Epidemiology of Extrapulmonary Tuberculosis Among Persons with AIDS in the United States

1993 ◽  
Vol 16 (4) ◽  
pp. 513-518 ◽  
Author(s):  
L. Slutsker ◽  
K. G. Castro ◽  
J. W. Ward ◽  
S. W. Dooley
Keyword(s):  
United States ◽  
Extrapulmonary Tuberculosis ◽  
The United States

Clinical Features, Diagnosis, and Treatment of Tuberculosis in Infants

PEDIATRICS ◽  
1994 ◽  
Vol 94 (1) ◽  
pp. 1-7
Author(s):  
Jesus G. Vallejo ◽  
Lydia T. Ong ◽  
Jeffrey R. Starke
Keyword(s):  
United States ◽  
Pulmonary Tuberculosis ◽  
Skin Testing ◽  
Extrapulmonary Tuberculosis ◽  
The United States ◽  
Response To Therapy ◽  
Tuberculin Skin Testing ◽  
Gastric Aspirate ◽  
Directly Observed Therapy ◽  
Contact Investigation

Objective. Despite the recent resurgence of tuberculosis among children in the United States, no series of infants <1 year of age with tuberculosis has been reported in the last 20 years. This study was undertaken to describe the epidemiology, clinical, and radiographic manifestations, and response to therapy in infants <1 year of age with tuberculous disease. Methods. The medical records were reviewed for all infants age 12 months or less with a diagnosis of tuberculosis and cared for at the Children's Tuberculosis Clinic at Ben Taub General Hospital in Houston, Texas between January 1, 1985 and June 30, 1992. Results. Of the 47 infants identified, 51% were female. The median age at diagnosis was 8 months (range 3.5 to 12 months). Fifty-one percent of the infants were African-American and over one-third were Hispanic. All patients were born in the United States. Diagnosis resulted from the examination of an ill infant in 79% of cases, a case contact investigation of an adult suspected of having tuberculosis in 19%, and routine tuberculin skin testing in 2%. An adult with infectious tuberculosis who had contact with the infant was identified in 68% of cases. Intrathoracic disease alone was present in 70% of cases. Fourteen (30%) infants had extrapulmonary tuberculosis (11 central nervous system disease, 2 disseminated disease, and 1 cervical adenitis). Gastric aspirate cultures yielded Mycobacterium tuberculosis from 75% of the infants with isolated intrathoracic disease. Forty-five infants successfully completed therapy and only one death was directly related to tuberculosis. Forty-eight percent of the infants with pulmonary tuberculosis were treated with a 6-month regimen consisting of isoniazid and rifampin supplemented during the first 2 months by pyrazinamide. Eighteen infants received some twice weekly directly observed therapy mainly due to documented or suspected nonadherence. Treatment was well-tolerated; one patient (2%) developed hepatotoxicity due to isoniazid. No infant had a relapse or recurrence of disease in 6 months to 7 years follow-up for a median of 3 years (range, 6 months to 7 years). Conclusion. Most infants with tuberculosis are symptomatic at the time of diagnosis, and bacteriologic confirmation was obtained in 70% of cases. A contact investigation of the household should be initiated immediately when an infant is suspected of having tuberculosis because valuable information needed to establish the diagnosis and guide therapy in the infant may be obtained. Intensive 6-month and twice weekly directly observed therapy appear to be well-tolerated and effective for the treatment of pulmonary tuberculosis in infants.

Extrapulmonary Tuberculosis in the United States

1990 ◽  
Vol 141 (2) ◽  
pp. 347-351 ◽  
Author(s):  
Hans L. Rieder ◽  
Dixie E. Snider ◽  
George M. Cauthen
Keyword(s):  
United States ◽  
Extrapulmonary Tuberculosis ◽  
The United States

scholarly journals Epidemiology of Extrapulmonary Tuberculosis in the United States, 1993–2006

2009 ◽  
Vol 49 (9) ◽  
pp. 1350-1357 ◽  
Author(s):  
Heather M. Peto ◽  
Robert H. Pratt ◽  
Theresa A. Harrington ◽  
Philip A. LoBue ◽  
Lori R. Armstrong
Keyword(s):  
United States ◽  
Extrapulmonary Tuberculosis ◽  
The United States

Tuberculosis: An Update for Clinicians

1996 ◽  
Vol 11 (5) ◽  
pp. 233-245
Author(s):  
Elizabeth R. Maslow ◽  
Richard L. Lubman ◽  
Peter F. Barnes
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Workers ◽  
Extrapulmonary Tuberculosis ◽  
The United States ◽  
Skin Tests ◽  
Respiratory Protection ◽  
Radiographic Findings ◽  
Resistant Tuberculosis ◽  
Care Workers

Tuberculosis is the most common cause of death due to a single pathogen world wide, and the number of tuberculosis cases in the United States has increased significantly since 1985. Drug-resistant tuberculosis is also increasing, and multidrug-resistant tuberculosis (resistant to isoniazid and rifampin) has fueled deadly epidemics in New York and Florida. The clinical manifestations of tuberculosis in patients with human immunodeficiency virus (HIV) infection are distinctive; chest radiographic findings include primary tuberculosis and an extremely high frequency of extrapulmonary tuberculosis. Promising new diagnostic tests for tuberculosis are based on amplification of mycobacterial DNA by polymerase chain reaction, but they have not yet been adapted to the clinical laboratory. Most tuberculosis patients in the United States should receive initial treatment with isoniazid, rifampin, pyrazinamide, and ethambutol. For drug-susceptible tuberculosis, these drugs are continued for 2 months, followed by isoniazid and rifampin for 4 months, which yields a cure rate of greater than 95%. For isoniazid-resistant organisms, rifampin, pyrazinamide, and ethambutol, with or without isoniazid, can be given for 6 months. For HIV-infected patients with drug-susceptible or isoniazid-resistant tuberculosis, we recommend continuation of therapy for a minimum of 9 months. Most forms of extrapulmonary tuberculosis due to drug-susceptible organisms are treated for 6 months, except for meningeal, miliary, and skeletal tuberculosis, for which a minimum of 12 months of therapy is recommended. To reduce nosocomial transmission of tuberculosis, health cafe facilities should institute administrative controls to reduce exposure to infectious patients, engineering controls to reduce the concentration of infectious droplet nuclei, and personal respiratory protection of health care workers with appropriate masks. Administrative controls are probably the most important part of a tuberculosis infection control program. Health care workers who were recently infected with Mycobacterium tuberculosis can be identified by serial skin testing, and those who convert their skin tests from negative to positive should receive chemoprophylaxis with isoniazid to prevent development of tuberculosis.

Correlative microscopy in distrubuted (client/server) computing environments: tools for catalyzing the rapid dissemination of information about the cell biology of the human prostate

1995 ◽  
Vol 53 ◽  
pp. 682-683
Author(s):  
A. Hakam ◽  
J.T. Gau ◽  
M.L. Grove ◽  
B.A. Evans ◽  
M. Shuman ◽  
...  
Keyword(s):  
United States ◽  
Cell Biology ◽  
Tissue Bank ◽  
The United States ◽  
Prostate Adenocarcinoma ◽  
Correlative Microscopy ◽  
Client Server ◽  
Critical Elements ◽  
Transplant Organ

Prostate adenocarcinoma is the most common malignant tumor of men in the United States and is the third leading cause of death in men. Despite attempts at early detection, there will be 244,000 new cases and 44,000 deaths from the disease in the United States in 1995. Therapeutic progress against this disease is hindered by an incomplete understanding of prostate epithelial cell biology, the availability of human tissues for in vitro experimentation, slow dissemination of information between prostate cancer research teams and the increasing pressure to “ stretch” research dollars at the same time staff reductions are occurring.To meet these challenges, we have used the correlative microscopy (CM) and client/server (C/S) computing to increase productivity while decreasing costs. Critical elements of our program are as follows:1) Establishing the Western Pennsylvania Genitourinary (GU) Tissue Bank which includes >100 prostates from patients with prostate adenocarcinoma as well as >20 normal prostates from transplant organ donors.

Digital image acquisition, processing, and analysis in a polymer microscopy laboratory

1994 ◽  
Vol 52 ◽  
pp. 454-455
Author(s):  
Vinod K. Berry ◽  
Xiao Zhang
Keyword(s):  
United States ◽  
Image Analysis ◽  
Digital Image ◽  
Image Acquisition ◽  
Image Transmission ◽  
The United States ◽  
Quantitative Image Analysis ◽  
Quantitative Image

In recent years it became apparent that we needed to improve productivity and efficiency in the Microscopy Laboratories in GE Plastics. It was realized that digital image acquisition, archiving, processing, analysis, and transmission over a network would be the best way to achieve this goal. Also, the capabilities of quantitative image analysis, image transmission etc. available with this approach would help us to increase our efficiency. Although the advantages of digital image acquisition, processing, archiving, etc. have been described and are being practiced in many SEM, laboratories, they have not been generally applied in microscopy laboratories (TEM, Optical, SEM and others) and impact on increased productivity has not been yet exploited as well.In order to attain our objective we have acquired a SEMICAPS imaging workstation for each of the GE Plastic sites in the United States. We have integrated the workstation with the microscopes and their peripherals as shown in Figure 1.

Silence of the Land: On the Historical Irrelevance of Territory to Congressional Districting and Political Representation in the United States

2001 ◽  
Vol 15 (01) ◽  
pp. 53-87 ◽  
Author(s):  
Andrew Rehfeld
Keyword(s):  
United States ◽  
House Of Representatives ◽  
Political Representation ◽  
The United States ◽  
Representative Government ◽  
Congressional District ◽  
Congressional Districts ◽  
Communities Of Interest

Every ten years, the United States “constructs” itself politically. On a decennial basis, U.S. Congressional districts are quite literally drawn, physically constructing political representation in the House of Representatives on the basis of where one lives. Why does the United States do it this way? What justifies domicile as the sole criteria of constituency construction? These are the questions raised in this article. Contrary to many contemporary understandings of representation at the founding, I argue that there were no principled reasons for using domicile as the method of organizing for political representation. Even in 1787, the Congressional district was expected to be far too large to map onto existing communities of interest. Instead, territory should be understood as forming a habit of mind for the founders, even while it was necessary to achieve other democratic aims of representative government.

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