A culture-specific nutrient intake assessment instrument in patients with pulmonary tuberculosis.

BACKGROUND & AIM: To develop and evaluate a culture-specific nutrient intake assessment tool for use in adults with pulmonary tuberculosis (TB) in Tbilisi, Georgia. METHODS: We developed an instrument to measure food intake over 3 consecutive days using a questionnaire format. The tool was then compared to 24 h food recalls. Food intake data from 31 subjects with TB were analyzed using the Nutrient Database System for Research (NDS-R) dietary analysis program. Paired t-tests, Pearson correlations and intraclass correlation coefficients (ICC) were used to assess the agreement between the two methods of dietary intake for calculated nutrient intakes. RESULTS: The Pearson correlation coefficient for mean daily caloric intake between the 2 methods was 0.37 (P = 0.04) with a mean difference of 171 kcals/day (p = 0.34). The ICC was 0.38 (95% CI: 0.03-0.64) suggesting the within-patient variability may be larger than between-patient variability. Results for mean daily intake of total fat, total carbohydrate, total protein, retinol, vitamins D and E, thiamine, calcium, sodium, iron, selenium, copper, and zinc between the two assessment methods were also similar. CONCLUSIONS: This novel nutrient intake assessment tool provided quantitative nutrient intake data from TB patients. These pilot data can inform larger studies in similar populations.

[Principles in the treatment and rehabilitation of patients with tuberculosis].

The etiotropic directionality of scientific searches of the introduction of new antibiotics and therapy regimens fails to substantially increase the efficiency of treatment of tuberculosis. The use of the strict multicomponent chemotherapy standards proposed for the treatment of different forms of tuberculosis with Mycobacterium tuberculosis (MBT) being kept in mind does not reduce the number of progressing processes. Etiotropic chemotherapy with the standard regimens of different combinations and intensity, which is aimed at suppressing MBT viability should be always combined with the methods rehabilitating the physiological processes of cell-tissue masses involved into a specific tuberculous process. The basic methods are improvement of the gas-exchange function of respiratory organs; balanced diet; widely use of natural climatic and artificial physical factors. The combined use of etiotropic and rehabilitative therapies accelerates reparative processes and substantially reduces the time of involution of tuberculous inflammation and the patient's recovery. Thus, out of 258 patients with acutely progressive tuberculosis, their use ceased bacillar isolation in 84.2%, by closing decay cavities in 79.8% whereas out of 284 patients receiving the routine chemotherapy regimens, these figures were 57.3 and 40.8%, respectively. The efficient use of general biological principles in the treatment and rehabilitation of patients with active tuberculosis can reduce the time of inpatient treatment by 1.5-2 times and accordingly economic expenses on the cure of a patient.

Avaliaçäo nutricional de pacientes tuberculosos em tratamento ambulatorial / Nutritional assessment of outpatients in the treatment of tuberculosis

Com o objetivo de avaliar o estado nutricional de pacientes matriculados no CSE-EPM em 1989 para tratamento de tuberculose, foram estudados 43 pacientes com idade entre 19 e 75 anos. Os parâmetros antropométricos utilizados foram peso e estatura e para a avaliaçäo nutricional empregou-se o índice de massa corpórea (IMC). Os resultados mostraram que 15 pacientes eram desnutridos, quatro eram obesos e 24 eram eutróficos, na primeira consulta. Foram acompanhados 12 pacientes com tuberculose pulmonar até o final do sexto mês de tratamento. Verificou-se que 85// do ganho de peso total desses pacientes ocorreu entre o terceiro e o quarto mês de tratamento. Concluindo, a amostra estudada apresentou uma freqüência elevada de desnutriçäo entre os pacientes com tuberculose pulmonar. Esta situaçäo tendeu a melhorar ao longo do tratamento. A maioria dos pacientes apresentou um ganho de peso significante, sendo que o maior incremento ponderal ocorreu nos primeiros meses de tratamento