Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A standardised procedure in contacts of patients with all types of newly diagnosed tuberculosis was undertaken by the British Thoracic Association Research Committee to assess the present relevance of contact examination in Britain. The results suggest that the tracing and examination of contacts remains a worthwhile procedure, resulting in the detection of significant numbers of previously unsuspected cases of tuberculosis in the contact population. The yield of new cases of tuberculosis is very similar for the Asian and non-Asian (mainly British) communities, namely 3.4% and 3.6% respectively, of the close contacts examined. The yield of new cases is about three times as great as the above percentages when the index case is positive on sputum smear, and about a third as great when the index case has non-respiratory tuberculosis. The examination of close contacts represents a larger workload in the Asian communities, where there are about five close contacts per index case, compared with about three in the other communities. Most close contacts were diagnosed at initial examination, but contacts of Asian index cases had an appreciable morbidity on re-examination at one or two years, as did the close contacts of smear-positive index cases of other ethnic groups. Prior BCG vaccination has a protective effect in both populations and chemoprophylaxis seems to be used infrequently in close contacts at high risk. All close contacts should be examined once. Close contacts of Asian index cases with respiratory disease, and close contacts of smear positive non-Asian index cases should be examined annually for at least two years; BCG vaccination or chemoprophylaxis should be considered in these groups. Casual contacts need be examined only if unusual exposure to a highly infectious case has occurred.
 ...
PMID:A study of a standardised contact procedure in tuberculosis. Report by the Contact Study Sub-Committee of The Research Committee of the British Thoracic Association. 72 82

A subcommitte was appointed by the Joint Tuberculosis Committee of the British Thoracic Society to review and bring up to date guidelines on control measures for tuberculosis. The updated code of practice emphasises that all cases of tuberculosis must be notified. A minority of patients need admission, and those with positive sputum smears should be regarded as infectious until they have received two weeks of chemotherapy. NHS staff at risk should be protected, and evidence of infectious tuberculosis should be sought as routine among certain prospective NHS employees, schoolteachers, and others. Contact tracing should be vigorously pursued, and all entrants to Britain from countries where tuberculosis is common should be screened. BCG vaccination should be offered in selected instances, and local organisation of tuberculosis services should be extended.
 ...
PMID:Control and prevention of tuberculosis in Britain: an updated code of practice. Subcommittee of the Joint Tuberculosis Committee of the British Thoracic Society. 236 69

In 1996, 30 patients with tuberculosis were reported from Haukeland University Hospital to the Norwegian Tuberculosis Registry. Culturing proved 63% with mycobacterium tuberculosis (M. tuberculosis). 13 of the patients, eight adults and five children, all natives, were identified as close relatives or friends (cluster). M. tuberculosis with identical restriction fragment length polymorphism pattern (RFLP) were found in all the adults, indicating that they carried the same bacteria strain. We have compared the clinical findings, bacteriology and treatment among the adults in the cluster with other patients with pulmonary tuberculosis identified the same year at the Department of Thoracic Medicine at Haukeland University Hospital. The patients in the cluster were young adults without any previous chest X-ray changes. The other natives with tuberculosis were older, two showing chest X-ray changes indicating former tuberculosis. No difference was seen in sex, BCG status, tuberculin sensitivity, symptoms, physical findings or chest X-ray between the two groups. In the cluster, four patients proved sputum smear positive, as compared to four in the other group. Spread of infection and new cases of M. tuberculosis with identical RFLP were found only in the cluster. Since RFLP analyses of M. tuberculosis started in Norway in 1993, this cluster in Bergen is the largest cluster observed with identical RFLP pattern.
 ...
PMID:[Tuberculosis in Bergen 1996]. 1002 1

The essential component of tuberculosis elimination strategy is to identify and treat persons with latent tuberculosis infection (LTBI) who are at high risk for developing active tuberculosis. The tuberculin skin test is the only proven method for identifying LTBI. Although the specificity and the sensitivity are decreased by cross reaction with BCG vaccination and by non tuberculous mycobacteria, there is no better diagnostic tool. The test's positive predictive value is poor in populations with low risk for tuberculosis. Identification of persons with LTBI is focused on groups at high risk who would benefit from therapy (targeted tuberculin testing). The interpretation of the tuberculin skin test reaction is dependent on the risk factors and the immune status of the patient. For the past 30 years, Isoniazid has been the drug of choice for treating patients with LTBI, but its application has been limited by poor compliance and toxicity. Therefore, there has been interest in the development of shorter course treatments such as rifampin (4 months) or rifampin and pyrazinamide (2 months). We describe the new guidelines for targeted tuberculin testing and different treatment regimens for LTBI as recommend by the American Thoracic Society.
 ...
PMID:[Latent tuberculosis infection: diagnosis and treatment]. 1194 12

Following the death of an unvaccinated 16-year-old school student with isoniazid resistant pulmonary tuberculosis, extended screening of sixth formers took place to identify further cases of tuberculosis and to establish the need for BCG vaccination. Eight hundred and four 16-19 year olds in the school underwent Heaf testing and completed a demographics questionnaire. Forty-nine (5.5%) of these children had a positive Heaf test and were offered a chest radiograph. Four children were diagnosed with pulmonary or mediastinal tuberculosis, none linked to the index case. Fifty-four students (6.7%) with no prior BCG had a Heaf grade 0-1 reaction and were recommended for vaccination. Ninety-one percent of students were from ethnic minority groups and 29% had been born outside the UK. British Thoracic Society recommendations on the management of tuberculin positive cases of this is open to interpretation and we suggest that a more directed and aggressive approach to TB control should be considered in inner city schools with a high proportion of at risk ethnic minority students.
 ...
PMID:Results of an extended tuberculosis screening programme among sixth formers in a London school--more questions than answers. 1273 67

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.
 ...
PMID:Reactivation of tuberculosis after apparently adequate chemoprophylaxis. 1632 45

Pediatricians are unfamiliar with chronic granulomatous disease (CGD) because of its rarity and paucity of available data, potentially leading to misdiagnosis, late treatments, and mortality. The main purpose of this study was to summarize the clinical manifestations and auxiliary examination findings of four children with CGD confirmed by genetic testing.This was a case series study of children hospitalized at the Pediatric Respiratory Department of Shandong Provincial Hospital. The clinical, laboratory, treatment, and prognosis data were analyzed.All 4 children were boys. Two were brothers. The children's age was from 34 days to 3 years and 2 months at disease onset. The manifestations were repeated pulmonary infection, lymphadenitis, skin infection, and granuloma formation. Pulmonary infections were common. Abnormal responses were common after BCG vaccination. Thoracic computed tomography (CT) mainly showed nodules and masses, while the consolidation area in CT images reduced slowly. No abnormalities in cellular immune functions and immunoglobulin were found. The disease in all four children was confirmed by genetic testing. Long-term antibiotics and anti-fungal drugs were needed to prevent bacterial and fungal infections.CGD should be considered in children with repeated severe bacterial and fungal infections. Abnormal responses after BCG vaccination and nodular or mass-shaped consolidation in thoracic CT images should hint toward CGD. Gene sequencing could provide molecular evidence for diagnosis. The treatments of CGD include the prevention and treatment of infections and complications. Immunologic reconstitution treatment is currently the only curative treatment for CGD.
 ...
PMID:Clinical manifestations and genetic analysis of 4 children with chronic granulomatous disease. 3250 33