ABSTRACT
An examination was made of the series of 439 lung tumours diagnosed ambulatorially at the Turin Social Health Dispensary to assess the diagnostic return from several techniques (cytology of the sputum, bronchial aspirate and brushing; histology on a biopsy specimen) used singly or in combination. It was also sought to determine the increase in sensitivity obtained by adding technique to each one other, and to establish the overall sensitivity of the protocol. It was found that biopsy was the most sensitive technique (91% in tumours visible by fibrobronchoscopy). The single cytological techniques displayed a lower sensitivity than in the literature, and there was no significant difference among them. The most sensitive combination was brushing + sputum (89.2%), while the sensitivity of the protocol as a whole was much the same as that reported in the literature. In the case of fibrobronchoscopically visible lesions, multiple biopsies (preferably 3) may be sufficient, whereas combination of the three cytological techniques is necessary to ensure acceptable sensitivity with regard to invisible lesions.
Subject(s)
Bronchial Neoplasms/diagnosis , Bronchoscopy/methods , Lung Neoplasms/diagnosis , Adult , Aged , Biopsy , Bronchial Neoplasms/pathology , Female , Fiber Optic Technology , Humans , Male , Middle Aged , Sputum/pathologyABSTRACT
Author debates the advantages of home treatment of tuberculosis and the question limits. These limits are essentially represented by a low compliance in many patients. At our Institute, we put in practice an home therapy trial of pulmonary and extra-pulmonary tuberculosis. Our treatment programme includes short-course chemotherapy (six or eight months of therapy) with rifampin, isoniazid and ethambutol associated or, instead of ethambutol, with morphazynamide. In 1982, 674 patients were treated according to this schedule. Previously we made a controlled clinical trial comparing home and hospital treatment of pulmonary tuberculosis in 50 patients newly diagnosed. The results of this study showed that both groups of patients entirely recovered at the same time. At last, Author points out that today politicians poorly know the importance of a therapeutic home programme.
Subject(s)
Ambulatory Care , Tuberculosis/therapy , Adaptation, Psychological , Drug Administration Schedule , Humans , Kidney Diseases/chemically induced , Pyrazines/therapeutic use , Rifampin/adverse effects , Socioeconomic Factors , Tuberculosis/drug therapy , Tuberculosis/transmissionABSTRACT
The diagnostic usefulness and practical possibilities of mass X-ray screening in lung cancer is examined. On the basis of the literature and personal experience, the conclusion is cautiously pessimistic, in agreement with what has recently been stated by Lemoine, Corda and others.