Advanced Cases Of Pulmonary Tuberculosis Research Articles

Influence of the 2009 financial crisis on detection of advanced pulmonary tuberculosis in Osaka city, Japan: a cross-sectional study

ObjectiveTo investigate the association between the economic recession and the detection of advanced cases of pulmonary tuberculosis in Osaka city from 2007 to 2009.DesignA repeated cross-sectional study.SettingOsaka city has been...

Increasing Proportions of Advanced Pulmonary Tuberculosis Reported in the United States

Delays in the diagnosis of tuberculosis (TB) can result in progression to advanced disease. Patients with pulmonary TB and advanced disease are more likely to transmit disease and fail treatment. To examine clinical, epidemiological, and geographic factors associated with advanced pulmonary TB to further understanding of delayed diagnosis and transmission. Pulmonary tuberculosis cases in persons older than 15 years of age reported to the U.S. National Tuberculosis Surveillance System with advanced disease (cavitation on chest radiograph and acid-fast bacilli smear-positive sputum result) were compared with those without advanced disease using trend and binomial regression analysis. There were 35,584 cases of advanced pulmonary tuberculosis (APT) and 125,077 cases of non-APT reported from 1993 through 2006. Proportions of pulmonary TB cases with APT increased from 18.5% in 1993 to 26.1% in 2006, and the increase in the proportion of APT was most notable for national TB rates below 6.6 per 100,000. At the county level, the association between APT and low TB incidence has grown incrementally since 2000. The proportion of APT increased greatest among whites (65.4%), the employed (63.3%), and the U.S. born (59.2%). The prevalence of APT was 44% greater among persons with multidrug-resistant TB compared with those without it. This study highlights the need for TB diagnosis at early stages of the disease to minimize APT and decrease the risk of transmission. Additional efforts should concentrate on reducing time to treatment initiation in low-incidence areas and among groups traditionally seen as being at low risk for TB disease.

Clinical Experience with Rifampicin in the Retreatment of 46 Cases of Advanced Pulmonary Tuberculosis

Clinical Experience with Rifampicin in the Retreatment of 46 Cases of Advanced Pulmonary Tuberculosis

Results of follow-up on advanced cases of pulmonary tuberculosis converted to negative with rifampicin treatment

Results of follow-up on advanced cases of pulmonary tuberculosis converted to negative with rifampicin treatment

Studies on the Fraction of Urine, Unadsorbable by Benzoic Acid, in Normal and far Advanced Cases of Pulmonary Tuberculosis.

Studies on the Fraction of Urine, Unadsorbable by Benzoic Acid, in Normal and far Advanced Cases of Pulmonary Tuberculosis.

Carlens気管支カテーテルによる左右別気管支肺容量測定に関する研究

Bronchospirometric study was performed with ambient air and oxygen on 46 patients of pulmonary tuberculosis. Entire series were divided into three groups. The first group was consisted of 28 patients where bronchospirometry was made under air and oxygen breathing, alternatively. The test was made on ten patients of the second group where one lung breath air and the other oxygen. The third group was consisted of 8 patients where one lung breath air and the other oxygen following oxygen breathing of both lungs.1) Decrease of oxygen uptake was marked under air breathing compared to in oxygen breathing in advanced cases of pulmonary tuberculosis. However, no constant changes in oxygen uptake were noted in moderately advanced and minimum cases.2) Increase of ventiratory volume, respiratory frequency and minute volume were usually noted in the lung which breathes ambient air. Increase of minute volume is marked in the side of better functioning lung.3) Respriatory equivalent increased in the lung which breathes air, especially marked in advanced and moderately advanced cases.4) Vital capacity increased slightly in the side breathing air.5) Bronchospirometry with air breathing can be performed without any undue burden on patients, if the test is limited in ten minutes, and give more precise information of pulmonary function of the affected lung than in ordinary bronchospirometry with oxygen.

STUDY ON THE FACTOR CONTRIBUTING TO THE INGRAVESCENCE OF PULMONARY TUBERCULOSIS

For all the benefit of therapeutic progress for pulmonary tuberculosis lately attained, advanced cases of pulmonary tuberculosis would not cease to exist-some of them discovered in advanced state and some others taking a turn for the worse notwithstanding the best possible medical care available.As a means for analyzing the factors influencing the resistance of the “host” against the disease, the author conducted electrocardiographical examination and calculation of serum-albumin values of the “urban group” and the “rural group” of pulmonary tuberculous patients, as well as measurement of serum-potassium values of some of them.The findings were dealt with in relation to the different types of pulmonary tuberculosis, esp.to the far advanced lesions (Type F according to Gakken Classification). Results of deliberation are as follows:1) Comparison between the “urban group ” and the “rural group” revealed a higher incidence of electrocardiographical abnormalities in the “rural group”; 2) in regard to serumalbumin values, the “rural group” had a higher percentage of hypoalbuminemic cases; 3) serum-albumin values were closely related to the incidence of electrocardiographically abnormal signs; 4) in the Type F, hypoalbuminemic cases were more frequently found. than in other types; 5) exclusively in regard to the Type F, incidence of hypoalbuminemia made no discrimination between the “urban” and the “rural” groups, but the incidence of electrocardiographical abnormalities was definitely higher in the “rural group”. Serum-potassium values of the 18 cases of hypoalbuminemia were measured, and showed the higher incidence of typopotassemia in the “rural group”. This hypopotassemia was regarded not as the condition caused by their pulmonary tuberculosis but as the sequence of undernutrition which had existed since before their illness.And such undernutrition was found to be one of the factors that contribute to the ingravescence of pulmonary tuberculosis.

COMRARISON OF TUBERCULOSIS IN RURAL AND URBAN DISTRICTS

It is statistically known that there are more cases of advanced pulmonary tuberculosis among rural people than among urban residents. The author worked on the difference in the behaviors of tuberculosis in such two groups of people from a point of view of pathological physiology and discovered the following facts:As a result of comparison of the rural and urban patients with radiographically similar extent of lesions, the rural patients were found to be inferior to the other group at the time of their hospitalization with respect to haemoglobin values, albumin-globulin ratio, body weight, icterus index, etc., and to show higher values of γ-globulin and higher rates of positive Gros reaction, Among these items, haemoglobin value, albumin-globulinratio and body weight of the rural group showed a marked increase after 6 months' and 12 months' hospitalization.Such increase is ragarded to be a combined effect of improvement both in disease and nutriture.There are many anemic cases in rural area even among the apparently healthy people free from hookworm infection, and they also present a decrease in total serum protein and albumin values, icterus index, etc., for which their inadequate or unbalanced dietary intake is said to be accountable.In the light of this fact, it is considered that prior to the attack of tuberculosis rural tuberculous patients have already been in more or less poor nutriture, which is further aggravated by the disease, while such poor nutriture assists the progress of the disease itself playing as a causative agent for its ingravescence.

Viomycin with oxytetracycline in the treatment of pulmonary tuberculosis

Twenty-one cases of advanced pulmonary tuberculosis were treated with viomycin and oxytetracycline for at least three months. Two similar cases were treated with viomycin alone, 2 g. twice weekly (V2 group). Oxytetracycline was given in doses of 2 g. daily to five patients (2TV2 group) and 4 g. daily to sixteen patients (4TV2 group). In the V2 group no clinical or radiological improvement occurred and viomycin resistance emerged after three and five and a half month's treatment respectively. In the 2TV2 group only one patient was improved, none was made sputum-negative and viomycin resistance emerged after six months in three patients. Three patients in the 4TV2 group failed to come to operation. All remained sputum-positive. Thirteen patients in the 4TV2 group underwent major thoracic surgery. Three post-operative deaths occurred. Of the ten surviving patients, sputum conversion occurred in six. One other had the degree of sputum positivity greatly reduced, but three have remained fully sputum-positive. No bacterial resistance to viomycin was found in sputum cultures isolated from this group, but in one patient cultures from a lung, resected after seven months' treatment, showed viomycin resistance. No serious toxic effects attributable to viomycin were encountered. In one patient treatment had to be discontinued after three months owing to intractable diarrhœa, presumably due to oxytetracycline. It is concluded that there drugs may prevent deterioration in patients with otherwise hopeless disease and perhaps permit of major surgery. The drugs should, however, be reserved for cases in which no other more effective chemotherapy is available.

Some observations on the results of high isoniazid dosage in pulmonary tuberculosis

Summary The administration of isoniazid in doses of 6–12 mg. per kg. to patients with early or only moderately advanced chronic pulmonary tuberculosis either obviated the need for collapse therapy or rendered it safe, and contributed towards reaching a state of quiescence and maintaining it for at least twelve months. Isoniazid treatment was also successful in a small group of acute pulmonary and miliary cases of tuberculosis. Chronic advanced cases of pulmonary tuberculosis failed on the whole to respond to this treatment. In only 4 out of 20 patients did sputum-conversion occur; all of the remainder became clinically and bacteriologically isoniazid-resistant. No toxic complications were observed in patients receiving up to 6–8 mg. of isoniazid per kg. Some patients receiving 10–12 mg. per kg. showed evidence of toxicity which cleared up when treatment was stopped. No patient developed hypersensitivity to isoniazid.

Thirty years ago: Extract from Tubercle, November 1922 — ‘A Few Observations on Cases of Advanced Pulmonary Tuberculosis’, by Frederick R. G. Heaf

Thirty years ago: Extract from Tubercle, November 1922 — ‘A Few Observations on Cases of Advanced Pulmonary Tuberculosis’, by Frederick R. G. Heaf

Pneumoperitoneum with Late Results Report of 560 Cases

SUMMARY We have used pneumoperitoneum in conjunction with phrenemphraxis on the worse side in most of the 560 white men and women, including minimal, moderately advanced and far advanced cases of pulmonary tuberculosis. Of these 246 have been successfully treated and most of them discontinued pneumoperitoneum in two to 10 years. This procedure is not particularly suitable for minimal cases, nor those with predominantly fibrotic lesions. This type of temporary collapse has been the orthodox treatment in Georgia for the past hive to six years. In our institution we give an average of about 25,000 fills yearly, with a patient load average of 1,500.

Thiosemicarbazone (T.B.I.): A year's experience of its use alone and in combination with PAS

Two series of comparable intermediate and advanced cases of pulmonary tuberculosis have been treated concurrently, the first with T.B.i alone and the second with that drug combined with PAS. T.B.i is considered to have a definite tuberculostatic effect; in combination with PAS, results comparable with those to be expected from streptomycin have in some cases been obtained.

Pneumoperitoneum with Diaphragmatic Paralysis in the Treatment of Pulmonary Tuberculosis

The histories and the results and complications of therapy in twelve cases of pulmonary tuberculosis treated with pneumoperitoneum and phrenic paralysis were tabulated and discussed: 1. Of these, six were far advanced cases of pulmonary tuberculosis and six moderately advanced. 2. The results were excellent in 7 (58 per cent); fair in 3 (25 per cent) and poor in 2 (17 per cent). 3. Cavities in the upper thirds of the lung fields were closed in 9 out of 11 cases. 4. In 8 out of 9 cases thoracoplasties were avoided by the use of pneumoperitoneum with hemi-diaphragmatic paralysis. 5. It was suggested that the estimation of diaphragmatic elevation and the volume of lung collapsed should be based on lateral as well as postero-anterior roentgenologic examination of the chest. 6. Pneumoperitoneum alone does not result in effective diaphragmatic elevation; it should be used with phrenic interruption to obtain the greatest benefits.

Insulin treatment in moderately and far advanced cases of pulmonary tuberculosis

Insulin treatment in moderately and far advanced cases of pulmonary tuberculosis

THE PLACING IN GENERAL SURGICAL WARDS OF PATIENTS ON WHOM THORACOPLASTY HAS BEEN PERFORMED

The more and more gratifying results obtained in late years from thoracoplasty in far advanced cases of pulmonary tuberculosis has created the desire to give the benefit of such surgical treatment to the consumptive poor as well as to the rich, but in the state of New York a serious obstacle has been met with in the law which forbids tuberculous patients to be admitted into the surgical wards of the general hospital. This law was enacted some years ago on the recommendation of the state board of charities. Dr. Willy Meyer called on me recently wishing to ascertain my personal opinion on the alleged danger of spreading the disease when a tuberculous patient on whom thoracoplasty has been performed is placed in the surgical ward of a general hospital. I felt then, as I feel today, that I could answer this question by saying that in the well conducted, sanitary

A few observations on cases of advanced pulmonary tuberculosis

A few observations on cases of advanced pulmonary tuberculosis

THE ALKALI RESERVE IN PULMONARY TUBERCULOSIS

The question of acidosis in tuberculosis is still a debatable one. Pottenger¹states that "there are probably many factors present in tuberculosis which have a tendency to increase acidosis, such as deficient intake of oxygen, deficient excretion of carbon dioxid, which occurs particularly in the disease, as a result of diminished pulmonary area, etc. Klebs²takes the opposite view, that "the gaseous metabolism in tuberculosis is but slightly, if at all, altered, the system accommodating itself to the lessened lung area, and, as is usual in the body, accomplishing the same amount of work with the decreased amount of tissue." A. Loewy, and Kraus and Chvostek³found a moderate increase in oxygen intake and carbon dioxid excretion in cases of pulmonary tuberculosis. It will be one of the objects of this work to show that in far advanced cases of pulmonary tuberculosis with considerable destruction of lung tissue by cavitation

REPORT OF A CASE OF PRIMARY TUBERCULOSIS OF FAUCIAL TONSILS

While tuberculosis is a very prevalent disease affecting practically all the tissues of the human body, being especially frequent in the glandular system, it is less often or seldom found as a primary infection of the faucial tonsils. The following case occurred in the otolaryngologic service of the base hospital at Camp Logan, Texas. REPORT OF CASE History. —W. H. F., a well nourished and developed white male nurse of German nationality, aged 26, stated that two years before, for a period of six months, he had had charge of a tuberculous ward in a general hospital for soldiers, located in Wisconsin. The patients in his charge had principally advanced cases of pulmonary tuberculosis. He had been away from the hospital for one year. The family history was negative. In December, 1917, he had had an attack of tonsillitis of a type unknown to him, lasting about two weeks. He

A NOTE ON THE TREATMENT OF COUGH IN ADVANCED PULMONARY TUBERCULOSIS

As the cough in pulmonary tuberculosis is often a very distressing symptom, especially during the night hours, any remedy that will give relief to the sufferer is of value. An intelligent patient of mine, who was suffering with advanced pulmonary tuberculosis, first called my attention to the fact that when he took acetylsalicylic acid (aspirin) in the evening, his cough was much relieved and as a result he passed a more comfortable night. I made use of this observation in several other cases of advanced pulmonary tuberculosis, asking the patients to let me know if they received any benefit from the treatment and in every case reports were favorable. I now frequently advise patients with advanced pulmonary tuberculosis to take acetylsalicylic acid 5 or 10 grains about 8 p. m. when they are troubled with an excessive cough at night. The smaller dose is often sufficient to control the cough