Biomedical subjects
Publications and source records attributed to H Blaha.
The aims of the anti-tuberculosis project are firstly to successfully conclude chemotherapy with few discontinuations of treatment and re-activations, and, secondly, via the determination of resistance, to identify problems in the fight against tuberculosis in Nepal, and to demonstrate therapeutic possibilities in problem patients.
Between January 1982 and April 1986 a double-blind randomized placebo controlled study of mopidamol, employed as adjunct therapy to surgery in patients with non-small cell bronchial carcinoma, was performed at 7 hospitals. The main criteria were occurrence of metastases and survival. Mopidamol was given perioperatively at a dose of 2 x mg i.v. daily, and postoperatively orally at a dose of 3 x 500 mg daily. The treatment period was scheduled to at least 2 years and in some of the patients was prolonged to 3 years. The standard therapy of each individual center was given as basic therapy. A total of 270 patients were included in the study, 147 in the placebo and 123 in the mopidamol group. By the end of the study 52 deaths from metastases had occurred in the placebo group (35%) compared with only 32 (26%) in the mopidamol group. This difference is statistically significant at p less than 0.05 with the one-sided test. A comparison of life-tables according to Kaplan-Meier shows a statistically significant difference in favour of the group treated with mopidamol (savage p less than 0.05). Cox's multivariate analysis confirmed the statistically significant difference in favour of the group treated with mopidamol, the inclusion of the risk factors tumour stage and histology in the evaluation results in a p-value of 0.02. With respect to the incidence of metastases there were no appreciable differences between the treatment groups. The incidence of side effects or undesired events was equal in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
A central surveillance register for all bacillary pulmonary tuberculosis cases reported in Bavaria (population in excess of 10 million) was established from 1974 to 1976. The aim of the study was to discover the quality and efficiency of health services delivery to the population in the field of tuberculosis under routine conditions, and to find out the relapse rate after cessation of chemotherapy in expatients who were found to be negative 2 years after starting chemotherapy. A total of 7850 German patients with bacillary pulmonary tuberculosis were diagnosed in Bavaria from 1974 to 1976 corresponding to an average annual rate of 25.7 per 100,000 population: 71% of them were smear-positive and 29% were positive by culture only. Reactivations formed 25% of all bacteriologically confirmed cases. Most (71%) smear-positive new cases were discovered because of symptoms. Of the 5157 cases of bacteriologically confirmed pulmonary tuberculosis reported during 1975 and 1976, 4% died from tuberculosis, 1% from sequelae of tuberculosis and 9% from causes other than tuberculosis. A further 3% of patients had drug side-effects, 3% were uncooperative, 2% emigrated or had no permanent address and 1% had no chemotherapy or no information on treatment. The overall results of treatment were very satisfactory: sputum conversion among 3991 patients in the group with complete treatment was achieved in 97.4% at 2 years, and in those with incomplete treatment in 96.2%. The duration of chemotherapy was long, i.e. 19 months or more in two thirds of the patients. The average reactivation rate during the 3rd, 4th and 5th follow-up years was 0.8% annually; it was higher among males than females and the rate increased with age. Of the 157 patients found to be bacteriologically positive at 2 years after the start of chemotherapy 46 died during the 3-year observation period and 109 were alive at 5 years, 23 of whom were harbouring tubercle bacilli.
Explore the source record for details and available documents.
The records of autopsies performed during the last year were examined with the view of assessing the accuracy of the diagnosis: death from tuberculosis. The study showed that the infection was only rarely the cause of death. Subsequently, in collaboration with R. Gruber, the deaths reported by the Study Group, Bavaria, were analysed. Over a period of two years there were 302 deaths in which tuberculosis was either the primary or a complicating disease. The analysis shows how important it is to establish the correct diagnosis and to ensure that in deaths attributed to tuberculosis the infection is, in fact, the sole cause of death and not a complicating factor.
Explore the source record for details and available documents.
Using the farmer's lung as an example, the various problems in establishing a diagnosis are discussed. The "instruments" of diagnosis such as history (exposition), functional parameters, macro- and micromorphology, and laboratory findings are described. The different criteria and their value, the compatibility of informations, and the quality of definitions ("fuzzy sets") are analytically evaluated--all this finally leading to the "quality" of diagnosis and of subsequent decisions.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The more efficient present day treatment with bactericidal anti-tuberculosis drugs combined with surgical procedures results in a much more rapid and longer lasting cure of tuberculous arthritis than previously. We assume actual periods of treatment between 2 and 4 months. It should be borne in mind that tuberculosis is a systemic disease and that the arthropathy only ranks second or third. Godd results are obtained if all concerned in the treatment of tuberculosis harmonize their approach to the treatment.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.