Enhanced work efficiency in agricultural workers with surgically treated pulmonary tuberculosis

Recommendations were developed and proposed for rational employment of agricultural workers operated on for pulmonary tuberculosis. The proposals were formulated with regard to the volume of the work done, impairment of the respiration and cardiovascular systems, activity of the specific lesions in the remaining lung tissue, character of the previous job and differential periods: short-term periods up to 1 year, medium-term periods up to 2 years and continuous periods of over 2 years.     

Effect of low hemoglobin levels on the diffusing capacity of the lungs for CO. Investigations in persons with healthy lungs and in patients with interstitial pulmonary fibrosis

The influence of the hemoglobin concentration in the peripheral venous blood on the diffusing capacity of the lungs for CO (DLCO) was tested with the single-breath method. 9 patients with histologically verified interstitial pulmonary fibrosis of varying etiology and 26 persons with healthy lungs with anemia requiring transfusions were investigated before and after compensation of the anemia. It was found that the true maximum diffusing capacity of the lungs measured in anemia patients was too low. In the test subjects with healthy lungs, there was a positive linear correlation between the hemoglobin content of the blood and DLCO. A correction factor to calculate the true DLCO in patients with healthy lungs but with anemia is specified. In the patients with interstitial pulmonary fibrosis, the influence of the reduced diffusing capacity of the alveolocapillary membrane on the extent of the diffusion disorder was in each case greater than the effects due to the anemia.     

Using the St. George respiratory questionnaire to ascertain health quality in persons with treated pulmonary tuberculosis

INTRODUCTION: Pulmonary tuberculosis (PTB) can result in anatomic and functional changes that are associated with pulmonary impairment after tuberculosis that occurs frequently and varies in severity. We completed the St. George Respiratory Questionnaire (SGRQ), a health-related quality-of-life (HRQoL) instrument validated for several types of lung disease, for patients in whom PTB or latent tuberculosis infection (LTBI) has been diagnosed. We measured HRQoL pattern changes and the usefulness of the SGRQ in their ascertainment. METHODS: Participants with known pulmonary function and a history of PTB or LTBI completed HRQoL questionnaires. The SGRQ was validated for content and construct using pulmonary function tests and the Medical Outcomes Study questionnaire. Internal consistency and test-retest methods assessed reliability. Significance of findings was determined with one-way analysis of variance with between-group comparisons. RESULTS: Over 15 months, 313 subjects completed the SGRQ. The SGRQ was valid and reliable in the study population (intraclass correlation, 0.927; p<0.01; Cronbach alpha, 0.93). The mean total score for posttuberculosis patients was significantly higher than for that for LTBI score (23.5 [SE, 2.2] vs 10.3 [SE, 1.0], respectively; p<0.001). CONCLUSIONS: We validated the SGRQ in a diverse population microbiologically cured of tuberculosis and found a mean 13.5-U difference in SGRQ score between these patients and a comparison group with similar risk factors (p<0.001). This difference indicates impairment after PTB has a substantial impact on human health worldwide. The microbiological cure of tuberculosis is not sufficient to avert chronic health loss. More aggressive treatment of LTBI and other case-preventing strategies is warranted worldwide.     

Radionuclide diagnosis of capillary pulmonary blood flow in new cases of pulmonary tuberculosis]

The radionuclide technique pulmonary perfusion scintigraphy was used to study 124 new cases of pulmonary tuberculosis before therapy and 25 controls. The data indicated that perfusion impairments were significant and rather noticeable in 84% of new cases of the disease. Evidence was provided for that pulmonary capillary blood flow was associated with the duration of the disease, with the initial type and phase of a tuberculous process, and with clinical manifestations. There was a predominance of significant and drastically marked vascular lesions in patients with infiltrative and disseminated tuberculosis under the present conditions.     

Differentiated examination of persons with Mycobacterium tuberculosis infection for improvement of tuberculosis detection and prevention

Tuberculosis morbidity in the adults, who were close relatives of infected children, is 5.2 times higher than the mean rate for the adult population; of them the individuals having 21 mm or more and 13-18 mm papules to the Mantoux test with 2 TU PPD-L showed 10.6 and 3.8-fold rates, respectively. 40% of the infected were subjects aged 18 to 29 years and living in the families with affected parents. The group under observation included persons highly allergic to tuberculin in 6.3 times more than amongst all the examined adults. The differential examination and observation of subjects at a risk of endogenous reactivation and belonging to the families of the infected groups are shown to be important in optimizing tuberculosis detection and prevention.