{"id":4497,"date":"2018-04-19T10:37:54","date_gmt":"2018-04-19T08:37:54","guid":{"rendered":"http:\/\/www.easistent.ro\/?p=4497"},"modified":"2018-06-06T15:45:23","modified_gmt":"2018-06-06T13:45:23","slug":"tuberculoza-cea-mai-veche-boala-a-omenirii","status":"publish","type":"post","link":"https:\/\/www.easistent.ro\/?p=4497","title":{"rendered":"Tuberculoza \u2013 cea mai veche boal\u0103 a omenirii?"},"content":{"rendered":"<p><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc.png\"><img class=\"alignleft size-medium wp-image-4484\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc-300x165.png\" alt=\"tbc\" width=\"300\" height=\"165\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc-300x165.png 300w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc.png 622w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>Bacteria Mycobacterium tuberculosis are origini deosebit de vechi \u2013 primele documente scrise care descriu tuberculoza dateaz\u0103 de peste 3000 de ani \u015fi provin din India \u015fi China. Studiul mumiilor egiptene a revelat, de asemenea, prezen\u0163a unor diformit\u0103\u0163i ale scheletului care sunt tipice tuberculozei.<\/p>\n<p>\u00cen acela\u015fi timp, dovezi arheologice din mun\u0163ii Anzi au ar\u0103tat prezen\u0163a tuberculozei \u015fi la mumii peruviene dintr-o perioad\u0103 premerg\u0103toare venirii primilor coloni\u015fti europeni \u00een America de Sud.<\/p>\n<p>\u00cen Grecia antic\u0103, tuberculoza era cunoscut\u0103 sub numele de ftizie (\u201cphtisis\u201d). Hipocrat a descris-o drept o boal\u0103 mortal\u0103, \u00een special pentru adul\u0163ii tineri. Isocrate este primul care a presupus c\u0103 este o boal\u0103 infec\u0163ioas\u0103. Galen, care a fost medicul \u00eemp\u0103ratului roman Marc Aureliu, a descris simptomele tuberculozei \u2013 febr\u0103, transpira\u0163ii, tuse, sput\u0103 cu s\u00e2nge \u2013 \u015fi a recomandat drept remedii aerul curat, laptele \u015fi c\u0103l\u0103toriile pe mare.<\/p>\n<p>\u00cen Evul Mediu, scrofuloza, afec\u021biune caracterizat\u0103 prin inflamarea ganglionilor limfatici cervicali, inghinali sau axilari, a fost descris\u0103 drept o nou\u0103 form\u0103 clinic\u0103 a tuberculozei. \u00cen Anglia \u015fi Fran\u0163a, aceasta era cunoscut\u0103 \u015fi drept \u201epacostea regelui\u201d \u015fi se credea c\u0103 poate fi vindecat\u0103 printr-o atingere a regelui sau reginei.<\/p>\n<p>\u00cen secolul al 16lea, Girolamo Fracastoro eviden\u0163iaz\u0103 natura contagioas\u0103 a bolii, iar aproximativ 100 de ani mai t\u00e2rziu, Francis Sylvius reu\u015fe\u015fte o descriere anatomo-patologic\u0103 exact\u0103. Cur\u00e2nd dup\u0103 aceea, republicile italiene iau \u00een considerare natura contagioas\u0103 a bolii \u015fi impun izolarea celor afecta\u0163i, interzic\u00e2nd admiterea lor \u00een spitalele de stat \u015fi \u00eenfiin\u0163\u00e2nd locuri speciale pentru tratarea lor.<\/p>\n<p>Termenul tuberculoz\u0103 a ap\u0103rut \u00een secolul al 19-lea, \u00eenlocuind treptat ceilal\u0163i termeni folosi\u0163i p\u00e2n\u0103 acum, de la ftizie la plaga alb\u0103 (denumire venit\u0103 de la paloarea extrem\u0103 pe care boala o aducea).<\/p>\n<p><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc1.png\"><img class=\"alignleft size-medium wp-image-4485\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc1-300x221.png\" alt=\"tbc1\" width=\"300\" height=\"221\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc1-300x221.png 300w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc1-80x60.png 80w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc1.png 700w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>\u00cen acea perioad\u0103, \u00een secolele 18-19, tuberculoza devenise o epidemie, cu o mortalitate de 900 de mor\u0163i la 100 000 de locuitori, rata fiind \u015fi mai mare \u00een r\u00e2ndul tinerilor.<\/p>\n<p>\u00cen timpul revolu\u0163iei industriale, perioad\u0103 caracterizat\u0103 de apari\u0163ia locurilor de munc\u0103 aglomerate \u015fi prost ventilate, similar cu situa\u0163ia locuin\u0163elor din marile ora\u015fe, date fiind condi\u0163iile sanitar-igienice improprii \u015fi malnutri\u0163ia, boala s-a r\u0103sp\u00e2ndit foarte mult.<\/p>\n<p>\u00cen secolul al 19lea, tuberculoza pandemic\u0103 a omor\u00e2t aproape un sfert din popula\u0163ia adult\u0103 a Europei.<\/p>\n<p>Din fericire, tot \u00een secolul al 19-lea au ap\u0103rut \u015fi primele descoperiri istorice pentru lupta \u00eempotriva tuberculozei.<\/p>\n<p>Astfel, \u00een 1843, medicul german Klecke a reu\u015fit reproducerea experimental\u0103 a formelor uman\u0103 \u015fi bovin\u0103 ale tuberculozei. \u00cen cur\u00e2nd apare \u015fi primul remediu eficace \u00eempotriva tuberculozei \u2013 apari\u0163ia curei la sanatoriu, descris\u0103 \u00een lucrarea \u201cTuberculoza este o boal\u0103 vindecabil\u0103\u201d a lui Hermann Brehmer, un student la botanic\u0103, bolnav el \u00eensu\u015fi de tuberculoz\u0103 \u015fi care s-ar fi vindecat dup\u0103 o c\u0103l\u0103torie \u00een Mun\u0163ii Himalaya. Brehmer a \u00eenfiin\u0163at apoi un sanatoriu \u00eentr-o zon\u0103 de munte cu scopul de a vindeca pacien\u0163ii cu aer curat \u015fi o alimenta\u0163ie corespunz\u0103toare. Sanatoriile s-au r\u0103sp\u00e2ndit semnificativ \u00een anii urm\u0103tori \u015fi au contribuit la vindecarea unui num\u0103r mare de pacien\u0163i \u00een deceniile urm\u0103toare.<\/p>\n<p>Chirurgul militar francez Jean-Antoine Villemin a avut contribu\u0163ii importante la dezvoltarea domeniului. \u00cen primul r\u00e2nd, \u00een 1865, a demonstrat natura infec\u0163ioas\u0103 a bolii, pe baza observa\u0163iilor din armat\u0103, unde a constatat c\u0103 tuberculoza era mai frecvent\u0103 printre solda\u0163ii care au stat mai mult timp \u00een bar\u0103ci, fa\u0163\u0103 de cei care petreceau mai mult timp pe c\u00e2mp. De asemenea, a constatat c\u0103 recrui\u0163ii s\u0103n\u0103to\u015fi proveni\u0163i din mediul rural se \u00eemboln\u0103veau doar la c\u00e2teva luni dup\u0103 \u00eenceperea serviciului militar.<\/p>\n<p>Bacilul tuberculozei a fost izolat, pentru prima oar\u0103, \u00een 1867, de c\u0103tre omul de \u015ftiin\u0163\u0103 Klebs. La 13 ani dup\u0103 aceea, \u00een 1882, Koch a izolat bacilul \u015fi a putut reproduce boala prin inocularea bacilului \u00een animale de laborator. Acesta a fost un moment de cotitur\u0103 \u00een istoria luptei \u00eempotriva tuberculozei. Bacteriologii francezi Calmette and Guerin de la Institutul Pasteur au dezvoltat apoi o tehnic\u0103 de vaccinare preventiv\u0103 \u00eempotriva tuberculozei. \u00cen 1920, ei au izolat tulpina BCG (Bacilul Calmette \u2013Guerin) de la o vac\u0103 infectat\u0103. Tulpina a fost atenuat\u0103 treptat timp de 13 ani de cultivare \u00een laborator, iar apoi a fost folosit\u0103 pe post de vaccin pentru a induce imunitatea organismului \u00eempotriva infec\u0163iei tuberculoase. Vaccinarea aceasta a dus la sc\u0103derea inciden\u0163ei tuberculozei \u00een r\u00e2ndul grupurilor vaccinate, \u00een compara\u0163ie cu cele nevaccinate.<\/p>\n<p><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc2.png\"><img class=\"alignleft size-medium wp-image-4486\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc2-300x198.png\" alt=\"tbc2\" width=\"300\" height=\"198\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc2-300x198.png 300w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/04\/tbc2.png 353w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>Tuberculoza a fost asociat\u0103 cu s\u0103r\u0103cia, aglomera\u0163ia extrem\u0103 \u015fi malnutri\u0163ia. \u0162\u0103rile \u00een curs de dezvoltare \u015fi zonele defavorizate din marile ora\u015fe ale \u0163\u0103rilor dezvoltate prezint\u0103 cea mai mare inciden\u0163\u0103 a tuberculozei \u015fi cea mai mare mortalitate cauzat\u0103 de tuberculoz\u0103. Acestea sunt contextele unde imigra\u0163ia, inegalit\u0103\u0163ile sociale, infectarea cu HIV sau abuzul de droguri \u015fi alcool sunt prezente \u00een num\u0103r mare, to\u0163i fiind factori puternic asocia\u0163i tuberculozei.<\/p>\n<p>Controlarea epidemiei impune extinderea programelor de preven\u0163ie, detectare \u015fi control al tuberculozei, \u00eenainte ca aceasta s\u0103 devin\u0103 rezistent\u0103 la medicamente. DOTS \u2013 Directly Observed Treatment, Short Course (Tratamentul administrat sub observare direct\u0103) s-a dovedit deosebit de eficace \u00een aceast\u0103 privin\u0163\u0103.<\/p>\n<p>Dezvoltat \u00een 1990, el cere ca lucr\u0103tori din s\u0103n\u0103tate sau chiar membri ai familiei sau alte persoane s\u0103 fie prezen\u0163i c\u00e2nd pacientul \u00ee\u015fi administreaz\u0103 tratamentul.<\/p>\n<p>Programele de preven\u0163ie \u015fi control sunt esen\u0163iale pentru succesul luptei \u00eempotriva acestei boli. Acestea au contribuit la sc\u0103derea inciden\u0163ei tuberculozei observat\u0103 \u00een ultimele decenii. Se a\u015fteapt\u0103 ca progresele f\u0103cute spre atingerea \u0163intelor de dezvoltare sustenabil\u0103 ale mileniului, care vor atenua probleme legate de s\u0103r\u0103cie, r\u0103sp\u00e2ndirea HIV sau abuzul de substan\u0163e, s\u0103 accelereze \u015fi atingerea \u0163intelor propuse de Organiza\u0163ia Mondial\u0103 a S\u0103n\u0103t\u0103\u0163ii \u00een lupta \u00eempotriva tuberculozei, care prev\u0103d eradicarea acesteia p\u00e2n\u0103 \u00een 2035.<\/p>\n<p>&nbsp;<\/p>\n<p><strong><em>Mirela Musta\u021b\u0103, Redactor Executiv E-Asistent<\/em><\/strong><\/p>\n<p><strong>Surse de documentare:<\/strong><\/p>\n<p><a href=\"http:\/\/www.bjmp.org\/content\/next-pandemic-tuberculosis-oldest-disease-mankind-rising-one-more-time\">http:\/\/www.bjmp.org\/content\/next-pandemic-tuberculosis-oldest-disease-mankind-rising-one-more-time<\/a><\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5432783\/\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5432783\/<\/a><\/p>\n<p><a href=\"https:\/\/academic.oup.com\/labmed\/...\/labmed13-0699.pdf\">https:\/\/academic.oup.com\/labmed\/&#8230;\/labmed13-0699.pdf<\/a> &#8211; <a href=\"https:\/\/www.google.ro\/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=7&amp;ved=0ahUKEwippJjhxPbZAhWLw6YKHYKoAZIQFghcMAY&amp;url=https%3A%2F%2Facademic.oup.com%2Flabmed%2Farticle-pdf%2F13%2F11%2F699%2F8268726%2Flabmed13-0699.pdf&amp;usg=AOvVaw0mBy5VjqGMRKvYpE6wY79h\">Centennial Discovery of Tubercle Bacillus &#8211; Oxford Academic<\/a><\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3691414\/\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3691414\/<\/a><\/p>\n<p><a href=\"http:\/\/content.time.com\/time\/health\/article\/0,8599,1846698,00.html\">http:\/\/content.time.com\/time\/health\/article\/0,8599,1846698,00.html<\/a><\/p>\n<p><a href=\"http:\/\/blogs.biomedcentral.com\/on-medicine\/2016\/03\/24\/tuberculosis-ancient-disease-modern-day-problem\/\">http:\/\/blogs.biomedcentral.com\/on-medicine\/2016\/03\/24\/tuberculosis-ancient-disease-modern-day-problem\/<\/a><\/p>\n<p><a href=\"https:\/\/www.cdc.gov\/tb\/webcourses\/tb101\/page3832.html\">https:\/\/www.cdc.gov\/tb\/webcourses\/tb101\/page3832.html<\/a><\/p>\n<p>Sursa foto: <a href=\"https:\/\/www.smore.com\/ac8p-industrial-revolution-conflicts\">https:\/\/www.smore.com\/ac8p-industrial-revolution-conflicts<\/a><\/p>\n<p>Sursa foto: <a href=\"http:\/\/www.cdc.gov\/tb\">www.cdc.gov\/tb<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bacteria Mycobacterium tuberculosis are origini deosebit de vechi \u2013 primele documente scrise care descriu tuberculoza dateaz\u0103 de peste 3000 de ani \u015fi provin din India \u015fi China. Studiul mumiilor egiptene a revelat, de asemenea, prezen\u0163a unor diformit\u0103\u0163i ale scheletului care sunt tipice tuberculozei. \u00cen acela\u015fi timp, dovezi arheologice din mun\u0163ii Anzi au ar\u0103tat prezen\u0163a tuberculozei [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":4484,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[152,13],"tags":[],"_links":{"self":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4497"}],"collection":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4497"}],"version-history":[{"count":1,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4497\/revisions"}],"predecessor-version":[{"id":4498,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4497\/revisions\/4498"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/media\/4484"}],"wp:attachment":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4497"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4497"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4497"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}