Tuberculosis recurrences and predictive factors in a vulnerable population in Catalonia.

BACKGROUND: Patients with a history of tuberculosis (TB) have a high probability of recurrence because long-term cure is not always maintained in successfully treated patients. The aim of this study was to identify the probability of TB recurrence and its predictive factors in a cohort of socially vulnerable patients who completed treatment in the TB referral center in Catalonia, which acts as the center for patients with social and health problems. METHODS: This retrospective open cohort study included all patients diagnosed with TB who were admitted and successfully treated in Serveis Clínics between 2000 and 2016 and who remained disease-free for a minimum of 1 year after treatment completion. We calculated the incidence density of TB recurrences per person-years of follow-up. We also estimated the cumulative incidence of TB recurrence at 1, 2, 5, and 10 years of follow-up. Bivariate analysis was conducted using Kaplan-Meier curves. Multivariate analysis was conducted using Cox regression. Hazard ratios (HR) were calculated with their 95% confidence intervals (95%CI). RESULTS: There were 839 patients and 24 recurrences (2.9%), representing 0.49 per 100 person-years. The probability of a recurrence was 0.63% at 1 year of follow-up, 1.35% at 2 years, and 3.69% at 5 years. The multivariate analysis showed that the predictive factors of recurrence were age older than 34 years (aHR = 3.90; CI = 1.06-14.34 at age 35-45 years and aHR = 3.88; CI = 1.02-14.80 at age >45 years) and resistance to at least one anti-TB drug (aHR = 2.91; CI = 1.11-7.65). CONCLUSIONS: Attention should be paid to socially vulnerable persons older than 34 years with a previous episode of resistant TB. Surveillance resources should be directed toward adequately treated patients who nevertheless have a high risk of recurrence.

Single Photon Emission Computed Tomography/Computed Tomography Detects a Second Ignored Intrathyroidal Parathyroid Adenoma.

The primary hyperparathyroidism (PHPT) is a result of high levels of parathyroid hormone and serum calcium, the most frequent cause is a solitary parathyroid adenoma. Double parathyroid adenoma is <5% of the PHPT. Intrathyroidal parathyroid adenoma (IPA) occurs< 3.2%. We present a case of 58-year-old female with persistent primary hyperparathyroidism due to a second undetected IPA, suspected by ultrasound and confirmed by 99mTc sestamibi single-photon emission computed tomography/computed tomography.

Human health risk of dietary intake of organochlorine pesticide residues in bovine meat and tissues from Veracruz, México.

Tissue distribution patterns of organochlorine pesticides in bovine carcasses varied significantly among seasons, geographic locations and tissues. The highest concentrations of Σ-DDT during the dry season were detected in lungs from Paso de Ovejas (2,834.90µg/kg lipid) and, during the rainy season, Lindane and Σ-HCH in muscle and lung samples from Paso de Ovejas (995.80 and 1,690.10µg/kg lipid). Estimated daily intakes of γ-HCH and Σ-DDT (3.35 and 1.22µg/kg bw/day) through consumption of muscle tissues from Paso de Ovejas and Puente Nacional during the rainy season showed the highest contribution. During the rainy season the highest non-cancer Hazard Ratios estimated corresponded to γ-HCH (3.97) and Σ-DDT (4.39) detected in muscle samples from Puente Nacional. The highest Hazard Ratios of cancer risk to the 95th centile daily consumption through meat corresponded to p,p'-DDT from Alvarado (7.76E+06) and from Paso de Ovejas for γ-HCH (1.50E+05) during rainy season. The results indicate potential non- and carcinogenic risks to consumer health through meat consumption.

Caracterización clínico-epidemiológica del asma bronquial en tres consultorios del médico de la familia / Clinical–epidemiological characterization of the bronchial asthma in three health clinics of the family physician

Se realizó un estudio descriptivo transversal con el objetivo de conocer las características clínico-epidemiológicas del asma bronquial en la edad adulta, en los consultorios 16, 21 y 22 del médico de la familia, pertenecientes al Policlínico Comunitario Docente "Tula Aguilera" de la ciudad de Camagüey, en el período comprendido de febrero de 1999 a febrero del 2000. Se utilizó espirometría con el objetivo de dosificar a los pacientes según la intensidad de la enfermedad, y una encuesta constituyó el registro primario de los datos en una muestra de 91 pacientes dispensarizados como asmáticos. La rinitis fue la manifestación alérgica asociada más frecuente, el 74,72 por ciento de los sujetos presentaron antecedentes patológicos familiares de atopia, el kerosene fue el combustible más utilizado para cocinar, predominaron las condiciones higiénicas regulares de las viviendas. Se constató que ser fumador pasivo influyó en la severidad del asma bronquial(AU)

Caracterización clínico-epidemiológica del asma bronquial en tres consultorios del médico de la familia / Clinical-epidemiological characterization of the bronchial asthma in three health clinics of the family physician

Se realizó un estudio descriptivo transversal con el objetivo de conocer las características clínico-epidemiológicas del asma bronquial en la edad adulta, en los consultorios 16, 21 y 22 del médico de la familia, pertenecientes al Policlínico Comunitario Docente Tula Aguilera de la ciudad de Camagüey, en el período comprendido de febrero de 1999 a febrero del 2000. Se utilizó espirometría con el objetivo de dosificar a los pacientes según la intensidad de la enfermedad, y una encuesta constituyó el registro primario de los datos en una muestra de 91 pacientes dispensarizados como asmáticos. La rinitis fue la manifestación alérgica asociada más frecuente, el 74, 72 % de los sujetos presentaron antecedentes patológicos familiares de atopia, el kerosene fue el combustible más utilizado para cocinar, predominaron las condiciones higiénicas regulares de las viviendas. Se constató que ser fumador pasivo influyó en la severidad del asma bronquial.

A descriptive, cross-sectional study with the aim of knowing clinicoepidemiological characteristics of bronchial asthma in the adulthood, in family physician health clinics 16, 21 and 22, belonging to Tula Aguilera communitary polyclinic of Camagüey city, was carried out from January 1999 to February 2000. Spirometry was used with the aim of dosifying patients according to disease intensity and a surgery was the primary register of data in a sample of 91 patients registered as asthmatic. Rhinitis was the allergic associated manifestation most frequent, 74, 72 % of subjects presented family pathologic antecedents of atopy, Kerosene was the fuel most used for cooking, regular hygienic conditions of lodgings prevailed, it was proved that passive smoking influenced in the severity of bronchial asthma.

Hemorragia del tracto gastrointestinal inferior: enfoque imaginológico

Se revisa la historia clínica, hallazgos imaginológicos y evolución en tres pacientes con hemorragia del tracto gastrointestinal inferior de diferentes etiologías que fueron estudiados con glóbulos rojos radiomarcados y angiografía selectiva con terapia endovascular mediante infusión intrarterial de vasopresina en el Hospital San Juan de Dios en santafé de Bogotá, entre Agosto de 1996 y Marzo de 1997. se revisa la literatura reciente y el abordaje diagnóstico y terapéutico utilizado como flujograma de manejo