Background: Tuberculosis has re-emerged as an infectious threatening disease. Some challenges encountered with tuberculosis are predominantly due to the lack of understanding of the disease, the rapid mutating properties of the TB microorganism, and to the lack of standardized TB screening. While great progress was made in the early 1900’s towards the development of the tuberculine skin test (TST) and successful development of an effective vaccine; the problem with standardizing accepted screening practices remain.Purpose: The purpose of this descriptive, cross-sectional study was to identify current TB screening practice preferences and commonalities among health care practitioners (HCPs) and to evaluate the length of time that takes HCPs to provide medical clearance to patients who tested positive for TB using a TST for screening. Methods: There were 210 participants identified as HCPs actively involved in TB screening practices. They completed a sixteen questions questionnaire. Results: Physicians were significantly more actively involved in TB screening than non-physician providers, (OR: 3.696 7 CI 1.047-13.047, p=0.03). Non-physician providers were significantly more likely to use the two-step tuberculine skin test (TST) (OR: 3.57; CI: 1.35-9.38; p = 0.007) and single blood assay (OR: 2.86; CI: 1.80-7.48; p = 0.028) than physicians. Conclusions: The findings suggest that although much research has been done on TB screening, with the advent of numerous blood assays single TB screening test, most HCPs have been extremely cautious to adopt these new practices, and continue to rely on proven TB screening tests and practice methods that have been established for many decades. However, it does not indicate that there is a commonly accepted TB screening practice among practicing HCPs. On the contrary, the study supports the variation of TB screening styles currently in use.
Zogopoulos Panagiotis is a resident of Neurosurgery at the General Hospital of Nikaia-Piraeus “Agios Panteleimon”, Athens, Greece. He has received a 6-month advanced clinical training (clinical fellow) at the Neurosurgery Department of Osaka University Hospital in Japan. Several of his papers have been published in reputed peer-review journals and he has presented various researches in international conferences.
Low back pain is a common musculoskeletal disorder defined as pain, muscle tension or stiffness in the lumbosacral area of the spine. It results in high health costs and incapacity to work causing a significant socio-economic burden. The optimal management of non-specific chronic low back pain has yet to be determined. Recently, acupuncture for chronic low back pain in addition to routine care is receiving increased recognition and acceptance by both patients and physicians. Clinicians treating patients with chronic low back pain with acupuncture may elicit an immediate sense of calmness with subsequent well-being benefits for their patients. Apart from its analgesic effect acupuncture has been also shown to inexpensively improve functional outcome and quality of life and to be a safe and cost-effective treatment modality. In a meta-analysis of recently published clinical trials incorporating more than 10.000 patients with chronic pain, the analgesic efficacy of acupuncture compared to other treatment modalities was highly statistically significant (P< 0.001). Therefore, acupuncture should be a part of the armamentarium of every physician who treats patients with chronic low back pain.