[Research on the occurrence of functional anomalies of the peripheral bronchi (small bronchi disease) in workers in a factory with respiratory noxious substances]. / Cercetari asupra frecventei anomaliilor functionale în bronhiile periferice (boala bronhiilor mici) la muncitorii dintr-o întreprindere cu noxe respiratorii.

A group of 908 subjects has been studied, of which two-thirds were males, classified in 5 categories: unexposed, with light exposure, and severely exposed to inhalation of volatile substances, or various types of dust. A B.M.R.C. file was filled for each of the subjects. This file concerns respiratory symptoms. A forced expirogram was also performed, and FEV 25-75%, FEV 75-85%, and TEM were determined. The two expiratory flows (median and final) are frequently disturbed in subjects without respiratory symptoms, more frequently in smokers with a normal FEV 1. In those exposed to respiratory risk the proportion of alterations increases, but association of smoking with inhalation of noxious chemical substances will determine a modification of FEW 1 and anomalies of the peripheral bronchi occur more frequently in smokers. Between the criteria suggesting the presence of small airways disease, the ratio FEV 25-75% under 60%, with a FEV 1/FVC ratio within normal limits, this being the most sensitive of the criteria, also appears as the most reliable.

[Long-term study of the evolution of chronic bronchitis detected by questionnaire 10 years earlier]. / Studiu longitudinal asupra evolutici bronsitelor cronice, depistate prin chestionar cu 10 ani anterior.

The longitudinal study carried out in a group of inhabitants from Craiova showed that 16,2% of these, classified according to previously filled questionnaires as suffering from chronic bronchitis, and 10,7% of those classified as suffering from minor forms of bronchitis (sporadic symptoms) had died, and one third of them were not found when the investigation was repeated. Re-examination of 106 adults with chronic bronchitis showed that the symptoms had disappeared in two-thirds of them, especially in those who gave up smoking; in 19,8% of them the symptoms had become more severe due to repeated attacks. Bronchial obstruction was present in 36% of the cases, and alterations in the small bronchial ducts were present in two-thirds of the patients. In 18-24% of the patients with minor forms of bronchitis the symptoms were more severe and chronic, and they can be classified as chronically ill patients. Frequently there were altered spirographic values. This study demonstrates that chronic bronchitis may evolve to: a) remission of the symptomatology (especially after suppression of smoking); b) more or less unmodified persistence of symptoms; c) increased severity of the symptoms following repeated acute attacks. Almost 25% of cases with sporadic coughing and expectoration became chronically ill over a period of 10 years. The questionnaire was demonstrated as having retrospective value for making a diagnosis of chronic bronchitis, but cough and expectoration are not sufficient for a differential assessment of the evolution, the spirographic data being of decisive importance.

[Current incidence and clinical significance of non-culturable bacilli or those culturable with difficulty]. / Frecventa actuala si semnificatia clinica a bacililor greu cultivabili sau necultivabili.

An analysis of 246 patients with positive smear present bacilli and negative cultures revealed that in only 9% of the cases no organized previous treatment had been applied, although almost half of these had benefited from short courses with streptomycin associated with penicillin before an exact diagnosis of tuberculosis had been made. Since the remaining 91% had had 1--2 months of chemotherapy, which frequently included rifampicin, the authors stress that microscopically detectable germs are frequently incapable to develop on culture media. These are frequently non-viable bacteria and in such conditions no subsequent modifications of the currently applied therapy scheme should be attempted. The authors show that only 26,2% of the germs from 519 positive cultures have developed after 21 days from the seeding. At 30 days the overall proportion increased to 71,2% while at 45 days 22,7% more positive cultures appeared and an additional 6,1% cultures became positive at 60 days. Tubercle bacilli become increasingly demanding and slower growing. If at 21 days only one colony was evident in 6% of the cases, while an infinite number of colonies were present in 58% of the cultures at 60 days a single colony was found in 42% of the cases, in contrast with only 9% cases with an infinite number of colonies (P less than 0,001). The delay in the growth of bacilli was parallel with the duration of chemotherapy. The results are compared with data from the literature.

[Incidence of pulmonary tuberculosis in diabetics (author's transl)]. / Zur Häufigkeit der Lungentuberkulose bei Diabetikern

Diabetics are particularly prone to tuberculosis, For this reason, radiological examination of the lungs must be carried out every half year. Chemoprophylactic therapy with INH should always be instituted even with the smallest apical changes. Glycemic equilibrium is essential for the success of antituberculous chemotherapy, and it must be achieved in every tuberculous diabetic.