[Reactivation of tuberculosis in patients treated with corticosteroids].
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Biomedical subjects
Publications and source records attributed to A Bergmann.
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Corticosteroid therapy is held to facilitate activity of tuberculous disease. This retrospective study is an analysis of 1355 patients suffering from tuberculosis who had been discharged from a chest hospital during a 9-year period starting in 1971. Those on corticosteroid therapy for the last 6 months prior to diagnosis, were included. There were no new cases of tuberculosis among these, but 40 patients or 3 per cent had reactivation of former disease. The findings should be representative of the national prevalence. Despite increasing use of corticosteroids, there is no indication that the number of reactivated cases associated with such treatment has increased during the years. A majority of our patients were suffering from serious corticosteroid-demanding diseases which might in themselves be as causative as the drug therapy in activating the tuberculosis.
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Issuing from the question of the value of a prophylactic anticoagulation for the purpose of prevention of arteriosclerosis 25 patients with haemophilia were examined with the aim to detect possible connections between coagulation potential and arteriosclerosis taking into consideration factors of risk and age. Indeed, also in these patients who were "anticoagulated" from birth factors of risk and references to an existing arteriosclerosis were found. Correlation analyses, however, indicated tendencies, which suggest a protective influence of the hypocoagulability concerning factors of risk and arteriosclerosis.
The germ levels of 2,182 milk samples obtained from udder quarters with subclinical mastitis were compared to milk sampled from 2,061 udder quarters with physiological cell counts or conductivity values. Three cattle herds were involved in the test programme. No germ growth was established from 9.5 per cent of all samples taken from udder quarters with increased cell counts and conductivities and from 4.1 per cent of those samples taken from intact udder quarters. Samples taken from udder quarters with subclinical mastitis exhibited the following rises in bacteria, as compared to samples from intact quarters: staphylococci by 3.1 per cent, staphylocci in germ mixtures by 3.0 per cent, CAMP-positive streptococci by 2.2 per cent, alpha-haemolytic CAMP-negative streptococci by 0.8 per cent, anhaemolytic streptococci in germ mixtures by 0.4 per cent, beta-haemolytic streptococci by 0.5 per cent, and Pseudomonas aeruginosa by 1.4 per cent. Other germ species and mixtures exhibited declining trends along with growing subclinical affection of udder quarters. All findings so far obtained in the presence of subclinical mastitis are likely to suggest that 11.4 per cent of detected bacteria were of pathogenicity to udders. However, attempts to localise those 11.4 per cent were unsuccessful, since no significant difference could be calculated by comparison of intact with affected udder quarters. Reference is made in the discussion to primary and secondary germ levels of milk samples and their relevance to the problem and its elucidation.
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Many studies have documented that placental development is altered by a variety of environmental factors which alter placental bed blood flow and/or oxygen delivery. One of these is sustained weight-bearing exercise. The purpose of this investigation was to examine the effects of running throughout pregnancy on villous vascular development and cell proliferation by testing the null hypothesis that continuing a regular running regimen throughout pregnancy has no effect on villous vascular volume or cell proliferation at term. Accordingly, placentae of 11 healthy runners with uncomplicated pregnancies were matched by placental weight, maternal diet and birth weight with those of 11 healthy controls and examined using systematic random sampling and point counting of placental tissues stained immunohistochemically with either an endothelial (CD 31, PECAM-1, endoCam) or a proliferative (Ki-67, MIB-1) marker. The placentae of the runners had greater villous vascular volumes in both absolute (77 +/- 20 cm(3) versus 47 +/- 18 cm(3), p < 0.02) and relative (% of total villous volume: 29 +/- 5% versus 20 +/- 6%, p < 0.003) terms. Likewise, they had a greater proliferation index (45 +/- 14 mitoses/1000 nuclei versus 29 +/- 10 mitoses/1000 nuclei, p < 0.008). We conclude that continuing to run regularly throughout pregnancy increases both absolute and relative villous vascular volume and cell proliferation at term. We also speculate that this exercise effect may have clinical value in cases at risk for anomalous feto-placental growth as increased villous vascular volume should improve feto-placental growth by enhancing placental transfer of oxygen and diffusible substrate.