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Ferreiro L, Ruano-Raviña A, Otero-Mallo R, Pou-Álvarez C, Riveiro-Blanco V, Casal A, Suárez-Antelo J, Toubes ME, Cruz-Ferro E, Rodríguez-Núñez N, Ursúa-Díaz MI, Lama A, Piñeiro-Lamas M, Rábade C, Zamarrón C, González-Barcala FJ, Valiño-López P, Anibarro L, Taboada-Rodríguez JA, Valdés L. Recent epidemiological trends in extrapulmonary TB in Galicia, Spain. Int J Tuberc Lung Dis 2021; 25:373-381. [PMID: 33977905 DOI: 10.5588/ijtld.20.0910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: To describe the epidemiological trends and characteristics of extrapulmonary tuberculosis (EPTB) in Galicia, Spain, from 2000 to 2019.METHODS: This was a retrospective cohort study based on data from the Galician TB information system.RESULTS: Of the total number of TB cases (n = 15,871), 5,428 (34.2%) had EPTB. The absolute number of cases and incidence of EPTB decreased dramatically (from 480 cases and 17.8 cases/100,000 in 2000, to 172 and 6.4 cases/100,000 in 2019, respectively), with a mean annual decrease of respectively 64% and 4.7% for absolute cases and incidence rates. The risk for EPTB was higher in men than in women (RR 3.86, 95% CI 3.66-4.07). The most frequent age group was 15-44 years (2,234 patients, 41.2%); overall reductions per age group were 82% (0-14 years), 75% (15-44 years), 44% (45-64 years) and 63% (≥65 years), with statistically significant differences. The most frequently locations were the pleura (1,916 cases; 35.3%) and the lymph nodes (1,504; 27.7%).CONCLUSION: The incidence of EPTB in Galicia has decreased significantly in the last 20 years. The epidemiological characteristics have not changed, except for the number of patients with risk factors. This improvement of EPTB epidemiological trends coincides with the implementation of the programme for the prevention and control of TB, which suggests that it has been very effective in the control of the EPTB.
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Affiliation(s)
- L Ferreiro
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago de Compostela, Santiago de Compostela, Spain
| | - A Ruano-Raviña
- Departamento de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - R Otero-Mallo
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - C Pou-Álvarez
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - V Riveiro-Blanco
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - A Casal
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - J Suárez-Antelo
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - M E Toubes
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - E Cruz-Ferro
- Programa Gallego de Prevención y Control de la Tuberculosis, Dirección General de Innovación y Gestión de la Salud Pública, Consellería de Sanidad, Xunta de Galicia, Santiago de Compostela, Spain
| | - N Rodríguez-Núñez
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - M I Ursúa-Díaz
- Programa Gallego de Prevención y Control de la Tuberculosis, Dirección General de Innovación y Gestión de la Salud Pública, Consellería de Sanidad, Xunta de Galicia, Santiago de Compostela, Spain
| | - A Lama
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - M Piñeiro-Lamas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - C Rábade
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - C Zamarrón
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - F J González-Barcala
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago de Compostela, Santiago de Compostela, Spain
| | - P Valiño-López
- Servicio de Neumología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - L Anibarro
- Unidad de Tuberculosis, Enfermedades Infecciosas, Servicio de Medicina Interna, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - J A Taboada-Rodríguez
- Programa Gallego de Prevención y Control de la Tuberculosis, Dirección General de Innovación y Gestión de la Salud Pública, Consellería de Sanidad, Xunta de Galicia, Santiago de Compostela, Spain
| | - L Valdés
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago de Compostela, Santiago de Compostela, Spain
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Sanjuán-López P, Valiño-López P, Ricoy-Gabaldón J, Verea-Hernando H. Amyotrophic lateral sclerosis: impact of pulmonary follow-up and mechanical ventilation on survival. A study of 114 cases. Arch Bronconeumol 2014; 50:509-13. [PMID: 24931271 DOI: 10.1016/j.arbres.2014.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 04/04/2014] [Accepted: 04/07/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To study the impact of ventilatory management and treatment on the survival of patients with amyotrophic lateral sclerosis (ALS). METHOD Retrospective analysis of 114 consecutive patients admitted to a general hospital, evaluating demographic data, type of presentation, clinical management, treatment with mechanical ventilation and survival. STATISTICS descriptive and Kaplan-Meier estimator. RESULTS Sixty four patients presented initial bulbar involvement. Overall mean survival after diagnosis was 28.0 months (95%CI, 21.1-34.8). Seventy patients were referred to the pulmonary specialist (61.4%) and 43 received non-invasive ventilation (NIV) at 12.7 months (median) after diagnosis. Thirty seven patients continued to receive NIV with no subsequent invasive ventilation. The mean survival of these patients was 23.3 months (95%CI, 16.7-28.8), higher in those without bulbar involvement, although below the range of significance. Survival in the 26 patients receiving programmed NIV was higher than in the 11 patients in whom this was indicated without prior pulmonary assessment (considered following diagnosis, P<.012, and in accordance with the start of ventilation, P<.004). A total of 7 patients were treated invasively; mean survival in this group was 72 months (95%CI, 14.36-129.6), median 49.6±17.5 (95%CI, 15.3-83.8), and despite the difficulties involved in home care, acceptance and tolerance was acceptable. CONCLUSIONS Long-term mechanical ventilation prolongs survival in ALS. Programmed pulmonary assessment has a positive impact on survival of ALS patients and is key to the multidisciplinary management of this disease.
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Affiliation(s)
- Pilar Sanjuán-López
- Servicio de Neumología, Complexo Hospitalario Universitario A Coruña, CHUAC, A Coruña, España
| | - Paz Valiño-López
- Servicio de Neumología, Complexo Hospitalario Universitario A Coruña, CHUAC, A Coruña, España
| | - Jorge Ricoy-Gabaldón
- Servicio de Neumología, Complexo Hospitalario Universitario A Coruña, CHUAC, A Coruña, España
| | - Héctor Verea-Hernando
- Servicio de Neumología, Complexo Hospitalario Universitario A Coruña, CHUAC, A Coruña, España.
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