Tuberculosis Infection, a Challenge to Diagnose and Treatment in Hemodialysis Patients
Bibliographic record
Abstract
PURPOSE OF STUDY: The immunologic rearrangements in chronic renal failure have increased the susceptibility to tuberculosis (TB) infection. We present our experience in the diagnosis and treatment of TB among hemodialysis patients in our centre. METHODS: Since 1997–2001 tuberculosis was diagnosed in 26 patients (17 male, 9 female, mean age: 44.5 ± 14.3 years, HD duration 52.6 ± 34.1 months) that make an incidence of %2 per year. RESULTS: TB infection was characterized with an insidious while the main symptoms were fever in 80.7%, weight loss in 46.1% and night sweats in 30.7% of the patients. PPD skin test was ≥ 10 mm in 46.1%, 5–10 mm in 30.8%, and anergic in 23.1% of the patients. The major site of presentation was extrapulmonary TB in 76.9% of the patients predominating as lymphadenitis in 11 patients where as there were bone involvements in 2, peritoneum 4, and liver granuloma formation in liver in 1 patient. In addition to 4 patients with pulmonary involvement, 2 patients were diagnosed to have miliary TB. Our therapy protocol included administration of morfazinamid and ethambutol for 2 months and isoniazid, rifampicin for 9 months. In patients with miliary TB streptomycin was added to therapy. Mortality rate was 15.3%, while the rest of the patients were completely cured of TB. Old age, presences of malnutrition and infection with other bacterial agents have been found to be the major factors influencing the morbidity and mortality in these patients. CONCLUSION: There is a high incidence of TB infection in HD patients in Turkey. Insidious onset and extrapulmonary involvement are challenging problems in the diagnosis. Mortality rate is still high despite appropriate treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".