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Volume 83, Issue 1
Displaying 1-6 of 6 articles from this issue
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Takeo INOUE, Haruki KOYASU, Satoru HATTORI2008 Volume 83 Issue 1 Pages 1-6
Published: January 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objectives] To elucidate TB transmission among nurses.
[Subjects and Methods] The subjects of this retrospective study were 1, 283 TB women aged 20-59 years registered in Aichi Prefecture between 1989 and 2003. All registration files were reviewed to identify their occupation and working places.
[Results] A total of 80 nurses were found amon g TB registers. Their age distribution was 45 (56. 2%) in 20-29 years, 15 (18. 8%) in 30-39 years, 14 (17. 5%) in 40-49 years, and 6 (7. 5%) in 50-59 years. The proportion of nurses aged 20-29 years decreased from 74. 2% in 1989-93 to 24. 0 % (p< 0. 001) in 1999-2003, while those aged 40-49 years increased from 2. 9% to 32. 0% (p< 0. 01). Regarding working places, 19 (23. 8%) were in 4 TB hospitals, 54 (67. 4%) in other 35 hospitals, 6 (7. 5%) in 6 clinics, and one (1. 3%) was in a home. The proportion of nurses in TB hospitals decreased from 31. 4% in 1989-1993 to 4. 0% (p< 0. 05) in 1999-2003. Out of 73 nurses working in hospitals, 58 (79. 5 %) were working in hospitals with more than 250 beds with an emergency department. TB incidence were 49. 1 per 100, 000 population among 73 nurses working in hospital, and 14. 3 among 6 nurses working in clinic, 39. 5 among total 80 nurses, and 13. 2 among 1, 203 women other than nurses. The relative risk was 3. 7 for hospital nurses, I. 1 for clinic nurses, and 3. 0 for whole 80 nurses.
[Conclusion] These findings suggest that TB incidence for nurses is 3-fold higher than age-matched women other than nurses, and that hospital nurses are infected with TB more frequently than clinic nurses.View full abstractDownload PDF (1180K) -
Muneyoshi MASUDA, Nobuyuki HARADA, Shinji SHISHIDO, Kazue HIGUCHI, Tor ...2008 Volume 83 Issue 1 Pages 7-11
Published: January 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objective] To diagnose M. tuberculosis infection and select subjects for chemoprophylaxis in a contact investigation, we used the whole blood interferon- γ response test, QuantiFERON® TB-2G (QFT), and examined the usefulness of QFT.
[Subjects a nd Methods] The index case (heavily positive for sputum smear, at grade 6 by Gaffky system, the duration of coughing being 8 months; hence the infectious risk index is 48) was found at a periodic mass health examination before proceeding to the second grade in a university. Since TB outbreak was suspected based on the results of tuberculin skin test (TST) in the contact investigation, QFT test was carried out to determine the subjects for chemoprophylaxis and to define the target of further contact investigations.
[Results] In the first TST, 57 co ntacts showed erythema of more than 30 mm in diameter, and these contacts would have been indicated for chemoprophylaxis based on TST results. Thus, this case would have been designated as a TB outbreak, and further investigation should be necessary for less close contacts. However, twice QFT tests revealed that only five contacts were positive for QFT (three showed erythema diameter of more than 30 mm, and two less than 29 mm). These five contacts were indicated chemoprophylaxis. Thus, the number of the secondary infections did not fulfill the criterion defined as a TB outbreak, and therefore an extended contact investigation was stopped. No contact has developed TB so far.
[Con clusion] QFT test was shown to be useful for determining subjects for chemoprophylaxis and selecting the range of the contact investigation.View full abstractDownload PDF (3141K) -
Yugo KANEKO, Naohiro NAGAYAMA, Yoshiko KAWABE, Masahiro SHIMADA, Junic ...2008 Volume 83 Issue 1 Pages 13-19
Published: January 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objectives] To investigate retrospectively the incidence of drug-induced hepatitis (DIH) caused by antituberculosis drugs including isoniazid (INH), rifampicin (RFP), with and without pyrazinamide (PZA), and to evaluate risk factors for DIH in tuberculosis patients complicated with chronic hepatitis (CH).
[Materials] On e hundred and seven tuberculosis patients with CH (M/F-= 96/11, mean age ± SE, 60. 8 ± 1. 4 yr) admitted to our hospital during 1998-2006, whose laboratory data had been followed before and at least 2 months after starting antituberculosis chemotherapy, were enrolled in this study. Of these, 58 were being treated with anti-tuberculosis chemotherapy consisting of INH, RFP and PZA (HRZ group) and the remaining 49 with INH and RFP (HR group). For a casecontrol study, patients admitted to the hospital during the same period and without CH were selected to each CH patient (n=107) of the same gender, the same treatment regimens, and the same age. Clinical diagnosis of CH was based on laboratory data and in some cases pathological findings; etiology of CH was C-CH (CH caused by hepatitis C virus) in 68 patients, B-CH (CH caused by hepatitis B virus) in 23, and alcoholic CH in 16.View full abstractDownload PDF (1277K) -
Junichi FUJITA, Kouichi SUNADA, Hirai HAYASHI, Kenji HAYASHIHARA, Take ...2008 Volume 83 Issue 1 Pages 21-25
Published: January 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 45-year-old man with multi-drug resistant tuberculosis were referred to our hospital for treatment. We started chemotherapy with cycloserine (CS), ethionamide (TH), kanamycin (KM), pyrazinamide (PZA), para-aminosalicylic acid (PAS) and gatifloxacin (GFLX). Two months later, psychosis and seizure occurred and worsened day after day. We suspected that these symptoms were due to CS. After stopping CS, psychosis and seizure disappeared. After surgical operation, positive tubercle bacilli in sputum converted to negative both on smear and culture. He was successfully discharged from our hospital. We should take care on side effects with second-line drugs that are often used in treating multi-drug resistant tuberculosis.View full abstractDownload PDF (2767K) -
Shigenori ISHIKAWA, Shuichi YANO, Yoshiyuki TOKUDA, Kanako KOBAYASHI, ...2008 Volume 83 Issue 1 Pages 27-31
Published: January 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSPleural effusion without occurrence of active pulmonary lesion due to nontuberculous mycobacteria is extremely rare. We report a case of Mycobacterium intracellulare pleurisy in an 84-year-old woman. The patient was admitted to a nearby hospital because of dyspnea. Massive right pleural effusion was observed on chest roentgenogram. Bacteriological examinations, smear and culture of the sputum or pleural effusion were negative. First we thought pleurisy was caused by M. tuberculosis as pleural effusion showed predominant lymphocyte count and high adenosine deaminase level. However, M. intracellulare was identified by the polymerase chain reaction method from pleural effusion. Based on clinical findings and laboratory data, we suspected pleurisy was due to M. intracellulare infection. Clarithromycin, kanamycin, rifampicin and ethambutol were administered. After four months of treatment pleural effusion disappeared without accompanying the active pulmonary lesion. Therefore, we diagnosed this case as pleurisy without pulmonary lesion due to M. intracellulare.View full abstractDownload PDF (3424K) -
2008 Volume 83 Issue 1 Pages 33-59
Published: January 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (12731K)
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