Patients with pulmonary tuberculosis (PTB) often present with atypical clinical symptoms in EmergencyDepartments (ED), which hinders early detection. Traditional screening is based on “cough with expectoration ≥ 15 days”, however, some patients produce sputum, without coughing. Consequently, in this study, TB screening was performed through active case finding, regardless of the presence or duration of respiratory symptoms and included the Xpert MTB/RIF test. The study was carried out under field conditions at the Dos de Mayo National Hospital's ED in Lima, Peru from 2017-2018. The study enrolled patients age ≥ 18 years , who could produce sputum, regardless of cough duration. Patients with a current TB diagnosis were excluded. Additional personnel were assigned for obtaining the informed consent, administering questionnaires and collecting sputum samples. Smear, Xpert MTB/RIF an...

Background: Tuberculosis has been associated with an increased risk of cardiovascular disease (CVD), including acute myocardial infarction (AMI). We investigated whether latent tuberculosis infection (LTBI) is associated with AMI. Methods: We conducted a case-control study in 2 large national public hospital networks in Lima, Peru, between July 2015 and March 2017. Case patients were patients with a first time diagnosis of type 1 (spontaneous) AMI. Controls were patients without a history of AMI. We excluded patients with known human immunodeficiency virus infection, tuberculosis disease, or prior LTBI treatment. We used the QuantiFERON-TB Gold In-Tube assay to identify LTBI. We used logistic regression modeling to estimate the odds ratio (OR) of LTBI in AMI case patients versus non-AMI controls. Results: We enrolled 105 AMI case patients and 110 non-AMI controls during the study period....

Antecedentes: Anteriormente informamos un aumento de los niveles sanguíneos no estimulados de interferón-gamma en personas con infección tuberculosa latente (LTBI) en los Estados Unidos, lo que sugiere una mayor activación inmunitaria en la LTBI. Para investigar esto más a fondo en un entorno endémico de TB, evaluamos los niveles de interferón-gamma en personas con y sin LTBI en Perú. Métodos: Analizamos datos de pacientes con y sin un infarto agudo de miocardio (IAM) tipo 1 reciente (espontáneo) que fueron inscritos en dos redes de hospitales públicos en Lima, Perú, y se sometieron a pruebas de ITBL utilizando el tubo QuantiFERON® TB Gold In-tube ( QFT) ensayo. Los participantes con una prueba QFT positiva se definieron como pacientes con LTBI, mientras que los participantes con una prueba QFT negativa se definieron como no LTBI. El interferón-gamma no estimulado se cuanti...

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