Tuberculosis continues to be a major concern for health-care workers throughout the world. The numbers of tuberculosis cases have declined steadily in western and central Europe, North and South America, and the Middle East, and have increased in countries of the former Soviet Union and in sub-Saharan Africa. In the United States, there were a total of 14,871 tuberculosis cases (5.1/100,000 population) during 2003, representing a 1.9% decline in the rate from 2002. Tuberculosis rates have increased in certain states in the United States.
The incidence of smear-positive tuberculosis in Saudi Arabia was estimated to be 20 per 100,000 population. The incidence rates of culture-positive tuberculosis in our study per 100,000 populations were 5.2 in 1989, 3.5 in 1993, 11.1 in 1998, and 7.6 in 2003. Thus, the incidence of tuberculosis in the current study showed an increasing linear trend over the study period from 1989 to 2003 (x2 = 19.647, p = 0.0001).
From 1989 to 2003, a total of 279 distinct positive culture findings for M tuberculosis were identified. The annual incidence rates per 100,000 populations are shown in Figure 1. The incidence in 1989 was 5.2/100,000, decreased to 3.5/100,000 in 1993, increased to 11.1/100,000 in 1998, and reached 7.6/ 100,000 in 2003. An increasing trend in incidence rates of culture-positive 
The present study demonstrates that in a surgical population of patients undergoing CABG, the existence of preoperative NSTE-ACS is associated with a significantly higher mortality within 30 days and a higher incidence of major adverse cardiac events, such as PMI or LCOS, depending on the degree of preoperative cTnI serum elevation. Furthermore, a pre-CABG cTnI level could be shown to be used as an incremental prognostic variable in this patient cohort. cTnI serum levels were either stratified into three different groups or used as a continuous variable. Patients who had undergone isolated CABG with preoperatively low level (0.11 to 1.5 ng/mL) increased cTnI values were at a twofold elevated risk, and patients with conventional (> 1.5 ng/mL) elevated cTnI values had an over fourfold increased risk of dying in hospital. A preoperatively elevated cTnI serum level could be identified as an independent predictor of risk even after adjustment for other confounding risk factors in a multivariate logistic regression model. Therefore, the present study not only confirmed the observations of prior studies in selected patients but also extends them in some important ways: (1) not only the risk for in-hospital mortality, but also for postoperative MACE, such as PMI or LCOS, was shown to be increased with preoperatively elevated cTnI serum levels; (2) a preoperative cTnI threshold level for increased risk was identified; and (3) these observations were made in a large, more general population of CABG patients with preoperative NSTE-ACS.
Mycobacterium tuberculosis is a major cause of iVx morbidity and mortality throughout the world, The number of cases of tuberculosis showed an initial decline in the United States from 84,304 in 1953 to 22,201 in 1985. The number of reported cases of tuberculosis in the United States increased in 1992 by 18%. The reversal of the downward trend was due to multiple factors, including the AIDS epidemic and the emergence of drug resistance. Drug resistance of M tuberculosis also shows marked geographic variation from one country to the other and ranges from 0 to 18%.2 In Saudi Arabia, the pattern of resistance of M tuberculosis also shows marked regional variation. There is only one published study about the prevalence of drug resistance of 
From January 2001 to September 2004, preoperative cTnI was measured in 1,978 consecutive patients scheduled for isolated CABG. Preoperative cTnI values were available in 1,978 of 3,124 patients who fulfilled the inclusion criteria and in whom primary isolated CABG had been performed. Among these patients, negative preoperative cTnI levels ( 1.5 ng/mL) [Fig 1].
Risk stratification and outcomes research is an emerging issue in cardiovascular surgery and particularly in coronary artery bypass grafting (CABG) to predict morbidity and mortality as a measure of health-care performance. Although most risk scores give consistent predictions, the extent of acute preoperative myocardial injury in unstable coronary artery disease (CAD) ranging from microinfarctions due to preexisting microembolizing unstable plaques up to non-ST elevation acute coronary syndrome (NSTE-ACS) and ST-segment elevation myocardial infarction (STEMI) have not been considered adequately. Since the extent of myocardial necrosis has become an important determinant for the risk of death and adverse prognosis, it is important to develop simple noninvasive techniques to predict prognosis before cardiac surgery in order to initiate appropriate operative and perioperative treatment modalities offered by 
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