Vemurafenib-Induced Dupuytren's Contracture; Levetiracetam-Induced Rage and Increased Risk of Suicide; PPD Tuberculin Skin Test–Induced Deep Necrotic Skin Lesion; Voriconazole-Induced Phototoxicity, Pseudoporphyria, and Photo-Onycholysis; Dronedarone-Induced Organizing Pneumonia

We investigated the prevalence and predictors of positive tuberculin skin test (TST) results among prospective Vietnamese migrants. We interviewed and medically screened 1395 Vietnamese people aged over 15 years who had applied to migrate to Australia. Approximately 44% of applicants had an induration of 10 mm or more, and 18·6% had an induration of 15 mm or more. A positive tuberculin skin test at 5 mm, 10 mm and 15 mm of induration cut-points was significantly associated with age (OR 1·01–1·02 per year) and duration of smoking (OR 1·03–1·12 per year). Smoking appears to be an important factor associated with increased susceptibility to mycobacterial infection. It is not yet clear whether the increased tuberculin reactivity associated with smoking reflects an increased risk of tuberculosis among these migrants.

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Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults

PLoS ONE ◽

10.1371/journal.pone.0253907 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0253907

Author(s):

Eva Van Ginderdeuren ◽

Jean Bassett ◽

Colleen F. Hanrahan ◽

Annelies Van Rie

Keyword(s):

Tuberculin Skin Test ◽

Skin Test ◽

Primary Care Clinic ◽

Multivariate Regression Analysis ◽

Cd4 Count ◽

Bivariate Analysis ◽

Future Research ◽

Care Clinic ◽

Lymphocyte Ratio ◽

Increased Risk

Background The tuberculin skin test (TST) identifies individuals at high risk of developing tuberculosis (TB) but poses many challenges. The blood monocyte-to-lymphocyte ratio (MLR) could be an alternative, as extremes in MLR have been associated with increased risk of TB disease. Methods At a primary care clinic in Johannesburg, a differential white blood cell count and TST was performed in adults starting antiretroviral treatment (ART) without symptoms suggestive of active TB. Results Of 259 participants, 171 had valid results of whom 30% (51/171) were TST positive and the median MLR was 0.18 (IQR 0.13–0.28). The MLR distribution differed between CD4 count categories (p < 0.01), with a broader range of values in TST negative participants with a low CD4 count (≤ 250 cells/mm3), likely reflecting HIV immunosuppression. MLR was associated with a positive TST (OR 0.78 per 0.1 increase, 95% CI 0.59, 0.97) in bivariate analysis but not in multivariate regression analysis (aOR 0.83 for every 0.1 increase, 95% CI 0.60, 1.08). Conclusion In ART-naïve adults without symptoms suggestive of active TB, MLR was not independently associated with TST positivity and is thus unlikely to be a useful alternative to TST. Future research should focus on development of a cheap, simple and accurate biomarker to identify those people benefiting most from preventive TB therapy.

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Prevalence and Risk Factors for Latent Tuberculosis in Polish Healthcare Workers: The Comparison of Tuberculin Skin Test and Interferon-gamma Release Assay (IGRA) Performance.

10.21203/rs.3.rs-139627/v1 ◽

2021 ◽

Author(s):

Monika Szturmowicz ◽

Beata Broniarek-Samson ◽

Urszula Demkow

Keyword(s):

Health Care ◽

Tuberculin Skin Test ◽

Skin Test ◽

Interferon Gamma ◽

Latent Tuberculosis ◽

Health Care Facilities ◽

Interferon Gamma Release Assay ◽

Published Data ◽

Increased Risk ◽

Release Assay

Abstract Background: Tuberculosis is still one of the most common infectious diseases worldwide. Health care workers (HCW) are at particular risk of the disease due to their constant exposure to TB patients or their specimens, nevertheless no specific surveillance is widely recommended in this group of professionals. Both, tuberculin skin test (TST) and interferon-gamma-release-assays (IGRAs) are widely applied to detect latent tuberculosis infection (LTBI). The aim of the present study was to evaluate the prevalence and risks of LTBI in the population of Polish HCW, to identify factors associated with LTBI, as well as to determine the rate of the discordance between the results of the two applied tests in relation to various factors in a TB endemic setting.Material and methods: LTBI status was prospectively evaluated in 222 HCW, 204 females, 18 males, aged 40.8±9 years, with tuberculin skin test (TST) and interferon gamma release assay (QuantiFERON-TB-Gold in Tube – QFT GIT). Results: TST≥10 mm was found in 58% of HCW, QFT GIT≥0.35 IU/ml in 23%. These results are comparable with previously published data concerning general Polish population, investigated in the same period of time. Nevertheless the relative number of positive QFT GIT in HCW above 45 years of age exceeded those obtained in general population. The risk of obtaining positive QFT GIT was significantly increased in the participants older than 44 years, in those employed >10 years, and in those who reported the direct contact with tuberculous patients or infected biological materials. The concordance between TST and IGRA was poor (kappa 0.23), especially in younger participants, possibly due to BCG vaccination in childhood. Conclusion: The increased risk of LTBI in Polish HCW was related to age, duration of employment and contact with infectious patients or their biological specimens. TB infection control measures in health care facilities in Poland are still insufficient. It is crucial to increase awareness about the importance of detecting and treating LTBI of HCW.

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Tuberculin Skin Test Conversion Among Medical Students at a Teaching Hospital in Rio de Janeiro, Brazil

Infection Control and Hospital Epidemiology ◽

10.1086/501976 ◽

2002 ◽

Vol 23 (10) ◽

pp. 591-594 ◽

Cited By ~ 17

Author(s):

Vania M. C. Silva ◽

Antonio Jose Ledo A. Cunha ◽

Afranio L. Kritski

Keyword(s):

Medical Students ◽

Confidence Interval ◽

Tuberculin Skin Test ◽

Skin Test ◽

Teaching Hospital ◽

Rio De Janeiro ◽

Clinical Training ◽

Multivariate Logistic Regression Analysis ◽

Tuberculin Skin Testing ◽

Increased Risk

Objective: To describe the cumulative incidence of and risk factors for tuberculosis (TB) infection among medical students.Design:In 1999, a cohort study of medical students with negative results (induration < 10 mm) on tuberculin skin test (TST) was performed. Students who had undergone two-step testing in 1998 were retested.Settings:University and teaching hospital and referral center for TB and acquired immunodeficiency syndrome, and the Health Sciences Building of the Medical School of the Federal University of Rio de Janeiro, Brazil.Participants:A sample of 618 consecutive medical students with negative TST results who had been tested 12 months before were approached. Information about sociodemographic characteristics, bacille Calmette-Guérin vaccination history, and potential exposures to TB was obtained using a standardized questionnaire. Four hundred fourteen (67%) students completed the study. Students were at two different levels of their training programs (juniors = no contact with patients; seniors = intensive contact with patients).Results:Of 414 participants, 16 (3.9%; 95% confidence interval, 1.06% to 12.1%) had converted to a positive reaction after 1 year. In a multivariate logistic regression analysis, higher level of clinical training was confirmed to be an independent factor associated with TST conversion (odds ratio, 4.77; 95% confidence interval, 1.01 to 22.46; P = .048).Conclusion:Senior medical students are at increased risk of Mycobacterium tuberculosis infection in this setting. Therefore, a program of routine tuberculin skin testing and specific TB infection control guidelines are needed for this population (Infect Control Hosp Epidemiol 2002;23:591-594).

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Comparison of the QuantiFERON-TB and tuberculin skin test for detection of latent tuberculosis infection in cancer patients in a developing country

ERJ Open Research ◽

10.1183/23120541.00258-2018 ◽

2019 ◽

Vol 5 (4) ◽

pp. 00258-2018

Author(s):

Javier Leonardo Galindo ◽

Adriana Catalina Galeano ◽

David Alfonso Suarez-Zamora ◽

Ana Milena Callejas ◽

Mónica Patricia Caicedo-Verástegui ◽

...

Keyword(s):

Tuberculin Skin Test ◽

Cancer Patients ◽

Skin Test ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Cross Sectional Study ◽

Tuberculosis Infection ◽

Test Results ◽

Cross Sectional ◽

Increased Risk

Cancer patients have an increased risk of reactivation of latent tuberculosis infection. It is unknown which strategy on screening should be used in this population in developing countries. We aimed to determine the concordance between the tuberculin skin test (TST) and QuantiFERON®-TB (QFT) assay in order to diagnose latent tuberculosis infection in cancer patients.We conducted a cross-sectional study of the agreement of diagnostic tests. Prevalence and agreement between tests were calculated. A logistic regression to assess predictors of discordance was performed. The accuracy of the TST to predict QFT results by a receiver operating characteristic (ROC) curve was evaluated.We included 149 adults with cancer without active tuberculosis. Prevalence of latent tuberculosis infection was 21.5% (n=32), defined as positive results on either test. Test agreement was moderate for the diagnosis of latent tuberculosis infection (κ=0.43, 90% CI 0.26–0.6). No predictor was associated with the chance of discordant results. Agreement improved slightly using a cut-off point ≥8 mm (κ=0.5, 90% CI 0.35–0.66).In a moderate-incidence setting, a moderate agreement was found between tests in cancer patients. Modification of the cut-off points of test results achieved marginally better agreement between the TST and QFT.

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Dupuytren's Contracture and Microvessels

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100098848 ◽

1981 ◽

Vol 39 ◽

pp. 470-471

Author(s):

C. W. Klscher ◽

D. Speer

Keyword(s):

Hypertrophic Scar ◽

Active Form ◽

Scar Tissue ◽

Vascular Supply ◽

Fiber Bundles ◽

Dupuytren’S Contracture ◽

Palmar Fascia ◽

Immune Disease ◽

Dupuytren's Contracture ◽

Longitudinal Fiber

Dupuytren's Contracture is a nodular proliferation of the longitudinal fiber bundles of palmar fascia with its attendant contraction. The factors attributed to its etiology have included trauma, diabetes, alcoholism, arthritis, and auto-immune disease. The tissue has been observed by electron microscopy and found to contain myofibroblasts.Dupuytren's Contracture constitutes a scar, and as such, excessive collagen can be observed, along with an active form of fibroblast.Previous studies of the hypertrophic scar have led us to propose that integral in the initiation and sustenance of scar tissue is a profusion of microvascular regeneration, much of which becomes and remains occluded producing a hypoxia which stimulates fibroblast synthesis. Thus, when considering a study of Dupuytren's Contracture, we predicted finding occluded microvessels at or near the fascial scarring focus.Three cases of Dupuytren's Contracture yielded similar specimens, which were fixed in Karnovskys fluid for 2 to 20 days. Upon removal of the contracture bands care was taken to include the contiguous fatty and areolar tissue which contain the vascular supply and to identify the junctional area between old and new fascia.

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