Povijest tuberkuloze - od tuberkulina do antituberkulotika (II. dio)

Autor: Željko Dugac, Željko Cvetnić
Jazyk: chorvatština
Rok vydání: 2020
Předmět:
Zdroj: Veterinarska stanica
Volume 51
Issue 5
ISSN: 0350-7149
1849-1170
DOI: 10.46419/vs.51.5.7
Popis: Otkriće uzročnika tuberkuloze M. tuberculosis 1882. godine bilo je jedno od najvažnijih otkrića u povijesti medicine, osobito u bakteriologiji. Obzirom da uzročnika tuberkuloze nije bilo moguće liječiti, postojali su mnogi pokušaji da se tuberkuloznim bolesnicima pomogne. Njemački liječnik Hermann Brehmer izgradio je prvi sanatorij 1857. godine u Görbersdorfu u Njemačkoj za liječenje i oporavak tuberkuloznih bolesnika. Jedan od osnivača lječilišta za tuberkulozu u Hrvatskoj (Brestovac na Sljemenu) bio je dr. Milivoj Dežman. Godine 1888. talijanski liječnik Carlo Forlanini napravio je prvi umjetni pneumotoraks uzrokujući kolaps pluća i napunio pleuralne šupljine dušikom. Kirurški tretmani tuberkuloze razvijali su se i primjenjivali sve do 1940-tih godina. Znatan iskorak u dijagnosticiranju tuberkuloze bilo je otkriće rentgentskih zraka 1895. godine. Robert Koch je otkrio 1890. godine tuberkulin, koji se nije zadržao kao lijek, ali je postao dijagnostičko sredstvo. Velikom napretku u borbi protiv tuberkuloze doprinijeli su Albert Calmette i njegov suradnik Camille Guérin. Oni su uspjeli razviti BCG (Bacillus Calmette- Guérin) cjepivo protiv tuberkuloze koje je 1921. godine prvi put primijenjeno u bolnici u Parizu. Početkom 1943. godine Jörgen Eric Lehmann otkrio je paraminosalicilnu kiselinu (PAS), a 1944., biokemičar Selman Abraham Waksman i njegovi suradnici razvili su antibiotik streptomicin. Bili su to prvi lijekovi kojima se liječila tuberkuloza. Od sredine 1950-tih kombinaciji streptomicin i PAS dodan je i izoniazid, a kasnije su otkriveni i mnogi drugi lijekovi poput pirazinamida (1954.), a ethambutol i rifampicin uvedeni su u liječenje 1961. i 1963. pa je nastala nova era liječenja tuberkuloze, a mnogi su sanatoriji za tuberkulozu bili zatvoreni. Novi način liječenja tuberkuloze, zajedno s BCG-om, u zapadnom svijetu smanjio je umiranje od tuberkuloze za gotovo 90 %, a trajanje terapije skraćeno je s dvije godine na šest mjeseci. Povijest kontrole i liječenja tuberkuloze ušlo je u novo poglavlje.
The discovery of the causative agent of tuberculosis Mycobacterium tuberculosis in 1882 was one of the most important events in medical history, especially bacteriology. Since the causes of tuberculosis were not treatable, there were various attempts to help tuberculosis patients. The German physician Hermann Brehmer built the first sanatorium in Görbersdorf, Germany in 1857 to treat tuberculosis patients. One of the founders of the tuberculosis sanatorium in Croatia (Brestovac on Mt. Sljeme) was Dr. Milivoj Dezman. In 1888, Italian doctor Carlo Forlanini performed the first artificial pneumothorax, causing lung collapse and filling the pleural cavities with nitrogen. Tuberculosis surgical treatments were developed and applied until the 1940s. A significant step forward in diagnosing tuberculosis was the discovery of the X-ray in 1895. Robert Koch discovered tuberculin in 1890, which initially was not a medicament but a diagnostic agent. Albert Calmette and his aide, Camille Guérin, achieved great progress in combatting tuberculosis. They succeeded in developing BCG (Bacillus Calmette- Guérin), a vaccine against tuberculosis first administered at a Paris hospital in 1921. In early 1943, Jörgen Eric Lehmann discovered paraminosalicylic acid (PAS), and in 1944, biochemist Selman Abraham Waksman and his associates developed the antibiotic streptomycin, the first medicine to treat tuberculosis. In the mid-1950s, an isoniazid was added to the combination of streptomycin and PAS, while and many other medicines such as pyrazinamides were subsequently discovered (1954). Ethambutol and rifampicin were introduced to the treatment protocol in 1961 and 1963, respectively. A new era of treatment for tuberculosis has begun and many tuberculosis sanatoriums have since been closed. The new treatment of tuberculosis in the Western world, together with BCG vaccination, reduced tuberculosis deaths by nearly 90% and shortened the duration of therapy from two years to six months. With this, the history of tuberculosis control and treatment has entered a new chapter.
Databáze: OpenAIRE
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