Cases Of Pulmonary Tuberculosis Patients Research Articles

Clinical characteristics and prognostic factors of pulmonary tuberculosis with concurrent lung cancer

To explore the clinical characteristics and prognostic factors of pulmonary tuberculosis with concurrent lung cancer. Comprehensive analyses were conducted for 58 cases of pulmonary tuberculosis patients with lung cancer. Their clinical symptoms, signs and imaging results were analyzed between January 1998 and January 2005 at Qingdao Chest Hospital. Kaplan-Meier method was utilized to calculate their survival rates. Nine prognostic characteristics were analyzed. Single factor analysis was performed with Logrank test and multi-factor analysis with Cox regression model. The initial symptoms were cough, chest tightness, fever and hemoptysis. Chest radiology showed the coexistence of two diseases was 36 in the same lobe and 22 in different lobes. And there were pulmonary nodules (n = 24), cavities (n = 19), infiltration (n = 8) and atelectasis (n = 7). According to the pathological characteristics, there were squamous carcinoma (n = 33), adenocarcinoma (n = 17), small cell carcinoma (n = 4) and unidentified (n = 4) respectively. The TNM stages were I (n = 13), II(n = 22), III (n = 16) and IV (n = 7) respectively. The median survival period was 24 months. And the 1, 3, 5-year survival rates were 65.5%, 65.5% and 29.0% respectively. Single factor analysis showed that lung cancer TNM staging (P = 0.000) and tuberculosis activity (P = 0.024) were significantly associated with patient prognosis. And multi-factor analysis showed that lung cancer TNM staging (RR = 2.629, 95%CI: 1.759-3.928, P = 0.000) and tuberculosis activity (RR = 1.885, 95%CI: 1.023-3.471, P = 0.042) were relatively independent prognostic factors. The clinical and radiological characteristics contribute jointly to early diagnosis and therapy of tuberculosis with concurrent lung cancer. And TNM staging of lung cancer and activity of tuberculosis are major prognostic factors.

In vitro drug susceptibility pattern of Mycobacterium tuberculosis in CAT I and CAT II pulmonary tuberculosis patients in Aligarh, Uttar Pradesh, India

ObjectiveTo evaluate in vitro resistance pattern of the first line anti-tubercular drugs in new and previously treated cases of pulmonary tuberculosis patients in Aligarh region. MethodsThis study was carried out involving 975 suspected tuberculosis patients. All the specimens of patients were subjected to Ziehl-Neelsen staining, cultured on Lowenstein-Jensen medium and resistance pattern was evaluated by standard proportion method. All patients diagnosed with pulmonary tuberculosis were placed in CAT I and II under Revised National Tuberculosis Control Programme guidelines. ResultOut of 220 patients, 129 (58.7%) were from CAT I and 91 (41.3%) were from CAT II. Totally 44.5% were resistant to one or more than two drugs and 18.6% patients showed resistance to both isoniazid and rifampicin. The individual resistance pattern of these first line drugs were as follows: 37.7% patients were resistant to isoniazid, 22.2% to rifampicin, 8.6% to streptomycin and 10% were resistant to ethambutol. ConclusionsOur findings concluded a high prevalence of in vitro drug resistance of Mycobacterium tuberculosis isolates, especially multidrug resistant tuberculosis, in both the categories. So there is an urgent need to further study the risk factors for transmission and multidrug resistant tuberculosis in these settings.

Risk Factors for Hemoptysis in Pulmonary Tuberculosis Patients from Southern China: A Retrospective Study

Clinical characteristics of tuberculosis (TB) patients from southern China with pulmonary tuberculosis hemoptysis (PTH) were analyzed retrospectively in order to improve the diagnosis of TB, reduce mortality and prevent the transmission of TB. A total of 1227 cases of pulmonary TB patients hospitalized in the Third Affiliated Hospital of Sun Yat-sen University and Guangzhou Chest Hospital from January to December of 2011 were analyzed retrospectively. 1) The male/female ratio of the 1227 tuberculosis cases was 2.15:1. There were 403 cases (32.8%) of PTH with a male/ female ratio of 3.03:1. 2) The ratio of patients with PTH to those with TB was designated as Rh. The Rh in the male group (36.2%, 303 cases) was higher than that in the female group (25.6%, 100 cases, risk ratio (RR) = 1.41, P ≤ 0.001). 3) The Rh in the elderly group (≥60 years old, 20.3%, 56 cases) was lower than that in the younger patients group (20 - 39 years old, 45.4%, 189 cases, RR = 2.51, P ≤ 0.001). 4) The Rh in initial treatment group (29.6%, 296 cases) was lower than that in the retreatment group (46.9%, 107 cases, RR = 1.58, P ≤ 0.001). 5) The Rh in sputum-positive TB patients (44.5%, 297 cases) was significantly higher than that in the smear-negative TB patients (18.9%, 106 cases, RR = 2.35, P ≤ 0.001). 6) The Rh of patients with lung lesions range 0.05). 7) The Rh of patients with cavities (51.8%, 309 cases) was higher than that of patients without cavities (14.9%, 94 cases, RR = 3.48, P ≤ 0.001). Male, young, retreated, sputum-positive TB patients and those with cavitary TB were more predisposed to PTH in southern China. TB patients with such characteristics should be sensitized and accorded good care.

Relatiomship between blood glucose levels and anti-TB efficiency of pulmonary tuberculosis with diabetes

Objective To observe the relationship between blood glucose levels and anti-TB efficiency of pulmonary tuberculosis with diabetes.Methods A retrospective analysis of clinical data of 168 cases of pulmonary tuberculosis patients with diabetes mellitus was done.Results The tuberculosis lesions healing rate of good blood glucose control group,passable glucose control group,poor glucose control group is respectively 65.8％,36.4％ and 20.0％.Void closure rate is respectively 52.1％,49.1％ and 17.5％.Sputum bacteria negative conversion rate is respectively 95.9％,89.1％ and 77.5 ％.By comparison of the three groups,the difference was statistically significant (all P＜0.05).Conclusion Actively controlling blood sugar was key to the treatment for pulmonary tuberculosis with diabetes,and long-tem anti-tuberculosis trentment program had more good effect. Key words: Diabetes; Tuberculosis,pulmonary; Blood glucose; Drug therapy

Clinical characteristics of Mycobacterium tuberculosis infection among rheumatoid arthritis patients

To evaluate the clinical characteristics of Mycobacterium tuberculosis infection in rheumatoid arthritis (RA) patients, we examined the clinical manifestations and radiography/computed tomography (CT) findings in RA patients with tuberculosis (RA+/TB+). A total of 1121 tuberculosis patients were admitted to our hospital from 1995 to 2003, with the RA patients among them comprising 1.8% (20 cases; 9 men and 11 women). This is approximately three times as high as the prevalence of RA in the entire population in Japan. In addition, the RA+/TB+ patients were older and had a longer history of RA than the 140 outpatients in our RA clinic who did not have tuberculosis (RA+/TB−). Half of the RA+/TB+ patients had no symptoms (e.g., cough, sputum, pyrexia), and their tuber-culosis was detected accidentally by radiography/CT. The positive rates of the bacilli in the smear and culture of the sputum from the RA+/TB+ patients were lower than those from 143 patients randomly selected from among 1091 tuberculosis patients without any collagen disease including RA (RA−/TB+). The RA+/TB+ patients had a higher incidence of extrapulmonary tuberculosis (30%), including four cases (20%) of miliary tuberculosis, an incidence seven times higher than among the general population of tuberculosis patients. Among 14 cases of pulmonary tuberculosis patients with RA, bilateral lesions and noncavitary lesions were found in 71.4% and 64.3%, respectively, which tended to be a higher incidence than in the RA−/TB+ patients. The mortality rate and sputum conversion time of the RA+/TB+ patients were no different from those of the RA−/TB+ patients. The prevalence of tuberculosis in RA patients is expected to increase after introduction of anticytokine therapy in Japan, and careful observation should be done to avoid this complication in RA patients.

Clinical characteristics of Mycobacterium tuberculosis infection among rheumatoid arthritis patients

To evaluate the clinical characteristics of Mycobacterium tuberculosis infection in rheumatoid arthritis (RA) patients, we examined the clinical manifestations and radiography/computed tomography (CT) findings in RA patients with tuberculosis (RA+/TB+). A total of 1121 tuberculosis patients were admitted to our hospital from 1995 to 2003, with the RA patients among them comprising 1.8% (20 cases; 9 men and 11 women). This is approximately three times as high as the prevalence of RA in the entire population in Japan. In addition, the RA+/TB+ patients were older and had a longer history of RA than the 140 outpatients in our RA clinic who did not have tuberculosis (RA+/TB-). Half of the RA+/TB+ patients had no symptoms (e.g., cough, sputum, pyrexia), and their tuberculosis was detected accidentally by radiography/CT. The positive rates of the bacilli in the smear and culture of the sputum from the RA+/TB+ patients were lower than those from 143 patients randomly selected from among 1091 tuberculosis patients without any collagen disease including RA (RA-/TB+). The RA+/TB+ patients had a higher incidence of extrapulmonary tuberculosis (30%), including four cases (20%) of miliary tuberculosis, an incidence seven times higher than among the general population of tuberculosis patients. Among 14 cases of pulmonary tuberculosis patients with RA, bilateral lesions and non-cavitary lesions were found in 71.4% and 64.3%, respectively, which tended to be a higher incidence than in the RA-/TB+ patients. The mortality rate and sputum conversion time of the RA+/TB+ patients were no different from those of the RA-/TB+ patients. The prevalence of tuberculosis in RA patients is expected to increase after introduction of anti-cytokine therapy in Japan, and careful observation should be done to avoid this complication in RA patients.