RESUMEN
High rates of drug-resistant tuberculosis in Ukraine suggest screening is necessary to mitigate public health hazards for host populations. A pathway was implemented in Wales and data prospectively collected Between 8 April and 21 December 2022. Of 5425 Ukrainian arrivals, notifications were received by TB teams on 2395 (44%) of whom 1955 (82%) were screened. The refugees were young (median age 30, IQR 14-41), and predominantly female (66.1%). Interferon- gamma release assay (IGRA) tests were positive in 112 (6.5%). One Case of active tuberculosis was identified (0.05%). Our data supports European guidelines that routine screening of this population is not recommended, but we remain uncertain as to the risks of this population going forwards.
Asunto(s)
Tuberculosis Latente , Refugiados , Tuberculosis Resistente a Múltiples Medicamentos , Humanos , Femenino , Adulto , Masculino , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/epidemiología , Prueba de Tuberculina , Gales/epidemiología , Ensayos de Liberación de Interferón gamma , Tuberculosis Resistente a Múltiples Medicamentos/diagnóstico , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Tamizaje MasivoRESUMEN
Medical thoracoscopy has an important place in the diagnosis and management of pleural disease. However, the application of this procedure is limited in the United Kingdom. This may be partly because respiratory physicians remain unfamiliar with standard rigid thoracoscopy instruments. However, the semirigid variant, popular in Europe and Japan, is similar in design to the commonly used flexible bronchoscope. The larger biopsy size obtained with the conventional rigid thoracoscope has been quoted as a reason for its superiority. To compare the histologic yield of the 2 instruments, the current authors studied a series of 66 patients with unilateral exudative pleural effusions. Twenty-seven rigid and 39 semirigid thoracoscopy procedures were included. Thoracoscopic pleural biopsy achieved a positive diagnosis in 26 of 27 patients in the rigid thoracoscopy group (96.3%) and 36 of 39 patients in the semirigid group (92.3%). Statistically, this difference was not significant (95% confidence intervals, -0.11 to 0.17). Our study demonstrates that the semirigid thoracoscope achieves a diagnostic yield similar to that of the conventional rigid instrument despite the smaller biopsy size. Both instruments remain valuable in the evaluation and management of pleural disease.
