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L Trnka

Publications and source records attributed to L Trnka.

At least 55 records · Page 3Linked to original sources
PubMed1983

Tuberculosis register in the Czech Socialist Republic compared with similar registers in other European countries.

Computer technique in the Czech Socialist Republic, as well as in other countries, has been increasingly used for the evaluation of epidemiological situation of tuberculosis control programmes, and for the effectivity and impact of individual control measures. The notification system of new tuberculous cases detected has been switched in the Czech Socialist Republic into a longtime follow-up of all the patients reported for tuberculosis. In all the new or relapse cases the data on the form and location of disease, the mode of detection, time needed for diagnosis or possible delay in diagnosis due to patients or doctors are analyzed. At regular one-year intervals the data on the treatment and sick-leave are evaluated. The tuberculosis register was put into operation in the Czech Socialist Republic on January 1, 1981. The two-year experience revealed the possibility of operative registration of tuberculous patients if a reliable system of data collection from district departments tuberculosis and respiratory diseases and that of control programmes in a computer had been built up. The advantage of tuberculosis register consists in dynamic information on patients which is processed and published at one-month, three--month, or one-year intervals. The system of tuberculosis register in the Czech Socialist Republic is compared to the advantages and disadvantages of retrospective and prospective studies, one-phase or repeated surveys, and to registers operating in Denmark, Sweden, Finland, the Netherlands, Bavaria, and Scotland. The tuberculosis register in the Czech Socialist Republic is presently considered as an advantageous approach to the establishment of tuberculosis surveillance system.(ABSTRACT TRUNCATED AT 250 WORDS)

Czechoslovakia↗
PubMed1982

[Models of tuberculosis control in countries with low tuberculosis prevalence].

To rationalize tuberculosis control in countries with low tuberculosis prevalence it is necessary to evaluate continuously some control measures and to propose suitable modifications. For years Czechoslovakia is taking part in the international research of methods of tuberculosis control; in compliance with the results of these studies its programme of tuberculosis control is being modified. Decision processes are more difficult, when measures till now applied should be limited or given up. In such cases it is necessary to evaluate not only the efficiency of defined health measures but also their possibilities of application, acceptability and influence on the tuberculosis situation in all. For the choice of appropriate models of tuberculosis control the application of experience from other countries should be regarded. However sometimes it is not possible to use this experience in the own country because there are obvious differences in other conditions. Mathematical simulation models may by of good help in the decision process answering the purpose of discerning the effect of different variants of the control measure on the epidemiological trends. For this purpose reliable statistic data should be available. To get such information a central tuberculosis register was established on CSR gathering data on new cases of tuberculosis, on relapses, on the further development of the cases of tuberculosis registered and on data concerning the quality of case-finding, diagnostics and therapy.

Adult↗
PubMed1980

[Chemotherapy of tuberculosis and the immunomechanisms of the macroorganism. I. Inhibition of migration of leucocytes and the concentration of serum-immunoglobulin A in the phase of prime therapy of tuberculosis of the respiratory system (author's transl)].

The inhibition of migration of leucocytes (stimulated by PPD) and the concentration of serum-immunoglobulin A had been controlled in 50 patients with bacteriologically verified tuberculosis of the respiratory system. All patients showed a clear hypersensitivity of delayed type with inhibition of migration of leucocytes and high concentrations of serum IgA before the therapy run. In patients with effective therapy there resulted a decline of hypersensitivity of delayed type and of the concentration of IgA. All patients, who still had mycobacterium tuberculosae in the sputa in spite of a correct therapy for 3 months no changes of controlled parameters could be recognized. These results will be interpreted that the effect of an antimycobacterial therapy is accompanied by a clear decline of hypersensitivity of delayed type and parallel decline of protective immunity at least of humoral character, likely not very favourable for the patients.

Antitubercular Agents↗
PubMed1980

Reaction of mouse lung tissue on the experimental airborne Klebsiella pneumoniae infection.

There are described the histological changes in the lung tissue of mice after airborne infection with the strains of Klebsiella pneumoniae CNCTC Klp 80/66 and CNCTC 82/67 whose clearance is significantly different. Using the strain Klp 82/67, which is fairly prompt eliminated from lungs, no morphological changes in the mucous membrane of bronchi were found. Using the strain Klp 80/66, which is characterised by a multiplication of organisms in the lungs already in the initial phase of infection without any remarkable adaptative phase, the accumulation of neutrophils in the walls and on the surface of bronchi was observed. The accumulation retarded during 48 hours when mostly the mononuclear cells were present. Uptake of 3H-thymidine in the lung tissue in vivo demonstrated that the proliferation response of bronchial lymphoid tissue is a relatively early reaction. Histological examination of spontaneously died animals revealed the changes characteristic for the purulent bronchopneumonia. The pathogenic activity of various Klebsiella pneumoniae strains is obviously conditioned by at least two factors, i. e. by surface structures determining the rate of bacterial elimination from the lungs and by the lipoprotein components of the cell walls inducing the leucocytes mobilization into bronchial tissue.

Aerosols↗
PubMed1980

Tuberculosis register and surveillance system of tuberculosis in the Czech Socialist Republic.

The policy of tuberculosis control in the Czechoslovak Socialist Republic has proved effective during the past 20 years under unfavourable epidemiological conditions. At present, however, it ceased to meet the requirements of the changing tuberculosis epidemiological situation. On the basis of data obtained from long-term follow-up of epidemiological indices and longitudinal epidemiological studies there was prepared a new system of compulsory reports on tuberculosis cases, supplemented with continuous supervision of persons registered for tuberculosis, and a proposal of centralized processing of the collected data. Starting January 1, 1981 a register of tuberculosis is planned in the Czech Socialist Republic which will utilize modern computer methods for ensuring the following objectives: 1. to establish data for operative and complex evaluation of epidemiological situation on tuberculosis in districts, regions and the total of Czech Socialist Republic, 2. to provide conditions for assessment of effectivity of tuberculosis control methods, to collect and evaluate data on basic economic aspects of tuberculosis control, 4. in a national project to elaborate and propose essential measures for the surveillance of tuberculosis applicable to existing conditions within the Czechoslovak Socialist Republic. The organization of the proposed tuberculosis register is described.

Czechoslovakia↗
PubMed1980

Factors influencing the effects of the initial phase of tuberculosis chemotherapy.

Two groups of patients suffering from extensive pulmonary tuberculosis treated with daily or twice-weekly regimens of isoniazid (INH) plus rifampicin (RMP) plus ethambutol (EMB) were formed by random selection. The effectiveness of treatment was expressed by the slope of regression line calculated for each patient in terms of quantitative time dependent decrease of mycobacteria isolated by culture per 1 ml of sputum. Chemically serum concentrations of drugs in five time intervals following simultaneous administration were established. It was shown that the rate of decrease of mycobacteria did not significantly vary in the compared groups. Negativity was reached in 48 day on the average. The mean regression line with double standard deviation allocated patients with rapid, normal or slow sputum conversion. Rapid convertors were the youngest, excreted largest amounts of mycobacteria before the start of treatment, and their x-ray showed predominantly changes of exudative character. Slow convertors excreted least amounts of mycobacteria. In the group of slow convetors with daily regimen was significantly higher number of rapid INH inactivators compared with groups of rapid and normal convertors. Analysis of multiple correlation and variance of the ratio of mycobacterial decrease rate and of the parameters of the biological availability of drugs as expressed by the area under the curve of drug serum levels reveal the rate of mycobacterial decrease to be dependent always on the drug out of the combination. In daily regimen the decrease rate was controlled by INH, in the intermittent regimen by RMP. The speed of negativization could therefore be increased in daily regimen by increased doses of INH, chiefly in rapid INH inactivators. The most important share of RMP in the mycobacterial decrease rate during intermittent administration can be judged from dependence of biological availability on the dose of RMP. Under the experimental circumstances of this study the pharmacological means for speeding up negativization were best utilized. Further shortening of time necessary for obtaining negativity would be practicable only when residual factors are involved presumably existing beyond the region of pathogen and drug relationship.

Adult↗
PubMed1980

The position of pneumology and physiology in the health care system of the Czechoslovak Socialist Republic.

The medical specialization of "phtisiology" was extended to the specialization of "tuberculosis and respiratory diseases" (corresponding to the demonination of "pneumology and phtisiology") in the Czechoslovak Socialist Republic in 1966. This branch is an additional specialization of the basic internal medicine. It provides preventive as well curative care for population of all age groups, as far as tuberculosis and increased risk of tuberculosis are concerned. This medical branch covers persons with non-tuberculous diseases of the respiratory system aged 18 years and over, especially cases having tendency to deterioration, those with complicated course or functional disorders. Comparison of statistical data on activities of phtisiologic institutions in 1965 and institutions for tuberculosis and respiratory diseases in 1978 (see table 1) reveal the following information: --BCG vaccination of newborns exceeded in both years 98%. --Utilization of radiophotography for screening of selected groups with increased risk of tuberculosis or malignant respiratory tumours or for examination of patients with symptoms has been increasing. --Number of beds decreased by 35%, but at the same time the number of cases hospitalized increased by 36%. The average duration of treatment of tuberculous patients was shortened and proportion of persons hospitalized for non-tuberculous respiratory diseases increased.

Adolescent↗
PubMed1979

Direct migration inhibition test with leukocytes as indicator of mycobacterial antigens in the human body.

In 32 patients with newly detected pulmonary tuberculosis positive on smear and culture, included in a controlled clinical trial, a significant correlation between diminishing inhibition of leukocyte migration (induced by PPD) and reduction of mycobacterial population in the sputum during the course of chemotherapy has been demonstrated. The changes of mycobacterial population in the host have been assessed in two ways: an indirect assessment was made from the time taken to achieve sputum smear and culture negativity; a direct assessment was based on repeated quantitative determinations of tubercle bacilli in the sputum. The direct migration inhibition test with peripheral buff-coated leukocytes, is an easy and reliable correlate of delayed hypersensitivity to mycobacterial antigens in the human body. It is suggested that its use in individual patients could indicate changes in mycobacterial population, particularly after microbiological negativity has been obtained, and thus could be helpful in estimating the optimum duration of chemotherapy.

Antigens, Bacterial↗
PubMed1979

Immunoprofile studies in patients with pulmonary tuberculosis. II. Correlation of levels of different classes of immunoglobulins and specific antibodies with the extent of tuberculosis.

Humoral immune response of patients with newly detected, bacteriologically confirmed pulmonary tuberculosis was determined prior to initiation of chemotherapy. Correlation with the extent of the disease was studied. A significant rise in the IgA and IgG levels in the serum was observed, the increase in the IgA levels correlated with the extent of the disease. In tuberculous patients elevated levels of anti-OT (ppd) antibodies were found by haemaggluination, but no marked correlation was observed with the extent of the disease. There was no interrelationship between the IgA or IgG increase and that of specific anti-OT (PPD) antibodies. The importance of the mentioned findings is discussed.

Antibodies, Bacterial↗
PubMed1979

Immunoprofile studies in patients with pulmonary tuberculosis. I. Correlation of pretherapy cellular tests with characteristics of the disease.

Cell immunity profiles were determined in 46 patients with previously untreated pulmonary tuberculosis, confirmed bacteriologically, and in 21 blood donors. Evaluations were made of T-lymphocytes, blastic transformation of lymphocytes after stimulation with phytohaemagglutinin or tuberculoprotein, and migration inhibition of blood leukocytes stimulated by tuberculo-protein. The average proportion of T-lymphocytes in the peripheral blood was significantly diminished in the group of tuberculous patients, and the intensity of the decline correlated both with age and extent of the disease. Similarly, migration of leukocytes in tuberculous patients was, in the presence of tuberculoprotein, markedly inhibited. The inhibition was correlated to the extent of the disease, expressed as the number of bacilli excreted. It can be concluded that, despite the depression of immunocompetent cells, active daughter clones under the influence of a specific antigen are capable of producing a factor conditioning migration inhibition.

Adolescent↗