[Chronic obstructive bronchopneumonia (COBP), a precancerous state through destabilization of body homeostasis and bioenergetics]. / Bronhopneumopatia obstructiva cronica (BPOC), stare precanceroasa prin destabilizarea homeostaziei si bioenergiei organismului.

Out of a number of 2113 of COLD ambulatory cases followed-up over 20 years, 170 cases of death were registered. The causes were: heart in 54%, cancer in 42% among which 37% lung cancer, exceeding 8 times the mean figures on the whole country. These diseases: COLD, atherosclerosis inducing heart disease and lung cancer have common risk factors which unbalance respiratory homeostasis. By obstructing the airways they lead to cellular O2 deficit. In this way the cell is compelled to shift to anaerobic glycolysis in order to supply the bioenergy necessary for life, resulting in malignancy mutagenesis. On a control group of 166 cases of lung cancer a ventilatory impairment was noted in the history: obstructive syndrome in 63.8%, restrictive syndrome in 28.3%, which means chronic respiratory insufficiency.

[The late results of intensive chemotherapy (9 months) in severe forms of tuberculosis in children]. / Rezultatele tardive ale chimioterapiei intensive (9 luni) în formele grave de tuberculoza la copil.

The short-course chemotherapy (9 months) in the severe forms of tuberculosis in children is a very modern item. It was very few approached on an international level and relatively short time ago in our country. There were applied the following therapeutical regimens: 3 HRZ2 6 HR2 (in the experimental group) and 3 HR/3 HR2/6 H2 (in the control group). In the granulias and the caseous forms the late results, at 5 years after treatment end, were very good in 100% of cases in both groups. In meningitis clinical very good results (without sequellae) presented a proportion of 70.1% in the experimental group and of 68.2% in the control group (difference statistically non significant). The main advantage of the intensive short course regimens (9 months) comparatively with the "classical" ones (of at least 12 months) consists in reaching finally the same good results but in at least 3 months shorter time interval.

[Tuberculosis in the elderly: sociomedical aspects]. / Tuberculoza la varstnici; aspecte medico-sociale.

A study on a group of 100 tb patients aged over 60 years registered between 1987-1991 in the district 4 of Bucharest has been carried out aiming at the evaluation of medical and social aspects. In order to increase the relevance of the obtained data, these were compared with a group of young tb patients aged 20-39 years, in the same territory and period of time. The results show: the case-finding predominantly passive, extrarespiratory forms in 25%, high contamination risk (63% acid fast bacilli eliminators on microscopy) non-compliance to treatment in 1/5 of cases. These aspects could be explained by psychic particular features in aged persons, associated diseases a.s.o., leading to treatment failures. The analysis of social and epidemiological aspects of tb in aged subjects evidences some lack of good results in this important public health problem of people.

[The efficacy of ethambutol compared to streptomycin in the initial quadruple phase of short-term regimens]. / Eficacitatea etambutolului comparativ cu a streptomicinei in faza initiala cvadrupla a regimurilor de scurta durata.

In order to test comparatively SM and EMB efficacies within quadruple regimens of short-term chemotherapy, two groups of patients with pulmonary tuberculosis at first treatment, sputum positive under microscopic examination, were constituted through randomization. One group (59 cases) was submitted to the standard regimen RHSZ 2/7, and the other (61 cases) to RHZE 2/7. Group structure was homogeneous from the standpoint of case repartition, according to the anatomo-radiological form, therapeutical regimen, and sensitivity to Tb drugs. Both bacteriological and radiological clinical evolutions show, even in the conditions of a short-time interval (2 months), a similar efficacy of SM and EMB within the quadruple regimens in the initially intensive phase of anti-Tb treatment. It is possible that the results may be dependent upon the concomitantly bactericidal action of: rifampicin, hydrazide and pyrazinamide. Therefore, a further testing of the comparative efficacy of the triple regimen RHZ 2/7 with the quadruple RHSZ 2/7 and RHZE 2/7 during a longer follow-up is required.

[The late results of short-term chemotherapy in benign forms of tuberculosis in children]. / Rezultatele tardive ale chimioterapiei de scurta durata în formele benigne de tuberculoza la copii.

The study included 359 cases of primary tuberculosis (benign forms) in children aged 0-14 years, out of which 181 non-complicated and 178 complicated forms. The therapeutical regimens were: 3HEZ2/3HE2 (study subgroup) and 6HE2/3H2 (control) for non-complicated forms, and 3HRZ2/3HR2 (study subgroup) and 3HES2/3HE2/3H2 (control) for complicated ones. Late results (5 years after treatment end) were very good (from clinical, radiological, bacteriological points of view) in 100% of cases. Thus, short-course regimens are preferable to longer ones (over 6 months) in the chemotherapy of the benign forms of pulmonary tuberculosis in children.

[The Cu/Fe ratio and its significance in the pathogenesis, diagnosis and prognosis of bronchopulmonary cancer]. / Raportul Cu/Fe si semnificatia sa în patogenia, diagnosticul si prognosticul cancerului bronhopulmonar.

In 197 cases with various bronchopulmonary affections, iron was dosed in serum, according to Weippel's method, and copper, according to Cantarov's method. Cu/Fe serous ratio was found in the normal patients between 0.7 and 1.7 higher than the control sample were reached (1.2); in OCBP the ratio was twice versus the control sample (2.62 versus 1.2). In the disease diagnosis and prognosis, the determination of the Cu/Fe serous ratio is suggested in those suspected of bronchopulmonary cancer. The increase of the ratio shows the aggravation by metastases, and the improvement after operations indicates the lack of metastases. The advantages of the test are: sensitivity, specificity, predictability, economy.

[The recovery of work capacity within the framework of short-term antitubercular chemotherapy]. / Recuperarea capacitatii de munca în cadrul chimioterapiei antituberculoase de scurta durata.

The authors compare the results of chemotherapy reflected in the proportion of recoveries of work capacity and the number of retired persons in two groups of patients--one including 102 cases treated between 1970 and 1971 by a 3/6 regimen, and another one including 91 patients treated in 1986 by a modern intensive 3 + 3 regimen. The data indicate better results with the 1986 lot as compared with the 1970-1971 lot. In the 1986 group there were no fatalities and the persons that recovered their work capacity represented 90.1% of the total. By contrast, in the group treated between 1970 and 1971 there were two fatalities and only 84.3% of all the patients did recover the work capacity. The number of retired persons decrease from 11.7% in the first group to 7.7% in the second. Temporary incapacity decreased from an average of 321 days to an average of 267 days in the second group. All these results were obtained by shortening the treatment from an average of 9 months to an average of 6 months.

[The means for evaluating and optimizing antitubercular chemotherapy as a measure to prevent and combat tuberculosis in county territory]. / Modalitati de evaluare si optimizare a chimioterapiei antituberculoase ca masura de prevenire si combatere a tuberculozei pe un teritoriu judetean.

The paper reports on 25 possible failure factors of antituberculosis chemotherapy in 262 cases recorded in 1982 and followed for 3 years. 58 of them were failures, relapses or bacteriological relapses under treatment. The failure factors analysed were subjected to a mathematical modelling method that yielded a number of codified predicting parameters. This prognostic calculation may be an efficient method for optimizing chemotherapy, reducing the failure rate.

[Reasons for delayed diagnosis of pulmonary tuberculosis]. / Cauze ale întîrzierii diagnosticului de tuberculoza pulmonara.

100 patients at first treatment were investigated according to a complete questionnaire for explaining the causes of tardy diagnosis in pulmonary tuberculosis. The roles of the disease, patient and physician in this delay were followed. The insidious or atypical onset of the disease in 82% of these patients explains the long interval (107.2 days on the average) elapsed between the appearance of the first symptoms and the diagnosis determination. As a consequence of low cultural level, many patients cannot give a correct interpretation of the symptomatology and they seek the physician's help after 69.1 days (on the average) from the appearance of the symptoms. The medical causes are numerous and can be rapidly cured. In the dispensary of general medicine, 55% patients were examined only clinically, 45% clinically and radiologically but only 7% were subjected to the bacteriologic examination for bK and 4% were sent to the TB wards for consultation. As the registration of the patient, his admission into the hospital and the tuberculostatic treatment depend on the bK presence in sputum--sometimes waiting for the result of the culture tests--the average interval between consultation and admission is of about 34.7 days. On admission, high average values were registered: cavities of 4.2 cm in diameter, lesions of 2.8 points and bacteriologically 44 bacilli/100 fields. For improving this situation the following recommendations are made: increase of the health education on TB activity in the population, continuous education of the general practitioners in the TB diagnosis methods, use of the radiologic examination together with the bacteriologic one and the biological tests for the early detection of the pulmonary tuberculosis.

[The advantages of Reprimum therapy in pulmonary sarcoidosis and other granulomatous diseases]. / Avantajele terapiei cu Reprimum în sarcoidoza pulmonara si alte boli granulomatoase.

In sarcoidosis and other granulomatous non-caseous diseases, the election treatment is immunosuppressive, mainly with cortisones that ensure more than 70% lasting remissions. Continuous use of cortisones for a long time (8-30 months) in high doses leads to serious side effects: gastric and intestinal ulcers, obesity, osteoporosis, suprarenal dysfunction, sensitivity to infections. Good results and elimination of the important side effects were obtained by treatment with Reprimum--a semisynthetic antibiotic with a wide spectrum and immunosuppressive properties--administered alone or with prednisone in small doses (15-20 mg once) in 6 weeks' series: 2 weeks--Reprimum 10/mg/kg daily +/- prednisone and for other 4 weeks--Reprimum 15 mg/kg twice a week +/- prednisone followed by two weeks' break. In 75 patients with histopathologically confirmed sarcoidosis (of whom 7-9.3% with outside-the-lung situs, too), the treatment with Reprimum gave: 94.7% lasting remission, only 5.3% failures, reduction of the treatment period to 6-12 months and the absence of any important side reaction. In other 37 sarcoidosis cases, failures of cortisone therapy (of which 11-30% relapses after 2-6 years), the treatment with Reprimum together with prednisone allowed recovery of 29 patients (78.4%). The same treatment with Reprimum, used in 22 patients with immunosuppressive treatment indication (dermatomyositis, Kaposi's syndrome, thrombocytopenias, nodose periarteritis, silicosis), of whom 18 (81.8%) were failures of the cortisone therapy, healed 20 of these cases (90.9%). Reprimum immunosuppressive property acts at the level of T4+ lymphocyte, involved in sarcoidosis pathogenesis. The functional blockage of T4+ lymphocyte can be also achieved by cyclosporine A.(ABSTRACT TRUNCATED AT 250 WORDS)