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At least 847 records · Page 47Linked to original sources
PubMed2003

[Treatment of acute pyopneumothorax during the tuberculosis epidemic].

Pathogenetical mechanisms of pyopneumothorax formation that cause hypoxia--hypoxemia, decreased cardiovascular function and intoxication have been described. The existing approach leads to the progression of disease, and the majority of patients die within the next 1.5-2 years. The immediate surgery (step-by-step thoracoplasty with modelling of parietal pleura on the terms of pneumoperitoneum) were suggested. Positive statistical data are provided.

Disease Outbreaks↗
PubMed1997

[Surgery of thoracic and pulmonary tuberculosis and the sequelae of its treatment in adults].

Surgery for tuberculosis was the starting point for thoracic and cardiovascular surgery in the modern day, but its place was more and more restricted to the treatment of the disease. Excisions (lobectomies, pneumonectomies, segmentestomies) currently represent the majority of operations, after this come operations on the pleura (decortication) and rarely those on the thoracic wall (thoracoplasty, parietectomy). The indications for excision are principally encountered with disease of the parenchyma itself: progressive disease under treatment or with resistant tubercle bacilli, sequelae of parenchymal complications (infections, aspergilloma or haemoptysis) and certain forms of atypical mycobacteria, and also a small but significant group in which excisions are aimed at diagnosis. Sometimes excisions are associated by necessity with decortication for pleural disease which may or may not have originally been intended for the underlying parenchyma or the lesions may be the sequelae of previous complications of treatment such as collapse therapy. Occasionally surgery is indicated in the treatment of lymph node masses in the mediastinum which have not responded to antituberculous therapy and during the treatment bronchial complications have evolved or there have been other sequelae. As for the indications for surgery of the thoracic wall such as thoracoplasty, they appear more than ever obsolete and even if they are still used in certain complications of surgery, they have apart from a few exceptions, lost their original therapeutic role in tuberculosis. However, currently there is a recrudescence of tuberculosis favoured by certain socio-economic situations and strengthened by the appearance of TB cultures which are more and more resistant. The surgery of tuberculosis in its oldest forms (thoracoplasty and removal of cavities) can no longer be said to be the surgery of the past. They proved in the old days that they could cure. Surgery has once more its place in the therapeutic arsenal of new forms of the disease and indirectly in limiting the risk of spread it has a role to play in prevention.

Adult↗
PubMedDate not supplied

A five year analysis of death in accident and emergency room of a semi-urban hospital.

A 5 year retrospective survey of deaths at the Accident and Emergency Unit was carried out to determine the demographic pattern, causes and time spent before demise. There were 475 deaths, annual rate of 95 cases. Males in 279 (58.8%) and 186 females (41.2%), age ranged from 15-90 years, mean 44 SD +/- 21 years. Medical diseases in 354 (74.5%), trauma in 72 (15.2%) and surgical conditions 49 (10.3%) patients There were 135 (38%) cases of cardiovascular diseases and pulmonary diseases 115 (32.6%) patients. Tuberculosis and pneumonia were the most common of pulmonary conditions. Central nervous diseases and gastro-intestinal diseases in 46 (13%) and 40 (11.2) respectively, mainly infectious conditions. Road Traffic Accident caused death in 51 (70.5%), assaults in 8 (11.4%) cases, gunshot and poison 5 (6.8%) each, and snake bites in only 3 (4.5%) cases of trauma. Surgical acute abdomen with peritonitis occurred in 18 (36%) cases, pyomyositis with septicaemia in 7(133%), gastrointestinal bleeding 5 (10%) and burns in only 3 (6.7%) cases In conclusion, over two-thirds of deaths in accident and emergency unit were due to medical problems. The means of the age were in late thirties- mid forties, there was no significant difference in the mean age of those who died of medical, trauma and surgical problems. Trauma victims spent the shortest mean time in accident and emergency before death, the longest staying were the victims of medical diseases.

Adolescent↗
PubMed1989

Comparison of younger and elderly patients with pulmonary tuberculosis.

A comparison of the clinical features, predisposing factors, drug-induced adverse effects and diagnostic approach in pulmonary tuberculosis in 37 younger and 35 elderly men was carried out. Elderly patients had a higher number of underlying diseases, including cardiovascular diseases and hypertension, than younger patients. The classic symptoms and signs of tuberculosis, such as productive cough, fever and general fatigue, were observed in relatively high proportions of both patients, whereas weight loss (43 vs. 16%) and crackles in the lung fields (49 vs. 16%) were significantly higher in the elderly patients than the younger ones. As for roentgenographic abnormalities, a higher involvement of middle and lower lung fields was seen in the elderly patients than in the younger. Although leukocytosis was noted in a significantly lower proportion of the elderly patients, neutropenia due to drug treatment was significantly higher (23%) than in younger patients (5%). In a mass survey, the detection of pulmonary tuberculosis in elderly men was significantly lower (23%) than that in younger men (54%), suggesting that an extensive mass survey for pulmonary tuberculosis in elderly men should be done.

Adult↗
PubMedDate not supplied

Clinical features of pulmonary tuberculosis in young and elderly men.

A comparison of the clinical features, predisposing factors, side effects by antitubercular drugs and diagnostic procedures in pulmonary tuberculosis in 37 younger and 35 elderly men was carried out. Elderly patients had a higher number of underlying diseases including cardiovascular diseases and hypertension than younger patients. The classic symptoms and signs of tuberculosis, such as productive cough, fever and general fatigue, were observed in relatively high proportions of both patients, whereas weight loss (43% vs. 16%) and crackles in the lung fields (49% vs. 16%) were significantly higher in the elderly patients than the younger ones. As for roentgenographic abnormalities, a higher involvement of middle and lower lung fields was seen in the elderly patients than in the younger. Although leukocytosis was noted in a significantly lower proportion of the elderly patients, neutropenia due to drug treatment was significantly higher (23%) than in younger patients (5%). In a mass survey, the detection of pulmonary tuberculosis in elderly men was significantly lower (23%) than that in younger men (54%). Although improved living conditions, better sanitation and the development of new chemotherapeutic agents have contributed to the decline of pulmonary tuberculosis in general populations, better procedures for early detection or diagnosis of pulmonary tuberculosis in the elderly people should be achieved as soon as possible.

Adult↗