Diagnostic standards and classification of tuberculosis in adults and children

A joint statement of the American Thoracic Society and the CDC, this article provides a framework for and an understanding of the diagnostic approaches to tuberculosis (TB) infection/disease and to present a classification scheme that facilitates management of all persons to whom diagnostic tests have been applied. The specific objectives of this revision of the Diagnostic Standards are to define diagnostic strategies for high- and low-risk patient populations based on current knowledge of TB epidemiology and information on newer technology and to provide a classification scheme for TB that is based on pathogenesis. Definitions of TB disease and latent infection have been selected that (1) aid in an accurate diagnosis; (2) coincide with the appropriate response of the health care team, whether it be no response, treatment of latent infection, or treatment of disease; (3) provide the most useful information that correlates with the prognosis; (4) provide the necessary information of appropriate public health action; and (5) provide a uniform, functional, and practical means of reporting. Because TB, even after it has been treated adequately, remains a pertinent and lifelong part of a person's medical history, previous as well as current disease is included in the classification. This edition of the Diagnostic Standards has been prepared as a practical guide and statement of principles for all persons involved in the care of patients with TB. References have been included to guide the reader to texts and journal articles for more detailed information on each topic. Section headings are (I) Epidemiology, (II) Transmission of Mycobacterium Tuberculosis, (III) Pathogenesis of Tuberculosis, (IV) Clinical Manifestations of Tuberculosis, (V) Diagnostic Microbiology, (VI) Tuberculin Skin Test, (VII) Classification of Persons Exposed to and/or Infected with Mycobacterium Tuberculosis, and (VIII) Reporting of Tuberculosis.I. Epidemiology -- II. Transmission of Mycobacterium Tuberculosis -- III. Pathogenesis of Tuberculosis -- IV. Clinical Manifestations of Tuberculosis -- V. Diagnostic Microbiology -- VI. Tuberculin Skin Test -- VII. Classification of Persons Exposed to and/or Infected with Mycobacterium Tuberculosis -- VIII. Reporting of Tuberculosis.This official statement of the American Thoracic Society and the Centers for Disease Control and Prevention was adopted by the ATS Board of Directors, July 1999. This statement was endorsed by the Council of the Infectious Disease Society of America, September 1999.Reprinted from American journal of respiratory and critical care medicine, Vol. 161, 2000.Also available on the World Wide Web (accessed 06/18/2010),Includes bibliographic references (p. 1392-1395)

American Thoracic Society 2019 Pediatric Core Curriculum

The American Thoracic Society Pediatric Core Curriculum updates clinicians annually in pediatric pulmonary disease in a 3 to 4 year recurring cycle of topics. The 2019 course was presented in May during the Annual International Conference. An American Board of Pediatrics Maintenance of Certification module and a continuing medical education exercise covering the contents of the Core Curriculum can be accessed online at www.thoracic.org.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152541/1/ppul24482_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152541/2/ppul24482.pd

Cardiopulmonary Exercise Testing as a Longitudinal Clinical Tool in Interstitial Lung Disease Management

This is an abstract from International Conference of the American-Thoracic-Society Location: Dallas, TX Date: MAY 17-22, 2019Royal Devon & Exeter Hospita

The Controversies and Difficulties of Diagnosing Primary Ciliary Dyskinesia

We welcome the correspondence from Lavie and Amirav (1), highlighting the difficulties diagnosing primary ciliary dyskinesia (PCD) and the role of high-speed video analysis (HSVA). As members of the European Respiratory Society (ERS) PCD Diagnostic Task Force (2) and/or large PCD Centres, we agree that HSVA has an important role that is not recognized by the American Thoracic Society (ATS) PCD Diagnostic Guideline (3). This risks a large proportion of false-negative “missed” diagnoses and a sizable number of false-positive cases; we make additional important observations.</div

Interpretation of Spirometry in Saskatchewan First Nations Adults

Originally Published in: Mark E. Fenton, Brian L. Graham, Sanja Stanojevic, Lorna Whitford, and Laurie Ironstand. Interpretation of Spirometry in Saskatchewan First Nations Adults. Annals of the American Thoracic Society 2018;Vol. 15:1237-1239. DOI: 10.1513/AnnalsATS.201711-909RL Copyright © 2018 the American Thoracic Society The final publication is available at https://doi.org/10.1513/AnnalsATS.201711-909RL.Saskatchewan Health Research FoundationPeer ReviewedThe Canadian First Nations and Inuit communities bear a large burden of respiratory disease, with increased rates of smoking, respiratory infections, asthma, chronic obstructive lung disease, and hospitalizations (1). Identification of respiratory disease and classification has relied on spirometric reference values from white individuals, or in the case of the Global Lung Initiative (GLI) dataset, “other” (2), because there are no published reference values for Canadian First Nations individuals. Several studies have suggested that spirometric values for Canadian Inuit populations may be different from those for white populations (3–7), but these observations are not consistent (7–10). This study investigated whether lung function measured in Plains Cree adults differed from that expected in white adults. Part of the data reported in this letter was presented at the 2014 American Thoracic Society International Conference in abstract form (11)

Physiological predictors of peak inspiRatory flow using Observed lung function results (POROS) : evaluation at discharge among patients hospitalized for a COPD exacerbation

This study was supported by AstraZeneca. The abstract of this paper was presented at the American Thoracic Society International Conference 2017 as a poster presentation with interim findings.Peer reviewedPublisher PD

New methodology for specific inhalation challenges with occupational agents

<p>Abstract</p> <p>Background</p> <p>Inhalation challenges are used for diagnosing occupational asthma (OA). The initial methodology consisted of a "realistic" exposure without monitoring nor controlling exposure. Our aim was to design an equipment, called the GenaSIC, that allows the generation of various agents regardless of the formulation and to assess the feasibility of its use in patients investigated for OA.</p> <p>Results</p> <p>GenaSIC can generate lactose, flour, malt, isocyanates, formaldehyde and N-butyl acetate with precise and fairly stable concentrations. Using N-butyl-acetate as a control agent and real time measurement, we show that normal breathing has a negligible effect on the concentration. We exposed forty-four different subjects to a control agent and/or to a suspected occupational agent. Nineteen of the subjects were only exposed to N-butyl acetate as a control agent without experiencing any significant irritant effect (no significant changes in spirometry thereafter). Eight subjects who were exposed to both N-butyl acetate and formaldehyde did not show significant reactions. Seven subjects were exposed to dry particles (flour in six instances, malt in the other) and five showed immediate asthmatic reactions which changes in FEV1 from 20% to a maximum of 28%. Finally, ten subjects were exposed to isocyanates, four of whom showed a positive reaction, including one subject with immediate maximum changes in FEV1 of 22%.</p> <p>Conclusion</p> <p>GenaSIC offers the possibility of reliable and safe exposures to dry particles, formaldehyde and isocyanates in the investigation of OA.</p