[The exclusively outpatient treatment of pulmonary tuberculosis under the conditions in Romania]. / Tratamentul exclusiv ambulator al tuberculozei pulmonare în conditiile tarii noastre.

In order to demonstrate the possibility of an exclusively outpatient treatment of pulmonary tuberculosis in the present conditions in our country, a study was performed on 140 cases in Bucharest. The admission criteria were as follows: sputum negative patients (M-C-); paubacillary cases, sputum positive only in culture (M-C+); Tb pleuritis; patients refusing hospitalization, regardless their bacteriological status, and sputum positive cases also at smear examination (M+C+), if they had no household contacts under 20 years of age or with a good social economic standard of life. The patients were given the intensive chemotherapy regimen HSRZ 2/7 for 6 months, that was prolonged to 9 months in specified cases. A number of 31 patients were non-bacillary (M-C-) out of which 14 cases with pleuritis; 70 were paucibacillary (M-C+), and 39 were smear positive (M+C+). Out of 109 patients which were bacteriologically confirmed, sputum reversion in culture was obtained in 71.6% of cases at 2 months and in 89.0% at 3 months. At treatment end, sputum negativation was not obtained in a single patient (0.9%). Case follow-up for 6-41 months after treatment end led to the registration of 8 therapeutical failures and bacteriological relapses (5.7%). Five cases recovered through re-treatment, 1 patient (0.7%) died through tuberculosis, and 2 (1.4%) became chronic case. Periodical control of the 95 contact children in the respective households revealed a single conversion of the tuberculin reaction and no Tb case after treatment start in index cases, which proves the epidemiological reliability of the method.

[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.

[Clinical, radiological and bacteriological study of pulmonary tuberculosis with bacteria showing drug resistance]. / Contributii la studiul clinic, radiologic si bacteriologic al tuberculozei pulmonare cu germeni cu chimiorezistenta primara.

The authors have investigated two groups of patients of young age suffering from tuberculosis with germs showing primary resistance to chemotherapeutic agents (61 cases), and with germs displaying sensitivity to these agents (64 cases). The following conclusions have been reached: tuberculosis with germs showing primary drug resistance did not display onset modalities, clinically and radiologically, that differed significantly from other types of tuberculosis; sputum conversion is more slow in patients with resistant germs than in those with sensitive germs in the first two months of treatment, but following application of the treatment according to the data resulting from the antibiogram, this differences quickly disappeared. The presence of a smaller number of complete recoveries and of a surplus of doubtful recoveries can be explained in the same way in this group of patients: the final results are similar in both groups of patients, evidencing that the treatment of pulmonary tuberculosis due to germs showing parimary drug resistance does not give rise to particular problems.