RESUMO
The purpose of this investigation was to assess the usefulness of mycobacteremia detection in human immunodeficiency virus (HIV) patients with suspected tuberculosis. The study included 47 patients with suspected tuberculosis and confirmed HIV infection. A first blood sample was incubated in a BACTEC 9050 MB system, while white blood cells isolation was performed on a second blood specimen before incubation in a BACTEC MGIT 960 system. The third specimen was taken from the affected organs of each patient according to their clinical profile. Twelve (25.5%) patients were positive for mycobacterial infection identified by any of the methods used. Ten (21.2%) were positive for Mycobacterium tuberculosis and 2 (4.3%) for M. avium. Six patients were diagnosed by the culture of specimen from affected organs only, whilst three other patients were positive exclusively for blood cultures. Three additional patients were diagnosed by both methods. Four patients with negative cultures were ultimately diagnosed with tuberculosis by measuring the adenosine deaminase levels. Mycobacteremia detection can be used to increase the sensitivity of the diagnosis of tuberculosis and other mycobacteria in patients with HIV. However, it cannot be used as the sole diagnostic method. Clinical specimen cultures do not provide 100% diagnostic accuracy and it is, therefore, critical to further improve the mycobacteria detection sensitivity.
Assuntos
Técnicas Bacteriológicas , Infecções por HIV/complicações , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/diagnóstico , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/complicações , Tuberculose/diagnóstico , Adenosina Desaminase/metabolismo , Bacteriemia/diagnóstico , Bacteriemia/microbiologia , Humanos , Infecção por Mycobacterium avium-intracellulare/complicações , Infecção por Mycobacterium avium-intracellulare/microbiologia , Sensibilidade e Especificidade , Tuberculose/microbiologiaRESUMO
INTRODUCTION: Behavioral Assessment System for Children (BASC) has demonstrated to be useful in the diagnosis of Attention Deficit Disorder (ADD). PATIENTS AND METHODS: A randomized sample of 120 children, 6 to 11-year-old, participants from the school of the city of Medellín, Colombia, was selected. The sample was stratified by sex and two socioeconomic status (SES). Parents were asked to answer the BASC Parent Rating Scale (PRS) 6-11, authorized Spanish version. RESULTS: Cronbach's alpha coefficient was 0.85 for the clinical scale (9 items). It was 0.75 for the Adaptive Scale (3 items). A scale designed with 4 items to assess ADD (hyperactivity, attention problems, aggression, and conduct problems) showed an alpha coefficient of 0.82. Male children scored significantly higher than female (ANOVA, p < 0.05) in hyperactivity, conduct problems, and atypicality. Children from low SES scored significantly higher than children of high SES on the most of clinical measures (p < 0.05) and lower on the three adaptive measures. Cluster analysis selecting six clusters found a prevalence of 61.6% for normal male children. In the total sample there were a 4% at risk of DDA type II (inattentive) and 14% at risk of DDA type I (combined). CONCLUSIONS: BASC PRS (6-11) showed reliability and validity to assessing the behavior in Spanish speaking Colombian children.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtornos do Comportamento Infantil/diagnóstico , Pais , Inquéritos e Questionários , Criança , Colômbia , Feminino , Humanos , Masculino , Reprodutibilidade dos TestesRESUMO
INTRODUCTION: American Psychiatric Association has defined the DSM-IV ADD diagnostic criteria and symptoms, however, there is not a quantitative instrument to evaluate them in Spanish speaker population. OBJECTIVE: To evaluate the utility of a ADD checklist in a Colombian schooling population. PATIENTS AND METHODS: A randomized and stratified by sex, age and socioeconomic level, 4 to 17-year old, sample of 540 schooling subjects was selected from Manizales City, Colombia. An ADD checklist was applied to the parents of these subjects. RESULTS: The reliability of the different dimensions of the questionnaire (18 total items, 9 items for inattention, 9 for hyperactivity-impulsivity, and 6 for hyperactivity) were strong in both sex and in all age groups (Cronbach's alpha coefficient 0.71-0.92). Only the impulsivity dimension formed by three variables showed fairly weak reliability (0.42-0.79 Cronbach's alpha). Some factorial analysis found two dimensions. In the male sample first dimension (inattention) explain around the 45% of the variance, and the second dimension (hyperactivity-impulsivity) explain around the 12 to 15% of the variance in the different age groups. In the female sample the first dimension was hyperactivity-impulsivity and the second dimension was inattention. A categorical (yes or not) scored questionnaire found a ADD estimated prevalence of 16.1, distributed in type I (combined) 3.3%, in type II (inattentive) 4.3%, and type III (hyperactive-impulsive) 8.5%. Male prevalence was 19.8% and female 12.4%. CONCLUSIONS: ADD checklist Spanish version showed a strong reliability. A bidimensional stable structured was found. A clinical related ADD prevalence was presented, it was much higher than the prevalence of the developed countries.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Inquéritos e Questionários , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Área Programática de Saúde , Criança , Colômbia/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Escalas de Graduação PsiquiátricaRESUMO
INTRODUCTION: According to factor brain organization of cognition model, it has been proposed that there are specific a shared underlie factors in the structure of each cognitive functions. OBJECTIVE: To determine if children with attention deficit disorder (ADD) have different verbal abilities than controls, and if verbal behaviors are related to inattention and hyperactive symptoms. PATIENTS AND METHODS: 32 children with attention deficit without hyperactivity (ADD/-H), 28 children with attention deficit hyperactivity (ADD/+H), according to DSM-IV criteria and higher than 60-T-Score on an ADHD checklist, and 32 control children were selected. Age, sex, school achievement, and socioeconomic status were controlled. All children had a WISC-R performance intelligence quotient (PIQ) > 80 and were 7-to-12-year old. Verbal test to assess comprehension, inferences, narrative, fluency, analogies and rapid naming were applied. RESULTS: Children from both ADD groups obtained significant lower WISC-R verbal intelligence quotient (VIQ), PIQ, full scale IQ (FSIQ), and phonologic fluency score than controls (ANOVA-Bonferroni's correction p < 0.005). ADD/+H children performed significant lower than controls in narrative and analogies (p < 0.005). An analysis of covariance (ANCOVA), using FSIQ as covariable, showed that phonologic verbal fluency continued presenting significant differences between control and ADD children. Inattention-hyperactivity checklist scores had significant inverse and mild correlations with inferences, items recalled in a narrative, phonologic verbal fluency, and analogies (r > -0.20, p < 0.05). There were significant and small correlations between inattention score and rapid naming errors, and between Inattention and rapid naming time (r > 0.20, p < 0.05). CONCLUSION: Our data found different verbal production, fluency and speed in ADD/+H and ADD/-H children. There were shared underlie relations between verbal abilities and behavioral symptoms.