Shimura A

Relationship between CT findings of pulmonary tuberculosis and the number of acid-fast bacilli on sputum smears.

PURPOSE To investigate the relationship between computed tomography (CT) findings in patients with active pulmonary tuberculosis (PTB) and the number of acid-fast bacilli (AFB) on sputum smears. METHODS We reviewed CT scans of 173 patients with active PTB. The patients were divided into groups according to the number of AFB on sputum smears as follows: A, negative (n = 40); B, doubtful (n = 21); C, + (n = 34); and D, ++ or greater (n = 78). The presence or absence and the number of lobes that included micronodules, nodules, consolidation and cavitation, the number of cavities and the maximum diameter of the cavity lumen were noted. RESULTS The frequency of micronodules and nodules did not significantly differ among the four groups. In contrast, the frequency of consolidation and cavitation increased with the number of AFB (P < .0001). Differences in the number of lobes involving micronodules, nodules, consolidation and cavitation were significant between Group D and the other groups (P < .0001), but not between Groups A or B and C. The number and maximum size of cavities significantly differed between Group D and the other groups (P < .0001). CONCLUSIONS CT findings correlated with the number of AFB in sputum smears to some extent. However, CT findings do not reliably discriminate between smear-negative patients and those with very few AFB excreting smear-positive patients.

Prevalence of arrhythmias and conduction disturbances in large population-based samples of children

The aim of our study is to provide data on the prevalence of disturbances of rhythm in the general population of children. Accurate estimates of true prevalence of such disturbances of rhythm from large samples are mandatory if we are to interpret properly electrocardiographic abnormalities. We analysed prevalence of disturbances of rhythm in a population of 152,322, comprised of 71,855 elementary school students, 36,692 males and 35,163 females, aged from 5 to 6 years, and 80,467 students of junior high school, 41,842 males and 38,625 females, aged from 12 to 13 years. We analysed the prevalence of premature atrial and ventricular contractions, first, second and third degree atrioventricular block, incomplete and complete right bundle branch block, Wolff-Parkinson-White syndrome, and prolongation of the QT interval. The prevalence of disturbances of rhythm in total rose with age, being found in 1.25% of elementary school students and 2.32% of junior high school students, and was higher in males than females, at 2.00% as opposed to 1.38%, both values being statistically significant at a level of less than 0.0001. Prevalences of all types of rhythmic disturbances were higher in junior high school students than elementary school students (p < 0.0001). Premature atrial and ventricular contractions and prolongation of the QT interval were higher in female than male students, at percentages of 0.089, 0.497, and 0.02 for males, and 0.123, 0.534 and 0.027 in females (p < 0.0001). In contrast, incomplete and complete right bundle branch blocks were higher in males than females, at 0.983% and 0.083% in males versus 0.410% and 0.161% in females (p < 0.0001). Disturbances of rhythm increased with age, and conduction disturbances were higher in male students than female, although premature atrial and ventricular contractions and prolongation of the QT interval were more frequent in female. These data may be useful for future comparative studies of disturbance of rhythm in children.