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Sociedad Argentina de Tisiologia
Sociedad Argentina de Tisiologia RODOLFO E. CUCCHIANI ACEVEDO, M.D.
Secretary
The Executive Committee of the Sociedad Argentina de Tisiologica appointed Dr. Oscar P. Aguilar, Dr. Juan R. Paso, and Dr . Rodolfo Cucchiani Acevedo as a permanent committee to investigate the use of streptomycin in tuberculosis, and the following statement is made as a result of their study. "Special sessions of the Sociedad Argentina de Tisiologia, held on October 23, and 24, 1947, were devoted to the question of streptomycin in the treatment of tuberculosis. The 'clinical protocol' presented at this meeting and the results published in the Primer Congreso Argentino de Tisiologia agree with the experience of the men in other countries, especially the United States. The results of this investigation are as follows: 1) Streptomycin represents a real advance in the treatment of tuberculosis; however, the effectiveness of this drug is variable and depends upon such factors as the type of disease, the stage of activity, whether it is a pulmonary or an extrapulmonary disease. 2) The use of this drug is too recent to evaluate properly, from the standpoint of Iastlng effect, the results obtained from streptomycin therapy. 3) The results obtained in the treatment of tuberculous meningitis are sufficiently promising to advocate the early and intensive use of streptomycin by the intramuscular and intrathecal method in all patients in whom the clinical diagnosis of tuberculous meningitis have been made. 4) Streptomycin should also be used parenterally in cases of acute miliary tuberculosis and in cases of hematogenous dissemination that precedes chronic tuberculosis with foci in various organs. 5) Streptomycin is effective in the treatment of fistulae of tuberculous ortgm. 6) Results obtained from streptomycin therapy in tuberculous lesions of the larynx, bronchus, or trachea are encouraging. Similar results have been observed in patients with ulcerative lesions of the digestive tract. 7) Use of streptomycin is justified in the acute forms of pulmonary tuberculosis. However, this is not always the case in III
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RODOLPO E. CUCCHIANI ACEVEDO
January. 19<19
pneumonic or bronchopneumonic episodes that occur in advanced cases of chronic pulmonary tuberculosis. 8) streptomycin is not effective in the treatment of fibrous or fibrocaseous chronic pulmonary tuberculosis and should not be used in such cases. The use of streptomycin is also contraindicated in early cases of tuberculosis that are amenable to other, recognized forms of therapy because of the toxicity that accompanies the use of this drug. 9) In general, streptomycin 15 an adjunct to, and does not take the place of therapeutic measures of proved effectiveness in pulmonary tuberculosis. Thus, it may be considered as an adjunct to collapse therapy, particularly when an inflammation of the bronchus interferes with cavity closure. 10) It is effective as a preventive and curative measure in postoperative tuberculous complications. 11) streptomycin seems to be destined to expand the range of indications for collapse therapy and surgical treatment of tuberculosis. 12) It is advisable that streptomycin should be used under the control of the phthisiologist as much as possible."
CORRECTION IN THE JULY-AUGUST ISSUE In Dr. A. J. Steiner's Discussion of Dr. C. C. Macklin's article, "Respiratory Volume Changes in the Pulmonary Blood Vessels in Relation to Artificial Relaxation Therapy ," on page 548; the percentages given were incorrectly printed. It should have read , "The areas of two pulmonary arteries increased on inspiration; a large one increased 35 per cent, and a smaller one increased 40 per cent."
Secretary
The Executive Committee of the Sociedad Argentina de Tisiologica appointed Dr. Oscar P. Aguilar, Dr. Juan R. Paso, and Dr . Rodolfo Cucchiani Acevedo as a permanent committee to investigate the use of streptomycin in tuberculosis, and the following statement is made as a result of their study. "Special sessions of the Sociedad Argentina de Tisiologia, held on October 23, and 24, 1947, were devoted to the question of streptomycin in the treatment of tuberculosis. The 'clinical protocol' presented at this meeting and the results published in the Primer Congreso Argentino de Tisiologia agree with the experience of the men in other countries, especially the United States. The results of this investigation are as follows: 1) Streptomycin represents a real advance in the treatment of tuberculosis; however, the effectiveness of this drug is variable and depends upon such factors as the type of disease, the stage of activity, whether it is a pulmonary or an extrapulmonary disease. 2) The use of this drug is too recent to evaluate properly, from the standpoint of Iastlng effect, the results obtained from streptomycin therapy. 3) The results obtained in the treatment of tuberculous meningitis are sufficiently promising to advocate the early and intensive use of streptomycin by the intramuscular and intrathecal method in all patients in whom the clinical diagnosis of tuberculous meningitis have been made. 4) Streptomycin should also be used parenterally in cases of acute miliary tuberculosis and in cases of hematogenous dissemination that precedes chronic tuberculosis with foci in various organs. 5) Streptomycin is effective in the treatment of fistulae of tuberculous ortgm. 6) Results obtained from streptomycin therapy in tuberculous lesions of the larynx, bronchus, or trachea are encouraging. Similar results have been observed in patients with ulcerative lesions of the digestive tract. 7) Use of streptomycin is justified in the acute forms of pulmonary tuberculosis. However, this is not always the case in III
112
RODOLPO E. CUCCHIANI ACEVEDO
January. 19<19
pneumonic or bronchopneumonic episodes that occur in advanced cases of chronic pulmonary tuberculosis. 8) streptomycin is not effective in the treatment of fibrous or fibrocaseous chronic pulmonary tuberculosis and should not be used in such cases. The use of streptomycin is also contraindicated in early cases of tuberculosis that are amenable to other, recognized forms of therapy because of the toxicity that accompanies the use of this drug. 9) In general, streptomycin 15 an adjunct to, and does not take the place of therapeutic measures of proved effectiveness in pulmonary tuberculosis. Thus, it may be considered as an adjunct to collapse therapy, particularly when an inflammation of the bronchus interferes with cavity closure. 10) It is effective as a preventive and curative measure in postoperative tuberculous complications. 11) streptomycin seems to be destined to expand the range of indications for collapse therapy and surgical treatment of tuberculosis. 12) It is advisable that streptomycin should be used under the control of the phthisiologist as much as possible."
CORRECTION IN THE JULY-AUGUST ISSUE In Dr. A. J. Steiner's Discussion of Dr. C. C. Macklin's article, "Respiratory Volume Changes in the Pulmonary Blood Vessels in Relation to Artificial Relaxation Therapy ," on page 548; the percentages given were incorrectly printed. It should have read , "The areas of two pulmonary arteries increased on inspiration; a large one increased 35 per cent, and a smaller one increased 40 per cent."