[Tuberculosis as an unusual cause of oligoamenorrhea and infertility]. / Tuberculose als ongebruikelijke oorzaak van oligoamenorroe en infertiliteit.

An 28-year-old Moroccan woman with primary infertility and OLIGO-amenorrhea was referred for hysteroscopic synechiolysis. When a diagnostic hysteroscopy was performed, a bizarre, irregular, 'cloudy' endometrium was seen. The diagnosis endometrial tuberculosis was confirmed by histological examination. Treatment with antituberculosis drug therapy resulted in a normal menstrual cycle. A normal endometrium and uterine cavity was seen at control hysteroscopy. Because of extensive irreparable tubal damage this patient will be offered IVF treatment.

Bronchial obstructive reactions after inhalation with endotoxin and precipitinogens of Haemophilus influenzae in patients with chronic non-specific lung disease.

Bronchial obstructive reactions occur after inhalation of Haemophilus influenzae in the absence of proteolytic activity in patients with CNLSD and a lowered histamine threshold in whom specific precipitins are demonstrated. It may be presumed, that the direct bronchial reaction is caused by its content of endotoxin, whereas the late bronchial reaction is the result of a toxic action and a type III allergic reaction. When proteolytic activity is present it lowers the histamine threshold and may influence the endotoxin effect in this way.

Cuirass respirator treatment of chronic respiratory failure in scoliotic patients.

The results are reported of domiciliary cuirass respirator treatment, using tailor-made shells, in four patients with severe thoracic scoliosis. Three of the patients had suffered from poliomyelitis. All complained of increasing dyspnoea on exertion, ultimately interfering with almost every activity of daily life; three patients had severe acute respiratory failure necessitating urgent admission to the Respiratory Care Unit. Right heart failure was present in two. Two patients required mechanical treatment via an endotracheal tube. All the patients were discharged home with a cuirass respirator. Standard type shells were used initially with low efficiency due to the poor fit of the cuirass shell to the deformed thoracic cage. Tailor-made shells were constructed from polyester reinforced with glass fibre, modelled on plaster casts of the thoracic cage. Subjectively the patients improved greatly and were able to resume and increase many activities. One patient committed suicide for reasons unconnected with treatment but the other three patients have been doing well from the time the cuirass respirator treatment was started, respectively, 3, 6, and 10 years ago. This treatment seems particularly effective in younger patients with severe paralytic scoliosis and cardiorespiratory failure, although the possibility of using it in older patients suffering from scoliosis of other aetiology should certainly be explored.