En revisión.

1. TUBERCULOSIS AGUSTIN VEGA VERA. MD [email_address]

2. pptPlex Section Divider [IMPORTANCIA TB] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

4. MUERTE ANUAL POR TB Deaths in millions Adapted from: Pilheu Int J Tuberc Lung Dis; 1999, 2:696 Discovery of TB Bacillus 1882 Sanatoria Movement Starts 1900 Discovery of First TB Drug 1945 WHO Declares Global Emergency 1993 The “Second” Epidemic Asia + Africa The “First” Epidemic Europe and Americas Do we have the tools we need to avert this?

5. Muertes causadas por enfermedades infecciosas en paises en desarrollo (1990 a 2020) Fuente: Banco Mundial, 1997 30% associado a TB TB 51.4% Inf. Respiratórias 10.0% HIV 8.6% Malaria 6.4% Otras 23.5% TB 54.7% Inf. Respiratórias 2.6% HIV 37.1% Malaria 1.3% Otras 4.4% 1990 2020

6. Principales 15 enfermedades por carga de enfermedad en el mundo. 1990-2020 (medida como años de vida perdido por incapacidad) 1990 2020 enfermedad enfermedad Infección de vias aereas inferiores1 Enfermedad diarreíca 2 Complicaciones perinatales 3 Depresión unipolar 4 Enfermedad cardiaca isquémica 5 Enfermedad cerebro vascular 6 TUBERCULOSIS 7 Sarampión 8 Accidentes de Tránsito 9 Anormalidades Congênitas 10 Malaria 11 E P O C 12 Quedas 13 Anemia ferropénica 14 Desnutrición proteíco-Calórica 15 16 17 19 28 33 1 Enfermedad cardiaca isquémica 2 Depresión unipolar 3 Accidentes Tránsito 4 E C V 5 EPOC 6 Infecciones de Vias Aéreas Inferiores 7 Tuberculosis 8 Guerras 9 Enfermedad Diarreica 10 HIV 11 Complicaciones Perinatales 12 Violência 13 Anormalidades Congênitas 14 Suicídio 15 Câncer de traquéa, Brônquios y Pulmón 19 24 25 37 39 Fuente: Banco Mundial, 1997

7. Epidemia poblacional en el area Urbana de VIH y tuberculosis HIV MDR Hospitales Prisiones TUBERCULOSIS

14. pptPlex Section Divider [Historia natural TB] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

17. pptPlex Section Divider [FISIOPATOLOGIA] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

18. TB. SUSCEPTIBILIDAD.

21. pptPlex Section Divider [TB / VIH]. SUSCEPTIBILIDAD. The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

24. pptPlex Section Divider [RESPUESTA INMUNE] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

26. pptPlex Section Divider [PROBLEMA CONTACTOS CON PACIENTES TUBERCULOSOS] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

29. pptPlex Section Divider [Ag RD1] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

31. INF γ

39. pptPlex Section Divider [PPD] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

40. Indicaciones de PPD

43. pptPlex Section Divider [DIAGNOSTICO] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

44. pptPlex Section Divider [CASO CLINICO] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

49. Describa los hallazgos radiográficos

55. pptPlex Section Divider [TRATAMIENTO] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

59. EVALUACION DE METAS CURAR EL 85% DE LOS CASOS NUEVOS BK POSITIVOS

66. Dr. Selman A. Wasksman - Descubrió la ESTREPTOMICINA en 1943 - Junto con su ayudante A. Schatz en el laboratotro

72. CATEGORIA I

73. CATEGORIA II.

77. pptPlex Section Divider [Impacto Calidad de tratamiento anti TB] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

78. Impacto de la Calidad del Tratamiento en las Tasas de Curacion 98% 64% 32% 20% 18% 50% 10% Dead Sputum negative Sputum positive No Tratamiento Mal Tratamiento Buen Tratamiento 0.8% 1.2% Gryzbowski S. BIUAT1978;53

79. pptPlex Section Divider [Toxicidad tratamiento] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

85. pptPlex Section Divider [RESISTENCIA TB MDR TB XDR] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

86. Atenuada Antecedente Genético Fenotipo mutador Fase Drogo suceptible Exposicion a Antibioticos INH-Mono MDR-Resistencia Mutacion Compensatoria Exposicion al Medio ambiente Patogenia Restaurada Linea de base Patogenicidad Patogenicidad Aumentada Historia Natural de la Adquisicion de Farmacorresistencia (Modelo)

87. Mycobacterium tuberculosis Resistencia genética Resistencia adquirida Resistencia primaria INH 1 en 10 5-6 RIF 1 en 10 7-8 SM 1 en 10 5-6 EMB 1 en 10 5-6 PZA 1 en 10 2-4 ? SELECCIÓN Terapia inadecuada Abandono TRANSMISIÓN Demoras diagnósticas Tratamiento inadecuado

88. pptPlex Section Divider [Qué explica la resistencia?] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

91. pptPlex Section Divider [Grupo de estudio TB SANTANDER] The slides after this divider will be grouped into a section and given the label you type above. Feel free to move this slide to any position in the deck.

92. [email_address]