3D fibre architecture of fibre-reinforced sand.

The mechanical behaviour of fibre-reinforced sands is primarily governed by the three-dimensional fibre architecture within the sand matrix. In laboratory, the normal procedures for sample preparation of fibre-sand mixtures generally produce a distribution of fibre orientations with a preferential bedding orientation, generating strength anisotropy of the composite's response under loading. While demonstrating the potential application of X-ray tomography to the analysis of fibre-reinforced soils, this paper provides for the first time a direct experimental description of the three-dimensional architecture of the fibres induced by the laboratory sample fabrication method. Miniature fibre reinforced sand samples were produced using two widely used laboratory sample fabrication techniques: the moist tamping and the moist vibration. It is shown that both laboratory fabrication methods create anisotropic fibre orientation with preferential sub-horizontal directions. The fibre orientation distribution does not seem to be affected by the concentration of fibres, at least for the fibre concentrations considered in this study and, for both fabrication methods, the fibre orientation distribution appears to be axisymmetric with respect to the vertical axis of the sample. The X-ray analysis also demonstrates the presence of an increased porosity in the fibre vicinity, which confirms the assumption of the "stolen void ratio" effect adopted in previous constitutive modelling. A fibre orientation distribution function is tested and a combined experimental and analytical method for fibre orientation determination is further validated.

European union standards for tuberculosis care.

The European Centre for Disease Prevention and Control (ECDC) and the European Respiratory Society (ERS) jointly developed European Union Standards for Tuberculosis Care (ESTC) aimed at providing European Union (EU)-tailored standards for the diagnosis, treatment and prevention of tuberculosis (TB). The International Standards for TB Care (ISTC) were developed in the global context and are not always adapted to the EU setting and practices. The majority of EU countries have the resources and capacity to implement higher standards to further secure quality TB diagnosis, treatment and prevention. On this basis, the ESTC were developed as standards specifically tailored to the EU setting. A panel of 30 international experts, led by a writing group and the ERS and ECDC, identified and developed the 21 ESTC in the areas of diagnosis, treatment, HIV and comorbid conditions, and public health and prevention. The ISTCs formed the basis for the 21 standards, upon which additional EU adaptations and supplements were developed. These patient-centred standards are targeted to clinicians and public health workers, providing an easy-to-use resource, guiding through all required activities to ensure optimal diagnosis, treatment and prevention of TB. These will support EU health programmes to identify and develop optimal procedures for TB care, control and elimination.

[A study of the risk factors for relapse in pulmonary tuberculosis patients and the results of the re-treatment]. / Studiul factorilor de risc de recidiva la bolnavii cu tuberculoza pulmonara si rezultatele retratamentului acestora.

The percentage of relapses among the global TB incidence in Romania increased from 7.7% in 1990 to 13.1% in 1999. The study group included 648 cases with relapsing lung tuberculosis, registered in the second semester, 1997. In more than half of the cases (54.9%) the relapse occurred in the 5 years following the healing of the previous episode. The percentage of 65.5% smear positives represents an increase compared to the first episode (61.7%) and illustrates the severity of these cases. From the first to the second episode, there was an increase of the percentage of "unemployed" and "retreated". Associated diseases were: COPD (10.6%), peptic ulcer (10%) and chronic hepatitis (9.6%). We found high percentages for drinking habits (46.9%) and smoking (41.5%). The re-treatment resulted in only 49% healing, compared to 75.7% at the first episode. This calls for an improvement of initial chemotherapy as well as re-treatment (introducing DOTS).

[The clinico-epidemiological aspects of tuberculosis occurring in medical personnel in pneumophthisiology units in Bucharest (1992-1996)]. / Aspecte clinico-epidemiologice ale tuberculozei survenite la personalul medical din unitatile de pneumoftiziologie din Bucuresti (1992-1996).

The authors studied 38 TB cases diagnosed between 1992 and 1996 among the 1092 employees (medical and nonmedical) of the pneumophthisiology departments in Bucharest (hospitals and ambulatory units). Most cases had pulmonary involvement (76.3%), 85.7% were bacteriologically tested for bK. Among them, 66.7% were confirmed. The therapeutic results evaluated after 1 year, showed just 1 failure. The medium annual risk of tuberculosis at the PF personnel is corresponding to an incidence of 700/100,000 (6.36 times higher than TB incidence in general population). This conclusions calls for emergency measures for protecting and compensating this personnel.

[The epidemiological profile and current evolutionary trends in tuberculosis in adolescents (15-19 years old) in the capital]. / Studiu asupra profilului epidemiologic si tendintelor actuale ale evolutiei tuberculozei la adolescenti (15-19 ani) în Capitala.

In Bucharest, the increasing TB incidence in the age group of 15 to 19 years till 100.11/100000 in 1996 has to become a concerning matter. The study of 585 cases aged 15 to 19 registered in Bucharest between 1991 and 1995 (more than 2/3 of all the cases in that period) revealed the important proportion of secondary TB (67.4%), as well as the frequency of pleural involvement (25.6%). The main discovering methods remain the examination of symptomatic cases (78.6%) and epidemiological inquiry (10%). The fact that 85% of the bacteriological confirmed cases had positive sputum specimens in microscopy confirms the idea of discovering the patients in advanced stages of disease, as well as epidemiological signification. Almost 50% of the ill teen-agers belong to families with low living status. At this age group we found an important degree of recovery after chemotherapy (82% rate of healing in the first year).

[The results of the chemotherapy of a patient cohort with pulmonary tuberculosis followed-up for a 3-year period]. / Rezultatele obtinute prin chimioterapie la o cohorta de bolnavi cu tuberculoza pulmonara, urmariti timp de 3 ani.

In 1992, in the fourth district of Bucharest 184 news adult patients with pulmonary tuberculosis were registered, and they received specific chemotherapy. The initial sputum bacteriological examination was M+C+ in 63.1% of these patients, M-C+ in 21.7% and M-C- in 15.2%. After three years of surveillance the results of the treatment were evaluated. 27 patients were excluded from the initial group, because they failed to be controlled. The final results were influenced by the sex and the initial bacteriological examination of sputum: the persistent negativation of sputum was obtained in 96.2% of the women, and only in 89.5% of men; depending on the initial bacteriological sputum examination, 100% of the M-C+ cases were negated, but only 86.4% of the M+C+ group.

Flutter-VRP1 Desitin--a new physiotherapeutic device for the treatment of chronic obstructive bronchitis.

Techniques and therapies intended to assist in the removal of excessive mucus from the lungs are now receiving greater attention in the medical practice. Flutter-VRP1 Desitin is a new pocket-sized personal therapeutic device used in the adjuvant treatment of respiratory diseases characterized by different degrees of bronchial obstruction, mainly due to disturbances of bronchial clearance and mucostasis. Used in a group of 20 patients with chronic obstructive bronchitis in whom the clinical and functional parameters were determined before and after regular use of the device for periods varying between two and eight weeks. The Flutter-VRP1 proved as a very promising technique, which can significantly ameliorate the evolution of chronic obstructive bronchitis, especially in the cases with mild to moderate deterioration.

[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 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 evolution and structure of morbidity from extrarespiratory tuberculosis in the last 15 years in Romania]. / Consideratii privind evolutia si structura morbiditatii prin tuberculoza extrarespiratorie în ultimii 15 ani in România.

Though in comparison with the overall lethality of tuberculosis the extra-respiratory localizations of the disease showed a markedly less weight than the respiratory ones during the past 15 years (12.8% in 1975 and 6.7% in 1989), this pathology chapter is still essential due to the diversity of Tb forms and localizations. The annual average rate of the decrease in extra-respiratory tuberculosis incidence was of 4.8% between 1975-1989, so the incidence value reached 4.2%000 at the end of the last year of study. Just like 15 years ago, in 1989 the extra-respiratory tuberculosis incidence was dominated by the localizations on the peripheral lymph nodes (1.2%000), on bones and joints (1.0%000), urogenital apparatus (0.7%000), meninges and central nervous system (0.5%000). The prevalence of patients with extra-respiratory Tb localizations was gradually diminished so that only 3415 cases were registered in the IIIrd group of the active case-index in 1989 (13,524 in 1975). More than half of the number of deaths through extra-respiratory tuberculosis were still due to tuberculous meningitis, particularly in children aged 0-4 years (82% of deaths in 1989). A further diminution up to a total elimination of extra-respiratory Tb localizations (still about 1,000 new cases a year) can be reached only by a restriction and liquidation at the same time of both primary and secondary pulmonary tuberculoses.

[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.