Serum lipids in pulmonary tuberculosis patients with various types of diabetes mellitus

In 12 patients with pulmonary tuberculosis and in 14 with the disease concurrent with types I and II diabetes mellitus, a somatotype was determined and lipid metabolism was studied by the blood levels of various lipid fractions, by the fractional composition of lipoproteins and atherogenicity coefficient. Lipid metabolic changes in patients with tuberculosis and in those with the accompanied abnormality were not found to depend upon sex, age, somatotype and the type of tuberculosis, but are apparently related with the severity of tuberculous intoxication. In the concurrent disease, lipid metabolic changes depended on the type of diabetes.     

Prevalence of tuberculosis in Kishtwar Tehsil of Jammu region in Jammu and Kashmir State

A study of prevalence of tuberculosis in Kishtwar tehsil of Jammu region was conducted from June 1991 to May 1992. A total of one thousand two hundred ninety-eight rural as well as urban population suffering from various types of lung diseases was studied for prevalence of tuberculosis and a sizeable number (98) of patients were found to be positive of various types of tuberculosis, viz, pulmonary tuberculosis, tuberculous pleural effusion and miliary tuberculosis. Of the population studied 7.55% were found to be positive for tuberculosis and among them 88.76% patients were anaemic and the commonest type of anaemia was normocytic normochromic and normocytic hypochromic. The ESR was raised in almost of all the patients. Of the population, 80.61% were seen to be positive on skiagram chest and 58.16% were found to be positive on other diagnostic tests like Mantoux's tests, sputum for acid-fast bacilli, etc. Mantoux's test was positive in 27.55% cases and sputum was positive in 30.61% cases. All the cases studied were subjected to special investigations. The changes in parameters are consistent with the diagnosis of tuberculosis. Large family size, poverty, excessive smoking, illiteracy, etc, are the major contributing factors.     

Problems in the treatment of patients with pulmonary tuberculosis

The paper presents the current approaches to chemotherapy in patients with pulmonary tuberculosis and shows the main reasons that do not allow one to achieve high outcomes of treatment. These involve the drug resistance of Mycobacterium tuberculosis, the morphological features of a specific process in the lung, the higher incidence of acutely progressive types of pulmonary tuberculosis in particular; tuberculosis-contaminant diseases (diabetes mellitus, gastrointestinal, hepatic, renal diseases, and non-specific respiratory diseases, etc.). Recommendations how to eliminate the reasons for ineffective treatment of pulmonary tuberculosis are given.     

An islander with seizures

An audit of 690 cases of tuberculosis out of 46,276 patients seen during the last 25 years in a busy general practice is reported. Of the 690 cases, 67% were pulmonary, 33% extra-pulmonary TB. Modes of both types of tuberculosis are described and the reason for increased incidence of extra-pulmonary tuberculosis are discussed.     

Detection of pulmonary tuberculosis among the homeless at Moscow reception-distribution facilities

A total of 5532 homeless persons were examined. The affection with pulmonary tuberculosis was 10.9%. The disease was first detected in 2.53% of the examinees. Relatively curable types of pulmonary tuberculosis were encountered in 70.2% of patients. A system of social and antituberculous measures should be set up for this population group.     

Para-aminobenzoic acid in therapy of experimental keratitis caused by herpes simplex virus in rabbits: the therapeutic effect and decrease of infectious titer

Immediate and long-term outcomes of repeated and multistage operations were analyzed in 190 patients with pulmonary tuberculosis. The aspects of work rehabilitation were studied in these patients. The efficiency of repeated and stage surgical interventions in patients both with disseminated and complicated types of tuberculosis and with pleural empyemas and in those with uncomplicated postoperative disease is 87.5 and 92.2%, respectively. The long-term results indicated that the complete clinical effect preserved in 79.2% of patients. Work rehabilitation was achieved in 64.8% of the examinees in the long-term postoperative period. The use of repeated and stage surgical interventions in patients with pulmonary tuberculosis may rehabilitate a rather large proportion of those operated on, assuming a great socioeconomic significance.     

IFN-gamma and IL-12 are increased in active compared with inactive tuberculosis

Cytokine-mediated immune responses to Mycobacterium tuberculosis infection are important determinants of M. tuberculosis disease development and pathology. However, the distinction between changes in cytokine profile attributable to M. tuberculosis infection and those associated with active pulmonary tuberculosis is unclear. We have compared T cells and their subsets, macrophages, and cytokine messenger RNA (mRNA) profile in the bronchoalveolar lavage (BAL) of patients with active pulmonary tuberculosis with inactive tuberculosis subjects. Ten patients with microbiologically confirmed active pulmonary tuberculosis and 25 subjects with inactive tuberculosis were recruited. Bronchoscopy with BAL was undertaken in all cases and BAL cytospins were examined using the techniques of immunocytochemistry and in situ hybridization. There was a significant increase in the percentage of BAL cells that were CD8+ T cells in active tuberculosis compared with inactive tuberculosis (mean +/- SEM: 7.2 +/- 0.9 versus 2.1 +/- 0.4, p < 0.001), but not CD3+ or CD4+ T cells nor macrophages. There were significant increases in the percentage of BAL cells expressing mRNA for interferon-gamma (IFN-gamma) and interleukin-12 (IL-12) in active versus inactive pulmonary tuberculosis subjects (8.0 +/- 0.6 versus 3.7 +/- 0.4 and 28.4 +/- 2.3 versus 10.2 +/- 1.0, p < 0.001, respectively). There were no significant differences between the active and inactive groups in the number of cells expressing mRNA for IL-2, tumor necrosis factor-alpha (TNF-alpha), IL-4, and IL-5. In conclusion, active pulmonary tuberculosis is associated with increased numbers of CD8+ cells and marked increases in the expression of IL-12 and IFN-gamma mRNA in the BAL, both of which may be useful markers of disease activity.     

Life after cancer

Medium-weight molecules (MWM) were measured in the plasma of 67 children and adolescents aged 11 to 17 years who were infected with and suffered from various types of tuberculosis. The highest values of MWM were found in patients with tuberculous exudative pleuritis and infiltrative pulmonary tuberculosis. During treatment, there was a significant reduction in the mean levels of MWM in 20 follow-up patients. It is concluded that it is expedient to employ this test to detect insidious tuberculosis activity during sanatorium treatment and to use it as a criterion for therapeutical efficiency.     

Women in dentistry

By analyzing the present-day tuberculosis epidemiological situation in the country and sociomedical characteristics of new cases, the authors present methods for detecting and treating patients, which are of paramount importance for today. Of the most significance is the need to promptly identify patients with strains on their referral to the general somatic hospitals for complaints by using 3-multiple sputum bacterioscopy for Mycobacterium tuberculosis by the Ziehl-Neelsen method. The vital problem is also to change chemotherapeutical regimens as more severe progressive types of the disease require more active treatment in the first months after detection especially in the cohort of socially disadapted persons.     

Improving the links between research and health policy in Pakistan

Autoptic specimens from tuberculosis patients operated on, delivered to the Laboratory of Pathomorphology, Institute of Tuberculosis, were used to examine quantitative changes, age-sex ratio, ethnicity, and admission of patients with pulmonary tuberculoma by climatic and geographical regions of Yakutia. The morphological types of tuberculomas, their numbers, size, activation, ratios by ethnicity were identified. Their clinical and morphological features were determined both by climatic and geographical conditions and the quality and nature of treatment, the distinguishing features of a contingent of patients. The pattern of the more severe process in the indigenous population calls for close attention and further study.     

The present situation, treatment and prognosis of drug-resistant pulmonary tuberculosis. Cooperative Study Unit of Chemotherapy of Tuberculosis of the National Sanitoria in Japan

We studied 266 patients with drug-resistant pulmonary tuberculosis at national sanatoria in Japan. The patients included 218 men (mean age, 58 years) and 48 women (mean age, 62 years). The levels of isoniazid and rifampicin resistance were determined at 1 mcg/mL and 50 mcg/mL, respectively. The results were as follows. (1) Most patients with drug-resistant pulmonary tuberculosis were middle-aged or past middle-aged. (2) There were many cases of drug-resistant pulmonary tuberculosis in previously treated tuberculosis patients with active disease and several cases in previously untreated pulmonary tuberculosis patients. However, in some previously untreated patients active tuberculosis was convert relatively easily to inactive tuberculosis. (3) Concerning life style, bachelors who drank heavily were more likely to develop drug-resistant pulmonary tuberculosis. (4) Most cases of drug-resistant pulmonary tuberculosis had at least one cavity on chest radiographs. (5) Several patients with drug-resistant tuberculosis left the hospital against the advice of their attending doctors; therefore, it was difficult to treat their illnesses. (6) In more than half the cases in which Mycobacterium tuberculosis was resistant to isoniazid and rifampicin, tolerance to streptomycin and ethanbutol was also seen. (7) When patients with drug-resistant pulmonary tuberculosis continued to have tuberculous bacilli in their sputum after 3 months of chemotherapy, there was a tendency for them to expectorate tuberculous bacilli in their sputum. For these drug-resistant tuberculosis patients, we must pay attention not only to the medical aspects but also to the social aspects of their disease.     

Displacement of gold marker in immunoelectron microscopy of human respiratory cilia

The incidence of tuberculosis is rising in the United States. Similarly, the incidence of pulmonary tuberculosis in Taiwan is increasing, but that of large bowel tuberculosis in this region has not been reported. The purpose of this study was to investigate the changing disease pattern and to determine some possible surgical prognostic factors for large bowel tuberculosis. Seventy cases of large bowel tuberculosis treated at our institute during the period 1965-1995 were reviewed and analyzed. A steady decline in the case number of large bowel tuberculosis were noted from 1975, but there seems to be a slight increase in cases since 1990. The average age of these patients was 65.1 years, and none had human immunodeficiency virus infection. The ileocecum is the most common region of involvement. Of these 70 patients, 59 had not been definitively diagnosed until surgery. Active pulmonary tuberculosis was found in 18 patients (25.7%). The incidence of postoperative pulmonary complications was higher in patients with active pulmonary tuberculosis or disseminating large bowel tuberculosis. Postoperative abdominal complications, including intestinal obstruction, abdominal cutaneous fistula, and wound infection, were seen in 13 patients, none of whom had active pulmonary tuberculosis. Although the incidence of tuberculosis has been reduced for years, it is now rising. Physicians should bear in mind the possibility of large bowel tuberculosis in patients with intestinal obstruction without specific origin. Postoperative respiratory care is important for patients with pulmonary tuberculosis, with either active or disseminating lesions.     

Pulmonary tuberculosis in the elderly

Clinical problems of pulmonary tuberculosis in the elderly patients were discussed. As for diagnosing tests, chest X ray sometimes shows atypical findings in patients with pre-existing pulmonary diseases (i.e. pulmonary emphysema, interstitial pneumonia and etc). It is most important to get bacteriologic evidence from suspected patients of pulmonary tuberculosis. Elderly patients have co-existing diseases except pulmonary tuberculosis. Controlling co-existing diseases is essential for treatment of pulmonary tuberculosis in the elderly patients. Treatment with standard chemotherapy leads to good result even in the elderly. However, we have to investigate the mechanism of rush cases, who dies in a few months in spite of adequate chemotherapy.     

New aspects in the etiopathogenesis of colorectal cancer

The paper analyzes the examination of 240 patients with alleviating pulmonary tuberculosis (follow-up group 2) and provides clinical and social characteristics of this group of patients who had poor social factors, such as a social behaviour, alcoholism, unemployment, etc. Ninety one patients had various concomitant visceral diseases. During treatment of pulmonary tuberculosis, most patients developed profound residual changes. This all requires more thorough follow-up while performing seasonal drug regimens and other prophylactic measures in Group 2 patients.     

Diagnosis and treatment of pulmonary tuberculosis complicated with chronic liver disease

Immunocompromised or malnutritional hosts are high risk group of pulmonary tuberculosis. Chronic liver disease especially decompensated cirrhosis of the liver is one of the risk group for this infection. When ascites or pleural effusion developed in patient with hepatic cirrhosis, complication of pulmonary tuberculosis must be considered. In such condition, drug metabolism was impaired so that anti-tuberculous drugs should be used carefully, but in almost cases except decompensated cirrhotic patients are tolerable for standard anti-tuberculous combination therapy and they could be cured. Hepatitis C virus infection is common in patients with old pulmonary tuberculosis because many of them were infected Hepatitis C virus at the time of blood transfusion for pulmonary resection or thoracoplasty. In such condition recurrence of pulmonary tuberculosis is rare but probability of recurrence must be considered when they developed decompensated cirrhosis.     

Occurrence of free D-aspartate and aspartate racemase in the blood shell Scapharca broughtonii

In spite of the high prevalence of tuberculosis worldwide, there are few studies on its psychiatric complications. The mental state of 53 patients with pulmonary tuberculosis seen in a Nigerian chest clinic was examined using the 30-item General Health Questionnaire (GHQ-30), the Present State Examination (PSE), and a clinical evaluation based on the International Classification of Disease, tenth edition (ICD-10). Results were compared with two comparison groups: (1) a group of 20 long-stay orthopedic patients with lower limb fractures; and (2) a group of 20 apparently healthy controls. The sociodemographic characteristics of the groups were also compared. A significantly higher prevalence of psychiatric disorders was found in the tuberculosis group (30.2%) than in the orthopedic group (15%) and the apparently healthy controls (5%). The types of psychiatric disorders encountered included mild depressive episode, generalized anxiety disorder, and adjustment disorder (ICD-10). Psychiatric morbidity was higher in tuberculosis patients with low educational attainment, and did not show a statistically significant relationship with other sociodemographic parameters. Ways of improving the mental health of tuberculosis patients are discussed.     

Antibodies to Bacillus megaterium H glycoprotein in patients with lung diseases

Enzyme immunoassay performed in patients with malignant and benign affections of the lungs determined antibodies (Abs) to glycoprotein isolated from saprophyte microorganism Bacilus megaterium H. In pulmonary tuberculosis and nonspecific pulmonary inflammation the above Abs occurred in patients with fibrous-proliferative changes and associated neoplastic conditions. In lung cancer the Abs were detected in well and moderately differentiated tumors. Nondifferentiated and poorly differentiated variants did not exhibit any rise in Abs to glycoprotein.     

Infectiousness of laryngeal tuberculosis

Two patients with laryngeal tuberculosis in the absence of extensive pulmonary tuberculosis are presented. In both, tuberculin testing of household members failed to show infectiousness of their disease. This contradicts the commonly held view that laryngeal tuberculosis is invariably highly infectious. The extent and activity of pulmonary disease probably determines the infectiousness of patients with laryngeal tuberculosis rather than the laryngeal lesion per se.     

Detection of HIV infection in pulmonary tuberculosis patients

Well documented 112 pulmonary tuberculosis patients were studied for the prevalence of human immunodeficiency virus (HIV) seropositivity by using two antibody screening tests along with western blot test. Nineteen of the pulmonary tuberculosis patients were HIV seropositive, 12 were acid-fast bacillus smear positive; 12 patients were tuberculin skin test positive and 15 patients were culture positive. As the incidence of HIV infection is increasing in India, it is observed that patients co-infected with HIV and TB are also on the rise. Recognition of the dual infection and taking adequate steps to deal with this epidemic are needed.     

Culturally competent healthcare

External respiratory function (ERF) was studied in 129 patients with restrictive pulmonary processes (tuberculomas, infiltrative and cavernous tuberculosis) before and after surgery. All the patients underwent saving lung resections. Changes in ERF were examined by conventional and the new method telespirography. This technique detects general and individual pulmonary ventilation disorders, which underlie criteria for assessing whether patients with pulmonary tuberculosis can be operated on. The authors show that the outcomes of surgical treatment are determined by the baseline status of the respiratory apparatus generally and each lung specifically. Distinctive features of complicated and uncomplicated postoperative periods are identified. The benefits of the new method are demonstrated.