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Bactericidal activity of leukocytes was investigated in 63 patients with new infiltrate pulmonary tuberculosis and 28 patients with fibrous cavernous pulmonary tuberculosis. The diverse oxygen-dependent bactericidal activity of phagocytes is typical of the patients suffering from both clinical forms of tuberculosis: reduction of nitrosative stress rates, which is more frequent in those suffering from fibrous cavernous tuberculosis, and increase of oxidative stress rates, which is more intensive in case of fibrous cavernous tuberculosis. The associated functions were detected among immune-competent cells, involved in the bactericidal function: in case of fibrous cavernous tuberculosis – between oxidative stress rates, and in case of infiltrate pulmonary tuberculosis – between nitrosative stress rates; the synergistic effect of respiratory burst was observed. In case of chronic pulmonary tuberculosis, both types of cells were equally responsible for bactericidal functions, while neutrophils were dominating in new infiltrate pulmonary tuberculosis, without prior treatment, being the cells of the first line of defense. The obtained results allowed concluding that in case of new pulmonary tuberculosis without prior treatment, nitrosative stress played the important role in the killing of tuberculous mycobacteria, while in case of chronic tuberculosis – it was oxidative stress.

The aim was to study the causes of death in HIV patients in the Novokuznetsk tuberculosis dispensary in 2016 (population is 550 thousand people; about 2% of population are HIV-positive). Materials and methods: Protocols of all autopsies of HIV-infected patients (n=221) performed in 2016 in the Novokuznetsk tuberculosis dispensary. Results: The mean age of the deceased was 37 Ѓ }6,9 years. HIV and tuberculosis (TB) co-infection was in 83,3% of patients (n=184), HIV/TB and other opportunistic or severe somatic diseases – in 10,4% (n=23), non-tuberculous opportunistic diseases – in 6,3% (n=14). The new tuberculosis cases were in 71,1% (n=147), relapses – in 7,2% (n=15), chronic tuberculosis cases – in 21,7% of patients (n=45). Disseminated form prevailed among the cases of respiratory tuberculosis; generalized tuberculosis (3 and more localizations) occurred in 87,0% (n=180), tuberculosis meningitis was found in 17,9% (n=37). Positive fluorescent sputum microscopy was in 72.5%, sputum cultures on Loewenstein-Jensen medium – in 78,3% with HIV/TB. Primary multidrug resistance was detected in 60,7% (including in 5,8% of them with primary extensively drug resistance). Severe opportunistic infections or malignancies were in 9,2% of HIV/TB (n=19) and in 78,7% of non-TB patients (n=11). Data on the CD4 level was known in 68,8% of cases (n=152): the median count was 75,5 cells/ μ l; 38,9% of new TB cases (n=46) were diagnosed with HIV in time of TB detecting. Antiretroviral therapy was performed only 13% of patients (n=29). Conclusion: There is a need for the optimization of HIV detecting approaches and early initiation of antiretroviral therapy before the appearance of incurable opportunistic diseases, as well as for comprehensive TB prevention.

With the help of the questionnaire on studying personal needs of people with different social status developed by the author three groups of people were questioned. In the basis of the questionnaire is the theory of Maslow A. One group consisted of practically healthy people; the second group – of people with chronic obstructive pulmonary disease, their social status was the same. And the third group consisted of people with chronic tuberculosis. They had similar changes in lungs as the people from the second group but their social status was low. The results showed that all the personal needs of the sick persons are reduced except the need in respect. Personal needs are dependent on the state of health except the need in respect. The need in respect is more important than health. The need in respect can be used as motivation for work, treatment, training and career development. DOI: 10.5901/mjss.2015.v6n6s3p360

Substitution of rifapentine (RFP) for rifampin (RIF) in the standard antituberculous regimen reduces the time required to cure chronic tuberculosis (TB) infection in mice, but not in guinea pigs. In order to gain insight into these discrepant findings, we conducted a steady-state pharmacokinetic (PK) study in healthy guinea pigs to study the metabolism and autoinduction of RIF and RFP. Both RFP and RIF 25-desacetyl metabolites (desRFP and desRIF, respectively), were detected at low concentrations in the serum of guinea pigs. The metabolite concentrations in guinea pigs are much lower than those seen in humans at steady state.

On Christmas Eve 1947, Eric Blair (pen-name, George Orwell) was admitted to Hairmyres Hospital near Glasgow.2 George Orwell (Figure 1) was a journalist and novelist, and the publication in 1945 of his political fable, Animal Farm,3 had made him famous. He was 44 years old, and tests at the hospital confirmed that he had infectious chronic tuberculosis in his lungs.4 Orwell has been described as ‘a representative of truth-telling, objectivity and verification’.5 As with other events in his life, he carefully analysed and documented his experience of care for his tuberculosis, including his time in a private sanitorium. Orwell had been given treatments that were common for tuberculosis in Britain at that time: ‘collapse therapy’ and other painful surgical procedures to keep the lung disabled to ‘rest’ it, vitamins, fresh air, and being confined to bed. The hospital staff confiscated his typewriter and told him to stop working6—but they didn’t seem to advise him to stop smoking! (Figure 2) Orwell’s work, a novel he would struggle to complete in the coming year—1948, was Orwell’s ‘last great obsession’.7 He twisted the numbers of that year to give the book one of the most famous titles and powerful symbols from the 20th century: Nineteen EightyFour,8 introducing Big Brother and words like ‘doublespeak’ to the international political and social landscape (Figure 3). Orwell was hopeful

Text and Interview by Hema Bashyam By figuring out how mycobacteria survive within the very cells that try to kill them, Ehrt hopes to find a way to combat chronic tuberculosis infections. For most bacteria, getting scooped up by macrophages means a rapid death at the hands of a lethal cocktail of

Background BAE for massive haemoptysis is potentially life-saving with low short-to-medium term failure rates in previous studies. We aimed to characterise patients referred for BAE, to examine long-term treatment success and identify risk factors for requiring repeat BAE. Methods We retrospectively identified all patients undergoing BAE from 1994 to 2007. We collated data from hospital databases and primary care on demographics, respiratory diagnoses and procedure with follow-up of up to 16 years. Outcomes were all-cause mortality and recurrence of haemoptysis requiring repeat BAE. Results 158 patients were embolised on 208 occasions. 85 (54%) patients were male and median age was 54 (IQR: 41–67) y. The most common underlying diagnoses were aspergilloma (n=38; 24% of patients), bronchiectasis (n=24; 15%), unidentified cause (n=17; 11%) chronic tuberculosis (n=14; 9%), active tuberculosis (n=12; 8%) and cystic fibrosis (n=11; 7%). All-cause mortality at 1 month and 3 years was 5.3% and 29.7%, and need for repeat BAE was 4.7% and 30.7% respectively. Repeat BAE at 3 years was most common with aspergilloma (50%) and least common with active TB (0%). 3-year mortality was highest in cystic fibrosis (40%) and least with unknown cause (7.7%) Neither number nor location of vessels embolised predicted mortality or need for repeat BAE. No major procedural complications were noted. Conclusions BAE by experienced operators is a safe, minimally invasive procedure for massive haemoptysis with excellent short-term success. It does not prevent late recurrence of haemoptysis nor obviate the need for repeat BAE, the risk of which is related to the underlying disease rather than to technical aspects of the procedure.

Two cases of miliary tuberculosis that were diagnosed clinically as lymphocytic leukemia are presented. Both cases had evidence of chronic tuberculosis which was of 43 years’ duration in Case 1 and of 28 years’ duration in Case 2. Both patients had granulocytopenia and anemia. Autopsy findings revealed no evidence of leukemic infiltration, but a diffuse miliary tuberculosis, involving all of the hematopoietic tissues, existed in both Cases.

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The subject of purpura in this paper is treated from the standpoint of the relationship it bears to tuberculosis. Several writers within the last two centuries have made observations on this phenomenon, endeavoring to find its cause and effect, and to discover the relation purpura has to other diseases with which it is associated. Mackenzie1 says : The great variety of supposed causes or associated conditions is sufficiently striking. Still more so is the fact that in one-third of 200 cases no explanation was offered for the purpura, though in several of the cases a necropsy was made. It will thus be seen how extremely complex is the pathology of purpura. All we can do in the present state of our knowledge is to accumulate further information and to exhaust every means—histological, bacteriological and chemical—in the investigation of cases. Osler 2 also maintains "that purpura is obscure, and is

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No disease has received more attention in the literature than tuberculosis, especially pulmonary tuberculosis, yet the subject is by no means exhausted. There is a type of pulmonary tuberculosis infrequently met with in children which is often overlooked, unless constantly kept in mind. The most frequent form of tuberculosis in children, aside from tuberculous meningitis and miliary tuberculosis, is tuberculous pneumonia, either of the lobar pneumonic or bronchopneumonic type. Chronic tuberculosis as met with in adults is almost unknown in infants and children under 2 years of age. With the aid of the roentgen ray more cases of the chronic and subacute forms are being discovered. (Reuben,1Dunn,2Eisler,3and Wesler and Bass,4speak of such cases.) The type of tuberculosis to which I wish to call attention may be defined as a diffuse or parenchymatous process involving that portion of the lung immediately adjacent to

The following work was undertaken for the purpose of producing an experimental chronic insufficiency of the adrenal glands. It was then our intention to study this experimental insufficiency in relation to the other glands of internal secretion, and to compare it with the clinical picture of Addison's disease. Thus far all experimental work has resulted only in an acute insufficiency of the adrenal function. Excision of the glands is followed by death in two or three days. It was accordingly necessary to devise some means of slowly but progressively injuring the function of the glands. For this purpose it was decided to try the injection of tuberculin over long periods. Tuberculin was selected because of the evidence presented by certain workers in this field that chronic tuberculosis causes a sclerosis and atrophy of the adrenal glands. Bernard and Bigard1have found, in the adrenals of the tuberculous, a

For the purpose of the present paper it does not especially concern us which or how many of the different tissues which together constitute a joint are affected, and I shall not attempt to discuss methods of treatment based on anatomic differentiation of the location of the lesion. It may, however, be stated that in the great majority of cases the initial lesion, so far as the joint is concerned, is in the bone; but in the purely conservative treatment the management of these cases differs hardly any from that of those which are primarily synovial. Underlying the treatment of all forms of chronic tuberculosis, of whatever tissue or wherever situated, is the gospel of rest and food. This is founded upon the fact, learned in the first place by experience, and confirmed later by the results of biologic investigations, that there is in living tissues an inherent antagonism to