Tuberculosis (Active and LTBI) - Revision history

JenniferH at 07:55, 11 March 2021

2021-03-11T07:55:46Z

← Older revision		Revision as of 07:55, 11 March 2021
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	A large percentage of the elderly on the Delta have had active TB in the past. You’ll see a lot of abnormal x-rays and find a lot of +PPD’s recorded in charts. If a patient doesn’t know if or how they were treated for TB, you can often find a report under the “x-ray” section of the chart on old “TB screening” x-ray reports. The public health nurses may also have a record of the patient’s treatment. The RPMS health summary of ten indicates TB status as well.		A large percentage of the elderly on the Delta have had active TB in the past. You’ll see a lot of abnormal x-rays and find a lot of +PPD’s recorded in charts. If a patient doesn’t know if or how they were treated for TB, you can often find a report under the “x-ray” section of the chart on old “TB screening” x-ray reports. The public health nurses may also have a record of the patient’s treatment. The RPMS health summary of ten indicates TB status as well.

	The most important thing to remember about TB is to remember TB. You may see new “converters”, new disease in a previous converter, reactivation. Be suspicion is the key to diagnosis of. CXR’s should be done on all converters (to determine skin test + vs. disease) and any person with a +PPD and symptoms suspicious for disease. Sputum’s can be sent to the State labs in “cans” x 3 for AFB and culture and sensitivity.		The most important thing to remember about TB is to remember TB. You may see new “converters”, new disease in a previous converter, reactivation. Having suspicion is the key to diagnosis of tuberculosis. CXR’s should be done on all converters (to determine skin test + vs. disease) and any person with a +PPD and symptoms suspicious for disease. Sputum’s can be sent to the State labs in “cans” x 3 for AFB and culture and sensitivity.

	Public Health Nursing does most of the screening, follow up, and other investigation. They provide skin testing, and school screening. MWF 1-3 is a good time for them. (907-543-2110)		Public Health Nursing does most of the screening, follow up, and other investigation. They provide skin testing, and school screening. MWF 1-3 is a good time for them. (907-543-2110)

	PPDs can also be placed in villages, or on outpatient units.		PPDs can also be placed in villages, or on outpatient units.

JenniferH: /* Resources/References */

2021-03-11T07:44:48Z

Resources/References

← Older revision		Revision as of 07:44, 11 March 2021
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	* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)		* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)
	* Ronald J. Bowerman (2020) [https://doi.org/10.1080/22423982.2020.1827786 Rapid detection of tuberculosis in remote Alaska], International Journal of Circumpolar Health, 79:1, 1827786, DOI: 10.1080/22423982.2020.1827786		* Ronald J. Bowerman (2020) [https://doi.org/10.1080/22423982.2020.1827786 Rapid detection of tuberculosis in remote Alaska], International Journal of Circumpolar Health, 79:1, 1827786, DOI: 10.1080/22423982.2020.1827786
	* [https://www.currytbcenter.ucsf.edu/sites/default/files/tb_sg3_chap6_pediatrics.pdf#tbltbdrugdosages Pediatric drug dosing for tablets, capsules, granules]. ''Drug Resistant Tuberculosis: A Survival Guide for Clinics: 3rd Edition.''		* Loeffler, Ann. [https://www.currytbcenter.ucsf.edu/sites/default/files/tb_sg3_chap6_pediatrics.pdf#tbltbdrugdosages Pediatric drug dosing for tablets, capsules, granules]. ''Drug Resistant Tuberculosis: A Survival Guide for Clinics: 3rd Edition.'' Ch. 6. released April 2016, updated October 2019.
	* [[media:LTBI.pdf\|Latent Tuberculosis Bacterial Infection (LTBI) YKHC Clinical Guideline]]		* [[media:LTBI.pdf\|Latent Tuberculosis Bacterial Infection (LTBI) YKHC Clinical Guideline]]
	* [[media:Active_TB.pdf\|Active Tuberculosis (>14 years) YKHC Clinical Guideline]]		* [[media:Active_TB.pdf\|Active Tuberculosis (>14 years) YKHC Clinical Guideline]]

JenniferH: /* Resources/References */

2021-03-11T07:39:35Z

Resources/References

← Older revision		Revision as of 07:39, 11 March 2021
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	* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)		* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)
	* Ronald J. Bowerman (2020) [https://doi.org/10.1080/22423982.2020.1827786 Rapid detection of tuberculosis in remote Alaska], International Journal of Circumpolar Health, 79:1, 1827786, DOI: 10.1080/22423982.2020.1827786		* Ronald J. Bowerman (2020) [https://doi.org/10.1080/22423982.2020.1827786 Rapid detection of tuberculosis in remote Alaska], International Journal of Circumpolar Health, 79:1, 1827786, DOI: 10.1080/22423982.2020.1827786
			* [https://www.currytbcenter.ucsf.edu/sites/default/files/tb_sg3_chap6_pediatrics.pdf#tbltbdrugdosages Pediatric drug dosing for tablets, capsules, granules]. ''Drug Resistant Tuberculosis: A Survival Guide for Clinics: 3rd Edition.''
	* [[media:LTBI.pdf\|Latent Tuberculosis Bacterial Infection (LTBI) YKHC Clinical Guideline]]		* [[media:LTBI.pdf\|Latent Tuberculosis Bacterial Infection (LTBI) YKHC Clinical Guideline]]
	* [[media:Active_TB.pdf\|Active Tuberculosis (>14 years) YKHC Clinical Guideline]]		* [[media:Active_TB.pdf\|Active Tuberculosis (>14 years) YKHC Clinical Guideline]]

JenniferH: /* Resources/References */

2020-11-20T14:08:11Z

Resources/References

← Older revision		Revision as of 14:08, 20 November 2020
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	* [[media:Peds_TB.pdf\|Tuberculosis (Pediatrics) YKHC Clinical Guideline]]		* [[media:Peds_TB.pdf\|Tuberculosis (Pediatrics) YKHC Clinical Guideline]]

	[[:~~Category~~:YKHC Guidelines]]
			[[:category:YKHC Guidelines\|YKHC Clinical Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

JenniferH: /* Resources/References */

2020-10-20T01:01:43Z

Resources/References

← Older revision		Revision as of 01:01, 20 October 2020
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	*[[media:Isoniazid-comstock.pdf\|Isonaiazid Prophylaxis in an Undeveloped Area -- George w. Comstock, 1962]]		*[[media:Isoniazid-comstock.pdf\|Isonaiazid Prophylaxis in an Undeveloped Area -- George w. Comstock, 1962]]
	*[[media:isoniazid.pdf\|Isoniazid Prophylaxis among Alaskan Eskimos: A Final Report of the Bethel Isoniazid Studies --1979]]		*[[media:isoniazid.pdf\|Isoniazid Prophylaxis among Alaskan Eskimos: A Final Report of the Bethel Isoniazid Studies --1979]]
			* [[media:Xpert_rapid MTB - 5-22-19.pdf\|Rapid (Active) TB Testing in YK Delta 2019]] (PowerPoint Presentation)
	* [[media:HighTechTB.PDF\|High Tech TB]] (Powerpoint Presentation by Ron Bowerman, MD, MPH)		* [[media:HighTechTB.PDF\|High Tech TB]] (Powerpoint Presentation by Ron Bowerman, MD, MPH)
	* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)		* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)

JenniferH at 22:00, 19 October 2020

2020-10-19T22:00:54Z

← Older revision		Revision as of 22:00, 19 October 2020
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	A TB isolation designation should be used for any patient admitted to the hospital for ‘rule-out TB”. Questions about this can be directed to infection control nurse or physician.		A TB isolation designation should be used for any patient admitted to the hospital for ‘rule-out TB”. Questions about this can be directed to infection control nurse or physician.

	~~'''~~Resources~~:'''~~		===Resources/References===
	*[[media:Rapid detection of TB.pdf\|The Promise of Rapid Detection of Active Pulmonary Tuberculosis in Rural Alaska by Dr. Ron Bowerman.]]		*[[media:Rapid detection of TB.pdf\|The Promise of Rapid Detection of Active Pulmonary Tuberculosis in Rural Alaska by Dr. Ron Bowerman.]]
	*[[media:Isoniazid-comstock.pdf\|Isonaiazid Prophylaxis in an Undeveloped Area -- George w. Comstock, 1962]]		*[[media:Isoniazid-comstock.pdf\|Isonaiazid Prophylaxis in an Undeveloped Area -- George w. Comstock, 1962]]

JenniferH at 23:09, 6 October 2020

2020-10-06T23:09:01Z

← Older revision		Revision as of 23:09, 6 October 2020
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	* [[media:HighTechTB.PDF\|High Tech TB]] (Powerpoint Presentation by Ron Bowerman, MD, MPH)		* [[media:HighTechTB.PDF\|High Tech TB]] (Powerpoint Presentation by Ron Bowerman, MD, MPH)
	* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)		* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)
			* Ronald J. Bowerman (2020) [https://doi.org/10.1080/22423982.2020.1827786 Rapid detection of tuberculosis in remote Alaska], International Journal of Circumpolar Health, 79:1, 1827786, DOI: 10.1080/22423982.2020.1827786
	* [[media:LTBI.pdf\|Latent Tuberculosis Bacterial Infection (LTBI) YKHC Clinical Guideline]]		* [[media:LTBI.pdf\|Latent Tuberculosis Bacterial Infection (LTBI) YKHC Clinical Guideline]]
	* [[media:Active_TB.pdf\|Active Tuberculosis (>14 years) YKHC Clinical Guideline]]		* [[media:Active_TB.pdf\|Active Tuberculosis (>14 years) YKHC Clinical Guideline]]

JenniferH at 04:42, 25 September 2020

2020-09-25T04:42:36Z

← Older revision		Revision as of 04:42, 25 September 2020
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	* [[media:HighTechTB.PDF\|High Tech TB]] (Powerpoint Presentation by Ron Bowerman, MD, MPH)		* [[media:HighTechTB.PDF\|High Tech TB]] (Powerpoint Presentation by Ron Bowerman, MD, MPH)
	* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)		* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)
			* [[media:LTBI.pdf\|Latent Tuberculosis Bacterial Infection (LTBI) YKHC Clinical Guideline]]
			* [[media:Active_TB.pdf\|Active Tuberculosis (>14 years) YKHC Clinical Guideline]]
			* [[media:Peds_TB.pdf\|Tuberculosis (Pediatrics) YKHC Clinical Guideline]]

	[[:Category:YKHC Guidelines]]		[[:Category:YKHC Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

JenniferH at 09:00, 24 September 2020

2020-09-24T09:00:16Z

← Older revision		Revision as of 09:00, 24 September 2020
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	* [[media:HighTechTB.PDF\|High Tech TB]] (Powerpoint Presentation by Ron Bowerman, MD, MPH)		* [[media:HighTechTB.PDF\|High Tech TB]] (Powerpoint Presentation by Ron Bowerman, MD, MPH)
	* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)		* [[media:LTBI Robert Tyree.pdf\|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)

			[[:Category:YKHC Guidelines]]
			<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

JenniferH: Created page with "A large percentage of the elderly on the Delta have had active TB in the past. You’ll see a lot of abnormal x-rays and find a lot of +PPD’s recorded in charts. If a patien..."

2020-09-24T08:59:42Z

Created page with "A large percentage of the elderly on the Delta have had active TB in the past. You’ll see a lot of abnormal x-rays and find a lot of +PPD’s recorded in charts. If a patien..."

New page

A large percentage of the elderly on the Delta have had active TB in the past. You’ll see a lot of abnormal x-rays and find a lot of +PPD’s recorded in charts. If a patient doesn’t know if or how they were treated for TB, you can often find a report under the “x-ray” section of the chart on old “TB screening” x-ray reports. The public health nurses may also have a record of the patient’s treatment. The RPMS health summary of ten indicates TB status as well.

The most important thing to remember about TB is to remember TB. You may see new “converters”, new disease in a previous converter, reactivation. Be suspicion is the key to diagnosis of. CXR’s should be done on all converters (to determine skin test + vs. disease) and any person with a +PPD and symptoms suspicious for disease. Sputum’s can be sent to the State labs in “cans” x 3 for AFB and culture and sensitivity.

Public Health Nursing does most of the screening, follow up, and other investigation. They provide skin testing, and school screening. MWF 1-3 is a good time for them. (907-543-2110)
PPDs can also be placed in villages, or on outpatient units.

The hospital has several physicians designated at TB Control Officer (Drs Roll, Bowerman, Chyi and Mondesir) by virtue of their interest and special training - they do all of the prescribing of anti-tuberculosis meds. Please notify this resource.

A TB isolation designation should be used for any patient admitted to the hospital for ‘rule-out TB”. Questions about this can be directed to infection control nurse or physician.

'''Resources:'''
*[[media:Rapid detection of TB.pdf|The Promise of Rapid Detection of Active Pulmonary Tuberculosis in Rural Alaska by Dr. Ron Bowerman.]]
*[[media:Isoniazid-comstock.pdf|Isonaiazid Prophylaxis in an Undeveloped Area -- George w. Comstock, 1962]]
*[[media:isoniazid.pdf|Isoniazid Prophylaxis among Alaskan Eskimos: A Final Report of the Bethel Isoniazid Studies --1979]]
* [[media:HighTechTB.PDF|High Tech TB]] (Powerpoint Presentation by Ron Bowerman, MD, MPH)
* [[media:LTBI Robert Tyree.pdf|Latent Tuberculosis]] (Powerpoint Presentation by Robert Tyree, MD)