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[Ganglionic mediastinal tuberculosis with severe tracheal stenosis].
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[Clinical value of detection of L forms of Mycobacterium tuberculosis in patients with residual tuberculous changes in the lungs].
To clarify the role of M. tuberculosis L-form in a recurring tuberculous process in subjects with residual tuberculous changes in the lungs, microbiological, ++clinico-roentgenological and laboratory examinations of 1651 persons recorded as having VIIA, VIIB, III and 0 groups were undertaken. The causative agent of tuberculosis was isolated in a typical bacillary and L-transformed forms in 3.1 and 5.0% of the screened persons, respectively. Active respiratory tuberculosis was diagnosed in 64.7% of sputum-positive patients, including 86.3% of them as bacillary carriers and 42.7% of those excreting L-forms of the tuberculosis agent. The detection of biologically altered forms of the causative agent indicates a potential activity of the process and requires an intensified medical examination control and differential prevention activities.
[Clinical manifestations of tuberculosis in children and adolescents].
Clinical manifestations of tuberculosis in children and adolescents living in the Tumen region during 1984-1989 are analysed. Out of 432 of the patients, local forms of tuberculous infection were detected in 79.4% and pneumonia in 4.4% of the cases, while all the rest children proved to be just infected. The most prevailing among the pulmonary forms of the disease was intrathoracic lymphatic tuberculosis (52.3%) and among the non-pulmonary ones--tuberculous meningitis (3.5%). A complicated course of a tuberculous process was registered in 37.3% of the cases, especially in 2/3 of the patients with intrathoracic lymphatic tuberculosis (mainly of a bronchial type) as a consequence, in a number of cases, of the absence of BCG vaccination and the presence of tuberculous contact. Bronchoscopy undertaken in 244 children and adolescents made it possible to discover active changes in the bronchial mucosa in the first 1-2 months of therapy.
[Results of ambulatory observation of patients registered as group O in an anti-tuberculosis dispensary].
414 patients registered under O-group, 149-under VIIB and 129-under IA were observed by the antituberculosis dispensary of Alma-Ata. The minor differences detected in the clinical symptomatology of these patients did not allow one to decide how the process was proceeding in a specific case. The results showed that it was advisable to enroll++ subjects not with focal, but with cirrhotic and disseminated processes, tuberculomas and intrathoracic lymphatic tuberculosis into the O-group. The presence of X-ray archiv does not rule the necessity of following-up in this group in some cases. The process activity in the O-group can be defined by such methods, as bacillary excretion test and study of X-ray dynamics in the presence of challenge therapy, while in cirrhoses and intrathoracic lymphatic tuberculosis, only bacillary excretion test can be done. The outcomes of observation, in addition traditional ones (transfer to IA and VIIB groups), may lead to the transfer to VIIA group and striking off the register of the antituberculosis dispensary. Direct and indirect economic impact of the observation in the O-group of the dispensary registration was estimated.
Multi-organ involvement of tuberculosis--case report of an atypical presentation.
A case involving tuberculosis of multiple organs and mimicking carcinoma in several respects is presented.
[Echography in tuberculosis of the full abdominal viscera].
109 cases of abdominal tuberculosis are reported and sonographic data are described in 25 cases with renal lesions, 30 cases with ganglionic lesions, 8 cases with hepatic lesions and 6 cases with splenic lesions. The lesions are not specific.
[A case of a generalized form of primary tuberculosis in a 3-year-old child].
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[Tuberculosis in tropical Africa. Tuberculosis primary infection: some clinical aspects in tropical Africa].
A review of 140 cases of tuberculous patent primary infections from the hospital of Abidjan University and from an antituberculous unit. The disease begins slowly, general condition is rapidly altered, ventilation troubles are very frequent and so are complications as meningitis and miliary dissemination. In 11,4 p. cent of the cases, measles occurred before the primo-infection. In 38 p. cent of the cases the source of contamination could be identified and in one out of two cases, the mother proved to be responsible for it.
[Effectiveness of intratracheal administration of contrykal in combined treatment of children with intrathoracic tuberculosis complicated by endobronchial pathology].
Local balance in the system of proteinases-inhibitors in bronchial secretion was studied in 97 children with intrathoracic tuberculosis involving the bronchial tree by activity of trypsin-like proteinases (TLP), free antitryptic activity (ATA) and total content of locally synthesized low molecular acid resisting proteinase inhibitors (ARI). In the children with endobronchial pathology there was observed imbalance in the system evident from increasing activity of TLP and simultaneous decreasing of ATA and the content of ARI. The maximum inhibition of ARI local secretion and increasing of the TLP activity were stated in the patients with purulent and specific endobronchitis. In the children with catarrhal endobronchitis the shifts were moderate. Local use of contrykal in the form of ultrasonic inhalations in complex therapy of tuberculosis promoted in short periods reduction of the inhibitory potential, a 2-fold decrease in the terms of clinical recovery from endobronchitis and a decrease in the frequency of marked fibrous lesions in the bronchi and lungs as compared to analogous patients in the control group treated without the use of the proteinase inhibitor.
[The endoscopic bronchial picture of patients with pulmonary tuberculosis of various age groups].
Endoscopic pictures of the bronchi were studied in 509 new cases of pulmonary tuberculosis. Tuberculosis of the bronchi and its aftereffects such as cicatricial lesions were detected in 31.1 per cent of the children and adolescents, 7.9 per cent of the adults at the age of 18 to 29 years, 9.0 per cent of the adults at the age of 30 to 55 years and 14.7 per cent of the adults at the age of 56 to 75 years. Nonspecific endobronchitis was diagnosed in 27.9 per cent of the children and adolescents, 44.9 per cent of the adults at the age of 18 to 29 years, 46.3 per cent at the age of 30 to 55 years and 44.1 per cent at the age of 56 to 75 years. The incidence and nature of tuberculosis of the bronchi and nonspecific endobronchitis were not related to the patients' age.
[Work capacity of patients with sarcoidosis of the respiratory organs].
The results of examination of 92 patients with sarcoidosis of the respiratory organs by a medical and labor examination commission were analyzed and it was shown that the majority of the patients (85.9 per cent) had no signs of permanent loss of the working ability. However, shortcomings in the work on diagnosing the disease resulted in late hormonal therapy of the patients and brought difficulties in drawing the conclusion on their working ability since the positive time course of pulmonary lesions was not sufficient because of short-term hormonal therapy. Permanent loss of the working ability resulted from progressing and generalized sarcoidosis, pronounced functional impairment of the cardiopulmonary system and unfavourable labor conditions.
[Health care channels for new cases of respiratory tuberculosis in Seine Saint-Denis in 1984-1986].
The purpose of this study was to observe routine practice in the care of tuberculosis cases treated in the Seine Saint-Denis department in 1984, with reference to the recent recommendations of the French Pneumology Society. The pathway of each patient through the care network was established for 336 adult cases being treated for respiratory tuberculosis for the first time. The social and economic cost of each pathway was evaluated. The results show the multiplicity of health services intervening in the care of these patients, the persistence of hospitalization, sanatorium care, and long sick-leaves from work, together with major differences in the care pathways according to the nationality, sex, and socio-economic group of the patients. The cost of tuberculosis treatment is shown to be high for both patients and the community.
Tubercular cold abscess over the manubrium sterni.
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The frequency of unsuspected tuberculosis found post-mortem in a geriatric population.
Over a period of 14.5 years, 1911 complete autopsies were performed consecutively in two divisions of the same University Department of Geriatric Care, i.e., the Geriatric Hospital and the Center for Continuous Care. Sixty cases of active tuberculosis were observed, of which 37 cases (mean age of 84.51 years) had been clinically undiagnosed. Comparison with other published series indicate that the risk of unsuspected active (in fact, reactivated) tuberculosis mainly concerns "high age". The conditions which favor the disease are mainly in the context of immunodeficiency. Those which hinder the diagnosis are various, e.g., non-indicative tuberculin test, frequent impossibility to perform eye fundus examination or more aggressive investigations, frequency of cancer, and frequency of dementia in elderly people.
[The dynamics of the bronchial system lesions in patients with pulmonary tuberculosis].
The state of the bronchial system was examined in 1066 patients within the period of 1964 to 1984. Infiltrative tuberculosis of the lungs predominated in the patients. There was a high incidence (30.1 per cent) of specific affections of the bronchial system complicating infiltrative tuberculosis. Within the last decade the incidence of tuberculosis of the bronchi complicating disseminated tuberculosis has markedly lowered. The incidence of newly detected inactive posttuberculous lesions on the bronchial mucosa and nonspecific endobronchitis increased.
[Tuberculosis in current clinical otorhinolaryngology].
39 cases of ENT tuberculosis diagnosed in the last 15 years are studied. We review the annual incidence, the distribution by age and sex and the different found localization: oropharyngeal, laryngeal cervical ganglionar, salivary and otical ones. We analyse the concomitance with tuberculous pulmonary lesions and the results of diagnostic explorations: Mantoux, bacilloscopy and biopsy. We discuss the method, diagnostic difficulties, therapeutic behaviour and the consequences of misdiagnosis.
[Local cellular protection in patients with various forms of pulmonary tuberculosis].
To study the cellular component of local immune defence, bronchoalveolar lavage fluid (BALF) was examined in 69 patients: 24 children and adolescents with primary tuberculosis and 45 patients with secondary patterns of tuberculosis complicated by catarrhal and purulent endobronchitis. With no appreciable lesions in the bronchial mucosa the cellular composition of BALF and functions of alveolar macrophages (AM) in patients with primary tuberculosis are determined by the phase of specific process. In secondary tuberculosis associated with endobronchitis, the cellular composition of BALF is mainly determined by the character of bronchial pathology whereas AM function by the patterns of both specific and nonspecific processes.