On the occasion of the tuberculosis investigation world day, it has been hold at Milan - at the Regional Reference Centre of Villa Morelli - a meeting especially focusing the situation in Lombardy. Tuberculosis, it must not be forgotten is among the infective diseases the one showing the highest mortality. Every year three millions persons die for this pathology, mainly in the endemic areas still without the most elementary therapeutic instruments and not carrying out any prevention policy. The matter is that over these last years also in the high rate industrial development countries it has been registered a resumption of this pathology, affecting mainly immigrates, the social group at greater risk. About these topics it has been talked about along the meeting during which it has been introduced the volume “The drug-resistant tuberculosis “, by Gioacchino Angarano (University of Bari), Sergio Carbonara (University of Bari), Mario Ravaglione (Health World Organization, Geneva) and Giovanni Di Pisa. The latter, attending the meeting of Milan, belongs to the Operative Unit of Phthisiology of the “E. Morelli” Hospital of Sondalo. The Sondalo

 

TUBERCOLOSYS IN ITALY SINCE 1955 TO 1996   10   8   6   4   2     1955    1960    1965    1970    1975    1980    1985    1990    1995

Hospital is since ever the national reference point regarding pulmonary diseases; patients coming from all over Italy converge here since the modernity of structure, besides the favourable natural position of the centre. Dr. Di Pisa has explained how it is increasing the incidence of drugs therapies resistant strains, a worrying and unfortunately under-evaluated phenomenon. In fact the matter has rather relevant political and social implications. On a side it gets back in the foreground the immigration policy of the western countries, on the other side there's the fact that it has been lowered

HOSPITAL OF SONDALO U. O di Tisiologia Incidence of the total resistance to drugs AMB in the triennium 1996-98 (excepted HIV+)
	Isolated strains	Resistant strains	% resistant strains
1996  1997  1998	164  166  77	47  55  33	28.6  33.2  42.8

the guard too soon against a pathology deemed as already defeated. The discovering of the first antitubercular medicines round 1940, has progressively reduced the incidence of the disease, till the end of the eighties, such that physicians find themselves in troubles to individualize symptoms of the disease and on consequence to address patients to skilled structures. This is due to the fact that over the years, the faculties of medicine have neglected the teaching of the symptomatology of the Tbc. Diagnosis is, in the cases of tuberculosis, very complex and symptoms can easily be interchanged with those showed by less serious pathologies; on consequence the role of the universities is essential in the physicians capacitation. Indeed tuberculosis started, slowly, to begin to catch on; in the Italian case, the resumption year was 1987. The book, on its side, offers a wide summary of the drug resistances; some chapters concern the world relevance of the phenomenon, the survey about the presence of the pathology in the population affected by the Hiv, the laboratory diagnostics and more. To end works Prof. Piergiorgio Spaggiari, General Director of the “Eugenio Morelli” Hospital intervened. Spaggiari reminded that Sondalo is by tradition the centre where pulmonary diseases are cured; the rise of the sanatorium - the first world level - dates up to 1932 and still now that the Eugenio Morelli” has turned to a lead poly-functional centre (let's think for example to the early institution of an investigation centre about the Parkinson disease), attention to phthisiology keeps unchanged.

 

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