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EN
Introduction: Tuberculosis (TB) continues to pose a major global health problem, causing an estimated 8.8 million new cases and 1.1 million deaths during 2010. The role of private sector in countering this global problem cannot be underestimated. Materials and Methods: A cross-sectional descriptive study of two months duration (February – March 2013) was conducted among all the clinical teaching faculty of various departments of a private Medical College in Kancheepuram district. A pre-tested, semi-structured questionnaire was designed after thoroughly studying the Revised National TB Control Program (RNTCP) training modules (Modules 1-4). All the study participants were administered the questionnaire after obtaining their informed consent. Data entry and statistical analysis was done using SPSS version 17. Results: Out of the 51 study participants only 4(7.8%) were trained in RNTCP. Almost 28(54.9%) participants wrongly responded that three sputum examinations are recommended for diagnosis of pulmonary tuberculosis. Approximately, half 25(49%) of the clinicians could not correctly ascertain the duration of treatment of TB . Conclusions: As the private sector plays a significant role in diagnosis of a major proportion of TB cases, the RNTCP cannot afford to disregard this sector. The study findings demonstrate wide gaps in knowledge about RNTCP guidelines among clinical faculties. The findings of the study should be an eye-opener for the health policy makers and program managers. Need of the hour is to train all private sector doctors in RNTCP and motivate them to comply with RNTCP guidelines.
PL
Artykuł przedstawia życie i działalność badawczą Eugenii Piaseckiej-Zeylandowej, wybitnej znawczyni problematyki prątka gruźlicy, docent Uniwersytetu Poznańskiego. Dla historii medycyny szczególną wartość mają informacje o jej ostatnich latach życia.
EN
The article describes Eugenia Piasecka-Zeylandowa, her life and research on the tubercle bacillus. Piasecka-Zeylandowa, reader of Poznan University, was an outstanding expert of issues of tuberculosis and BCG vaccination. This article provides information on her last years
XX
The emergence of resistance to first-line drugs used to treat tuberculosis (TB) has become a significant public health concern and an obstacle in implementation of effective TB control activities globally. In India, Revised National TB Control Program (RNTCP) introduced the programmatic management of drug-resistant TB (PMDT) services to address the needs of MDR-TB patients. To execute the plan with perfection, RNTCP has devised MDR suspect criteria – A, B, and C so that gradually PMDT services can be extended to the whole country. These criteria were framed to run in tandem with the strengthening of the laboratory services so that the existing certified laboratories can carry out the culture and DST services without being overburdened. Altogether, RNTCP is committed for the strengthening and capacity building of its resources to offer culture and DST services right at the time of diagnosis.
EN
Introduction. Cervical lymph nodes are lymph nodes found in the neck. Hijab is a head cover worn by some Muslim women in the presence of any adult male outside of their immediate family, which usually covers the head, neck and chest. It is strictly forbidden to Muslim woman to unveil any single hair of her head, so they use many pins around the head to fix their Hijab. Often, while using pins they are self-pricked. Aim. The main aim of our work is to reveal a new cause of lymphadenopathy, which is not known till now. Material and methods. Retrospective study during the past five years among seventy-five female outpatients, visited our Oral and Maxillofacial clinic in dental department. Our data was collected according to medical history of patients; all female patients with cervical lymphadenopathy were using (A hijab). Results. Data collected of 75 female patients. Lymphadenopathy causes were various. Most of these causes resulted from nonspecific lymphadenitis (67 patients), 4 tuberculosis, 2 lymphoma, 2 cat scratch disease. Aetiology of 67 nonspecific lymphadenitis was 40 patients of dental cause, 10 of sore throat, 7 of acne vulgaris, 3 of mild facial injuries, and 7 of (Hijab pin pricks). Conclusion. Hijab pin prick cervical lymphadenitis in Islamic communities is not uncommon and, unexplained cervical lymphadenitis should be considered as potential cause
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EN
Introduction. Tuberculosis is one of the oldest infections known to mankind. Of all infectious diseases, tuberculosis causes the most fatalities of any infection. The incidence of tuberculosis on the rise due to the increased prevalence of HIV infection. The incidence of drug resistance strains of mycobacterium is also on the rise. When the mycobacterium is resistant to both INH and rifampicin it is called multi drug resistant tuberculosis. There is a primary and an acquired type of drug resistance. Multidrug resistant tuberculosis is a not only a problem for the patient but also for society at large. The treatment of multidrug resistant tuberculosis requires an entirely different approach. Aim. In this review, we are going to describe the etiopathogenesis, diagnosis, investigations and treatment of multi drug resistant tuberculosis. Material and methods. Analysis of the current literature. Results. Genetic factors, previous treatment, and other factors predisposes the onset of drug resistance. By early detection and prevention of spread of drug resistant strains we can prevent the spread of resistant strains. Conclusion. Drug resistance in tuberculosis is a very complex and dangerous problem. We have to prevent the development and spread of MDRTB. Good quality drugs should be used and made available to all sections of the population. Enhancing the National tuberculosis programs is the best way to attain an effective way to control this menace.
Mäetagused
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2010
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vol. 45
39-52
EN
Private letters are the least researched genre of autobiographical writings. Irrespective of this fact, letters can indeed offer abundant research material about the ailing person’s perceptions of the disease and how he/she depicts this in writing. The article dwells upon the depiction of disease, based on the letters by Ilmi Kolla (1933–1954), using the concept of (auto)pathography as an analytical means. The focus is on how the illness is being textualised in letters and how the epistolary genre affects such a depiction. Ilmi Kolla’s letters reflect the progress of her disease, presenting this from the author’s viewpoint, yet adapting it according the addressees – e.g., Ilmi Kolla’s letters to her mother are written in a more optimistic tone regarding her illness than the ones to poet Debora Vaarandi expressing greater concern. The letters reveal various facets of the disease and her state of mind with regard to the illness, presenting a picture of sanatorium and hospital treatment. In line with the growing severity of Ilmi Kolla’s disease, the illness becomes gradually more visible in her letters, encompassing increasing textual space. Thus, the ailment has become one of the main topics in I. Kolla’s letters sent from the hospital during the last six months of her life. The fact that letters tend to be fragmentary texts separated from each other by a temporal-spatial distance becomes evident in the narrative of disease constructed by the letters. Although such an illness narrative lacks coherence intrinsic of a traditional linear autobiographic text, such a life history or a diary, an epistolary story of an illness can be studied from the viewpoint of auto-pathography as the letters create an autobiographic description of the illness. As unpublished texts, letters can both reflect and oppose the discourses of the time. The depiction of the disease, and that of an ailing body, revealed in Ilmi Kolla’s letters, functions as a counter-discourse to the body image of the Stalinist era, which highlighted a healthy, strong and powerful female body. As such, the reflection of the disease in the letters actually brings out the cultural and gender-wise meanings related to the disease, highlighting the illness as a cultural construct.
EN
Background. Unfinished tuberculosis (TB) treatment has slowly but surely become an unexpected event in the disease’s development into drug-resistant TB. Developing countries, mostly comprised of Asian and Eastern European countries, including Indonesia, have been overwhelmed in preventing drug-resistant TB outcomes and have also failed to avoid the development of this disease. Objectives. This review discusses the current issue of an unfinished first-line TB treatment strategy in primary care in Indonesia, presenting some relevant strategies in developing countries. Material and methods. A narrative review approach conducted on all existing evidence in selected scientific bibliographic sources. The researchers defined the keywords based on the research question as a search strategy. Results. Scarce resources and limited access, alongside national policy on TB control and management, contribute in different ways to impede first-line TB treatment in Indonesia. Empowerment of TB patients and their families are considered the best ways to increase awareness on TB medication in a low- to middle-income setting. The role of the hospital and private practitioner networks in the treatment and management of TB patients is essential for developing active-case-finding-approach programs for TB suspects in primary care in an Indonesian setting. Contrarily, the potential misunderstandings in TB treatment have led to peculiar events affected by poor surveillance systems for TB investigation contacts to prevent TB incidences in large populations. Conclusions. This study addressed the barrier of all stakeholders, particularly primary care, to achieve the Indonesian government’s goals of TB elimination by 2030 and zero TB findings by 2050
PL
In the second half of the 19th century, social development based on science, technological innovation, rationalism and capitalist economy presents itself as full of promise insofar as it proclaims the upcoming progress of civilization. The downside of this process is the increase in crime, massive neurosis, various forms of moral disorder, and the epidemics of somatic diseases such as tuberculosis and syphilis. Consequently, the perception of the new generation as degenerate is actually the way to articulate anxiety in the culture of the time. Croatian literature at the end of the 19th and at the beginning of the 20th century frequently refers to illness, bodies burdened by drives, and to sick, tense or perverted minds. The paper, therefore, reads tuberculosis as a metaphor for the discontent and fear that permeate the contemporary Croatian society due to, for instance, the failure of the traditional concept of identity, changed gender roles, frequent sexual transgressions, increased mortality and generally due to the inefficiency of modernization processes in solving numerous social problems and crises.
EN
On the basis of correspondence between Franz Kafka and Robert Klopstock, which was recently published by the author, this study presents the last years and days in the life of Franz Kafka, his connections with his family and friends and particularly with Klopstock, a medical student, who became acquainted with Kafka in 1921 at the Matliary sanatorium in the Tatras and with whom Kafka formed his last great friendship in life. Klopstock, who was himself literarily active, was very close to Kafka in the last years of his life; both were brought together by their intellectual interests. Kafka endeavoured to help Klopstock even materially, while Klopstock selflessly accompanied the writer in the last weeks of his life. This study also shows how classic medical ideas used in the treatment conflicted with Kafka’s own ideas and the efforts of his mistress Dora Diamantová, who advocated “natural cures”.
EN
This paper considers the discipline of palaeopathology, how it has developed, how it is studied, and what limitations present challenges to analysis. The study of disease has a long history and has probably most rapidly developed over the last 40-50 years with the development of methods, and particularly ancient pathogen DNA analysis. While emphasizing that palaeopathology has close synergies to evolutionary medicine, it focuses then on three ‘case studies’ that illustrate the close interaction people have had with their environments and how that has impacted their health. Upper and lower respiratory tract disease has affected sinuses and ribs, particularly in urban contexts, and tuberculosis in particular has been an ever present disease throughout thousands of years of our existence. Ancient DNA methods are now allowing us to explore how strains of the bacteria causing TB have changed through time. Vitamin D deficiency and ‘phossy jaw’ are also described, both potentially related to polluted environments, and possibly to working conditions in the industrial period. Access to UV light is emphasized as a preventative factor for rickets and where a person lives is important (latitude). The painful stigmatizing ‘phossy jaw’ appears to be a condition related to the match making industries. Finally, thoughts for the future are outlined, and two key concerns: a close consideration of ethical issues and human remains, especially with destructive analyses, and thinking more about how palaeopathological research can impact people beyond academia.
EN
This article discusses the Polish doctors’ views on the issue of smallpox vaccine and tuberculosis vaccine. The cognitive aim of the study was to present the history of introducing both vaccines on the territory of Europe, show the Polish doctors’ opinions on this background and catch the similarities and differences in attitudes to both vaccines. Important factor is that smallpox vaccine was introduced before formulating the standard of microbiology, whereas tuberculosis vaccine was introduced after formulating this standard. Smallpox vaccine was introduced on the territory of Poland in 1801. Thanks to its effectiveness, the vaccine became a regular part of the prevention of infectious diseases. Polish doctors have frequently taken the subject of vaccination in periodicals, writing not only about its advantages and values, but also about many issues related to it. Tuberculin was accepted by the medical community as a revelation and miracle drug. However, after several months of trials, it exposed its imperfections, such as some complications (deterioration of the patient’s condition, death) and no cases of complete cure. For these reasons tuberculin was criticized by doctors and withdrawn from use.
PL
Wstęp. Szczepienia są jedną z metod profilaktyki przeciw wielu chorobom zakaźnym. Podczas analizy różnic w realizacji podstawowych szczepień u noworodków w poszczególnych krajach Unii Europejskiej wyłania się istotny problem braku ujednolicenia tego rodzaju programów profilaktycznych. W Polsce na rodziców nałożony jest obowiązek szczepień noworodków. W pierwszej dobie życia dziecka obowiązkowe są dwa szczepienia: przeciw gruźlicy i wirusowemu zapaleniu wątroby typu B. Obecnie w Polsce zwiększa się liczba rodziców, którzy odmawiają zaszczepienia swoich dzieci.
EN
Background. Vaccinations are one of the methods of prevention against many infectious diseases. During the analysis of differences in the implementation of basic vaccinations in newborns in individual countries of the European Union, there emerges the significant problem of the lack of unification of such types of prevention programs. In Poland, parents are obliged to vaccinate newborns. In the first day of the child’s life, two vaccinations are obligatory: against tuberculosis and hepatitis B. Currently, the number of parents who refuse to vaccinate their children is increasing in Poland.
EN
Tuberculosis remains a significant cause of human suffering and death in the twenty-first century and represents a relevant public health problem. The article analyzes how the conflict between individual freedom and public health is related to tuberculosis treatment and how they are perceived and managed by the professionals and contacts involved in the process. This is qualitative research, in which semi-structured interviews were conducted with contacts of tuberculosis patients, as well as health professionals from the Epidemiological Surveillance and Family Health Strategy, involved in Tuberculosis Control in the city of Araçuaí, MG.The data analysis verifies the tension between individual freedom and public health, showing that the discontinuity of treatment is related to two political senses of freedom. While in the negative sense the person is considered free when no person or group interferes with his actions, in the positive sense freedom is understood as the self-determination of the individual. Therefore, considering the risks that freedom in the decision not to adhere to treatment (positive sense) may bring to the community, the conception of negative freedom applied by the Brazilian health system is based on interference, requiring conduct and strategies in these cases.
ES
A tuberculose permanece causando sofrimento humano e morte em pleno século XXI, representando um relevante problema de saúde pública. O artigo analisa os conflitos entre a liberdade individual e a saúde pública relacionados ao tratamento da tuberculose e como eles são percebidos e gerenciados pelos profissionais e contatos envolvidos no processo. Trata-se de uma pesquisa qualitativa, na qual entrevistas semi-estruturadas foram realizadas com os contatos dos portadores de tuberculose, bem como, com os profissionais de saúde da Vigilância Epidemiológica e da Estratégia Saúde da Família, envolvidos no Controle da Tuberculose no município de Araçuaí - MG. Na análise dos dados verificou-se a tensão entre a liberdade individual e a saúde pública, evidenciando que a descontinuidade do tratamento se relaciona com os dois sentidos políticos de liberdade. Enquanto no sentido negativo a pessoa é considerada livre quando nenhuma pessoa ou grupo interfere em suas ações, no sentido positivo, a liberdade é compreendida como a autodeterminação do indivíduo. Portanto, considerando os riscos que a liberdade na decisão por não aderir ao tratamento (sentido positivo) pode acarretar para a coletividade, a concepção de liberdade negativa aplicada pelo sistema de saúde brasileiro está baseada na interferência, exigindo condutas e estratégias diante desses casos.
EN
The article focuses on the presentation and analysis of selected excerpts from Frédéric Chopin’s letters from the 1824-1849 period that illustrate their author’s attitude towards physical experiences. In contrast to the “disembodied” reception of the artist that reproduces the “soul of the piano” metaphor, the article describes a broad representation of the composer’s texts on physical appearance, the role of the body in the performance act, living through illness and the oncoming death. The cross-sectional and chronologically ordered study presented in the article shows the evolution of the subject’s attitude towards his own body along the progress of his illness. It is at the same time an illustration of the style and imagery used by the author of the letters while describing specific aspects of physical experience.
EN
The end of the nineteenth century was marked by a strangely affirming attitude to disabilities, diseases, and bodily deformities. From the Romantics, the artists of the Young Poland movement inherited a fascination with tuberculosis amounting to the mythologization of the sick; tuberculosis, or the “white plague,” was one of the favourite themes of the modernist studies of human disability and mortality. The turn of the century was also a time of extensive research into mental diseases. The naturalists, for that matter, equipped the great prose writers of the Belle Epoque with the medical conceptual apparatus and developed a sophisticated language of “clinical literature.” This article, focusing on several literary works representative of the Young Poland movement, strives to explain how, at the turn of the century, the experience of illness influenced the texts of culture and, vice versa, how literature shaped the understanding of illness.
PL
Schyłek wieku XIX odznaczał się osobliwym, wręcz afirmującym stosunkiem do ułomności, chorób i deformacji cielesnych. Po romantykach artyści Młodej Polski odziedziczyli fascynację gruźlicą, swoistą mitologizację chorych. Tuberkuloza była jednym z ulubionych tematów modernistycznych studiów nad ludzką ułomnością i śmiertelnością. Naturaliści z kolei wyposażyli wielkich prozaików belle époque w medyczny aparat pojęciowy, rozwinęli wyrafinowany język „literatury klinicznej”. Przełom wieków to także czas intensywnych badań nad chorobami umysłowymi. W artykule pochylono nad reprezentacyjnymi utworami, starając się zbadać, jak chorobowe doświadczenia ludzi przełomu wieków wpływały na teksty kultury – i na odwrót.
EN
In the early 1900s, European citizens, especially from the working class, suffered from diseases caused by nutrient deficiencies. In addition to tuberculosis, which was spreading in poor city quarters, so called skrofula (a lymphadenitis of the cervical lymph nodes associated with tuberculosis) and rickets were also spread. Houses for weakened and malnourished residents were built on the Baltic coast for preventive or rehabilitation purposes. That is why these spas were called "Seehospiz" or "Heilstätte" in German. The article presents the most important objects that existed about 100-125 years ago in the territory of the present West Pomeranian Voivodeship.
PL
Na początku XX wieku obywatele europejscy, zwłaszcza ci z klasy robotniczej, cierpieli choroby spowodowane niedoborami substancji odżywczych. Oprócz gruźlicy, która szerzyła się w biednych dzielnicach miast, rozpowszechniły się także skrofuloza (tak zwana gruźlica węzłów chłonnych) i krzywica. W celach profilaktycznych lub rehabilitacyjnych wzdłuż wybrzeża Bałtyku na Pomorzu Zachodnim budowano domy dla osłabionych i niedożywionych mieszkańców. Dlatego też sanatoria te nazywano w języku niemieckim "Seehospiz" lub "Heilstätte". Poniżej przedstawiamy najważniejsze obiekty, które istniały około 100-125 lat temu na terenie obecnego województwa zachodniopomorskiego.
EN
The author of the text draws on the Polish Film Chronicle (PKF, Polska Kronika Filmowa) in which the subject of disability and illnesses is presented in a very original manner compared to the Chronicle’s typical propaganda contents. Appearing as early as in the first episodes after World War II, with minor exceptions, it remains free of propaganda accents. Instead a stronger emphasis is put on issues related to advancements in medicine, medical technologies and therapies. One of the most interesting topics addressed in the Chronicle are Polish health resorts and sanatoriums, among which the ones intended for children were of particular importance. The article also discusses the poetics of the films, ways of presenting the diseases and therapies in the PKF. The author examines popular episodes about disabilities, medicine and physical therapy, exploring what and how was accentuated by the filmmakers, what characters, patients and convalescents, they were particularly interested in, and how the narrative of the chronicles changed between the 1940s and 1970s.
EN
Tuberculosis is a chronic infectious disease caused by acid-fast mycobacteria from the Mycobacterium tuberculosis complex group. The disease spreads when people with pulmonary tuberculosis excrete bacteria when they cough, sneeze, laugh or speak. Prisons are often called reservoirs of patients with tuberculosis, posing a great threat to their staff. Longer working hours in prison and penitentiary facilities aid latent contamination among the prison staff. So far, there have been few works discussing latent tuberculosis infection issues among the prisoners and prison staff.Material and MethodsA total of 84 employees of penitentiary facilities located in the Lublin Voivodship were examined using the QuantiFERON-TB Gold In-Tube (QFT-GIT) test which was approved for use in 2005 by the U.S. Food and Drug Administration as an aid in the diagnosis of Mycobacterium tuberculosis. The material for the research included blood samples collected using the QFT-GIT.ResultsPositive test results of latent tuberculosis infections were found in 16.6% of officers. The highest percentage with positive results of tuberculosis infections was found among the surveyed single women aged 36–57, working in penitentiary facilities. There have been no statistically significant differences between the position of officers and the risk factors increasing the chance of the latent tuberculosis infection. Work experience and contact with inmates were found to have an impact on tuberculosis infection.ConclusionsThe obtained results partially confirm other authors’ observations concerning the influence of the risk factors of latent tuberculosis infections in prisons. Work experience and contact with inmates have an impact on tuberculosis infections among the prison staff in the Lublin Voivodeship. Med Pr. 2021;72(4):415–22
PL
Gruźlica jest chorobą zakaźną wywoływaną przez prątki kwasooporne z grupy Mycobacterium tuberculosis complex. Choroba rozprzestrzenia się, gdy chorzy na gruźlicę płucną wydalają bakterie podczas kaszlu, kichania, śmiania się czy mówienia. Więzienia, które są często nazywane rezerwuarami chorych na gruźlicę, stwarzają duże zagrożenie dla zatrudnionych w nich osób. Dłuższy czas pracy w więzieniu i ośrodkach penitencjarnych sprzyja zakażeniu latentnemu wśród personelu więziennego. Dotychczas opublikowano niewiele prac dotyczących zagadnienia latentnego zakażenia prątkami gruźlicy wśród pracowników zakładów karnych.Materiał i metodyPrzebadano łącznie 84 pracowników zakładów karnych zlokalizowanych w województwie lubelskim. Zastosowano test QuantiFERON-TB Gold In-Tube (QFT-GIT), który w 2005 r. został zatwierdzony do użytku przez amerykańską Agencję ds. Żywności i Leków jako pomoc w diagnozowaniu zakażenia M. tuberculosis. Materiał do badań stanowiły próbki krwi pobrane metodą testu QFT-GIT.WynikiLatentne zakażenie gruźlicą stwierdzono u 16,6% funkcjonariuszy. Największy odsetek wyników dodatnich zaobserwowano wśród badanych funkcjonariuszek z zakładu karnego, w wieku 36–57 lat, stanu cywilnego wolnego. Nie wykazano istotnych statystycznie różnic między stanowiskiem pracy funkcjonariuszy służby więziennej a czynnikami ryzyka zakażenia gruźlicą latentną. Okazało się, że na ryzyko zakażenia gruźlicą wpływają staż pracy i kontakt z osadzonymi.Wnioski Wyniki badań częściowo potwierdzają obserwacje innych autorów dotyczące oddziaływania czynników ryzyka latentnego zakażenia gruźlicą pracowników zakładów karnych. W badanych zakładach karnych staż i kontakt miały wpływ na zakażenie. Med. Pr. 2021;72(4):415–422
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