پاورپوینت “ مهندسی ارزش ( Value Engineering ) ”

اختصاصی از اینو دیدی پاورپوینت “ مهندسی ارزش ( Value Engineering ) ” دانلود با لینک مستقیم و پر سرعت .

پاورپوینت “ مهندسی ارزش ( Value Engineering ) ” در 63 اسلاید

Value of the Tuberculin Skin Test in Screening for Tuberculosis in Dialysis Patients

اختصاصی از اینو دیدی Value of the Tuberculin Skin Test in Screening for Tuberculosis in Dialysis Patients دانلود با لینک مستقیم و پر سرعت .

M.A. Habesoglu, D. Torun, Y.Z. Demiroglu, M. Karataslı, N. Sen, H. Ermis, Nurhan Ozdemir,
and F.O. Eyuboglu
ABSTRACT
Background. Hemodialysis patients are at high risk for tuberculosis, and a tuberculin
skin test (TST) is not usually helpful in detecting tuberculosis infection because of anergic
reactions. Prophylactic therapy against tuberculosis in dialysis patients is important to
enhance transplantation success. Herein we evaluated the value of TST in screening for
tuberculosis and analyzed any compounding factors that might affect the results of the test
in hemodialysis patients in an endemic area of Turkey.
Methods. A total of 187 (96 female, 91 male) patients were screened using a 2-step TST.
Test results were compared with clinical, radiologic, and laboratory data.
Results. None of the patients had active tuberculosis during the study and 55% had been
vaccinated against tuberculosis. After the first purified protein derivative (PPD) test,
55.1% of the patients showed a positive reaction, ultimately reaching a total of 68.4%
following the second test. Cumulative positive TST results were significantly correlated
with male gender (P .001, r .352), previous tuberculosis history (P .013, r .183)
positively, whereas with the ferritin level (P .001, r .233) negatively; but there were
no significant relationships between TST results and other data.
Conclusions. Impairment of delayed-type hypersensitivity reaction is frequent in dialysis
patients, but we observed high rates of positivity with the two-step TST which could be
attributed to tuberculosis being endemic in Turkey. Further comparative studies with more
specific diagnostic methods will be helpful to evalute the importance of TST positivity in
identifying tuberculosis-infected HD patients.