array:24 [
  "pii" => "S087321591530132X"
  "issn" => "08732159"
  "doi" => "10.1016/S0873-2159(15)30132-X"
  "estado" => "S350"
  "fechaPublicacion" => "2009-03-01"
  "aid" => "10"
  "copyright" => "Sociedade Portuguesa de Pneumologia/SPP"
  "copyrightAnyo" => "2009"
  "documento" => "simple-article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "rev"
  "cita" => "Rev Port Pneumol. 2009;15:295-304"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2187
    "formatos" => array:3 [
      "EPUB" => 213
      "HTML" => 1322
      "PDF" => 652
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0873215915301331"
    "issn" => "08732159"
    "doi" => "10.1016/S0873-2159(15)30133-1"
    "estado" => "S350"
    "fechaPublicacion" => "2009-03-01"
    "aid" => "11"
    "copyright" => "Sociedade Portuguesa de Pneumologia/SPP"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "Rev Port Pneumol. 2009;15:305-12"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3115
      "formatos" => array:3 [
        "EPUB" => 224
        "HTML" => 1845
        "PDF" => 1046
      ]
    ]
    "pt" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Caso Cl&#237;nico&#47;Case Report</span>"
      "titulo" => "Exacerba&#231;&#227;o aguda da fibrose pulmonar idiop&#225;tica"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "305"
          "paginaFinal" => "312"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Acute exacerbation of idiopathic pulmonary fibrosis"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Nat&#225;lia Melo, Carla Damas, Concei&#231;&#227;o Souto Moura, Ant&#243;nio Morais"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Nat&#225;lia"
              "apellidos" => "Melo"
            ]
            1 => array:2 [
              "nombre" => "Carla"
              "apellidos" => "Damas"
            ]
            2 => array:2 [
              "nombre" => "Concei&#231;&#227;o Souto"
              "apellidos" => "Moura"
            ]
            3 => array:2 [
              "nombre" => "Ant&#243;nio"
              "apellidos" => "Morais"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915301331?idApp=UINPBA00004E"
    "url" => "/08732159/0000001500000002/v1_201509151524/S0873215915301331/v1_201509151524/pt/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0873215915301318"
    "issn" => "08732159"
    "doi" => "10.1016/S0873-2159(15)30131-8"
    "estado" => "S350"
    "fechaPublicacion" => "2009-03-01"
    "aid" => "9"
    "copyright" => "Sociedade Portuguesa de Pneumologia&#47;SPP"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2009;15:261-93"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2886
      "formatos" => array:3 [
        "EPUB" => 214
        "HTML" => 1955
        "PDF" => 717
      ]
    ]
    "pt" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original&#47;Original Article</span>"
      "titulo" => "Nanorradiolipossomas modulados molecularmente para estudar a drenagem linf&#225;tica pulmonar profunda"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "261"
          "paginaFinal" => "293"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Nanoradioliposomes molecularly modulated to study the lung deep lymphatic drainage"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Maria Filomena Raba&#231;a Roque Botelho, Maria Alcide Tavares Marques, C&#233;lia Maria Freitas Gomes, Augusto Marques Ferreira da Silva, Vasco Ant&#243;nio Andrade Figueiredo Bairos, Manuel Amaro de Matos Santos Rosa, Antero Pena Abrunhosa, Jo&#227;o Jos&#233; Pedroso de Lima"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Maria Filomena Raba&#231;a Roque"
              "apellidos" => "Botelho"
            ]
            1 => array:2 [
              "nombre" => "Maria Alcide Tavares"
              "apellidos" => "Marques"
            ]
            2 => array:2 [
              "nombre" => "C&#233;lia Maria Freitas"
              "apellidos" => "Gomes"
            ]
            3 => array:2 [
              "nombre" => "Augusto Marques Ferreira"
              "apellidos" => "da Silva"
            ]
            4 => array:2 [
              "nombre" => "Vasco Ant&#243;nio Andrade Figueiredo"
              "apellidos" => "Bairos"
            ]
            5 => array:2 [
              "nombre" => "Manuel Amaro de Matos Santos"
              "apellidos" => "Rosa"
            ]
            6 => array:2 [
              "nombre" => "Antero Pena"
              "apellidos" => "Abrunhosa"
            ]
            7 => array:2 [
              "nombre" => "Jo&#227;o Jos&#233; Pedroso"
              "apellidos" => "de Lima"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915301318?idApp=UINPBA00004E"
    "url" => "/08732159/0000001500000002/v1_201509151524/S0873215915301318/v1_201509151524/pt/main.assets"
  ]
  "pt" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Artigo de Revis&#227;o&#47;Review Article</span>"
    "titulo" => "Teste tubercul&#237;nico&#46; Como optimizar&#63;"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "295"
        "paginaFinal" => "304"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Raquel Duarte"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Raquel"
            "apellidos" => "Duarte"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "af0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:3 [
            "entidad" => "Assistente Hospitalar de Pneumologia"
            "etiqueta" => "1"
            "identificador" => "af0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Tuberculin skin test&#46; How to optimise&#63;"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2008-09-29"
    "fechaAceptado" => "2008-11-10"
    "PalabrasClave" => array:2 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec570450"
          "palabras" => array:3 [
            0 => "Tuberculose"
            1 => "teste tubercul&#237;nico"
            2 => "Mantoux"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key-words"
          "identificador" => "xpalclavsec570449"
          "palabras" => array:3 [
            0 => "Tuberculosis"
            1 => "tuberculin skin test"
            2 => "Mantoux"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Os testes utilizados no diagn&#243;stico de infec&#231;&#227;o latente pelo <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span>&#44; o teste tubercul&#237;nico e o doseamento do interfer&#227;o gama &#40;IGRA&#41; identificam a exist&#234;ncia de uma resposta imunol&#243;gica adaptativa de mem&#243;ria contra os antig&#233;nios micobacterianos&#46; Considerando as limita&#231;&#245;es dos dois testes&#44; a melhor solu&#231;&#227;o passa por tirar proveito das melhores caracter&#237;sticas de cada um&#46; A maior parte dos autores concorda com a utiliza&#231;&#227;o dos dois testes&#44; utilizando os IGRA sobretudo na confirma&#231;&#227;o da positividade do teste tubercul&#237;nico &#40;tirando proveito da sua maior especificidade&#41;&#46;</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">As caracter&#237;sticas operativas do teste tubercul&#237;nico dependem da preval&#234;ncia da doen&#231;a na comunidade e dos objectivos da sua realiza&#231;&#227;o &#40;as suas caracter&#237;sticas s&#227;o superiores quando utilizada no &#226;mbito de rastreio ou como teste diagn&#243;stico&#41;&#46; Para interpretar correctamente um teste tubercul&#237;nico&#44; o cl&#237;nico deve conhecer a epidemiologia da tuberculose na comunidade e definir correctamente as indica&#231;&#245;es para a sua realiza&#231;&#227;o&#46;</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009&#59; XV &#40;2&#41;&#58; 295-304</span></p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">The tests used in the diagnosis of tuberculosis latent infection&#44; the tuberculin skin test &#40;TST&#41; and the interferon-gamma assays &#40;IGRA&#41;&#44; identify the existence of an adaptive immune response towards mycobacterial antigens&#46; Considering the limitations of the two tests&#44; the best solution is to take advantage of the best characteristics of each one&#46; Most of the authors agree to the use of the two tests&#44; using the IGRAS in the confirmation of a positive TST &#40;because of its higher specificity&#41;&#46; The operative characteristics of TST depend on the prevalence of the illness in the community and the aim of its use &#40;its operative characteristics are higher when used in the tracing scope or as a diagnostic test&#41;&#46; To interpret correctly a TST&#44; the physician must know the epidemiology of tuberculosis in the community and correctly define the indications for its use&#46;</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009&#59; XV &#40;2&#41;&#58; 295-304</span></p></span>"
      ]
    ]
    "lecturaRecomendada" => array:1 [
      0 => array:3 [
        "vista" => "all"
        "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia</span>"
        "seccion" => array:1 [
          0 => array:2 [
            "vista" => "all"
            "bibliografiaReferencia" => array:34 [
              0 => array:3 [
                "identificador" => "bb0005"
                "etiqueta" => "1&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Story of the tuberculin test"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:2 [
                              0 => "P&#46; Edwards"
                              1 => "L&#46; Edwards"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:5 [
                          "tituloSerie" => "Am Rev of Resp Dis"
                          "fecha" => "1960"
                          "volumen" => "81"
                          "paginaInicial" => "1"
                          "paginaFinal" => "49"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              1 => array:3 [
                "identificador" => "bb0010"
                "etiqueta" => "2&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Targeted tuberculin testing and treatment of latent tuberculosis infection"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:1 [
                              0 => "ATS&#47;CDCP &#40;American Thoracic Society&#47;Center for Dis Control&#44; Prevention&#41;"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/ajrccm.161.supplement_3.ats600"
                        "Revista" => array:6 [
                          "tituloSerie" => "Am J Respir Crit Care Med"
                          "fecha" => "2000"
                          "volumen" => "161"
                          "paginaInicial" => "S221"
                          "paginaFinal" => "S247"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10764341"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              2 => array:3 [
                "identificador" => "bb0015"
                "etiqueta" => "3&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "The tuberculin skin test"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:1 [
                              0 => "J&#46; Bass"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/ajrccm/142.1.24"
                        "Revista" => array:6 [
                          "tituloSerie" => "Am Rev Resp Dis"
                          "fecha" => "1990"
                          "volumen" => "142"
                          "paginaInicial" => "24"
                          "paginaFinal" => "28"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2368973"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              3 => array:3 [
                "identificador" => "bb0020"
                "etiqueta" => "4&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "The tuberculin test"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:1 [
                              0 => "J&#46; Bass"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "LibroEditado" => array:2 [
                          "titulo" => "Tuberculosis&#58; a comprehensive international approach"
                          "serieFecha" => "1993"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              4 => array:3 [
                "identificador" => "bb0025"
                "etiqueta" => "5&#46;"
                "referencia" => array:1 [
                  0 => array:1 [
                    "referenciaCompleta" => "Berkel GM&#44; Cobelens FG&#44; <span class="elsevierStyleItalic">et al&#46;</span> Tuberculin skin test&#58; Estimation of positive and negative predictive values from routine data&#46; Int J Lung Dis 9 &#40;3&#41;&#58;310-316&#46;CDC&#46;"
                  ]
                ]
              ]
              5 => array:3 [
                "identificador" => "bb0030"
                "etiqueta" => "6&#46;"
                "referencia" => array:1 [
                  0 => array:1 [
                    "referenciaCompleta" => "MMWR Morb Mortal Wkly Rep 2000&#46; Dispon&#237;vel em <a href="http://www.cdc.gov/mmwr">http&#58;&#47;&#47;www&#46;cdc&#46;gov&#47;mmwr</a>&#46;"
                  ]
                ]
              ]
              6 => array:3 [
                "identificador" => "bb0035"
                "etiqueta" => "7&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Evaluation of investigations conducted to detect and prevent transmission of tuberculosis"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:8 [
                              0 => "M&#46;R&#46; Reichler"
                              1 => "R&#46; Reves"
                              2 => "S&#46; Bur"
                              3 => "V&#46; Thompson"
                              4 => "B&#46;T&#46; Mangura"
                              5 => "J&#46; Ford"
                              6 => "S&#46;E&#46; Valway"
                              7 => "I&#46;M&#46; Onorato"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "JAMA"
                          "fecha" => "2002"
                          "volumen" => "287"
                          "numero" => "8"
                          "paginaInicial" => "991"
                          "paginaFinal" => "995"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11866646"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              7 => array:3 [
                "identificador" => "bb0040"
                "etiqueta" => "8&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:1 [
                        "titulo" => "Control and prevention of tuberculosis in the United Kingdom&#58; code of practice 2000&#46; Joint Tuberculosis Committee of the British Thoracic Society&#46; Joint Tuberculosis Committee of the British Thoracic Society"
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Thorax"
                          "fecha" => "2000"
                          "volumen" => "55"
                          "numero" => "11"
                          "paginaInicial" => "887"
                          "paginaFinal" => "901"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11050256"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              8 => array:3 [
                "identificador" => "bb0045"
                "etiqueta" => "9&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:1 [
                        "titulo" => "Efficacy of various durations of isoniazid preventive therapy for tuberculosis&#58; five years of follow-up in the IUAT trial&#46; International Union Against Tuberculosis Committee on Prophylaxis"
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Bull World Health Organ"
                          "fecha" => "1982"
                          "volumen" => "60"
                          "numero" => "4"
                          "paginaInicial" => "555"
                          "paginaFinal" => "564"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6754120"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              9 => array:3 [
                "identificador" => "bb0050"
                "etiqueta" => "10&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Treatment of latent tuberculosis infection in HIV infected persons"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:2 [
                              0 => "S&#46; Woldehanna"
                              1 => "J&#46; Volmink"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:2 [
                      0 => array:1 [
                        "Revista" => array:3 [
                          "tituloSerie" => "The Cochrane Database System Rev"
                          "fecha" => "2005"
                          "numero" => "4"
                        ]
                      ]
                      1 => array:1 [
                        "WWW" => array:1 [
                          "link" => "http&#58;&#47;&#47;www&#46;cochrane&#47;clsysrev"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              10 => array:3 [
                "identificador" => "bb0055"
                "etiqueta" => "11&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Guidelines for using the quantiferon-TB Test for diagnosing latent <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> infection"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:2 [
                              0 => "G&#46; Mazurek"
                              1 => "M&#46; Villarino"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:2 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "MMWR"
                          "fecha" => "2003"
                          "volumen" => "52"
                          "numero" => "No&#46; RR-2"
                          "paginaInicial" => "15"
                          "paginaFinal" => "19"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12583541"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                      1 => array:1 [
                        "WWW" => array:1 [
                          "link" => "http&#58;&#47;&#47;www&#46;cdc&#46;gov&#47;mmwr"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              11 => array:3 [
                "identificador" => "bb0060"
                "etiqueta" => "12&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Interferon gamma assays in the immunodiagnosis of tuberculosis&#58; a systematic review"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:2 [
                              0 => "M&#46; Pai"
                              1 => "L&#46; Riley"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1016/S1473-3099(04)01206-X"
                        "Revista" => array:6 [
                          "tituloSerie" => "Lancet"
                          "fecha" => "2004"
                          "volumen" => "4"
                          "paginaInicial" => "761"
                          "paginaFinal" => "775"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15567126"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              12 => array:3 [
                "identificador" => "bb0065"
                "etiqueta" => "13&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:1 [
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:2 [
                              0 => "L&#46; Reichman"
                              1 => "K&#46; Lambregts"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Libro" => array:3 [
                          "titulo" => "Guidelines for the diagnosis of latent tuberculosis infection for the 21st century"
                          "fecha" => "2004"
                          "editorial" => "New Jersey Medical Scholl&#46; National tuberculosis Center"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              13 => array:3 [
                "identificador" => "bb0070"
                "etiqueta" => "14&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Diagnosing latent tuberculosis infection&#46; Turning glitter to gold"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:1 [
                              0 => "P&#46; Barnes"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/rccm.2404004"
                        "Revista" => array:6 [
                          "tituloSerie" => "Am J Respir Crit Care Med"
                          "fecha" => "2004"
                          "volumen" => "170"
                          "paginaInicial" => "5"
                          "paginaFinal" => "6"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15220119"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              14 => array:3 [
                "identificador" => "bb0075"
                "etiqueta" => "15&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Comparison of T-cell-based assay with tuberculin skin test for diagnosis of Mycobacterium infection in a school tuberculosis outbreak"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:2 [
                              0 => "K&#46; Ewer"
                              1 => "J&#46; Deeks"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1016/S0140-6736(03)12950-9"
                        "Revista" => array:6 [
                          "tituloSerie" => "Lancet"
                          "fecha" => "2005"
                          "volumen" => "361"
                          "paginaInicial" => "1168"
                          "paginaFinal" => "1173"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12686038"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              15 => array:3 [
                "identificador" => "bb0080"
                "etiqueta" => "16&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "<span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> infection in health care workers in rural India&#58; comparison of a whole-blood interferon gamma assay with tuberculin skin testing"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:2 [
                              0 => "P&#46; Gokhale"
                              1 => "J&#46; Dogra"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1001/jama.293.22.2746"
                        "Revista" => array:7 [
                          "tituloSerie" => "JAMA"
                          "fecha" => "2005"
                          "volumen" => "293"
                          "numero" => "22"
                          "paginaInicial" => "2746"
                          "paginaFinal" => "2747"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15941804"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              16 => array:3 [
                "identificador" => "bb0085"
                "etiqueta" => "17&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Discrepancy between the tuberculin skin test and the whole-blood interferon gamma assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden country"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:2 [
                              0 => "Y&#46;A&#46; Kang"
                              1 => "H&#46; Lee"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1001/jama.293.22.2785"
                        "Revista" => array:7 [
                          "tituloSerie" => "JAMA"
                          "fecha" => "2005"
                          "volumen" => "293"
                          "numero" => "22"
                          "paginaInicial" => "2785"
                          "paginaFinal" => "2787"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15941809"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              17 => array:3 [
                "identificador" => "bb0090"
                "etiqueta" => "18&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "<span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> infection in health care workers in rural India&#46; Comparison of a whole blood interferon gamma assay with tuberculin skin testing"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:1 [
                              0 => "M&#46; Pai"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1001/jama.293.22.2746"
                        "Revista" => array:7 [
                          "tituloSerie" => "JAMA"
                          "fecha" => "2005"
                          "volumen" => "293"
                          "numero" => "22"
                          "paginaInicial" => "2746"
                          "paginaFinal" => "2755"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15941804"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              18 => array:3 [
                "identificador" => "bb0095"
                "etiqueta" => "19&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Interferon assays for tuberculosis&#46; Is anergy the Achiles&#39;heel&#63;"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:1 [
                              0 => "M&#46; Pai"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/rccm.2506003"
                        "Revista" => array:6 [
                          "tituloSerie" => "Am J Resp Crit Care Med"
                          "fecha" => "2005"
                          "volumen" => "172"
                          "paginaInicial" => "519"
                          "paginaFinal" => "520"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16120714"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              19 => array:3 [
                "identificador" => "bb0100"
                "etiqueta" => "20&#46;"
                "referencia" => array:1 [
                  0 => array:1 [
                    "referenciaCompleta" => "Ridzon R&#46; Optimal latent TB control methods&#46; Int J Tuberc Lung Dis 9 &#40;3&#41;&#58;236"
                  ]
                ]
              ]
              20 => array:3 [
                "identificador" => "bb0105"
                "etiqueta" => "21&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "T cell-based diagnosis of childhood tuberculosis infection"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:2 [
                              0 => "A&#46; Lalvani"
                              1 => "K&#46;A&#46; Millington"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1097/QCO.0b013e32813e3fd8"
                        "Revista" => array:7 [
                          "tituloSerie" => "Curr Opin Infect Dis"
                          "fecha" => "2007"
                          "volumen" => "20"
                          "numero" => "3"
                          "paginaInicial" => "264"
                          "paginaFinal" => "271"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17471036"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              21 => array:3 [
                "identificador" => "bb0110"
                "etiqueta" => "22&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Preparation of purified tuberculin RT-23"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:2 [
                              0 => "M&#46; Magnusson"
                              1 => "M&#46;W&#46; Bentzon"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:6 [
                          "tituloSerie" => "Bull WHO"
                          "fecha" => "1958"
                          "volumen" => "19"
                          "paginaInicial" => "829"
                          "paginaFinal" => "843"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13618721"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              22 => array:3 [
                "identificador" => "bb0115"
                "etiqueta" => "23&#46;"
                "referencia" => array:1 [
                  0 => array:1 [
                    "referenciaCompleta" => "World Health Organization&#46; The WHO standard tuberculin test&#46; WHO&#47;TB&#47;Technical Guide&#47;3&#46;22 February 1963&#46;"
                  ]
                ]
              ]
              23 => array:3 [
                "identificador" => "bb0120"
                "etiqueta" => "24&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Practical problems of tuberculin test"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:2 [
                              0 => "P&#46;D&#46;O&#46; Davies"
                              1 => "A&#46;G&#46; Leitch"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "LibroEditado" => array:4 [
                          "titulo" => "Clinical Tuberculosis"
                          "paginaInicial" => "345"
                          "paginaFinal" => "349"
                          "serieFecha" => "1944"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              24 => array:3 [
                "identificador" => "bb0125"
                "etiqueta" => "25&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Guidelines for conducting tuberculin skin test surveys in high prevalence countries"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:4 [
                              0 => "T&#46; Arnadottir"
                              1 => "H&#46;L&#46; Rieder"
                              2 => "A&#46; Trebucq"
                              3 => "H&#46;T&#46; Waller"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:6 [
                          "tituloSerie" => "Tubercle Lung Dis"
                          "fecha" => "1996"
                          "volumen" => "77"
                          "numero" => "Suppl"
                          "paginaInicial" => "1"
                          "paginaFinal" => "20"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              25 => array:3 [
                "identificador" => "bb0130"
                "etiqueta" => "26&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Interpretation of the tuberculin skin test"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:3 [
                              0 => "D&#46;N&#46; Rose"
                              1 => "C&#46;B&#46; Schechter"
                              2 => "J&#46;J&#46; Adler"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "J Gen Intern Med"
                          "fecha" => "1995"
                          "volumen" => "10"
                          "numero" => "11"
                          "paginaInicial" => "635"
                          "paginaFinal" => "642"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8583267"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              26 => array:3 [
                "identificador" => "bb0135"
                "etiqueta" => "27&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Diagnostic utility of BCG test in children"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:4 [
                              0 => "R&#46;K&#46; Kapoor"
                              1 => "I&#46; Wakhlu"
                              2 => "P&#46;K&#46; Gupta"
                              3 => "P&#46;N&#46; Saksena"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:5 [
                          "tituloSerie" => "J Indian Medical Ass"
                          "fecha" => "1982"
                          "volumen" => "78"
                          "paginaInicial" => "177"
                          "paginaFinal" => "180"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              27 => array:3 [
                "identificador" => "bb0140"
                "etiqueta" => "28&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Diagnostic value of BCG test in childhood tuberculosis"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:3 [
                              0 => "N&#46;R&#46; Bhandari"
                              1 => "S&#46;S&#46; Bhambal"
                              2 => "V&#46; Beohar"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:6 [
                          "tituloSerie" => "Indian Pediatrics"
                          "fecha" => "1984"
                          "volumen" => "21"
                          "paginaInicial" => "555"
                          "paginaFinal" => "559"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6519783"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              28 => array:3 [
                "identificador" => "bb0145"
                "etiqueta" => "29&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "The prognosis of a positive tuberculin reaction in childhood and adolescence"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:3 [
                              0 => "G&#46;W&#46; Comstock"
                              1 => "V&#46;T&#46; Livesay"
                              2 => "S&#46;F&#46; Woolpert"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Am J Epidemiol"
                          "fecha" => "1974"
                          "volumen" => "99"
                          "numero" => "2"
                          "paginaInicial" => "131"
                          "paginaFinal" => "138"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4810628"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              29 => array:3 [
                "identificador" => "bb0150"
                "etiqueta" => "30&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Lifetime risks&#44; incubation period&#44; and serial interval of tuberculosis"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:2 [
                              0 => "E&#46; Vynnycky"
                              1 => "P&#46;E&#46; Fine"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Am J Epidemiol"
                          "fecha" => "2000"
                          "volumen" => "152"
                          "numero" => "3"
                          "paginaInicial" => "247"
                          "paginaFinal" => "263"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10933272"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              30 => array:3 [
                "identificador" => "bb0155"
                "etiqueta" => "31&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:8 [
                              0 => "P&#46;A&#46; Selwyn"
                              1 => "D&#46; Hartel"
                              2 => "V&#46;A&#46; Lewis"
                              3 => "E&#46;E&#46; Schoenbaum"
                              4 => "S&#46;H&#46; Vermund"
                              5 => "R&#46;S&#46; Klein"
                              6 => "A&#46;T&#46; Walker"
                              7 => "G&#46;H&#46; Friedland"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1056/NEJM198903023200901"
                        "Revista" => array:7 [
                          "tituloSerie" => "N Engl J Med"
                          "fecha" => "1989"
                          "volumen" => "320"
                          "numero" => "9"
                          "paginaInicial" => "545"
                          "paginaFinal" => "550"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2915665"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              31 => array:3 [
                "identificador" => "bb0160"
                "etiqueta" => "32&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "A prospective study of the risk of tuberculosis among HIV-infected patients"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:10 [
                              0 => "A&#46; Guelar"
                              1 => "J&#46;M&#46; Gatell"
                              2 => "J&#46; Verdejo"
                              3 => "D&#46; Podzamczer"
                              4 => "L&#46; Lozano"
                              5 => "E&#46; Aznar"
                              6 => "J&#46;M&#46; Miro"
                              7 => "J&#46; Mallolas"
                              8 => "L&#46; Zamora"
                              9 => "J&#46; Gonzalez"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Aids"
                          "fecha" => "1993"
                          "volumen" => "7"
                          "numero" => "10"
                          "paginaInicial" => "1345"
                          "paginaFinal" => "1349"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8267907"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              32 => array:3 [
                "identificador" => "bb0165"
                "etiqueta" => "33&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Risk factors for tuberculosis in HIV-infected persons&#46; A prospective cohort study&#46; The Gruppo Italiano di Studio Tubercolosi e AIDS &#40;GISTA&#41;"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:4 [
                              0 => "G&#46; Antonucci"
                              1 => "E&#46; Girardi"
                              2 => "M&#46;C&#46; Raviglione"
                              3 => "G&#46; Ippolito"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "JAMA"
                          "fecha" => "1995"
                          "volumen" => "274"
                          "numero" => "2"
                          "paginaInicial" => "143"
                          "paginaFinal" => "148"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7596002"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              33 => array:3 [
                "identificador" => "bb0170"
                "etiqueta" => "34&#46;"
                "referencia" => array:1 [
                  0 => array:1 [
                    "referenciaCompleta" => "Programa Nacional de Luta Contra a Tuberculose &#8211; Sistema de Vigil&#226;ncia &#40;SVIG-TB&#41;&#46; Ponto da situa&#231;&#227;o epidemiol&#243;gica e indicadores de desempenho&#46; Ano 2006 Direc&#231;&#227;o-Geral de Sa&#250;de&#46; Divis&#227;o de Doen&#231;as Transmiss&#237;veis"
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/08732159/0000001500000002/v1_201509151524/S087321591530132X/v1_201509151524/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "43356"
    "tipo" => "SECCION"
    "pt" => array:2 [
      "titulo" => "Artigos de revis&#227;o"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "pt"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001500000002/v1_201509151524/S087321591530132X/v1_201509151524/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087321591530132X?idApp=UINPBA00004E"
]
Share
Journal Information
Vol. 15. Issue 2.
Pages 295-304 (March - April 2009)
Share
Share
Download PDF
More article options
Vol. 15. Issue 2.
Pages 295-304 (March - April 2009)
Artigo de Revisão/Review Article
Open Access
Teste tuberculínico. Como optimizar?
Tuberculin skin test. How to optimise?
Visits
5188
Raquel Duarte1
1 Assistente Hospitalar de Pneumologia
This item has received

Under a Creative Commons license
Article information
Resumo

Os testes utilizados no diagnóstico de infecção latente pelo Mycobacterium tuberculosis, o teste tuberculínico e o doseamento do interferão gama (IGRA) identificam a existência de uma resposta imunológica adaptativa de memória contra os antigénios micobacterianos. Considerando as limitações dos dois testes, a melhor solução passa por tirar proveito das melhores características de cada um. A maior parte dos autores concorda com a utilização dos dois testes, utilizando os IGRA sobretudo na confirmação da positividade do teste tuberculínico (tirando proveito da sua maior especificidade).

As características operativas do teste tuberculínico dependem da prevalência da doença na comunidade e dos objectivos da sua realização (as suas características são superiores quando utilizada no âmbito de rastreio ou como teste diagnóstico). Para interpretar correctamente um teste tuberculínico, o clínico deve conhecer a epidemiologia da tuberculose na comunidade e definir correctamente as indicações para a sua realização.

Rev Port Pneumol 2009; XV (2): 295-304

Palavras-chave:
Tuberculose
teste tuberculínico
Mantoux
Abstract

The tests used in the diagnosis of tuberculosis latent infection, the tuberculin skin test (TST) and the interferon-gamma assays (IGRA), identify the existence of an adaptive immune response towards mycobacterial antigens. Considering the limitations of the two tests, the best solution is to take advantage of the best characteristics of each one. Most of the authors agree to the use of the two tests, using the IGRAS in the confirmation of a positive TST (because of its higher specificity). The operative characteristics of TST depend on the prevalence of the illness in the community and the aim of its use (its operative characteristics are higher when used in the tracing scope or as a diagnostic test). To interpret correctly a TST, the physician must know the epidemiology of tuberculosis in the community and correctly define the indications for its use.

Rev Port Pneumol 2009; XV (2): 295-304

Key-words:
Tuberculosis
tuberculin skin test
Mantoux
Full text is only aviable in PDF
Bibliografia
[1.]
P. Edwards, L. Edwards.
Story of the tuberculin test.
Am Rev of Resp Dis, 81 (1960), pp. 1-49
[2.]
ATS/CDCP (American Thoracic Society/Center for Dis Control, Prevention).
Targeted tuberculin testing and treatment of latent tuberculosis infection.
Am J Respir Crit Care Med, 161 (2000), pp. S221-S247
[3.]
J. Bass.
The tuberculin skin test.
Am Rev Resp Dis, 142 (1990), pp. 24-28
[4.]
J. Bass.
The tuberculin test.
Tuberculosis: a comprehensive international approach,
[5.]
Berkel GM, Cobelens FG, et al. Tuberculin skin test: Estimation of positive and negative predictive values from routine data. Int J Lung Dis 9 (3):310-316.CDC.
[6.]
MMWR Morb Mortal Wkly Rep 2000. Disponível em http://www.cdc.gov/mmwr.
[7.]
M.R. Reichler, R. Reves, S. Bur, V. Thompson, B.T. Mangura, J. Ford, S.E. Valway, I.M. Onorato.
Evaluation of investigations conducted to detect and prevent transmission of tuberculosis.
JAMA, 287 (2002), pp. 991-995
[8.]
Control and prevention of tuberculosis in the United Kingdom: code of practice 2000. Joint Tuberculosis Committee of the British Thoracic Society. Joint Tuberculosis Committee of the British Thoracic Society.
Thorax, 55 (2000), pp. 887-901
[9.]
Efficacy of various durations of isoniazid preventive therapy for tuberculosis: five years of follow-up in the IUAT trial. International Union Against Tuberculosis Committee on Prophylaxis.
Bull World Health Organ, 60 (1982), pp. 555-564
[10.]
S. Woldehanna, J. Volmink.
Treatment of latent tuberculosis infection in HIV infected persons.
The Cochrane Database System Rev, (2005),
[11.]
G. Mazurek, M. Villarino, et al.
Guidelines for using the quantiferon-TB Test for diagnosing latent Mycobacterium tuberculosis infection.
MMWR, 52 (2003), pp. 15-19
[12.]
M. Pai, L. Riley, et al.
Interferon gamma assays in the immunodiagnosis of tuberculosis: a systematic review.
[13.]
L. Reichman, K. Lambregts, et al.
Guidelines for the diagnosis of latent tuberculosis infection for the 21st century, New Jersey Medical Scholl. National tuberculosis Center, (2004),
[14.]
P. Barnes.
Diagnosing latent tuberculosis infection. Turning glitter to gold.
Am J Respir Crit Care Med, 170 (2004), pp. 5-6
[15.]
K. Ewer, J. Deeks, et al.
Comparison of T-cell-based assay with tuberculin skin test for diagnosis of Mycobacterium infection in a school tuberculosis outbreak.
Lancet, 361 (2005), pp. 1168-1173
[16.]
P. Gokhale, J. Dogra.
Mycobacterium tuberculosis infection in health care workers in rural India: comparison of a whole-blood interferon gamma assay with tuberculin skin testing.
JAMA, 293 (2005), pp. 2746-2747
[17.]
Y.A. Kang, H. Lee, et al.
Discrepancy between the tuberculin skin test and the whole-blood interferon gamma assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden country.
JAMA, 293 (2005), pp. 2785-2787
[18.]
M. Pai, et al.
Mycobacterium tuberculosis infection in health care workers in rural India. Comparison of a whole blood interferon gamma assay with tuberculin skin testing.
JAMA, 293 (2005), pp. 2746-2755
[19.]
M. Pai.
Interferon assays for tuberculosis. Is anergy the Achiles'heel?.
Am J Resp Crit Care Med, 172 (2005), pp. 519-520
[20.]
Ridzon R. Optimal latent TB control methods. Int J Tuberc Lung Dis 9 (3):236
[21.]
A. Lalvani, K.A. Millington.
T cell-based diagnosis of childhood tuberculosis infection.
Curr Opin Infect Dis, 20 (2007), pp. 264-271
[22.]
M. Magnusson, M.W. Bentzon.
Preparation of purified tuberculin RT-23.
Bull WHO, 19 (1958), pp. 829-843
[23.]
World Health Organization. The WHO standard tuberculin test. WHO/TB/Technical Guide/3.22 February 1963.
[24.]
P.D.O. Davies, A.G. Leitch.
Practical problems of tuberculin test.
Clinical Tuberculosis, pp. 345-349
[25.]
T. Arnadottir, H.L. Rieder, A. Trebucq, H.T. Waller.
Guidelines for conducting tuberculin skin test surveys in high prevalence countries.
Tubercle Lung Dis, 77 (1996), pp. 1-20
[26.]
D.N. Rose, C.B. Schechter, J.J. Adler.
Interpretation of the tuberculin skin test.
J Gen Intern Med, 10 (1995), pp. 635-642
[27.]
R.K. Kapoor, I. Wakhlu, P.K. Gupta, P.N. Saksena.
Diagnostic utility of BCG test in children.
J Indian Medical Ass, 78 (1982), pp. 177-180
[28.]
N.R. Bhandari, S.S. Bhambal, V. Beohar.
Diagnostic value of BCG test in childhood tuberculosis.
Indian Pediatrics, 21 (1984), pp. 555-559
[29.]
G.W. Comstock, V.T. Livesay, S.F. Woolpert.
The prognosis of a positive tuberculin reaction in childhood and adolescence.
Am J Epidemiol, 99 (1974), pp. 131-138
[30.]
E. Vynnycky, P.E. Fine.
Lifetime risks, incubation period, and serial interval of tuberculosis.
Am J Epidemiol, 152 (2000), pp. 247-263
[31.]
P.A. Selwyn, D. Hartel, V.A. Lewis, E.E. Schoenbaum, S.H. Vermund, R.S. Klein, A.T. Walker, G.H. Friedland.
A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection.
N Engl J Med, 320 (1989), pp. 545-550
[32.]
A. Guelar, J.M. Gatell, J. Verdejo, D. Podzamczer, L. Lozano, E. Aznar, J.M. Miro, J. Mallolas, L. Zamora, J. Gonzalez, et al.
A prospective study of the risk of tuberculosis among HIV-infected patients.
Aids, 7 (1993), pp. 1345-1349
[33.]
G. Antonucci, E. Girardi, M.C. Raviglione, G. Ippolito.
Risk factors for tuberculosis in HIV-infected persons. A prospective cohort study. The Gruppo Italiano di Studio Tubercolosi e AIDS (GISTA).
JAMA, 274 (1995), pp. 143-148
[34.]
Programa Nacional de Luta Contra a Tuberculose – Sistema de Vigilância (SVIG-TB). Ponto da situação epidemiológica e indicadores de desempenho. Ano 2006 Direcção-Geral de Saúde. Divisão de Doenças Transmissíveis
Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?