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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The diagnosis of tuberculosis in patients with negative acid-fast bacillus smears poses a challenge to both clinicians and public health authorities&#46; In an attempt to aid diagnosis in such cases&#44; an expert committee was established in the province of Ciudad de La Habana&#44; Cuba in 1995&#46; The aim of this study was to describe the progress of the committee&#39;s work and the corresponding results for the period 1996 through 2003&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">For each patient studied by the committee&#44; we analyzed the following data&#58; patient&#39;s residence and referring center&#44; tentative diagnosis proposed by the attending physician&#44; history of antibiotic treatment&#44; and final diagnosis made by the committee&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the 1703 patients studied&#44; 84&#46;8&#37; were from the province of Ciudad de La Habana&#44; 48&#46;4&#37; were 55 years or older&#44; and 63&#46;8&#37; were men&#46; Between 2001 and 2003&#44; 11&#46;3&#37; of patients were already on antituberculosis treatment when their case was studied by the committee&#46; The corresponding percentage for 1996 through 2000 was 16&#46;9&#37; &#40;<span class="elsevierStyleItalic">P&#61;</span>&#46;001&#41;&#46; Active tuberculosis was confirmed in 43&#46;1&#37; of a total of 918 patients with full test results during the period 1996 through 2000 and in 52&#46;2&#37; of a total of 619 patients &#40;52&#46;2&#37;&#41; during the period 2001 through 2003 &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;001&#41;&#46; Of 344 patients with suspected pulmonary tuberculosis and negative acid-fast bacillus smears between 2001 and 2003&#44; 128 &#40;37&#46;2&#37;&#41; were diagnosed with active tuberculosis&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">These findings indicate that the work of the committee is viable&#44; sustainable&#44; and useful for preventing overdiagnosis and inappropriate treatment&#44; and that it also serves an educational purpose&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">El diagn&#243;stico de los pacientes con tuberculosis pulmonar y muestras negativas para bacilos &#225;cido-alcohol resistentes &#40;BAAR&#41; representa un desaf&#237;o cl&#237;nico y de salud p&#250;blica&#44; por lo que en Ciudad de La Habana se cre&#243; en 1995 una comisi&#243;n para esclarecer su diagn&#243;stico&#46; El objetivo de este estudio ha sido describir los progresos y resultados del trabajo de esta comisi&#243;n entre 1996 y 2003&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se han analizado los datos recogidos de cada paciente presentado en las sesiones de la comisi&#243;n&#58; procedencia&#44; diagn&#243;stico de sospecha planteado por el m&#233;dico que present&#243; el caso&#44; antecedentes de tratamiento anterior con antibi&#243;ticos y diagn&#243;stico realizado por la comisi&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Del total de 1&#46;703 pacientes presentados a esta comisi&#243;n para esclarecer el diagn&#243;stico&#44; un 84&#44;8&#37; proced&#237;a de la Ciudad de La Habana&#44; el 48&#44;4&#37; pertenec&#237;a al grupo de edad igual o mayor de 55 a&#241;os y el 63&#44;8&#37; eran varones&#46; El porcentaje de casos consultados con tratamiento espec&#237;fico contra la tuberculosis ya comenzado fue en 2001-2003 del 11&#44;3&#37;&#44; y en el per&#237;odo 1996-2000&#44; del 16&#44;9&#37; &#40;p &#61; 0&#44;001&#41;&#46; En 1986-2000&#44; de 918 pacientes que completaron sus ex&#225;menes&#44; tuvo diagn&#243;stico final de tuberculosis activa un 43&#44;1&#37;&#44; y en 2001-2003&#44; el 52&#44;2&#37; de 619 &#40;p &#61; 0&#44;000&#41;&#46; De un total de 344 casos estudiados con sospecha de tuberculosis pulmonar con BAAR y cultivo negativos en 2001-2003&#44; el diagn&#243;stico se corrobor&#243; en 128 &#40;37&#44;2&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los resultados indican que el trabajo de la comisi&#243;n es viable&#44; sostenible y de utilidad porque evita el sobrediagn&#243;stico y el tratamiento inapropiado&#44; adem&#225;s de cumplir una funci&#243;n docente&#46;</p>"
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Original Articles
An Alternative for Improving the Diagnosis of Smear-Negative Tuberculosis and Other Bronchopulmonary Disorders in Cuba
José Sevy Courta, Delfina Machado Molinaa, Luisa Armas Pérezb, Mariana Peralta Pérezb, Libertad Carreras Corzoa, Reinaldo Sánchez de la Osaa, Carmen Rosas Valladaresa, Edilberto González Ochoab,
Corresponding author
ochoa@ipk.sld.cu

Correspondence: Prof E. González Ochoa Instituto Pedro Kourí, Autopista Novia del Mediodía, km 6,5 La Lisa, La Habana, Cuba
a Hospital Universitario Neumológico Benéfico Jurídico, La Habana, Cuba
b Grupo de Investigaciones y Vigilancia de Tuberculosis, Lepra e IRA, Instituto Pedro Kourí, La Habana, Cuba
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ISSN: 15792129
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