Stented cryopreserved aortic allograft for reconstruction of long-segment post-tuberculosis tracheal stenosis.

Tracheobronchial tuberculosis is one of the conditions causing long segment tracheal stenosis and is a clinically challenging scenario. This report describes a successful tracheal reconstruction in a 44-year-old man with long-segment post-tuberculosis tracheobronchial stenosis, utilizing a stented cryopreserved aortic allograft. The procedure was necessitated by the failure of conventional treatments. The stenotic segment was resected and replaced with a cryopreserved aortic allograft, supported by a metallic stent to maintain airway patency. Post-surgery, the patient experienced resolution of dyspnea without major complications. Currently, at 33 months post-operation, the patient enjoys an enhanced quality of life with effective breathing, speaking, swallowing abilities, and has resumed normal daily activities, with regular bronchoscopic follow-ups. This report demonstrates a novel approach for managing challenging tuberculosis-induced long segment airway stenosis.

Risk of tuberculosis after endoscopic resection and gastrectomy in gastric cancer: nationwide population-based matched cohort study.

BACKGROUND: This study aimed to investigate the association between gastrectomy and endoscopic resection for gastric cancer and the subsequent tuberculosis incidence. METHODS: We conducted a nationwide matched cohort study using data from the Korea National Health Insurance Service from 2013 to 2019. We created two cohorts: patients who underwent gastrectomy and those who had endoscopic resection. Each patient was matched 1:1 with an unexposed individual based on index year, age, sex, income, and various comorbidities. The primary outcome was the incidence of tuberculosis during the follow-up period. RESULTS: Our study comprised 90,886 gastrectomy patients and 46,759 endoscopic resection patients. The tuberculosis incidence was significantly higher in the gastrectomy group compared to its matched non-gastrectomy group (IRR 1.69, 95% CI 1.43-1.99, p < .001). In contrast, there was no significant difference in tuberculosis incidence between the endoscopic resection group and its matched non-resection group (IRR 0.95, 95% CI 0.75-1.19, p = 0.627). The Kaplan-Meier cumulative incidence also did not differ between the two groups. However, tuberculosis incidence significantly increased in the first year after endoscopic resection. CONCLUSION: Gastrectomy for gastric cancer is associated with a higher incidence of subsequent tuberculosis, while no significant association was observed for endoscopic resection. However, tuberculosis incidence increases significantly during the first year after endoscopic resection.

Tuberculosis en cabeza y cuello. Experiencia en la Patagonia chilena y revisión de la literatura / Tuberculosis in head and neck. Experience in Chilean Patagonia and literature review

La tuberculosis (TBC) es una de las patologías infecciosas que más muertes ha producido a nivel mundial, sobrepasando al virus de inmunodeficiencia humana (VIH). En Chile a pesar de la baja incidencia de la patología, aun no es posible llegar a su erradicación. La TBC es una enfermedad que habitualmente compromete el pulmón, sin embargo, en ocasiones compromete otros sitios del organismo, siendo la ubicación en cabeza y cuello una de las más importantes. Las manifestaciones clínicas son variadas y el curso de estas puede ser larvado, simulando otras patologías de mayor frecuencia en el ámbito otorrinolaringológico y transformando su diagnóstico en un desafío mayor. En este artículo se presentan tres casos clínicos diagnosticados y manejados en nuestra en región, además de una revisión de la literatura disponible en relación a la presentación clínica, orientación diagnóstica y tratamiento de la patología.

Tuberculosis is one of the infectious diseases which has produced more deaths around the world, even more than human immunodeficiency virus. In Chile, despite of the low incidence, there is still not possible to eradicate it. Tuberculosis is a disease which commonly compromises lungs, however, in some occasions involves another site of the organism, been the location in head and neck one of the most important. The clinical features are diverse and the natural history of those can be masked, for this reason it can simulate another more frequent disease in otolaryngology field, making the diagnosis a real challenge. In this article, we present three clinical cases diagnosed and treated in our region, besides, a review of the available literature related with the clinical presentation, diagnosis orientation and treatment of this pathology.

Clinical study of movable external fixation for elbow tuberculosis / 中国骨伤

OBJECTIVE@#To compare clinical effect of movable external fixation and fusion fixation for the treatment of elbow tuberculosis.@*METHODS@#From October 2013 to June 2019, 52 patients with elbow tuberculosis treated with standard antituberculosis therapy were divided into movable external fixation group and fusion fixation group according to treatment methods. In group A, there were 25 patients, including 11 males and 14 females, aged from 24 to 75 years old with an average of (42.81± 9.01) years old; the courses of diseases ranged from 2 to 9 months with an average of (3.96±1.45) months. In group B, there were 27 patients, including 15 males and 12 females, aged from 23 to 77 years old with an averageof (44.08±7.44) years old; the courses of diseases ranged from 2 to 7 months with an average of (3.88±1.67) months. All patients were performed focus debridement. Intraoperative blood loss, operative time were compared between two groups. VAS score before operation, 2 weeks and 12 months after operation were applied to evaluate pain relieve;Mayo elbow performance score (MEPS) before operation, 1 and 12 months after operation were used to evaluate clinical effect;changes of erythrocyte sedimentation rate (ESR) and Creactive protein, CRP) before operation, 3 weeks after antituberculosis therapy, 1 week and 6 months after operation were compared between two groups.@*RESULTS@#All patients were followed up from 12 to 20 months with an average of (13.50±4.85) months. No mixed infection and recurrence of tuberculosis occurred. There were no statistical differences in intraoperative blood loss and operative time(@*CONCLUSION@#For elbow tuberculosis, movable external fixation and fusion fixation have equal effect in operative time, amount of bleeding and control of tuberculosis infection indicator. Movable external fixation need earlier functional exercise, not conducive to pain relief at early stage, which may be better than fusion fixation, it is worth clinical promoting.

La colapsoterapia como tratamiento de la tuberculosis pulmorar / Collapse therapy of pulmonary tuberculosis

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Identificación de factores de riesgo para tuberculosis mediante epidemiologia molecular en el Departamento de La Paz, Bolivia, diciembre de 1998 a mayo de 2000 / Identification of risk factors for tuberculosis throgh molecular epidemiology in the Departament of La Paz, Bolivia, december 1998 to may 2000

Tomando en cuenta la situación de la tuberculosis (TB) en Bolivia y en La Paz y con el afán de poder hallar soluciones al problema de la salud pública que representa, se pretende implementar un estudio de epidemiologia molecular con el empleo de la técnica llamada reacción en cadena de la Polimerasa de doble elemento repetitivo (DRE-PCR). tomando en cuenta las ventajas que proporcionael empleo del DRE-PCR para la subtipificación de capas de M. tuberculosis y aplicando epidemiologia molecular con un modelo de investigación de casos y controles, se pretende identificar los factores de riesgo principales que son responsables de la diseminación de la TB en el departamento de La Paz...

Tuberculose da parede torácica: relato de caso / Tuberculosis of thoracic wall: case report

Relatamos um caso de tuberculose da parede torácica em um paciente do sexo feminino, de três anos de idade, apresentando ao exame clínico massa na parede anterior do tórax, em projeção do terço superior do esterno. A radiografia do tórax não demonstrou anormalidades. Ao ultra-som o aspecto era predominantemente sólido, e na tomografia computadorizada apresentava-se como massa heterogênea associada a destruição óssea e cartilagínea, com realce após a injeção do contraste endovenoso, sem sinais de acometimento do parênquima pulmonar. A biópsia da lesão evidenciou processo inflamatório crônico granulomatoso do tipo tuberculóide, com extensas áreas de necrose caseosa. A pesquisa de bacilo álcool-ácido resistente (BAAR) no material foi positiva.

Tuberculosis suprarrenal: a propósito de una observación / Suprarenal tuberculosis: an observation

Se presenta una paciente de 40 años con insuficiencia suprarrenal crónica, cuyo estudio confirmó la presencia de tuberculosis en dicha glándula. Se hacen consideraciones clínicas, etiológicas y diagnósticas, al mismo tiempo que se expone la importancia de tuberculosis extrapulmonar para el médico en el momento actual(AU)

La chirurgie de la tuberculose pulmonaire aux Cliniques Universitaires de Kinshasa : etude de 322 cas

La revue de 322 cas de tuberculose pulmonaire operes dans leur service permet aux auteurs de relever les 3 types de lesions qui ont fait indiquer les gestes chirugicaux a savoir les lesions pleurales (17 pour cent); bronchiques (8 pour cent) et parenchymateuses (75 pour cent). Allies au traitement medical; les actes chirurgicaux des plus simples (drainage pleural p.e.) aux plus mutilantes exereses parenhymateuses ont abouti a de nombreuses guerisons avec un taux de mortalite de 7 pour cent. L'association de plus en plus frequente entre le SIDA et la tuberculose pulmonaire souleve des problemes ethiques qui pesent sur la decision chirurgicale

Tuberculosis abdominal / Abdominal tuberculosis

The authors studied the symptoms, signs and diagnostic procedures in 9 cases of abdominal tuberculosis, six in women, three in men, 17 to 84 and average of 43 years old, who were treated in the Social Security Arnulfo Arias Madrid Hospital Complex in Panama City. In 8 cases the diagnosis was confirmed by biopsy with laparotomy, in 5 with laparoscopy in 1 case because by concomitant lung tuberculosis and improvement with antituberculosis drugs. They present the clinical histories of 2 patients in order to discuss the presenting complaints in abdominal tuberculosis, review the pathology and arouse interest in the study of this entity precisely now that since the initiation of the AIDS epidemic in Panama in 1984 until July 1992 there have been a total of 369 confirmed cases of which 18% had tuberculosis as the first or second opportunistic infection

La toracoplastia / Thoracoplasty

La toracoplastia disenada por Sehede, es la reseccion parcial o total de la pared toracica, usada para el tratamiento de secuelas de tuberculosis pleuropulmonar, reduccion de cavidades residuales, o exceresis de neoplasias de pulmon con invasion a pared o tumores de pared toracica. Las indicaciones pueden ser pulmonares, pleurales o en cavidades residuales postoperatorias. En nuestra casuistica, fueron sometidos a toracoplastia 5 pacientes de sexo masculino por secuelas sangrantes de tuberculosis pulmonar y supurativas pleurales; se hizo reseccion entre 3 o 4 costillas. Los resultados fueron satisfactorios en tres pacientes y fracasaron en dos. Esto nos hace ver que a pesar de lo antiguo del procedimiento en la actualidad aun podemos contar con el para los casos de secuelas bacilares sin condiciones de reseccion pulmonar.

Tuberculose ano-retal / Anorectal tuberculosis

Foram estudados 8 pacientes com tuberculose ano-retal, avaliando-se o quadro clinico, criterio de diagnostico, frequencia da tuberculose pulmonar associada, tipo macroscopico da lesao e tratamento clinico e cirurgico. Houve predominio do sexo masculino (3:1), e a idade esteve acima dos 38 anos na maioria dos pacientes com tuberculose anal, e foi de 33 e 38 anos na tuberculose retal. A dor ao evacuar foi o sintoma mais frequente na forma anal, e dor abdominal, nauseas, vomitos e emagrecimento predominaram na forma retal. Realizamos pesquisa BAAR no escarro (50 por cento), biopsia da lesao ano-retal (25 por cento), histopatologia do trajeto fistuloso ressecado (50 por cento), transito delgado (37,5 por cento), enema opaco (50 por cento), Mantoux (100 por cento), e raio X simples de torax (100 por cento), como criterios de diagnostico. A associacao com tuberculose pulmonar estava presente em 62,5 por cento dos casos. O exame microscopico, revelou 1 caso de tuberculose retal ulcerativa, e outro de ulcero-hiperplastica. Todos os casos de tuberculose anal foram do tipo ulcerativo. A cura foi observada em 100 por cento dos casos com o tratamento especifico. O tratamento cirurgico foi realizado em 4 pacientes, portadores de fistula anal.

Surgical abdominal tuberculosis in Nigerians: a series of 17

Seventeen cases of abdominal tuberculosis were seen over a period of thirteen years in the surgical units of the University of Benin Teaching Hospital. There were 9 males and 8 females and their ages ranged from 15 to 60 years with a median age of 38.9 years. There were 7 cases of tuberculous mesentric lymphadenitis; 3 of gastric tuberculosis; 2 each of tuberculous peritonitis and ileo-ccaecal tuberculosis fistula-in-ano. The common presenting clinical faetures were abdominal pain; fever; vomiting; weight loss; abdominal distension and abdominal mass which were not always diagnostic. Laparotomy was mostly used to obtain tissues for diagnosis in which there was histological confirmation of tuberculosis in all 17 cases and positive bacterial examination in only 5 patients. [abstract terminated]

TBC genitourinaria: 10 años de experiencia / Genitourinary tuberculosis: review over 10 years

Entre 1979 y 1989 hemos tratado a 129 pacientes portadores de TBC génitourinaria, con 3 esquemas de quimioterapia acortada, con duración aproximada de 7-8 meses cada uno. Todos incluyen RMP, HIN, SM y PZ. Lográndose un 98% de éxito bacteriológico. El tiempo de seguimiento promedio fue de 3 años con un rango entre 3 meses y 6 años, 27 pacientes necesitaron algún tipo de cirugía: en 13 con fines diagnósticos antes del tratamiento y en 14 durante o luego de finalizada la quimioterapia; en 8 de ellos fue de tipo reparadora o conservadora y en 6 fue resectiva. En general los efectos adversos de la quimioterapia fueron menores, siendo los más frecuentes alergia a alguno de los fármacos, gastritis y ototoxicidad. Concluímos que con la quimioterapia acortada se pueden obtener buenos resultados, en tuberculosis génitourinaria, similares a los obtenidos previamente utilizando la quimioterapia clásica

Otite média tuberculosa: aspectos diagnósticos; relato de um caso / Tuberculous otitis media: diagnostics aproaches; a case report

O presente artigo tem como objetivo relatar as dificuldades diagnósticas frente a um caso de otite média tuberculosa ressaltando a importância do estudo anátomo-patológico, e a necessidade de se estar atento em todos os casos de otite supurativa que evoluem de maneira incomum

Hemorragia tuberculosa incontrolável: uma urgência cirúrgica / Uncontrolled tuberculosis hemorrhage: a surgical emergency

O trabalho apresentado, focaliza uma entidade clínico-patológica designada Hemoptise Tuberculosa Incoercível, frente ao tratamento clínico convencional indicado. É analisada a dominante do quadro clínico, caracterizado por hemoptises maciças incontroláveis, repetidas e persistentes. Dentre os exames complementares, valorizamos a importante contribuiçäo da radiologia, o emprego PEEP e os aspectos anátomo-patológicos mais característicos da lesäo. Säo tecidas consideraçöes acerca do tratamento cirúrgico, enfatizando a terapia resseccionalista como única condiçäo viável à cura desta entidade mórbida

Tuberculosis abdominal / Abdominal tuberculosis

El registro de casos de tuberculosis abdominal activa (TBAA) cuyo diagnóstico fue arduo, como así publicaciones que en la última década detectaron dificultades diagnósticas en tuberculosis son los motivos de este estudio restrospectivo. Se revisaron los registros médicos de los pacientes internados (lapso 1972-82) en Medicina y Cirugía en el Hospital Castex. En 21 pacientes se estableció diagnóstico histopatológico de TB AA; 14/21 operados, 8/14 requirieron laparotomías urgentes; 7/21 tuvieron diagnóstico por biopsias laparoscópicas o por punción. En la Tabla 1 se sintetizan los antecedentes, clínica, cirugía, patología y seguimiento de los 21 pacientes, en la Tabla 2 se reúnen en síndromes las formas de presentación clínica (11/21) o quirúrgica (10/21), y en la Tabla 3, se agrupan el tipo de lesiones anatómicas. Se discuten los factores que obstaculizan el diagnóstico de la TB AA y los ajustes educativos y operativos necesarios para mejorar el hospital general como centro integrador del tratamiento y control de la endemia tuberculosa (AU)

Tuberculosis abdominal / Abdominal tuberculosis

El registro de casos de tuberculosis abdominal activa (TBAA) cuyo diagnóstico fue arduo, como así publicaciones que en la última década detectaron dificultades diagnósticas en tuberculosis son los motivos de este estudio restrospectivo. Se revisaron los registros médicos de los pacientes internados (lapso 1972-82) en Medicina y Cirugía en el Hospital Castex. En 21 pacientes se estableció diagnóstico histopatológico de TB AA; 14/21 operados, 8/14 requirieron laparotomías urgentes; 7/21 tuvieron diagnóstico por biopsias laparoscópicas o por punción. En la Tabla 1 se sintetizan los antecedentes, clínica, cirugía, patología y seguimiento de los 21 pacientes, en la Tabla 2 se reúnen en síndromes las formas de presentación clínica (11/21) o quirúrgica (10/21), y en la Tabla 3, se agrupan el tipo de lesiones anatómicas. Se discuten los factores que obstaculizan el diagnóstico de la TB AA y los ajustes educativos y operativos necesarios para mejorar el hospital general como centro integrador del tratamiento y control de la endemia tuberculosa