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Reproducibility of a protocol for standardized reading of chest X-rays of children household contact of patients with tuberculosis / Lina Marcela Cadavid Álvarez ; Lucila Beatriz Molinares Arevalo    

Público ISBD Título : Reproducibility of a protocol for standardized reading of chest X-rays of children household contact of patients with tuberculosis Tipo de documento : documento electrónico Autores : Lina Marcela Cadavid Álvarez, ; Lucila Beatriz Molinares Arevalo, Fecha de publicación : 2022 Títulos uniformes : BMC Pediatrics Idioma : Inglés (eng) Palabras clave : Tuberculosis  Pulmonary  Latent Tuberculosis  Clinical Protocols  Radiography  Thoracic  Observer Variation  Reproducibility of Results Resumen : Background: The interpretation of the chest radiograph may vary because it depends on the reader and due to the non-specificity of findings in tuberculosis (TB). We aim to assess the reproducibility of a standardized chest radiograph reading protocol in contacts of patients with pulmonary TB under the 5 years of age. Methods: Descriptive, cross-sectional study with children under the age of five, household contacts of patients with confirmed pulmonary TB from Medellín, Bello and Itagüí (Colombia) between Jan-01-2015 and May-31-2016. Standardized reading protocol: two radiologists, blinded independent reading, use of template (Dr. Andronikou design) in case of disagreement a third reading was performed. Kappa coefficient for intra and inter observer agreement, and prevalence ratio were estimated of sociodemographic characteristics, TB exposure and interpretation of chest X-ray. Results: From 278 children, standardized reading found 255 (91.7%) normal X-rays, 10 (3.6%) consistent with TB, and 13 (4.7%) other alterations. Global agreement was 91.3% (Kappa = 0.51). Inter-observer agreement between readers 1-2 was 90.0% (Kappa = 0.59) and 1-3 93.2% (Kappa = 0.59). Intra-observer agreement for reader 1 was 95.5% (Kappa = 0.86), 2 84.0% (Kappa = 0.51), and 3 94.7% (Kappa = 0.68). Greater inter-observer disagreement was between readers 1-2 for soft tissue density suggestive of adenopathy (4.6%), airspace opacification (1.17%) and pleural effusion (0.58%); between readers 1-3 for soft tissue density suggestive of adenopathy (4.2%), opacification of airspace (2.5%) and cavities (0.8%). Conclusions: Chest radiographs are an affordable tool that contributes to the diagnosis of TB, so having a standardized reading protocol showed good agreement and improves the reproducibility of radiograph interpretation. Mención de responsabilidad : María Margarita Lozano-Acosta, María Alejandra Rubiano-Arenas, Lina Marcela Cadavid, Guillermo Vélez-Parra, Beatriz Molinares, Diana Marcela Marín-Pineda, María Patricia Arbeláez-Montoya & Dione Benjumea-Bedoya Referencia : BMC Pediatr. 2022 May 24;22(1):307. DOI (Digital Object Identifier) : 10.1186/s12887-022-03347-6 PMID : 35610599 Derechos de uso : CC BY En línea : https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03347-6 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6082 Reproducibility of a protocol for standardized reading of chest X-rays of children household contact of patients with tuberculosis [documento electrónico] / Lina Marcela Cadavid Álvarez, ; Lucila Beatriz Molinares Arevalo,  . - 2022. Obra : BMC Pediatrics Idioma : Inglés (eng) Palabras clave : Tuberculosis  Pulmonary  Latent Tuberculosis  Clinical Protocols  Radiography  Thoracic  Observer Variation  Reproducibility of Results Resumen : Background: The interpretation of the chest radiograph may vary because it depends on the reader and due to the non-specificity of findings in tuberculosis (TB). We aim to assess the reproducibility of a standardized chest radiograph reading protocol in contacts of patients with pulmonary TB under the 5 years of age. Methods: Descriptive, cross-sectional study with children under the age of five, household contacts of patients with confirmed pulmonary TB from Medellín, Bello and Itagüí (Colombia) between Jan-01-2015 and May-31-2016. Standardized reading protocol: two radiologists, blinded independent reading, use of template (Dr. Andronikou design) in case of disagreement a third reading was performed. Kappa coefficient for intra and inter observer agreement, and prevalence ratio were estimated of sociodemographic characteristics, TB exposure and interpretation of chest X-ray. Results: From 278 children, standardized reading found 255 (91.7%) normal X-rays, 10 (3.6%) consistent with TB, and 13 (4.7%) other alterations. Global agreement was 91.3% (Kappa = 0.51). Inter-observer agreement between readers 1-2 was 90.0% (Kappa = 0.59) and 1-3 93.2% (Kappa = 0.59). Intra-observer agreement for reader 1 was 95.5% (Kappa = 0.86), 2 84.0% (Kappa = 0.51), and 3 94.7% (Kappa = 0.68). Greater inter-observer disagreement was between readers 1-2 for soft tissue density suggestive of adenopathy (4.6%), airspace opacification (1.17%) and pleural effusion (0.58%); between readers 1-3 for soft tissue density suggestive of adenopathy (4.2%), opacification of airspace (2.5%) and cavities (0.8%). Conclusions: Chest radiographs are an affordable tool that contributes to the diagnosis of TB, so having a standardized reading protocol showed good agreement and improves the reproducibility of radiograph interpretation. Mención de responsabilidad : María Margarita Lozano-Acosta, María Alejandra Rubiano-Arenas, Lina Marcela Cadavid, Guillermo Vélez-Parra, Beatriz Molinares, Diana Marcela Marín-Pineda, María Patricia Arbeláez-Montoya & Dione Benjumea-Bedoya Referencia : BMC Pediatr. 2022 May 24;22(1):307. DOI (Digital Object Identifier) : 10.1186/s12887-022-03347-6 PMID : 35610599 Derechos de uso : CC BY En línea : https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03347-6 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6082

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Outcomes and complications of hospitalised patients with HIV-TB co-infection / Alicia Inés Hidrón Botero  

Público ISBD Título : Outcomes and complications of hospitalised patients with HIV-TB co-infection Tipo de documento : documento electrónico Autores : Alicia Inés Hidrón Botero, Fecha de publicación : 2021 Títulos uniformes : Tropical Medicine & International Health Idioma : Inglés (eng) Palabras clave : co-infection HIV/TB  drug toxicity  latent tuberculosis  mortality  readmission Resumen : Background: Tuberculosis is one of the most common causes of hospitalisation in patients with HIV. Despite this, hospital outcomes of patients with this co-infection have rarely been described since antiretroviral therapy became widely available. Methods: Prospective cohort study of HIV-infected adult patients hospitalised with TB in six referral hospitals in Medellin, Colombia, from August 2014 to July 2015. Results: Among 128 HIV-infected patients hospitalised with tuberculosis, the mean age was 38.4 years; 79.7% were men. HIV was diagnosed on admission in 28.9% of patients. The median CD4 + T-cell count was 125 (±158 SD) cells/µL. Only 47.3% of patients with a known diagnosis of HIV upon admission were on antiretroviral therapy, and only 11.1% had a tuberculin skin test in the previous year. Drug toxicity due to tuberculosis medications occurred in 11.7% of patients. Mean length of stay was 23.2 days, and 10.7% of patients were readmitted. Mortality was 5.5%. Conclusions: Hospital mortality attributable to tuberculosis in patients with HIV is low in reference hospitals in Colombia. Cases of tuberculosis in HIV-infected patients occur mainly in patients with advanced HIV, or not on antiretroviral therapy, despite a known diagnosis of HIV. Only one of every 10 patients in this cohort had active screening for latent tuberculosis, possibly reflecting missed treatment opportunities. Mención de responsabilidad : Carlos Andrés Agudelo, María Fernanda Álvarez, Alicia Hidrón Juan Pablo Villa, Lina María Echeverri‐Toro, Adriana Ocampo Glenys Patricia Porras, Iván Mauricio Trompa, Laura Restrepo, Alejandro Eusse, Carlos Andrés Restrepo Referencia : Trop Med Int Health. 2021 Jan;26(1):82-88. DOI (Digital Object Identifier) : 10.1111/tmi.13509 PMID : 33155342 En línea : https://onlinelibrary.wiley.com/doi/10.1111/tmi.13509 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5754 Outcomes and complications of hospitalised patients with HIV-TB co-infection [documento electrónico] / Alicia Inés Hidrón Botero,  . - 2021. Obra : Tropical Medicine & International Health Idioma : Inglés (eng) Palabras clave : co-infection HIV/TB  drug toxicity  latent tuberculosis  mortality  readmission Resumen : Background: Tuberculosis is one of the most common causes of hospitalisation in patients with HIV. Despite this, hospital outcomes of patients with this co-infection have rarely been described since antiretroviral therapy became widely available. Methods: Prospective cohort study of HIV-infected adult patients hospitalised with TB in six referral hospitals in Medellin, Colombia, from August 2014 to July 2015. Results: Among 128 HIV-infected patients hospitalised with tuberculosis, the mean age was 38.4 years; 79.7% were men. HIV was diagnosed on admission in 28.9% of patients. The median CD4 + T-cell count was 125 (±158 SD) cells/µL. Only 47.3% of patients with a known diagnosis of HIV upon admission were on antiretroviral therapy, and only 11.1% had a tuberculin skin test in the previous year. Drug toxicity due to tuberculosis medications occurred in 11.7% of patients. Mean length of stay was 23.2 days, and 10.7% of patients were readmitted. Mortality was 5.5%. Conclusions: Hospital mortality attributable to tuberculosis in patients with HIV is low in reference hospitals in Colombia. Cases of tuberculosis in HIV-infected patients occur mainly in patients with advanced HIV, or not on antiretroviral therapy, despite a known diagnosis of HIV. Only one of every 10 patients in this cohort had active screening for latent tuberculosis, possibly reflecting missed treatment opportunities. Mención de responsabilidad : Carlos Andrés Agudelo, María Fernanda Álvarez, Alicia Hidrón Juan Pablo Villa, Lina María Echeverri‐Toro, Adriana Ocampo Glenys Patricia Porras, Iván Mauricio Trompa, Laura Restrepo, Alejandro Eusse, Carlos Andrés Restrepo Referencia : Trop Med Int Health. 2021 Jan;26(1):82-88. DOI (Digital Object Identifier) : 10.1111/tmi.13509 PMID : 33155342 En línea : https://onlinelibrary.wiley.com/doi/10.1111/tmi.13509 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5754

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