To determine the usefulness of artificial pneumothorax (AP) in the management of pulmonary tuberculosis (PTB) patients when anti-tuberculosis treatment is ineffective.
We evaluated the outcome of therapy in 214 patients with cavitary PTB bacteriologically confirmed by culture treated during 1998-2004, 78.9% of whom had multidrug resistance. AP was applied in 109 patients (56 newly diagnosed TB and 53 retreatment cases). A control group consisted of 105 patients (respectively 55 and 50) treated without AP. The average period of AP application was 4.5 months for newly diagnosed patients and 9 months in retreatment cases. Anti-tuberculosis treatment regimens in both groups were based on drug susceptibility test results.
Culture negativity was achieved in patients treated with AP in all new cases and in 81.1% of retreatment cases. Cavity closure occurred in 94.6% and 67.9% respectively. In the control group, culture negativity was achieved in respectively 70.9% and 40.0%, and cavity closure occurred in respectively 56.3% and 24.0%.
AP considerably improved the treatment outcome in both newly diagnosed and retreatment patients. This procedure can be considered a useful addition in managing certain patients with cavitary TB, particularly those with drug resistance.
Possibilities of roentgenologic method of examination with the use of roentgenography and tomography in the diagnosis of current forms of silicotuberculosis and tuberculosis in workers of the industries highly exposed to silicosis are analysed. ++Clinico-roentgenological+ pictures of 305 patients were studied in their dynamics for the period of 3 to 10 years. Being characterized by a benign course, silicotuberculosis is most often diagnosed in persons who left their work. A follow-up at least at 6-month intervals is of great importance in assessing its activity.
