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Prosthesis use in surgical repair of abdominal wall is becoming nowadays a worldwide method, being imposed by its efficiency in solving the defects. The authors are speaking in the light of their experience gained with 100 patients that underwent the operation of prosthesis implant inside the abdominal wall between 1990 and 1996. There have been correlated the early and late postoperative results with some features of this surgical procedure (see below), to prove its efficacy. The authors discuss some principles of alloplastic treatment, which represent also the conclusions of the study: the moment of when a prosthesis is recommended, the choice of synthetic material, where and how is placed the prosthesis, some additional measures which contribute to therapeutic success.

Organizatoric and efficiency aspects are presented of five integral detections (the fifth presently in the final stage), carried out over a period of 14 years (1960--1973) in the territory of the anti-tuberculous dispensary of Turda. In the course of the four radiophotographic detections that have already been finally processed approximately 400.000 subjects have been examined. Mobilization was, in most of the cases, higher than 95% and the proportion of suspects was of 2--3.5%. The complex investigation of the suspects was higher than 95%. The index of detection of tuberculosis decreased severalfold (0.63% in the first investigation, 0.07% in the 4-th) when integral detections were repeated.

In a lot of 452 patients with various forms of tuberculosis, in various locations, the authors have investigated the efficiency of tests currently employed in detecting tuberculin sensitivity (intradermoreaction to PPD, the test to sensitines and the Ustvedt test), in relation with several immunologic tests performed in vitro (index of lymphoblastogenesis to PPD and/or phytohaemagglutinin, leucocyte migration inhibition test, and the rosette test). It was noted that the two groups of investigations give similar results when tuberculin reactions are positive and intense. Under the conventionally admitted threshold of tuberculinic allergy the test of blastic transformation of lymphocytes, and especially the leucocyte migration inhibition tests are still positive and may be considered as a valuable means for measuring infra-tuberculinic allergy, as well as for the diagnosis of latent tuberculous infections.

An analysis is made of the tuberculous endemia in several of the most important industrial branches over the last years, as compared with the endemy outside the industrial environment. Although the global morbidity through tuberculosis in industrial enterprises has declined to approximately one half of the initial values (considering the year 1975 as the basis), it is still above the level in the territory. The gap between the two curves, much wider at the beginning of the interval, has narrowed consistently with time. The factors are discussed, that may determine this relative morbidity, and the necessary measures for their neutralization. The necessity for a close cooperation is stressed, between the enterprise physician and the pneumologist (or phthisiologist) from the territorial polyclinic.

Two indicators are of primary importance in the assessing the tuberculous endemia in a determined area: the prevalence of bacilliferic sources, especially of those that have been confirmed by bacteriological examinations (bacterioscopy), and the annual incidence of the tuberculous infection (the real infection risk). Possibilities are described, and examples provided, for approximation of the incidence of the tuberculous infection through: a) conversion index; b) the ratio between the prevalence of the tuberculous infection and the median tested age; c) the Styble-Meijer-Sutherland logarithmic ecuation; d) the nomogram variant with tables B and C established by Styblo-Meijer-Sutherland; e) the R. Narain graphic methods. For those countries in which BCG vaccination is practiced on an extensive scale the authors suggest the incidence risk indice could also be calculated, for supra-infection, which can be correlated and completed by the incidence (risk) of infection.

In view of differentiating post-vaccinal allergy from that developing after tuberculosis infection, the authors have investigated comparatively intradermal-reactions to tuberculin according to classical allergometry, and to the 4 types described by Palmer-Edwards in a group of 1549 students and 211 patients. All the subjects were tested with 2 units of PPD IC 65. It was noted that the type I and II Palmer reactions corresponded, in the majority of the cases, to intense, or hyperergic ID reactions, while the types III and IV of Palmer corresponded to slightly positive, or to negative ID reactions. The presence of the post-vaccinal scar does not appear to influence significantly the type of the reaction, but the presence of active specific lesions is accompanied by reactions of type I and II of the Palmer classification. It is concluded that although the Palmer types do not allow to make a clear differentiation between the two variants of allergy they provide however useful indications for the interpretation of IDR in a more sophisticated manner, as compared with the conventional allergometry.

The effectiveness of the intermittent treatment (2/7) with Rifampicin + Etambutol, administered over periods of 3 to 24 months, was tested in a log of 229 out-patients suffering from tuberculosis (bacilli carriers). Negativation of the cultures was obtained in 88.4% of the cases, most of the failures being recorded in the aged patients from rural areas, suffering from various other associated diseases and in those who did not cooperate. As these patients raise particular problems concerning the therapeutical attitude, the authors consider they should be admitted to hospital, at least during the critical periods of the disease.

A study was carried out in 266 571 students, examined during the 1952--1974 interval, on a series of risk factors of infection and morbidity from tuberculosis with regard to certain epidemiological, immunobiologic and peristasis parameters. In the interval studied, morbidity from tuberculosis fell sharply from 923 per 100,000 in 1952 to 83 per 100,000 in 1974. The highest proportion of infection occured in the first three years at the university, particularly among meidcal students. The risk of infection of alergic subjects with an intradermoreaction greater than 15 mm in diameter, was approximately twice that the hypo- or normoergic subjects and the proportion of vaccinates who contracted the disease three times smaller than that of the non-vaccinated subjects.

Starting from the premise that in the methodology of tuberculosis control priority should be given to the higher risk groups, the authors tried to identify such groups and list them in the order of their priority within the district of a dispensary serving a population of about 400,000 inhabitants. On comparing the results of the detection of risk factors among the population in general with that per endangered groups it was found that the former presented a decrease (from 1.09 to 0.44 per thousand) and the latter an increase (from 0.91 to 1.5 per thousand). The 126 747 examinations for risk factors revealed a succesive increase in the detection indices as follows: 0.76 per thousand among students, 1.36 per thousand in silicogen risk enterprises, 2.07 per thousand among the workers on building sites, 2.22 per thousand among diabetics, 2.76 per thousand among contacts, 2.85 per thousand among hyperergic subjects, 3.89 per thousand among former patients no longer on the files, 4.17 per thousand among alcoholics and patients under psychical treatment, 6.01 per thousand among patients with minimal lesions and 6.82 thousand among those with sequelae.

The authors have performed 58435 microscopic examinations, of which 3813 were positive, and found 209 (5,48%) cases of non-cultivable Koch bacilli. The major bacteriological, clinico-evolutive and therapeutical aspects are examined. Most of the cases showing a syndrome of positive homogenate with a negative culture were rather recent ones (an evolution of less than 2 years in 73,68% of the total) and the highest frequency was found in those in which the treatment was in its first year. No direct relationship could be demonstrated between the number of germs (the Gaffky scale) and the frequency of the syndrome. The factors influencing the occurrence and the development of the syndrome are: the structure of the lesions, the method of bacteriologic examination, the therapy applied, and a certain immunologic reactivity. According to the authors the significance of this syndrome is positive in most of the cases, indicating a regression that has not been completed. The most reasonable attitude is a differentiated one, depending on each case, integrating the data obtained by the bacteriological examination in the therapeutic and evolutive clinico-radiologic context.