[Analysis of circumstances regarding deaths from tuberculosis in inhabitants of the Torun Province in the years 1990-1993 as an important factor in assessing the causes of tuberculosis treatment failure]. / Analiza okolicznosci zgonów na gruzlice u osób zamieszkalych w województwie torunskim w latach 1990-1993 jako waznego elementu oceny przyczyn niepowodzen leczenia gruzlicy.

The aim of this study was to verify the diagnoses of tuberculosis in 98 cases of death from tuberculosis (TB) in Torun province in the years 1990-1993. The data of the official register of death were compared, with the hospital records and with the autopsy reports. Tuberculosis was accepted as the cause of death in all patients treated for sputum positive tuberculosis, and also in those in whom pathological proof of tuberculosis existed. In addition tuberculosis was accepted as the cause of death in 6 patients in whom no bacteriological examination was done, but who were tuberculosis contacts and who had the radiological picture of the lung compatible with tuberculosis. Those patients were admitted to hospital in terminal state and the permission for autopsy was refused. Tuberculosis was excluded as the cause of death in those who were treated for tuberculosis but were considered cured and also in those in whom a proof of other severe disease existed. Seventy two cases of tuberculosis death were officially registered in the above-mentioned time. In 23 of the 72 cases tuberculosis was excluded. Additionally 26 patients who died of tuberculosis were officially registered as death from other causes. After verification have found that 75 patients died of tuberculosis. In 26 of them the diagnosis was established only after death during the autopsy examination and/or positive culture for tubercle bacilli. In 27 patients tuberculosis was diagnosed very late, 15 days before death in 12 and 30 days in other 15 patients. In 19 patients the diagnosis was established 30 days or later before death. In majority of them, however, the treatment was interrupted or proceeding irregularly. It is concluded that: the real number of death from tuberculosis was similar to the registered although the errors in registered deaths from TB are in two directions; the main cause of death from TB in Torun province in the years 1990-1993 was the late diagnosis; the late diagnoses of tuberculosis was stabilized mainly in those who died at home and also in those who were admitted to hospital in critical state and died during the first two weeks of hospitalization.

[Deaths from tuberculosis among permanent residents of Torun in the years 1990-1993]. / Zgony na gruzlice wsród stalych mieszkanców województwa torunskiego w latach 1990-1993.

The aim of this was to verify the cases of death from tuberculosis (TB) in Torun province in the years 1990-1993. The data of the official register of death were compared, with the hospital records and with the autopsy reports. Tuberculosis was accepted as the cause of death in all patients treated for sputum positive tuberculosis and also in those in whom pathological proof of tuberculosis existed. In addition tuberculosis was accepted as the cause of death in patients in whom no bacteriological examination was done, but who were tuberculosis contacts and who had the radiological picture of the lung compatible with tuberculosis. Those patients were admitted to the hospital in terminal state and the permission for autopsy was refused. Tuberculosis was excluded as the cause of death in those who were treated for tuberculosis but were considered cured and also in those in whom a proof of other severe disease existed. 72 cases of tuberculosis death were officially registered in the above-mentioned time. In 23 of those 72 causes tuberculosis was excluded. On the other hand 26 patients who died of tuberculosis were officially registered as death from other causes. After verification we have found that 75 patients died of tuberculosis. Thus the real number of death from tuberculosis was similar to the registered one although the errors in registered deaths from tuberculosis are in two directions.

[Analysis of tuberculosis mortality in the Torun province in the years 1990-1993]. / Analiza przyczyn niepomyslnego przebiegu gruzlicy w województwie torunskim w latach 1990-1993.

There were 75 deaths from tuberculosis in Torun Vojevodship province in 1990-1993. In 26 of them the diagnosis was made only after death during the autopsy examination and/or by positive culture for tubercle bacilli. In 27 patients diagnosis of tuberculosis was made very late, 15 days before death in 12, and 30 days in other 15 patients. In 19 patients the diagnosis was made 30 days or more before death. In majority of them, however, the treatment was interrupted or taken irregularly. We conclude that the main cause of death from tuberculosis in Torun province in the years 1990-1993 was the late diagnosis. The late diagnosis of tuberculosis was established mainly in those who died at home and also in those who were admitted to hospital in critical state and died during the first two weeks of hospitalization.

[Evaluation of penetrating heart wounds by echocardiography]. / Ocena penetrujacych ran serca z wykorzystaniem echokardiografii.

The paper presents a rare case of a penetrating endocardial wound, managed conservatively, in which echocardiography was used in the serial monitoring. Heart injuries constitute about 6% of all chest injuries. Because of the possibility of cardiac tamponade and the massive bleeding into the pleural cavity, they are life-threatening. In such cases only surgical intervention gives a chance to save the patient (5). It turns out, however, that patients with normal echocardiogram and normal vital signs can be managed conservatively, with echocardiographic monitoring.

[A case of pleurisy with effusion in the course of rheumatoid arthritis]. / Przypadek wysiekowego zapalenia oplucnej, w przebiegu reumatoidalnego zapalenia stawów.

The case of pleurisy with effusion in the rheumatoid arthritis (RA), observed in the Chest Diseases and Tuberculosis Clinic in Szczecin is described. Diagnosis was based on the presence of rheumatoid factor and low glucose level in the pleural effusion, (the glucose level in serum was normal) and the aggravation symptoms of RA. Pleural biopsy did not confirmed the presence of rheumatoid nodules.