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Original Article03-02-2004
Management of massive hemoptysis with the rigid bronchoscope and cold saline lavage
Jornal de Pneumologia. 2003;29(5):280-286
Abstract
Original ArticleManagement of massive hemoptysis with the rigid bronchoscope and cold saline lavage
Jornal de Pneumologia. 2003;29(5):280-286
DOI 10.1590/S0102-35862003000500006
Views13See moreBACKGROUND: Massive hemoptysis is a high morbidity and high mortality condition, independently of the treatment administered. A variety of methods are used to control the acute bleeding. The instillation of iced saline solution through a rigid bronchoscope was described in 1980. OBJECTIVE: To establish the efficacy of repeated instillations of iced saline solution (4ºC) using a rigid bronchoscope for the acute control of massive hemoptysis. METHOD: A group of 94 patients with massive hemoptysis was treated with rigid bronchoscopy and lavage with iced saline solution of the actively bleeding lung. The absence of bleeding recurrence within the following 15 days was considered a therapeutic success. The causes of hemoptysis included: pulmonary tuberculosis: 78 (83%), among which 48 had active disease, and 30 had tuberculosis sequelae, bronchiectasis (6), lung cancer (5), intracavitary aspergilloma (3), and unknown (2). The bleeding site was found in 93 patients (99%). The mean saline volume used in the bronchoscopy was 528 mL, ranging from 160 mL to 2,500 mL. RESULTS: All patients stopped bleeding during the procedure. Fifteen patients were submitted to some kind of procedure (surgery, embolization, or radiation therapy) within 15 days, and the efficacy of lavage could not be assessed. Twenty of the 79 patients followed-up for more than 15 days had recurrence of hemoptysis. Cold saline lavage was repeated once in 13 patients, twice in 6 patients, and 3 times in one patient. CONCLUSION: The control of tracheobronchial hemorrhage through bronchoscopy and lavage with iced saline is an effective procedure and can be repeated in case of re-bleeding. It is a safe procedure, and allows the definitive treatment to occur in better clinical conditions.
Views13
Abstract
Original ArticleManagement of massive hemoptysis with the rigid bronchoscope and cold saline lavage
Jornal de Pneumologia. 2003;29(5):280-286
DOI 10.1590/S0102-35862003000500006
Views13See moreBACKGROUND: Massive hemoptysis is a high morbidity and high mortality condition, independently of the treatment administered. A variety of methods are used to control the acute bleeding. The instillation of iced saline solution through a rigid bronchoscope was described in 1980. OBJECTIVE: To establish the efficacy of repeated instillations of iced saline solution (4ºC) using a rigid bronchoscope for the acute control of massive hemoptysis. METHOD: A group of 94 patients with massive hemoptysis was treated with rigid bronchoscopy and lavage with iced saline solution of the actively bleeding lung. The absence of bleeding recurrence within the following 15 days was considered a therapeutic success. The causes of hemoptysis included: pulmonary tuberculosis: 78 (83%), among which 48 had active disease, and 30 had tuberculosis sequelae, bronchiectasis (6), lung cancer (5), intracavitary aspergilloma (3), and unknown (2). The bleeding site was found in 93 patients (99%). The mean saline volume used in the bronchoscopy was 528 mL, ranging from 160 mL to 2,500 mL. RESULTS: All patients stopped bleeding during the procedure. Fifteen patients were submitted to some kind of procedure (surgery, embolization, or radiation therapy) within 15 days, and the efficacy of lavage could not be assessed. Twenty of the 79 patients followed-up for more than 15 days had recurrence of hemoptysis. Cold saline lavage was repeated once in 13 patients, twice in 6 patients, and 3 times in one patient. CONCLUSION: The control of tracheobronchial hemorrhage through bronchoscopy and lavage with iced saline is an effective procedure and can be repeated in case of re-bleeding. It is a safe procedure, and allows the definitive treatment to occur in better clinical conditions.
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Original Article10-01-2003
Impact of multiple biopsies in two different sites of the pleural surface for the diagnosis of tuberculosis
Jornal de Pneumologia. 2000;26(2):55-60
Abstract
Original ArticleImpact of multiple biopsies in two different sites of the pleural surface for the diagnosis of tuberculosis
Jornal de Pneumologia. 2000;26(2):55-60
DOI 10.1590/S0102-35862000000200003
Views11For diagnostic purposes of pleural tuberculosis, three pleural fragments are routinely obtained from a single site by needle biopsy. The objective of this study is to compare the diagnostic yield of the routine procedure with two different approaches: harvesting five fragments on a single site (A), and collection of fragments at an additional site (B); from the same cutaneous orifice, the needle was partially removed up to the subcutaneous tissue and redirected at a 45º angle. The authors performed a prospective study in 115 patients submitted to pleural biopsy. The first three pleural fragments were placed in a vial (VA1-3), the 5 subsequent fragments obtained at the same site were placed in a second vial (VA4-8), and the five fragments from the second site were placed in a third vial (VB1-5). Analysis of fragments from VA1-3 revealed granuloma in 72/92 tuberculosis cases (78.3%), whereas in fragments VA5-8 and VB1-5, granuloma was observed in 74/92 cases (80.5%). In 6/92 patients the diagnosis at VA1-3 was non-specific pleuritis, but granuloma was found in VA4-8, resulting in a diagnosis increment of 8.3% (adding six to the 72 patients). In 7/92 patients (7.6%) the histopathological examination at site A led to a non-specific result but granuloma was found at site B, leading to a diagnostic increment of 9.0% (7 to 78 patients). Histological concordance of two examinations by the same pathologist had a kappa index of 0.62 (0.54 to 0.7) whereas concordance between two different pathologists had a kappa index of 0.64 (0.56 to 0.72). The performance of multiple biopsies at two different sites at the pleural surface led to an additional diagnosis of 13 patients, i.e., an increase of 18% (13 to 72) relative to the routine procedure. Considering the low cost increase of obtaining the fragments, adoption of this method is recommended in routine pleural tuberculosis diagnosis.
Keywords:TuberculosisSee moreViews11Abstract
Original ArticleImpact of multiple biopsies in two different sites of the pleural surface for the diagnosis of tuberculosis
Jornal de Pneumologia. 2000;26(2):55-60
DOI 10.1590/S0102-35862000000200003
Views11For diagnostic purposes of pleural tuberculosis, three pleural fragments are routinely obtained from a single site by needle biopsy. The objective of this study is to compare the diagnostic yield of the routine procedure with two different approaches: harvesting five fragments on a single site (A), and collection of fragments at an additional site (B); from the same cutaneous orifice, the needle was partially removed up to the subcutaneous tissue and redirected at a 45º angle. The authors performed a prospective study in 115 patients submitted to pleural biopsy. The first three pleural fragments were placed in a vial (VA1-3), the 5 subsequent fragments obtained at the same site were placed in a second vial (VA4-8), and the five fragments from the second site were placed in a third vial (VB1-5). Analysis of fragments from VA1-3 revealed granuloma in 72/92 tuberculosis cases (78.3%), whereas in fragments VA5-8 and VB1-5, granuloma was observed in 74/92 cases (80.5%). In 6/92 patients the diagnosis at VA1-3 was non-specific pleuritis, but granuloma was found in VA4-8, resulting in a diagnosis increment of 8.3% (adding six to the 72 patients). In 7/92 patients (7.6%) the histopathological examination at site A led to a non-specific result but granuloma was found at site B, leading to a diagnostic increment of 9.0% (7 to 78 patients). Histological concordance of two examinations by the same pathologist had a kappa index of 0.62 (0.54 to 0.7) whereas concordance between two different pathologists had a kappa index of 0.64 (0.56 to 0.72). The performance of multiple biopsies at two different sites at the pleural surface led to an additional diagnosis of 13 patients, i.e., an increase of 18% (13 to 72) relative to the routine procedure. Considering the low cost increase of obtaining the fragments, adoption of this method is recommended in routine pleural tuberculosis diagnosis.
Keywords:TuberculosisSee more -
Original Article09-24-2003
Epidemiological profile of tuberculosis infection and disease among cocaine users admitted to hospitals of the Greater São Paulo city
Jornal de Pneumologia. 2003;29(3):125-132
Abstract
Original ArticleEpidemiological profile of tuberculosis infection and disease among cocaine users admitted to hospitals of the Greater São Paulo city
Jornal de Pneumologia. 2003;29(3):125-132
DOI 10.1590/S0102-35862003000300003
Views9See moreOBJECTIVE: To evaluate the prevalence and the risk factors for tuberculosis (TB) infection and disease among hospitalized cocaine users. METHOD: A cross-sectional study performed on a sample of 440 addicts over 18 years of age, admitted to hospitals of the metropolitan area of the Greater São Paulo city, whose clinical conditions allowed them to answer a standard questionnaire, and who agreed to participate in the study. The prevalence of TB infection was assessed through positive tuberculin testing (PPD), and of TB disease by the finding of M. tuberculosis in the sputum of patients with respiratory symptoms. RESULTS: Respiratory symptoms were present in 21% of the patients, the most frequent being weight loss and cough, which disappeared when cocaine use was discontinued. The general prevalence of TB infection was 28%. The prevalence of TB disease was 0.6%. The factors which were associated with positive PPD were: age, color/race, time spent in prison, and drug use in prison. CONCLUSION: No increased prevalence of TB infection and disease was found in these patients. Older addicts had a higher probability of having TB infection, and so had those who had been in prison.
Views9Abstract
Original ArticleEpidemiological profile of tuberculosis infection and disease among cocaine users admitted to hospitals of the Greater São Paulo city
Jornal de Pneumologia. 2003;29(3):125-132
DOI 10.1590/S0102-35862003000300003
Views9See moreOBJECTIVE: To evaluate the prevalence and the risk factors for tuberculosis (TB) infection and disease among hospitalized cocaine users. METHOD: A cross-sectional study performed on a sample of 440 addicts over 18 years of age, admitted to hospitals of the metropolitan area of the Greater São Paulo city, whose clinical conditions allowed them to answer a standard questionnaire, and who agreed to participate in the study. The prevalence of TB infection was assessed through positive tuberculin testing (PPD), and of TB disease by the finding of M. tuberculosis in the sputum of patients with respiratory symptoms. RESULTS: Respiratory symptoms were present in 21% of the patients, the most frequent being weight loss and cough, which disappeared when cocaine use was discontinued. The general prevalence of TB infection was 28%. The prevalence of TB disease was 0.6%. The factors which were associated with positive PPD were: age, color/race, time spent in prison, and drug use in prison. CONCLUSION: No increased prevalence of TB infection and disease was found in these patients. Older addicts had a higher probability of having TB infection, and so had those who had been in prison.
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Original Article09-24-2003
Comparative analysis of tuberculosis incidence during childhood and adolescence in 1993 and 1997 in Paraíba Valley, State of São Paulo (Brazil)
Jornal de Pneumologia. 2003;29(3):133-138
Abstract
Original ArticleComparative analysis of tuberculosis incidence during childhood and adolescence in 1993 and 1997 in Paraíba Valley, State of São Paulo (Brazil)
Jornal de Pneumologia. 2003;29(3):133-138
DOI 10.1590/S0102-35862003000300004
Views6See moreOBJECTIVE: To describe and to compare the incidence of tuberculosis in childhood and adolescence in the Paraíba Valley (State of São Paulo, Brazil) in 1993 and 1997. METHOD: Descriptive study with secondary records obtained from the Tuberculosis Division of the Health Department of the State of São Paulo (Divisão de Tuberculose da Secretaria de Saúde de São Paulo). The variables were the type of case, age, form of detection, diagnosis confirmation, clinical presentation, X-ray results, and anti-HIV test results. RESULTS: The global incidence of tuberculosis in all age ranges was of 97.3 cases/100,000 inhabitants in 1993, and 127.6 cases/100,000 inhabitants in 1997. In the age group up to 15 years old, there were 93 new cases in 1993, and 68 new cases in 1997, representing an incidence of 11.7 cases/100,000 inhabitants in 1993 and 7.9 cases/100,000 inhabitants in 1997. The most common clinical presentation was the pulmonary form; the most important form of detection was by searching communicants; the most frequent diagnosis confirmation was by X-ray, and there was an increasing number of anti-HIV tests between 1993 and 1997. The distribution by age range was similar to the literature data in both years analyzed. CONCLUSION: The values of tuberculosis incidence in childhood and adolescence found in this study are higher than those existing in developed countries.
Views6Abstract
Original ArticleComparative analysis of tuberculosis incidence during childhood and adolescence in 1993 and 1997 in Paraíba Valley, State of São Paulo (Brazil)
Jornal de Pneumologia. 2003;29(3):133-138
DOI 10.1590/S0102-35862003000300004
Views6See moreOBJECTIVE: To describe and to compare the incidence of tuberculosis in childhood and adolescence in the Paraíba Valley (State of São Paulo, Brazil) in 1993 and 1997. METHOD: Descriptive study with secondary records obtained from the Tuberculosis Division of the Health Department of the State of São Paulo (Divisão de Tuberculose da Secretaria de Saúde de São Paulo). The variables were the type of case, age, form of detection, diagnosis confirmation, clinical presentation, X-ray results, and anti-HIV test results. RESULTS: The global incidence of tuberculosis in all age ranges was of 97.3 cases/100,000 inhabitants in 1993, and 127.6 cases/100,000 inhabitants in 1997. In the age group up to 15 years old, there were 93 new cases in 1993, and 68 new cases in 1997, representing an incidence of 11.7 cases/100,000 inhabitants in 1993 and 7.9 cases/100,000 inhabitants in 1997. The most common clinical presentation was the pulmonary form; the most important form of detection was by searching communicants; the most frequent diagnosis confirmation was by X-ray, and there was an increasing number of anti-HIV tests between 1993 and 1997. The distribution by age range was similar to the literature data in both years analyzed. CONCLUSION: The values of tuberculosis incidence in childhood and adolescence found in this study are higher than those existing in developed countries.
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Original Article08-20-2003
Prevalence of HIV infection in patients hospitalized due to tuberculosis
Jornal de Pneumologia. 2000;26(4):189-193
Abstract
Original ArticlePrevalence of HIV infection in patients hospitalized due to tuberculosis
Jornal de Pneumologia. 2000;26(4):189-193
DOI 10.1590/S0102-35862000000400006
Views11See moreObjectives: To verify the prevalence of tuberculosis (TB)/HIV co-infection and the ability of the clinical history to detect the HIV infection in TB inpatients. Setting: Eduardo de Menezes Hospital, reference for both TB and AIDS. Patients and methods: All patients admitted with TB in a pneumology ward were evaluated prospectively from 1/1/1997 to 1/31/1998. The clinical history was directed to the presence of risk factors for AIDS or TB, previous treatments or abandoned treatments for TB, and TB clinical forms. Patients with AIDS defining illnesses, except for TB, and with previous anti-HIV tests were excluded. All patients had an ELISA anti-HIV serology, and when positive, a Western-Blot test was performed to confirm the previous result. X-square test and Fisher test were used for statistical analysis. Results: Sixty-five patients were divided into group I (positive serology for HIV, n = 6) and group II (negative serology for HIV, n = 59). There were no statistical differences between the groups comparing the risk factors for AIDS and TB, previous treatments or abandoned treatments for TB, or TB clinical forms. Conclusions: The high prevalence of TB/HIV co-infection (9.2%) reinforces that: 1) the clinical history was not able to detect a significant number of patients with TB/HIV co-infection and that: 2) anti-HIV serology should be performed in all patients with active TB forms.
Views11Abstract
Original ArticlePrevalence of HIV infection in patients hospitalized due to tuberculosis
Jornal de Pneumologia. 2000;26(4):189-193
DOI 10.1590/S0102-35862000000400006
Views11See moreObjectives: To verify the prevalence of tuberculosis (TB)/HIV co-infection and the ability of the clinical history to detect the HIV infection in TB inpatients. Setting: Eduardo de Menezes Hospital, reference for both TB and AIDS. Patients and methods: All patients admitted with TB in a pneumology ward were evaluated prospectively from 1/1/1997 to 1/31/1998. The clinical history was directed to the presence of risk factors for AIDS or TB, previous treatments or abandoned treatments for TB, and TB clinical forms. Patients with AIDS defining illnesses, except for TB, and with previous anti-HIV tests were excluded. All patients had an ELISA anti-HIV serology, and when positive, a Western-Blot test was performed to confirm the previous result. X-square test and Fisher test were used for statistical analysis. Results: Sixty-five patients were divided into group I (positive serology for HIV, n = 6) and group II (negative serology for HIV, n = 59). There were no statistical differences between the groups comparing the risk factors for AIDS and TB, previous treatments or abandoned treatments for TB, or TB clinical forms. Conclusions: The high prevalence of TB/HIV co-infection (9.2%) reinforces that: 1) the clinical history was not able to detect a significant number of patients with TB/HIV co-infection and that: 2) anti-HIV serology should be performed in all patients with active TB forms.
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Original Article06-23-2003
Profile of a Brazilian population with severe chronic obstructive pulmonary disease
Jornal de Pneumologia. 2003;29(2):64-68
Abstract
Original ArticleProfile of a Brazilian population with severe chronic obstructive pulmonary disease
Jornal de Pneumologia. 2003;29(2):64-68
DOI 10.1590/S0102-35862003000200004
Views13See moreChronic obstructive pulmonary disease (COPD) is a public health problem. Tobacco smoking is the major cause, but not the only one. Air pollution, exposure to chemicals, environmental smoke exposure, and passive smoking are among other contributing causes; being viral and bacterial infections also risk factors. Gender and weight are associated to the severity of the disease. Co-morbidity is frequent. OBJECTIVE: To characterize a population of COPD outpatients followed at an outsourced medical service. METHODS: Questionnaires were applied to patients with COPD. The data included gender, age, weight, body mass index (BMI), oxygen delivery users, and FEV1, exposure to tobacco smoke, exposure to wood smoke, history of tuberculosis and co-morbid diseases. RESULTS: Of the 70 patients enrolled in the study, 70% (49) were men with an average age of 64 ± 10 years, average weight of 63 ± 16 kg and average BMI of 22 ± 5 kg/m². Mean FEV1 was 35 ± 14% and 45.7% were oxygen dependent. Nine (12.8%) patients never smoked, while 78.8% had quit tobacco smoking, (38 ± 11 pack/years was the average). Nine (12.8%) smoked corn husk cigarettes. Eighteen (25.7%) were exposed to wood smoke. Eleven (15.7%) patients had tuberculosis, 5.7% complained of asthma symptoms, 2.8% had bronchiectasis, 11.4% diabetes mellitus, 51.4% hypertension, and 20% Cor pulmonale. CONCLUSION: Other possible COPD etiologies must be investigated. Determinants of the pulmonary injury could be environmental smoke exposure associated to former infections. Men with low BMI are typically representative of this severe patient population. Hypertension and Cor Pulmonale are frequent co-morbidity factors.
Views13Abstract
Original ArticleProfile of a Brazilian population with severe chronic obstructive pulmonary disease
Jornal de Pneumologia. 2003;29(2):64-68
DOI 10.1590/S0102-35862003000200004
Views13See moreChronic obstructive pulmonary disease (COPD) is a public health problem. Tobacco smoking is the major cause, but not the only one. Air pollution, exposure to chemicals, environmental smoke exposure, and passive smoking are among other contributing causes; being viral and bacterial infections also risk factors. Gender and weight are associated to the severity of the disease. Co-morbidity is frequent. OBJECTIVE: To characterize a population of COPD outpatients followed at an outsourced medical service. METHODS: Questionnaires were applied to patients with COPD. The data included gender, age, weight, body mass index (BMI), oxygen delivery users, and FEV1, exposure to tobacco smoke, exposure to wood smoke, history of tuberculosis and co-morbid diseases. RESULTS: Of the 70 patients enrolled in the study, 70% (49) were men with an average age of 64 ± 10 years, average weight of 63 ± 16 kg and average BMI of 22 ± 5 kg/m². Mean FEV1 was 35 ± 14% and 45.7% were oxygen dependent. Nine (12.8%) patients never smoked, while 78.8% had quit tobacco smoking, (38 ± 11 pack/years was the average). Nine (12.8%) smoked corn husk cigarettes. Eighteen (25.7%) were exposed to wood smoke. Eleven (15.7%) patients had tuberculosis, 5.7% complained of asthma symptoms, 2.8% had bronchiectasis, 11.4% diabetes mellitus, 51.4% hypertension, and 20% Cor pulmonale. CONCLUSION: Other possible COPD etiologies must be investigated. Determinants of the pulmonary injury could be environmental smoke exposure associated to former infections. Men with low BMI are typically representative of this severe patient population. Hypertension and Cor Pulmonale are frequent co-morbidity factors.
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Case Report06-23-2003
Tuberculous pericarditis in acquired immune deficiency syndrome patients
Jornal de Pneumologia. 2003;29(2):98-100
Abstract
Case ReportTuberculous pericarditis in acquired immune deficiency syndrome patients
Jornal de Pneumologia. 2003;29(2):98-100
DOI 10.1590/S0102-35862003000200009
Views10See moreTwo quite dyspneic HIV positive patients were admitted to the Emergency Room; they presented clinical signs and images suggesting pericardial effusion. The analysis of an initial liquid puncture did not show any specificity and the patients did not exhibit any clinical improvement. Both patients were submitted to a subxiphoid pericardial window, all the effusion liquid was drained, and a biopsy of the pericardium tissue was completed, revealing a granulomatous process. Immediately after the onset of specific treatment, the patients showed a good evolution. Such findings draw attention to a high possibility of pericardial suffusion in AIDS patients being tuberculosis, particular if one considers the high prevalence of this disease in Brazil. The results also showed that the opening of a subxiphoid pericardial window and the specific triple scheme was a procedure that led to good therapeutic evolution in these patients.
Views10Abstract
Case ReportTuberculous pericarditis in acquired immune deficiency syndrome patients
Jornal de Pneumologia. 2003;29(2):98-100
DOI 10.1590/S0102-35862003000200009
Views10See moreTwo quite dyspneic HIV positive patients were admitted to the Emergency Room; they presented clinical signs and images suggesting pericardial effusion. The analysis of an initial liquid puncture did not show any specificity and the patients did not exhibit any clinical improvement. Both patients were submitted to a subxiphoid pericardial window, all the effusion liquid was drained, and a biopsy of the pericardium tissue was completed, revealing a granulomatous process. Immediately after the onset of specific treatment, the patients showed a good evolution. Such findings draw attention to a high possibility of pericardial suffusion in AIDS patients being tuberculosis, particular if one considers the high prevalence of this disease in Brazil. The results also showed that the opening of a subxiphoid pericardial window and the specific triple scheme was a procedure that led to good therapeutic evolution in these patients.
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Original Article06-02-2003
Comparative study of criteria for the diagnosis of tuberculosis in children seen in a health care center
Jornal de Pneumologia. 2000;26(5):219-226
Abstract
Original ArticleComparative study of criteria for the diagnosis of tuberculosis in children seen in a health care center
Jornal de Pneumologia. 2000;26(5):219-226
DOI 10.1590/S0102-35862000000500001
Views13See moreSetting: Considering the difficulty to establish diagnosis of tuberculosis in childhood, the authors studied three diagnostic criteria published in the literature in the last 20 years, evaluating their sensitivity, specificity, and accuracy. Material and methods: In a prospective study, 94 children at ages ranging from 0 to 15 years having contact with bacillary tuberculous adults were studied in the Municipal Health Center of Duque de Caxias, Rio de Janeiro. The following criteria were studied: Keneth Jones, described by Stegen et al.(1), World Health Organization(2) and Keith Edwards, described by Crofton et al.(3). Results: Among the criteria studied, those of Keith Edwards showed the best sensitivity and specificity, with 84% and 97%, respectively. WHO criterion showed a 100% specificity but zero sensitivity. Keneth Jones criterion showed 56% sensitivity and a 94% specificity. Conclusion: In poor areas, such as that of this study, where easy-to-handle operational methods are required, the criteria studied proved to be adequate to detect tuberculosis cases in children in contact with tuberculous adults. Those of Keith Edwards were the most useful although some changes are necessary for a better adaptation to Brazil.
Views13Abstract
Original ArticleComparative study of criteria for the diagnosis of tuberculosis in children seen in a health care center
Jornal de Pneumologia. 2000;26(5):219-226
DOI 10.1590/S0102-35862000000500001
Views13See moreSetting: Considering the difficulty to establish diagnosis of tuberculosis in childhood, the authors studied three diagnostic criteria published in the literature in the last 20 years, evaluating their sensitivity, specificity, and accuracy. Material and methods: In a prospective study, 94 children at ages ranging from 0 to 15 years having contact with bacillary tuberculous adults were studied in the Municipal Health Center of Duque de Caxias, Rio de Janeiro. The following criteria were studied: Keneth Jones, described by Stegen et al.(1), World Health Organization(2) and Keith Edwards, described by Crofton et al.(3). Results: Among the criteria studied, those of Keith Edwards showed the best sensitivity and specificity, with 84% and 97%, respectively. WHO criterion showed a 100% specificity but zero sensitivity. Keneth Jones criterion showed 56% sensitivity and a 94% specificity. Conclusion: In poor areas, such as that of this study, where easy-to-handle operational methods are required, the criteria studied proved to be adequate to detect tuberculosis cases in children in contact with tuberculous adults. Those of Keith Edwards were the most useful although some changes are necessary for a better adaptation to Brazil.
Tuberculosis Archives - Page 4 of 19 - Respiratory Research & Clinical Practice
