[Mycobacterial drug resistance in patients with pulmonary tuberculosis]

The drug resistance of 1,860 human mycobacterial strains was analysed. Of these 987 were isolated from new cases and 873 from cases who underwent a treatment for pulmonary tuberculosis. The investigation lowered 3 years (1986-1988). It resulted that the frequency of primary resistance was of 23.8% and that of secondary resistance was of 47.6%. As part of primary and secondary resistance, mono-resistance to SN and bi-resistance to SN and INH were the most common.

Cholesterol and lipid levels in the hair: indicators of the lipid metabolism balance

A new method of long term, retrospective evaluation of the lipid metabolism balance, by cholesterol and lipid assays in the human hair, is described. The correlation index between the blood and the hair cholesterol and lipid concentrations was + 0.980 and + 0.9925, respectively. The effects of hypolipemic diet and drug therapy on the cholesterol and lipid values were studied comparatively in the blood and in successive hair segments. The results demonstrate that the new method permits an evaluation of the therapy effectiveness and of the lipid metabolism variations during several weeks or months.

Evolution of ischemic heart disease risk factors in "The Bucharest Multifactorial Preventive Trial of Coronary Heart Disease" after 15-year follow-up

The paper presents the evolution of the levels of smoking, hypercholesterolemia, essential hypertension and obesity in the course of a prophylactic action carried out for 15 years (1971-1986) in a group of 5000 males aged 40-60 years. In the group still available after 15 years of follow up consisting of 2000 subjects, a decrease was obtained in the number of smokers, from 22.3% to 5.6% of hypercholesterolemia from 31.3% to 23.7%. The cumulated incidence of essential hypertension has increased from 15.5% to 36.7% and of obesity from 12.6% to 14.4%. At the same time the incidence of angina pectoris and myocardial infarction increased from 1.1% to 5.3%. For comparison are presented data obtained in a similar control group.

A study on the types of diabetes mellitus in first degree relatives of diabetic patients

The genetic characteristics of the diabetic types have been assessed by following up their frequency in first degree relatives of some non-selected diabetic patients, registered at eight different centers of the country. Out of 1,003 non-diabetic controls only 46 (4.6%) had 52 diabetic relatives, 65.4% of type 2 (non-insulin-dependent). Comparatively, out of the 704 patients, 172 (24.4%) had 229 diabetic first degree relatives, 72.5 of type 2. Out of 231 type 1 (insulin-dependent) diabetic patients, 29 (12.6%) had 34 diabetic relatives, 55.9% of type 1. Out of 300 type 2 patients, 99 (33.0%) had 121 diabetic relatives, 84.0% of type 2. The other 173 diabetic patients presented an "intermediary" type of the disease (needing insulin many years after onset). Forty-four (25.4%) of them had 64 diabetic relatives, 67.2% of type 2, 20.3% of type 1 and 12.5% with "intermediary" diabetes. The five times higher frequency of diabetes in patients' relatives versus controls is pointed out. Type 2 diabetic relatives predominated. The proportion of probands with diabetic relatives increased from 4.6% in non-diabetics to 12.6% in type 1, to 25.4% in "intermediary" diabetes and to 33.0% in type 2. The heredity of type 1 prevailed in type 1 and that of type 2 in type 2 and in "intermediary" diabetes. The fact that "intermediary" diabetes tends towards type 1 (insulin-dependent) as therapy and towards type 2 (non-insulin-dependent) as heredity might be an argument supporting the controversy on the diabetic syndrome classification.

Electrophoretogram of lysates deriving from mononuclear cells. Preliminary observation

Electrophoresis of mononuclear lysates was applied for the first time in the study of the lymphocyte protein content as an additional method beside the rosette test and scanning electron microscopy. The specification of T and B lymphocytes in the presence of discordant results sometimes obtained by the latter methods is facilitated by the additional data supplied by the study of their endoplasmic protein contents. The electfophorogram contributes to a better knowledge of the immunologic status of patients with autoimmune and lymphoproliferative diseases as well as to a more precise determination of the effects following the administration of immunomodulating treatment.

Normal blood cell values in groups of population from various geographic areas of Romania

The aim of this work was to determine the normal values of erythro-, leuko-, and thrombocytes in several groups of population situated in various geographic areas (hills, plain, sea-side), considering that such data could be useful for the delimitation between the normal conditions and the near-normal ones. Sixteen hematologic parameters have been investigated in 2,053 healthy subjects, insisting particularly on those most frequently required in the clinic, i.e., erythrocytes/microliter, hemoglobin (g%), hematocrit (%), leukocytes/microliter, and thrombocytes/microliter. No significant differences related to the geographic areas were recorded. The normal values of the hematologic parameters are presented in separate tables.

The evolution of essential hypertension in a primary prophylactic survey. Ten-year longitudinal epidemiologic study (1971-1982)

The present work presents the evolution over a ten-year period of subjects with essential hypertension (EH) detected in a group of 5,000 men, aged 40-60 years, randomly selected in an urban environment. The prevalence of EH in the group studied was 20.5%, whereas "borderline" hypertension presented a prevalence of 21.4% reported in an earlier study. A proportion of 76.6% of the hypertensive patients were cared for in an outpatient unit; normal blood pressure values were obtained in about one third of the cases. This result is consistent in itself and, all the more so, bearing in mind ageing of the patients in the course of the study. The study had in view the annual incidence of essential hypertension and the evolution of atherogenic risk factors in hypertensive patients. The incidence of cerebrovascular accidents during the follow up period in this group was 6.85%, sudden death 1.7% and myocardial infarction 6.2%.

The evolution of atherosclerotic risk factors in a primary prophylactic survey. Ten-year longitudinal epidemiologic study (1971-1982)

The present work is a study of the evolution of atherosclerotic risk factors in the course of ten years, in a group of 5,000 male subjects, aged 40 to 60 years, from an urban district, undergoing a programme of primary prevention against ischemic heart diseases. The general intervention methodology and the results after five years follow-up were published in earlier papers. The present work describes the ten year evolution of the prevalence of the main atherogenic risk factors studied, the yearly rate of prevalences, first appearance and correction potency of the risk factors detected.

The metabolic behaviour of the cellular populations in the pleural or peritoneal effusions from patients with malignant diseases

Complex morphologic, biochemical and cyto-enzymochemical investigations have been performed in the pleural or peritoneal effusions which occurred in 80 patients with various neoplastic diseases (pleural, pulmonary, hepatic, genital or breast cancers). As shown by the morphologic and biochemical tests, the proportion of fluids with a malignant or benignant character varied widely in the different forms of neoplasias. In the same effusions, the authors have studied the metabolic behaviour of acid phosphatase activity, the glycogen and nucleolar RNA amounts in the lymphocytes, in the malignant cells and in the mesothelial ones. High values of these cyto-enzymochemical components were found in the lymphocytes and the malignant cells from fluids with a positive malignant character, although similar changes were also observed in many cells of the effusions with morphologically negative reactions, and in a lesser proportion in those from patients with adenocirrhosis. It is concluded that such investigations could contribute to a better understanding of the metabolic behaviour of the cells from neoplastic effusions thus increasing the possibility of detecting the malignant character of the cells in the pleural or peritoneal effusions with a morphologically negative character.

Study of respiratory and immunologic changes in the workers of a poultry farm

The present investigation was designed to the study of respiratory symptoms and immunologic changes in workers of a poultry farm, chronically exposed to various organic allergens (avian, fungi, etc.). The group studied included 202 exposed subjects (109 at the slaughter house, 93 on the farms) and 100 controls. Although the group was chiefly made up of young women, non-smokers, exposure to avian allergens increased the prevalence of respiratory symptoms. Thus, coughing and expectoration was noted in 8.2% of the workers in the slaughter house and 10.7% of those on the farms, wheezing being present especially in the latter (13.9%). An apparently obstructive pulmonary function was observed in 16.10% of the farm hands and 1% of controls. The study of humoral immunity suggested that the presence of precipitation antibodies (76% positive reactions in the farms, 63% in the slaughter house, 44% among the controls) indicated exposure to avian allergens rather than the clinical and radiologic presence of the disease.

[Peptic ulcer of the cologastric anastomosis in esophagoplasties]

Two cases of cologastric anastomotic peptic ulcer after esophagoplasty for stenosis from caustic burns are reported, one developing 2 1/2 years and the other 12 years after operation. One case was treated by complex gastrocolic resection and the other by distal gastrectomy with ulcer excision and retrimming of the cologastric anastomosis. Long-term postoperative results were good. The different surgical procedures reported in the literature are discussed, and the value of combined gastrotomy and exploratory colotomy for detection of lesion extension emphasized. The preferred method is complex cologastric resection with conservation of the stomach in the digestive circuit.

Drug allergy: incidence in terms of age and some drug allergens

The authors studied the incidence of drug allergy in 3 groups of subjects. In the first group the incidence was established in terms of the subjects' age: 1.8% in children up to 14 years old (323 subjects), 5.8% in middle-aged subjects (389 subjects) and 2.9% in the elderly (243 subjects). In the second partly selected group, drug allergy was studied in patients admitted to the 3rd Medical Clinic--Craiova between 2 Jan. 1981 and 31 Dec. 1982; 103 of the 8,760 patients admitted presented allergic reactions, a relatively high incidence rate (1.01%) as compared to other published reports. The third group of previously selected cases consisted of 197 patients who had come to the allergology service with complaints of present or past sensitivity to drugs. The total number of patients was 336 selected or preselected from about 10,000 subjects, to which 17 patients with a diagnosis of "asthmatic triad" must be added. Drug allergy in terms of the drug used was dominated by penicillin, pyramidon-algocalmin, aspirin, iodine preparations, etc.; foremost among the clinical syndrome were the dermatologic syndromes types I, III and IV; syndromes of the "anaphylactic shock" type, "serum sickeness" bronchial asthma, angioneurotic oedema.

The Bucharest Multifactorial Prevention Trial of Coronary Heart Disease--ten year follow-up: 1971-1982

The trial begun in 1971 and the paper brings the results after a ten-year follow-up. Both the intervention and control group contained 5000 men with a similar socioeconomic and professional structure; the intervention group was examined every six months in the first 5 years and annually in the second phase. The control group was examined "only after" 5 years and a second time at the final moment. The decreases of the cumulative ten-year incidences were: for hard events--26.7%; for myocardial infarction--20%; for fatal myocardial infarction--52%; for stroke--31%; for cardiovascular mortality--38%; for total mortality--14%. The trend of serum cholesterol and cigarettes/day was downward, but the blood pressure had a rather flat evolution in the intervention group. The control group disclosed also some downward trends.

[Somesthetic evoked potentials of the spinal cord and cervico-brachial neuralgia]

Thirty patients with active cervico-brachial neuralgia were investigated by detection of the sensory action potential of the nerve, the spinal somaesthetic evoked potential and the cerebral somaesthetic evoked potential. Stimulation is applied to the affected side and symmetrically to the healthy side, at the finger and at the wrist. The digital stimulation recruits a more specific root territory (2nd finger C6-C7, 5th finger C8-T1). These results were compared to those obtained in a population of 14 controls. In cases of active cervico-brachial neuralgia, the spinal somaesthetic evoked potential from digital stimulation (N16) was always abolished in the painful territory; it was also abolished on the pain free side in 75% of cases, while it was present in 96% of the controls. The spinal somaesthetic evoked potential from stimulation of the wrist was only abolished on the painful side in 29% of cases, but the mean amplitude of N13 was reduced. In contrast, the cerebral somaesthetic evoked potential and the sensory action potential of the nerve were only minimally altered. These changes regress after clinical cure. There is a correlation between the severity of the clinical course and the electrophysiological findings. Isolated abolition of the spinal somaesthetic evoked potential from digital stimulation is a constant feature of benign cervico-brachial neuralgia, while abolition of the spinal somaesthetic evoked potential by stimulation of the finger and of the wrist, bilaterally, corresponds to the most severe forms.

The dynamic of impaired glucose tolerance in women with fetal gigantism

In a group of 51 women who had given birth to giant children, the glucose tolerance test (GTT) was performed at entry in the study and after intervals of 6 to 12 years. The results of the first determination, estimated according to the WHO's criteria (1980), have revealed an impaired glucose tolerance (IGT) in 7 cases (14%); the second determination showed IGT in 10 cases (20%) and diabetes mellitus in 2 (4%). Insulinemia assays, concomitant with the second performance of GTT, showed the highest values in the diabetic subjects, moderate values in those with IGT, and low values in those with normal glucose tolerance. The presence of obesity in some cases could not be considered as fully responsible for the glucose tolerance impairment in the women with fetal gigantism. The dynamics of glucose tolerance disorders showed variations in time, i.e. the initial pathologic changes were no more recorded on the second testing in the same subjects, while women with normal initial GTT showed high insulinemia or IGT on the second determination.