Polymerase chain reaction test in induced sputum of patients with pulmonary tuberculosis.

INTRODUCTION: Induced sputum (IS) is an alternative method of obtaining sputum, but IS smears are frequently negative. Culture is more time consuming in its results, and less useful to guide the diagnosis. Polymerase chain reaction (PCR) is the most common methodology for rapid diagnosis of tuberculosis (TB), and few studies evaluated its role in IS samples. OBJECTIVES: The objective of this study is to determine the diagnostic yield of PCR for TB compared with culture in IS samples. MATERIALS AND METHODS: Prospective study. Inpatients and outpatients of >18 years with respiratory symptoms suggestive of PTB were invited to participate. The subjects were interviewed using a standardized questionnaire, and collected IS. Three samples were obtained for AFB smear and culture. A fourth sample was obtained for PCR test. RESULTS: A total of 116 IS samples were evaluated. The sensitivity, specificity, positive predictive value and negative predictive values of PCR were 95.2%, 48.4%, 29.0% and 97.9%, respectively. The area under the receiver operating characteristic curve was .72 for the PCR test (P < .0001). CONCLUSIONS: Although the PCR specificity could be underestimated, if we consider PCR to be more sensitive than the culture method used, we believed that these PCR-positive tests mean false positives. The results of PCR should always be interpreted carefully in conjunction with clinical information.

Perfil epidemiológico de pacientes queimados admitidos em umserviço terciário de Caxias do Sul - RS / Epidemiological profile of patients burned allowed in a tertiary service of Caxias do Sul - RS

Objetivos: Determinar o perfil epidemiológico de pacientes queimados admitidos em um serviço terciário de Caxias do Sul/RS. Método: Estudo transversal, por meio da análise dos prontuários dos pacientes com diagnóstico de queimadura de 2006 a 2011. Os dados foram tabulados em frequência e proporção. Resultados: O sexo masculino foi o mais acometido, com 51,6%; a faixa etária entre 19-59 anos concentrou o maior número de pacientes queimados (71%); o grau de lesão misto foi predominante em 64,5%; em relação à superfície corporal queimada (SCQ), prevaleceram pacientes grandes queimados (83,9); a alta hospitalar predominou em 80,6% dos casos. Conclusão: Conclui-se, com essa pesquisa, que o estudo epidemiológico de qualquer tipo de afecção é de suma relevância para organização de campanhas de prevenção e de elaboração de tratamentos adequados, proporcionando, assim, melhor atendimento e melhor qualidade de vida à população.

Objectives: To determine the epidemiological profile of burn patients admitted to a tertiary Caxias do Sul / RS. Method: This is a cross-sectional study, through the analysis of medical records of patients with diagnosis of burn 2006-2011. Data were tabulated by frequency and proportion. Results: males predominated with 51.6% aged between 19-59 years had the largest number of burn patients (71%), the degree of joint damage was prevalent in 64.5%, compared the SCQ prevailed extensively burned patients (83.9), discharge predominated in 80.6% of cases. Conclusion: It is concluded from this research that the epidemiological study of any type of pathology, is of utmost relevance for organizing prevention campaigns and development of appropriate treatments, thus providing a better service and a better quality of life for the population.

Perfil epidemiológico da tuberculose pulmonar em Unidade Sanitária de referência em Porto Alegre, RS / Epidemiological Features of pulmonary tuberculosis in a reference health center for the disease in Porto Alegre, RS

Introdução: Tuberculose tem diagnóstico e tratamento efetivos em condições ideais. Todavia, vários problemas ocorrem na condução rotineira dos casos, o que implica prejuízos para população. O objetivo deste estudo foi estudar uma série de pacientes com tuberculose pulmonar bacilífera e não bacilífera, descrevendo características demográficas e verificando associação destas, da baciloscopia, HIV e alcoolismo com resultados do tratamento. Métodos: De 2005 a 2007, foram analisados prontuários de pacientes no Centro de Saúde Modelo, Porto Alegre, RS. Casos extrapulmonares, mudança no diagnóstico, transferência e com dados incompletos foram excluídos. Resultados do tratamento: sucesso ou insucesso (abandono/óbito). Resultados: 175 casos de Tuberculose pulmonar, 74,8% com confirmação bacteriológica, sendo 94% pela baciloscopia. A cura prevaleceu (76%), mas ocorreu abandono em 37 casos. Não foi verificada associação da baciloscopia, gênero e idades com os resultados do tratamento. Foi encontrada associação de “insucesso” com a HIV, mas não com o alcoolismo. Menor escolaridade apresentou associação com o insucesso do tratamento. Conclusão: Mais casos de tuberculose pulmonar (bacilífera e não bacilífera) em relação às formas não pulmonares. A doença foi mais frequente em homens brancos, de 20 e 59 anos, 1º e 2° graus. A baciloscopia foi mais utilizada para diagnóstico. Houve mais casos de cura. Houve associação do insucesso com HIV e escolaridade mais baixa, mas não significativamente com o alcoolismo.

Introduction: The diagnosis and treatment of tuberculosis is effective under ideal conditions. However, several problems occur in the management of the cases, and this implies in damage to the population. The aim of this study was to investigate a series of patients with bacillary or nonbacillary pulmonary tuberculosis by describing demographic characteristics and assessing the association of these with bacilloscopy, HIV and alcoholism and treatment outcomes. Methods: From 2005 to 2007, we analyzed medical records of patients in a reference health center in Porto Alegre/RS. Extrapulmonary cases, change in diagnosis, transfer, and incomplete data were excluded. Treatment outcomes: success or failure (abandonment/death). Results: 175 cases of pulmonary tuberculosis, 74.8% with positive sputum, 94% of which by bacilloscopy. Healing prevailed (76%), but abandonment occurred in 37 cases. No association was found of bacilloscopy, ages and gender with the treatment outcomes. “Failure” was found to be associated with HIV but not with alcoholism. Less schooling was associated with treatment failure. Conclusion: There were more cases of pulmonary tuberculosis (bacillary and non-bacillary) than non-pulmonary forms. The disease was more frequent in white males, 20 and 59 years, 1st and 2nd degrees. Bacilloscopy was mostly used for diagnosis. There were more cases of healing. There was an association of failure with HIV and lower education, but not significantly with alcoholism.