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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tuberculosis control strategies include the treatment of cases, treatment of latent tuberculosis infection and vaccination. Recent evidence underscores the importance of treating latent infection to reduce disease incidence. Diagnosis of latent infection relies on the tuberculin skin test, although newer methods are under development. Targeting screening to high risk groups will identify true positives who will benefit from preventive therapy. Isoniazid (INH) has been the mainstay of preventive therapy for 40 years, but its use is limited by concerns about toxicity and poor adherence. Careful monitoring of patients allows for the safe use of INH, even in those older than 35 years. Supervised preventive therapy can improve adherence. New short-course regimens for the treatment of latent tuberculosis have been evaluated in the past decade, and are efficacious and associated with better adherence. Guidelines for the treatment of latent tuberculosis infection have recently been published by the American Thoracic Society and the Centers for Disease Control and Prevention. These guidelines should contribute to improved tuberculosis control globally, and to tuberculosis elimination in the United States.
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PMID:New developments in the treatment of latent tuberculosis. 1114 50

Screening of the close contacts of patients with pulmonary tuberculosis remains an important component in the control and prevention of the disease. It is carried out to identify active and latent infection, and those requiring BCG vaccination. Guidelines suggest giving chemoprophylaxis to asymptomatic contacts with a positive Heaf test (grades 2-4) and normal chest radiograph [Control and prevention of tuberculosis in the United Kingdom: code of practice 2000. Joint Tuberculosis Committee of the British Thoracic Society. Thorax 2000;55:887-901]. We report a case involving a close contact where current guidelines were followed, but failed to prevent subsequent development of active disease from the same strain of M. tuberculosis.
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PMID:Reactivation of tuberculosis after apparently adequate chemoprophylaxis. 1632 45

This review highlights the key messages from the 2010 British Thoracic Society Guidelines on the management of Mycobacterium tuberculosis infection and disease in adult patients with chronic kidney disease. These guidelines were developed in response to many requests for advice from respiratory and infectious diseases physicians who treat patients with tuberculosis, as there was very little information available to help clinicians manage the disease in this population of often very sick patients. Renal units in the United Kingdom were prescribing variable chemoprophylaxis regimens that frequently had no basis in evidence, and drug doses used to treat tuberculosis were often inappropriate because of clinicians' natural concern about poisoning a patient with little or no renal function. The guidelines address these issues together with when and how to screen for latent infection and the different needs of patients with renal impairment, those needing dialysis and those with a transplanted kidney. It became very clear in compiling these guidelines that there is a shortage of both background information on rates of tuberculosis in such patients in countries with low background prevalence, and good randomized controlled trials of treatment regimens. Wherever possible, the recommendations made are evidence-based, but this was not always available. This review gives a summary of those recommendations and reiterates some of the important messages; in particular, tuberculosis should be managed with the full involvement of the chest or infectious diseases physician who is the local lead for this important infection.
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PMID:How should we treat tuberculosis in adult patients with chronic kidney disease? Key messages from the British Thoracic Society Guidelines. 2098 Sep 48