Tuberculosis--HIV/AIDS associated cases registered in the Department of Mureş between 1994-1999 are under a low rate--24 patients, meaning 0.69% of all tuberculosis cases. 79% of these were children (7.1% of the tuberculosis in children). There was a dominance of the pulmonary location (22-91.5%). The bacteriologic confirmation among these cases is low: 37.5% vs. 66.5% in HIV negative patients; this imposes the improvement of the diagnosis using methods as bronchoscopy, hemocultures, biopsies and modern bacteriological methods as Bactec and molecular biology in these cases. In 62.5% of the cases the tuberculosis diagnosis was established by combining epidemiological, clinical, radiological and biological data. Skin test was positive in 12.5% of the cases. The clinical and radiological data showed aspects near to the common pulmonary tuberculosis, but with a high rate of the complicated forms in children (66.6%). 14 patients (58%) originated from a positive-contact environment. The standard treatment was well tolerated in 91.6% of the cases; there were 2 side effects to PZM and EMB. The evolution under treatment was generally favorable; there were 2 deaths with AIDS during active tuberculosis. The early diagnosis of HIV infection in high-risk patients and of the latent tuberculous infections would allow the decrease of the rate of this high-gravity associated illness.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

[Considerations upon diagnosis and treatment of lung and pleural tumors in Mures county].

We studied 171 patients with pulmonary and pleural tumours, in 1999. Within this group we had 87.7% primary lung cancers, 8.8% pulmonary methastatic tumors and 3.5% pleural mesothelioma. The primary lung cancer is more frequent in men (male-female ratio = 8.4) and in patients living in rural area; it involved persons over 40 years only. The chronic tobacco use is the main risk factor we found among these patients (80%). All the patients showed symptoms linked to delayed diagnosis. Radiology was characteristic in 100% of the cases, showing typical aspects of lung tumours and complications and contributed to staging. The bronchoscopy was the main procedure in diagnosis (80.1%), allowing the microscopic confirmation and contributing in staging. The thoracic computed thomography was performed in 30.4% of the cases. We had a late case finding (56.7% in the stage III, 26% in the stage IV) allowing the surgical treatment in only 15.2% of the cases. The early diagnosis of lung cancers would be possible by "oncological screening", combining clinical aspects with data from radiology and bronchoscopy in high-risk persons (heavy smokers, contacts with cancer producing substances). Performing bronchoscopy and computed tomography in all patients with lung cancer would allow the histological diagnosis and the proper staging for a proper treatment. The education against smoking will allow the decrease of the lung cancer in the future.

Adult↗

PubMedDate not supplied