Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Modern National Tuberculosis Program (NTP) of Japan started in 1951 when Tuberculosis (TB) Control Law was legislated, and 3 major components were health examination by tuberculin skin test (TST) and miniature X-ray, BCG vaccination and extensive use of modern TB treatment. As to the treatment program, Japan introduced Public-Private Mix (PPM) from the very beginning, and major reasons why PPM was adopted are (1) TB was then highly prevalent (Table 1), (2) TB sanatoria where many specialists are working are located in remote inconvenient places due to stigma against TB, (3) health centers (HCs) in Japan are working exclusively on prophylactic activities, and minor exceptions are treatment of sexually transmitted diseases and artificial pneumothorax for TB cases, however, as it covers on the average 100,000 population, access is not so easy in rural area, (4) Out-patients clinics mainly operated by general practitioners (GPs) are located throughout Japan, and the access is easy. Methods of TB treatment was developing rapidly in early 1950s, however, in 1952, as shown in Table 2, artificial pneumothorax and peritoneum were still used in many cases, and to fix the dosage of refill air, fluoroscopy was needed. Hence, GPs treating TB under TB Control Law had to be equipped with X-ray apparatus. To maintain the quality of TB treatment, "Criteria for TB treatment" was provided and revised taking into consideration the progress in TB treatment. If applied methods of treatment fit with the above criteria, public support is made for the cost of TB treatment. To discuss the applied treatment, TB Advisory Committee was set in each HC, composing of 5 members, director of HC, 2 TB specialists and 2 doctors recommended by the local medical association. In 1953, the first TB prevalence survey using stratified random sampling method was carried out, and the prevalence of TB requiring treatment was estimated at 3.4%, and only 21% of found cases knew their own disease, and more than half of all TB were found above 30 years of age. Based on these results, mass screening was expanded to cover whole population in 1955, and since 1957, cost of mass screening and BCG vaccination was covered 100% by public fund. Unified TB registration system covering whole Japan was introduced in 1961, and in the same year, national government subsidy for the hospitalization of infectious TB cases was raised from 50% to 80%. Hence, Japan succeeded to organize PPM system in TB care, and with 10% annual decline of TB, in 1975, Japan moved into the TB middle prevalence country.
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PMID:[PECULIARITY OF NATIONAL TUBERCULOSIS PROGRAM, JAPAN--Public-Private Mix from the Very Beginning, and Provision of X-ray Apparatus in Most General Practitioner's Clinics]. 2726 29

The pathography of the famous painter and sculptor Amedeo Modigliani (1884-1920) shows that he had tuberculosis and died of tubercular meningitis aged 35. The nineteenth century was characterized by numerous milestones in the history of tuberculosis. In 1853, Hermann Brehmer, first used the term tuberculosis referred to at the time as "phthisis". In 1865, Jean Antoine Villemin demonstrated the infectious etiology of the disease. This was confirmed in 1882 by Robert Koch by identifying the tubercle bacillus. Koch also invented the diagnostic tuberculin test. Charles Mantoux and Florence Seibert improved this test. Identification of the infectious etiology of tuberculosis led to experiments of effective treatments for this disease. The most successful treatment for tuberculosis was by sanatorium regime. From the late nineteenth century, more invasive therapeutic approaches such as artificial pneumothorax were introduced. The advent of streptomycin in 1945 changed the social view of tuberculosis. This previously romanticized disease became a social stigma which was associated with poor social and moral standards; patients were kept in isolation. Fearing social ostracism, Modigliani refused treatment for tuberculosis and instead deliberately fostered his reputation as an alcoholic and addict in order to conceal the disease.
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PMID:Amedeo Modigliani and his "great secret": a brief history of medical and social aspects of tuberculosis in the nineteenth and early twentieth century. 3024 74