 (Jerant 2000). Pregnant women with PTB are usually subjected to treatment until after delivery, but those belonging to the high-risk groups or recently infected are often given isoniazid as soon as the active disease is excluded (Jerant). Usual dosage is 5-300 mg isoniazid per kilogram body weight a day for nine months. The nine-month program is preferred to the previous six months' treatment schedule on account of the findings of randomized trials among HIV / AIDS-negative patients. The findings showed that treatment for 9 months was more effective than 6 months. A regimen of 12 months also showed minimal benefit. A twice weekly dosage also seemed acceptable when compliance with the daily dosage becomes difficult or questionable.
The nine-month treatment regimen already has stated advantages, but the six-month regimen exhibited protection and appeared superior in certain tests, which used placebo in HIV / AIDS-negative and HIV / AIDS-positive patients (Jerant 2000). In view of the wide variations of patient responses and compliance and local health department resources, health authorities recommend the six-month instead of the nine-month regimen if the six-month treatment would produce more favorable outcomes and prove more cost-effective. These authorities and the American Academy of Pediatrics, however, stress on the nine-month duration of treatment for children. Pyridoxine or hexa-betalin is often prescribed at a dosage of 10-50 mg a day to reduce the likelihood of drug-related peripheral neuropathy with the use of isoniazid for all children six years and older. Pyridoxine...
Tuberculosis The Emergence and Re-emergence of Tuberculosis: Prevalence of Multi-Drug-Resistant Tuberculosis in the 21st Century In the 2003 lung disease statistics, tuberculosis is considered the "foremost cause of death from a single infectious disease," wherein TB is prevalent among developing countries, causing 99% of deaths (ALA, 2004). Indeed, American Lung Association (2004) considers tuberculosis as the an "ancient scourge," gaining prevalence in the 19th century and resurging once again in the 21st
5 per 100,000 in 1986. In 1994, the number of TB cases among residents of correctional facilities for 59 reporting areas had reached 24,361 (4.6% of the total reporting correctional population) (Braithwaite et al.). The incidence rate was 139.3 per 100,000 by 1993 and the unadjusted case rates for prison populations in many areas are significantly higher than the rates for the general population (Braithwaite et al.). According to these
Microbiology Please develop your own strategy for TB prevention. The Source of the Disease As mentioned in the above question, tuberculosis is a complex disease that has ravaged society for centuries. Whereas in the Western countries, it is now possible to receive treatment and become healthy despite contacting tuberculosis, there are areas of the world where, due to societal or environmental and political problems, it is difficult both to seek and obtain care,
Scope and Depth of the Problem One of the top ten causes of death worldwide, tuberculosis kills almost two million people per year (World Health Organization, 2018). Viewed another way, the Centers for Disease Control and Prevention (CDC, 2018) claims that one quarter of the world’s population is currently infected with tuberculosis. The number of cases in the United States has declined slowly, and is currently less than 10,000 (CDC, 2017a).
China Preventive Health Services and U.S. Preventive Health Services The objective of this study is to compare and contrast China preventive health services and U.S. preventive health services. The work of Clarke (2010) reports that prevention "was a prominent feature of the health care reforms that took place in the late 1960s through the early 1970s. During that time strategies such as universal vaccination, promotion f lifestyle changes, population screenings, and
Native American's With Alcoholism And Diabetes The health situation with regard to Native Americans is shown in numerous studies to be seriously below the standard and average of other groups in the country. This fact is underscored and emphasized in research studies such as Richardson's, The Need to Empower Indian Tribes, in which he states that, As the nation reviews its health needs, it can look to American Indians as the ethnic
Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.
Get Started Now