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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Control of tuberculosis &#40;TB&#41; in healthcare workers requires an early recognition of contacts&#44; the adoption of efficient protective measures and screening for cases of latent tuberculosis &#40;TL&#41; and recent TL&#46;</p> <span class="elsevierStyleSectionTitle">Aims</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Systematic screening for TB and TL in healthcare workers with contact with patients or other workers with TB and risk of contagion&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In a hospital with approximately 5400 workers 13 screenings were performed September 2007&#8211; December 2008 due to risk of continued TB&#46; These consisted of clinical observation&#44; tuberculin skin test &#40;PT&#41;&#44; Quantiferon&#174;-TB Gold &#40;QTF&#41; test if PT &#8805;10<span class="elsevierStyleHsp" style=""></span>mm and &#60;15<span class="elsevierStyleHsp" style=""></span>mm and chest X-ray&#46; The diagnoses were performed according to the recommendations of the Portuguese Pulmonolgy Society &#40;SPP&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">792 workers &#40;563 &#9794;&#59; 229 &#9792;&#41; were included in the 13 screenings&#46; Of these&#44; 75 presented symptoms and 31 had radiology abnormalities&#46; PT was performed in 490 workers&#44; with results &#60;10<span class="elsevierStyleHsp" style=""></span>mm in 250&#44; &#8805;10 and &#60;15<span class="elsevierStyleHsp" style=""></span>mm in 175 &#40;QTF positive in 36&#41; and &#8805;15<span class="elsevierStyleHsp" style=""></span>mm in 65&#46; Of the screened workers&#44; 280 had a previous PT &#8805;15<span class="elsevierStyleHsp" style=""></span>mm&#44; and therefore it was not repeated&#46; 1 case of active TB was diagnosed in a worker&#44; as well as 408 cases of TL &#40;51&#46;5&#37;&#41; and 42 cases of recent TL &#40;5&#46;3&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">TB is considered an occupational disease in healthcare workers&#46; The screening of contacts and TL cases is an important tool for an early diagnosis of active disease and for identifying the cases with higher risk of future disease&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O controlo da tuberculose &#40;TB&#41; em profissionais de sa&#250;de passa pelo reconhecimento precoce dos contactos&#44; adop&#231;&#227;o de medidas de protec&#231;&#227;o eficazes e despiste dos casos de tuberculose latente &#40;TL&#41; e latente recente&#46;</p> <span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Rastreio sistem&#225;tico de TB e TL nos profissionais de sa&#250;de com contacto com doentes ou funcion&#225;rios com TB e risco de cont&#225;gio&#46;</p> <span class="elsevierStyleSectionTitle">Material e m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Num hospital com aproximadamente 5400 funcion&#225;rios&#44; entre Setembro de 2007 e Dezembro de 2008&#44; realizaram-se 13 rastreios de risco de TB continuada&#46; Estes foram constitu&#237;dos por observa&#231;&#227;o cl&#237;nica&#44; realiza&#231;&#227;o de prova de tuberculina &#40;PT&#41;&#44; teste de Quantiferon&#174;-TB Gold &#40;QTF&#41; se PT &#8805;10<span class="elsevierStyleHsp" style=""></span>mm e &#60;15<span class="elsevierStyleHsp" style=""></span>mm e RX t&#243;rax&#46; O diagn&#243;stico foi efectuado de acordo com as recomenda&#231;&#245;es da SPP&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Nos 13 rastreios efectuados foram englobados 792 profissionais &#40;563 &#9792;&#59; 229 &#9794;&#41;&#46; Destes&#44; 75 apresentavam sintomas e 31 altera&#231;&#245;es radiol&#243;gicas&#46; A PT foi efectuada em 490 profissionais&#44; sendo &#60;10 <span class="elsevierStyleHsp" style=""></span>mm em 250&#44; &#8805;10 e &#60;15<span class="elsevierStyleHsp" style=""></span>mm em 175 &#40;QTF positivo em 36&#41; e &#8805;15<span class="elsevierStyleHsp" style=""></span>mm em 65&#46; Dos profissionais rastreados&#44; 280 tinham PT anterior &#8805;15<span class="elsevierStyleHsp" style=""></span>mm&#44; pelo que n&#227;o foi repetida&#46; Durante o rastreio foi diagnosticado um caso de TB activa num profissional&#44; 408 casos de TL &#40;51&#44;5&#37;&#41; e 42 de TL recente &#40;5&#44;3&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A TB &#233; considerada como doen&#231;a profissional nos profissionais da sa&#250;de&#46; O rastreio dos contactos e dos casos de TL &#233; uma importante ferramenta para o diagn&#243;stico precoce de doen&#231;a activa e para a identifica&#231;&#227;o dos casos de maior risco de doen&#231;a futura&#46;</p>"
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Tuberculosis – Risk of continued transmission in healthcare workers
Tuberculose – Risco de transmissão continuada em profissionais de saúde
José Torres Costa1,2,3,
Corresponding author
zecatoco@sapo.pt

Correspondence to/Correspondência: Estrada de St.ª Luzia, n.° 269, 4900-408 Viana do Castelo, Portugal.
, Rui Silva1,2,3, Raul Sá1, Maria João Cardoso4, José Ferreira1, Carla Ribeiro1, Mário Miranda1,2,3, José Luís Plácido1,2
1 Serviço de Saúde Ocupacional, Hospital S. João, EPE – Porto/Occupational Health Unit, Hospital S. João, EPE – Porto, Portugal
2 Serviço de Imunoalergologia, Hospital S. João, EPE – Porto/Allergology and Clinical Immunology Unit, Hospital S. João, EPE – Porto, Portugal
3 Faculdade de Medicina, Universidade do Porto/Faculty of Medicine, Universidade do Porto, Portugal
4 Serviço de Patologia Clínica, Hospital S. João, EPE – Porto/Clinical Pathology Unit, Hospital S. João, EPE – Porto, Portugal
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Control of tuberculosis &#40;TB&#41; in healthcare workers requires an early recognition of contacts&#44; the adoption of efficient protective measures and screening for cases of latent tuberculosis &#40;TL&#41; and recent TL&#46;</p> <span class="elsevierStyleSectionTitle">Aims</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Systematic screening for TB and TL in healthcare workers with contact with patients or other workers with TB and risk of contagion&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In a hospital with approximately 5400 workers 13 screenings were performed September 2007&#8211; December 2008 due to risk of continued TB&#46; These consisted of clinical observation&#44; tuberculin skin test &#40;PT&#41;&#44; Quantiferon&#174;-TB Gold &#40;QTF&#41; test if PT &#8805;10<span class="elsevierStyleHsp" style=""></span>mm and &#60;15<span class="elsevierStyleHsp" style=""></span>mm and chest X-ray&#46; The diagnoses were performed according to the recommendations of the Portuguese Pulmonolgy Society &#40;SPP&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">792 workers &#40;563 &#9794;&#59; 229 &#9792;&#41; were included in the 13 screenings&#46; Of these&#44; 75 presented symptoms and 31 had radiology abnormalities&#46; PT was performed in 490 workers&#44; with results &#60;10<span class="elsevierStyleHsp" style=""></span>mm in 250&#44; &#8805;10 and &#60;15<span class="elsevierStyleHsp" style=""></span>mm in 175 &#40;QTF positive in 36&#41; and &#8805;15<span class="elsevierStyleHsp" style=""></span>mm in 65&#46; Of the screened workers&#44; 280 had a previous PT &#8805;15<span class="elsevierStyleHsp" style=""></span>mm&#44; and therefore it was not repeated&#46; 1 case of active TB was diagnosed in a worker&#44; as well as 408 cases of TL &#40;51&#46;5&#37;&#41; and 42 cases of recent TL &#40;5&#46;3&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">TB is considered an occupational disease in healthcare workers&#46; The screening of contacts and TL cases is an important tool for an early diagnosis of active disease and for identifying the cases with higher risk of future disease&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O controlo da tuberculose &#40;TB&#41; em profissionais de sa&#250;de passa pelo reconhecimento precoce dos contactos&#44; adop&#231;&#227;o de medidas de protec&#231;&#227;o eficazes e despiste dos casos de tuberculose latente &#40;TL&#41; e latente recente&#46;</p> <span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Rastreio sistem&#225;tico de TB e TL nos profissionais de sa&#250;de com contacto com doentes ou funcion&#225;rios com TB e risco de cont&#225;gio&#46;</p> <span class="elsevierStyleSectionTitle">Material e m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Num hospital com aproximadamente 5400 funcion&#225;rios&#44; entre Setembro de 2007 e Dezembro de 2008&#44; realizaram-se 13 rastreios de risco de TB continuada&#46; Estes foram constitu&#237;dos por observa&#231;&#227;o cl&#237;nica&#44; realiza&#231;&#227;o de prova de tuberculina &#40;PT&#41;&#44; teste de Quantiferon&#174;-TB Gold &#40;QTF&#41; se PT &#8805;10<span class="elsevierStyleHsp" style=""></span>mm e &#60;15<span class="elsevierStyleHsp" style=""></span>mm e RX t&#243;rax&#46; O diagn&#243;stico foi efectuado de acordo com as recomenda&#231;&#245;es da SPP&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Nos 13 rastreios efectuados foram englobados 792 profissionais &#40;563 &#9792;&#59; 229 &#9794;&#41;&#46; Destes&#44; 75 apresentavam sintomas e 31 altera&#231;&#245;es radiol&#243;gicas&#46; A PT foi efectuada em 490 profissionais&#44; sendo &#60;10 <span class="elsevierStyleHsp" style=""></span>mm em 250&#44; &#8805;10 e &#60;15<span class="elsevierStyleHsp" style=""></span>mm em 175 &#40;QTF positivo em 36&#41; e &#8805;15<span class="elsevierStyleHsp" style=""></span>mm em 65&#46; Dos profissionais rastreados&#44; 280 tinham PT anterior &#8805;15<span class="elsevierStyleHsp" style=""></span>mm&#44; pelo que n&#227;o foi repetida&#46; Durante o rastreio foi diagnosticado um caso de TB activa num profissional&#44; 408 casos de TL &#40;51&#44;5&#37;&#41; e 42 de TL recente &#40;5&#44;3&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A TB &#233; considerada como doen&#231;a profissional nos profissionais da sa&#250;de&#46; O rastreio dos contactos e dos casos de TL &#233; uma importante ferramenta para o diagn&#243;stico precoce de doen&#231;a activa e para a identifica&#231;&#227;o dos casos de maior risco de doen&#231;a futura&#46;</p>"
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