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PubMed2003

[Anesthesia in the pleuropulmonary complications surgery of tuberculosis: a 79 cases study].

Reported is a retrospective study carried out from Aristide Le Dantec Hospital in patients who underwent pleuropulmonary surgery after tuberculosis complication, from June 1995 to June 1999. The aim of this study was to evaluate the anaesthesiology procedures and outcomes of tuberculosis pleuropulmonary complications surgery. Seventy nine patients were studied. Their mean age was 34.63 years, and the sex ratio was 3.14. They all underwent general anaesthesia procedures with barbituric, morphinics et myorelaxants drugs. The peroperative complications noted were distributed as follow: 50 cases of haemorrhage needing transfusion, 18 cases of hypotension associated to the anaesthesia. In the intensive care period, we have noticed 30 atelectasia cases associated to a spastic bronchopathy, 3 cases of pulmonary oedema and 1 case of pulmonary infarctus. In the postoperative period, 8 cases of hemodynamic instability occurred, including 5 cases of cardiovascular collapsus treated by filling, and 2 septic shocks cases. An infectious bronchopneumopathy was noticed on 11 patients with two cases of septicaemia. The mortality rate was 6.3% (5 cases of death). The pleuropulmonary surgery in tuberculosis complication is very haemorrhagic, and therefore require an adequate preoperative preparation.

Adolescent↗
PubMed1992

[Analysis of the quality of clinical diagnosis based on autopsy data].

The material is based on the autopsy findings collected over 15 years (1975-1989). Findings related to 748 fatal outcomes were subjected to analysis in which 90 (12%) cases were misdiagnosed regarding the principal disease. A percentage of diagnostic errors with respect to tuberculosis was 1.8 on the whole and in the diagnosis of clinical forms and phases it was considerably higher-15.9 and 19.4, respectively. Hyperdiagnosis was typical of disseminated tuberculosis and caseous pneumonia, while hypodiagnosis--of primary, fibrocavernous tuberculosis and post-tuberculous changes. A percentage of hypodiagnosis in nontuberculous pathology varied from 12.5 to 50. Dynamic observation by the five-year plans demonstrated an increase in the percentage of misdiagnosis of the concurrent pathology and its decrease when the phase of a specific process was established. Purely medical errors accounted for 75% of misdiagnosis.

Adolescent↗
PubMed1994

Routine preoperative chest roentgenogram and its impact on intraoperative complications.

Routine preoperative chest X-rays and operative complications were studied in the patients at Songklanagarind Hospital from January 1990 to December 1991. Preoperative chest X-rays was performed in 9583 patients (87.5%). Only patients over 15 years old are included in our studies. Patients undergoing Caesarean section, cardiothoracic surgery and emergency patients were excluded. The studied population were 6347. Chest X-rays abnormalities were found in 9.8 percent of the investigated patients (625 from 6347). The percentage of patients with chest X-rays abnormalities increase 4 folds in patients in those with age group greater than 45 years when compared to the other young groups. The prevalence of tuberculosis in our patients was 1.2 per cent (76 over 6347). Age could be one of the important factors associated with the risk of intraoperative respiratory and cardiovascular complications. Chest X-rays abnormalities did not associated with respiratory complication. The risk of intraoperative cardiovascular complications (arrhythmia, hypertension and/or hypotension) increased in group with chest film abnormalities and age over 45 years. Chest X-rays investigation is not necessary for routine preoperative investigations in patients under 45 years except those with previous history of heart and lung diseases or clinical indications.

Adolescent↗
PubMed1997

[Surgical management of constrictive pericarditis].

Cases of constrictive pericarditis per a institute is few for decrease of this disease. Therefore for surgical management of constrictive pericarditis, it has not been clear whether cardiopulmonary bypass during operation is necessary or not, and the reports of long term results are few. We gathered information by questionnaires from thirty-four institutes, which constitute Tokai Cardiovascular Surgeons Conference in Shizuoka, Aichi, Mie and Gifu Prefecture, for surgical management of constrictive pericarditis, and investigated its results. Etiology of constrictive pericarditis is idiopathic (49%), tuberculosis (29%) or post open heart surgery (10%). Hospital death included operative death is 14%, and postoperative liver complications was many next to heart complications. The cases, whose NYHA functional class at discharge did not improve compared with preoperative state, was 33%. At one year after operation two third of them improved in NYHA functional class, but the others did not improved.

Adolescent↗
PubMed1992

[Central and peripheral hemodynamics in patients with tuberculous spondylitis and spinal cord disorders].

The results of study of central and peripheral hemodynamics in 79 tuberculosis spondylitis patients are presented. The rate and degree of central and peripheral hemodynamic disorders were dependent on the presence and severity of cerebrospinal disturbances. It is recommended that the body's integral rheography, rheovasography and thermovision be used as a diagnostic means for early detection of cardiovascular disorders as well as the determination of their manifestation degree and control of treatment effectiveness.

Adult↗
PubMed2006

Effect of antituberculosis treatment on cardiopulmonary responses to exercise in miliary tuberculosis.

BACKGROUND & OBJECTIVES: Tuberculosis (TB) is a major health problem in the developing world. In this preliminary study, we report the effect of antituberculosis treatment (ATT) on cardiopulmonary responses to exercise in patients with miliary tuberculosis (MTB). METHODS: The prospective study of cardiopulmonary responses to exercise in patients with MTB within one month of starting (n=14), on completion of ATT (n=7) and in 15 healthy subjects using the incremental exercise test was performed on a bicycle ergometer. RESULTS: In MTB patients, mean body mass index (BMI), exercise duration (3.1 vs 4.6 min), work load (63 vs 91.4 watts), resting tachycardia, tachypnoea and the mean oxygen saturation improved significantly (P<0.05) with ATT. Mean oxygen consumption (V . O(2)) at anaerobic threshold (546.7 vs 580.9 ml/min) and maximum exercise (1008.1 vs 1022 ml/min) were similar before and after ATT. In MTB patients, post-treatment mean body weight, BMI, resting heart rate, respiratory rate and oxygen saturation during maximum exercise were similar, but exercise duration (4.6 vs 6.2 min, P<0.05), work load (91.4 vs 145.5 watts, P<0.05), V . O(2) and oxygen pulse were significantly lower as compared to healthy subjects. INTERPRETATION & CONCLUSION: In MTB patients, though there was significant improvement in clinical parameters, functional abnormalities persisted on exercise testing after completion of ATT. As most patients with MTB are young and economically active, these observations obviously have long-term implications for these individuals.

Adult↗
PubMed1981

[Analysis of a series of 500 clinical post mortem studies. II. Basic diagnosis (author's transl)].

Anatomopathologic diagnosis were studied in a series of 500 clinical autopsies (440 adults and 9 children between 1 and 14 years old). Cancer was the most frequent cause of death (27.7%) followed by infectious processes (26.9%) divided between respiratory infections (14.3%), non-respiratory (8.8%) and tuberculosis (3.8%). Vascular disorders accounted for 25.2% and cirrhosis for 10.2%. The diagnosis of cancer were incorrect in 28.8%, of those, 16% were over-assessed and 12.8% under-assessed. Cancer was multiple in 2.7% of all cases, hepatic cancer was found in 17.6% of cirrhosis cases and in 11% of all cases, thromboembolism of different degree was seen.

Adolescent↗
PubMed1986

Medical problems in Ethiopian refugees airlifted to Israel: experience in 131 patients admitted to a general hospital.

Within a 2 month period 131 Ethiopian immigrants were admitted for treatment at a general hospital in Jerusalem. There were 52 patients with malaria, 13 with typhoid fever, 24 with pneumonia, seven with tuberculosis, nine with shigella and 11 with campylobacter. Over three-quarters of these patients were anaemic. In the majority of cases anaemia was normocytic and was most probably secondary to malaria and other intercurrent infections. The prevalence of diffuse non-toxic goitre was 7% in children and 19% in adults with a male to female ratio of 4:13. A positive rapid plasma reagin (RPR) test was found in 4% of sera tested and a positive HBsAg in 13%. IgG antibodies to HBc antigen were found in 75% of subjects. All patients with infectious diseases responded to therapy and, despite their poor condition at arrival, there were no fatalities and no late sequelae. The high HBsAg carrier state calls attention to the risk of vertical transmission by infected mothers and underlines the need for active immunization of infants at risk. The high prevalence of untreated tuberculosis and malaria poses a potential public health hazard, but with the current systematic screening of this population leading to identification and effective treatment of affected subjects, chances for the practical eradication of malaria and tuberculosis are excellent. Finally, the large scale transfer of a population from rural Africa to a modern and largely urban society presents a unique opportunity for a prospective study of the impact of environment on the emergence of diseases which plague modern society such as diabetes, atherosclerotic cardiovascular disease, hypertension and cancer.

Adolescent↗
PubMed2005

The double burden of communicable and non-communicable diseases in developing countries.

Now, at the dawn of the third millennium, non-communicable diseases are sweeping the entire globe. There is an increasing trend in developing countries, where the demographic and socio-economic transition imposes more constraints on dealing with the double burden of infectious and non-infectious diseases in a poor environment, characterized by ill-health systems. It is predicted that, by 2020, non-communicable diseases will cause seven out of every ten deaths in developing countries. Among non-communicable diseases, special attention is devoted to cardiovascular disease, diabetes, cancer and chronic pulmonary disease. The burden of these conditions affects countries worldwide but with a growing trend in developing countries. Preventative strategies must take into account the growing trend of risk factors correlated to these diseases. In parallel, despite the success of vaccination programmes for polio and some childhood diseases, other diseases like AIDS, tuberculosis, malaria and dengue are still out of control in many regions of the globe. This paper is a brief review of recent literature dealing with communicable and non-communicable diseases in developing countries. It gives a global view of the main diseases and their impact on populations living in low- and middle-income nations.

Cardiovascular Diseases↗
PubMed1988

Apartheid and health in the 1980s.

The last 5 years have seen dramatic developments in South Africa, with wide-based internal political struggles and international pressure forcing the government into a well publicized if temporary series of reforms. Yet this has not been paralleled by any substantial improvement in the health conditions of the majority of the population. Apart from improvements in black infant mortality in some urban areas, the health gap remains, a material expression of the social inequality that is part of the definition of apartheid. Black children continue to die from preventible afflictions at about 10 times the rate of their white counterparts. Maternal deaths among women classified as black, coloured or Asian continue to occur, mostly due to septic abortions. At national level, blacks are nearly 30 times more at risk of being diagnosed to have tuberculosis than whites, with some age groups being at still worse risk. Black children under the age of 4 years in Cape Town in 1984 were 205 times more likely to have tuberculosis than their white counterparts. The last 5 years has also seen a revival of rhetoric echoing the international support for primary health care in the 1970s, but health care processes have not been modified to cope with the continuing racial stratification of disease and access to health care. A move towards privatization of the health services has only benefited a few.

Black People↗
PubMed1989

[Mortality among patients with diabetes mellitus in Warsaw--a 10-year prospective study].

In the period 1973/74-1983 a prospective observation was carried out on 4591 out-patients (2095 males and 2496 females) aged 18-68, with predominantly non-insulin treated diabetes of 1-10 years' duration. During the ten years period over a third of initial cohort died. Age-standardized mortality rate was twice that for the general population of Warsaw for the median year 1978. The risk of death rose with decreasing age, especially in females. The most frequent causes of death were cardiovascular diseases, particularly coronary heart disease, standardized mortality ratios amounting to 2.7 and 2.4 respectively. Among diabetic cohort the risk of death was also higher for nephritis, nephrosis, cirrhosis of the liver and pneumonia. No excess death rate could be found for tuberculosis, malignant neoplasms, and diabetes itself. Diabetic patients were less frequently exposed to accidental deaths than the general population of Warsaw. The mortality diabetic patients in Warsaw was similar to that seen in most of the developed countries with the exception of the higher mortality due to cirrhosis of the liver and smaller due to accident, trauma and poisoning.

Adolescent↗