Successful use of rifampicin for Hispanic foreign-born patients with latent tuberculosis infection.

SETTING: Four months of rifampicin (4R) is recommended for the treatment of latent tuberculosis infection (LTBI), although data regarding its use are limited. The majority of tuberculosis (TB) cases in the USA occur among foreign-born persons. OBJECTIVE: To determine tolerability, hepatotoxicity and completion rates associated with 4R among foreign-born persons. DESIGN: We retrospectively evaluated 4R treatment among a cohort of predominantly Hispanic foreign-born LTBI patients in four Middle-Tennessee public health clinics from February 2000 to February 2004. Patients' charts were reviewed to abstract demographic, social and clinical data. 4R completion rates, new symptoms and hepatotoxicity (serum aminoalanine transferase >or=120U/l with gastrointestinal symptoms or >or=200 regardless of symptoms) were evaluated. RESULTS: Of 749 patients treated, 571 (76%) completed 4R. Among all subjects, Hispanics had a lower risk of non-completion (OR 0.6, 95%CI 0.4-0.7) than non-Hispanics. Among non-Hispanic subjects, the risk of non-completion was higher for Blacks than non-Blacks (adjusted OR 2.6, 95%CI 1.5-4.7), but was lower for foreign-born than non-foreign-born subjects (adjusted OR 0.5, 95%CI 0.2-0.9). During treatment, 85 subjects (11%) developed new symptoms, and hepatotoxicity occurred in three patients. CONCLUSION: With high completion rates and minimal side effects, 4R is a favorable LTBI treatment regimen for Hispanic and other foreign-born patients.

Prediction of postoperative pulmonary function with the lateral position test. A prospective study.

Ten patients undergoing pneumonectomy were evaluated with the lateral position test (LPT) in addition to routine pulmonary function tests (PFTs). On the basis of the percentage of ventilation estimated to be contributed by each lung on LPT, predictions were made for expected values for each patient's post-pneumonectomy PFTs. One to three months after surgery patients were again evaluated with complete pulmonary function studies. Results were found to agree closely with preoperative predictions in most patients. We conclude that the easily performed LPT, previously found to yield values which correlate with those found on bronchospirometry and macroaggregate lung scanning, does indeed yield acceptable results clinically and is deserving of more widespread application, especially in the large number of institutions without nuclear medicine capabilities.