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Biomedical subjects

A Spiegel

Publications and source records attributed to A Spiegel.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Ivermectin or diethylcarbamazine in spaced dosages in Bancroft's filariasis: which protocol?].

58 apparently healthy Polynesian Wuchereria bancrofti carriers were randomly allocated to 5 treatment groups: 1) two annual doses of ivermectin 100 mcg/kg, 2) three semi-annual doses of ivermectin 100 mcg/kg, 3) two annual doses of diethylcarbamazine (DEC) 3 mg/kg, 4) semi-annual doses of DEC 3 mg/kg, 5) two annual doses of DEC 6 mg/kg. Results observed during the 12-month period which followed last treatment have confirmed that efficacy of ivermectin is higher than that of DEC in terms of immediate clearance or complete negativation of microfilaremia, but not in terms of sustained reduction and that efficacy of repeated single doses of either DEC 3 mg/kg or ivermectin 100 mcg/kg is much higher when given semi-annually than annually. They also have indicated that (i) 6 months after last treatment: 3 semi-annual doses of 100 mcg/kg of ivermectin have resulted in high reduction of microfilaremia (85%) and, 2 annual doses of 6 mg/kg and 3 semi-annual doses of 3 mg/kg of DEC have resulted in even greater reduction (96 and 98% respectively) and (ii): 12 months after last treatment, the greatest reductions of microfilaremia (95 and 92%) have been observed in carriers treated, respectively, with 3 semi-annual doses of 3 mg/kg or with 2 annual doses of 6 mg/kg of DEC.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

A comparative study of detection methods for evaluation of microfilaremia in lymphatic filariasis control programmes.

The evaluation of microfilaremia (mf) was performed in 96% of the population aged 15 years or more in a village of Moorea, one of the Society Islands in French Polynesia. Finger-prick and venous blood samples were collected simultaneously from 782 individuals in order to compare the results obtained by the standard blood film method and the membrane filtration technique. Of the 782 blood-sampled inhabitants 69 (8.8%) were found mf positive. 39 (5%) were mf positive by both methods and 30 were mf positive by the membrane filtration technique only. In these latter 30 carriers the geometric mean mf count was 19.7 mf/ml, significantly lower than that of 651.1 mf/ml in the 39 carriers positive by both techniques. Using the membrane filtration technique, the mf carrier prevalence rate increased from 1.9% in the youngest age group (15-19 years) to 16.9% in the oldest (< or = 60 years) while using the blood film method, it increased from 1.3% to 12.7%. Roughly, when using the membrane filtration technique, the mf carrier prevalence rate was 1.77 higher than that found using the blood film method, considering either the whole population or successive age-groups. Moreover, when using the blood film method in the 40 years and more age group, the mf carrier prevalence rate was 10%, a proportion similar to the 8.8% prevalence rate determined by the membrane filtration technique in the whole population. Further studies are planned to assess whether the last finding may be confirmed in other Polynesian populations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Comparative efficacy of annual and semi-annual doses of ivermectin or diethylcarbamazine for the prevention of lymphatic filariasis].

A double blind randomized trial was performed on 58 healthy Polynesian Wuchereria bancrofti carriers, they were randomly allocated to treatments with repeated annual or semi-annual doses of ivermectin 100 mcg/kg or diethylcarbamazine (DEC) 3 mg/kg, or with repeated annual doses of DEC 6 mg/kg. After the 12-month treatment, the clearance of microfilaremia was complete in 7 of the 23 carriers treated with ivermectin and in 3 of the 35 treated with DEC. Nine months after that treatment, the lowest mean microfilaremia was observed in the carriers treated with 3 successive semi-annual doses of DEC 3 mg/kg. Adverse reactions were comparable in carriers treated with ivermectin and in those treated with DEC, and did not interfere with daily activities of treated subjects.

Adolescent↗
PubMed1992

Compared efficacy of repeated annual and semi-annual doses of ivermectin and diethylcarbamazine for prevention of Wuchereria bancrofti filariasis in French Polynesia. Final evaluation.

In October 1989, 58 apparently healthy Polynesian Wuchereria bancrofti carriers, in whom microfilarial (mf) density was greater than or equal to 100 mf/ml, were randomly allocated to treatment groups receiving single doses of either ivermectin at 100 mcg/kg or diethylcarbamazine (DEC) at 3 and 6 mg/kg. Six months later, half of the carriers initially treated with ivermectin 100 mcg/kg or DEC 3 mg/kg were given a second similar dose while the rest were given a placebo. Six months later again, all of the carriers received a last treatment dose similar to the initial one. The results observed during the 12-month period which followed this last treatment have confirmed that (i) in terms of immediate clearance or complete negativation of microfilaremia, the efficacy of ivermectin is higher than that of DEC (at dosage of 3 or 6 mg/kg), (ii) DEC is more effective than ivermectin in sustaining the reduction of microfilaremia over a longer period of time and (iii) the efficacy of repeated single doses of either DEC 3 mg/kg or ivermectin 100 mcg/kg is much higher when given semi-annually than annually.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Comparative study of 3 bacteriological tests of cerebrospinal meningitis during the epidemiological period].

During an outbreak of group A meningococcal meningitis in Chad in 1988, a comparative study of three bacteriological techniques (direct microscopic examination, latex agglutination, and culture) was conducted with 120 samples of cerebrospinal fluid (CSF) for diagnosis. The results correlated well with cloudy or purulent CSF specimens. Direct microscopic examination was as good a diagnostic indicator as the other tests. The authors recommend using direct microscopic examination, which is easy to perform under field conditions and accurate enough for a rapid diagnosis of cerebrospinal meningitis during an epidemic. However, complete identification of the first cases in the epidemic is important in order to establish control measures as soon as possible.

Bacteriological Techniques↗
PubMed1991

Longitudinal study on relapses of leprosy in Polynesian multibacillary patients on dapsone monotherapy between 1946 and 1970.

Between 1946 and 1970, 295 new leprosy patients were detected in French Polynesia, of whom 145 were multibacillary. Of these 145, put on dapsone monotherapy, 131 reached bacteriological negativity in a period of time ranging from 2 to 12 years (average 4.72 years) and were followed-up for a period of time ranging from 19 to 43 years (median follow-up period after bacteriological negativity; 18 years). Among the 131 patients, 36 relapses were detected, the first one 4 years after bacteriological negativity and the last one 26 years after. The crude relapse rate was 27.5%, the risk of relapse was 1.39 per 100 patient years and the cumulative relapse probability, calculated using the lifetable method, reached 0.38 +/- 11 by year 31 of the study. From these findings one may assume that, at least in French Polynesia, one-third to one-half of multibacillary patients put on dapsone monotherapy would relapse if still present 36 years after bacteriological negativity. Such results re-emphasize the need for leprosy patients to be treated with multidrug therapy as recommended by WHO.

Dapsone↗
PubMed1991

Single versus repeated doses of ivermectin and diethylcarbamazine for the treatment of Wuchereria bancrofti var. pacifica microfilaremia. Results at 12 months of a double-blind study.

In October 1989, 58 apparently healthy Polynesian Wuchereria bancrofti carriers in whom microfilarial (mf) density was greater than or equal to 100 mf/ml were randomly allocated to treatment groups receiving single doses of either ivermectin at 100 mcg/kg or diethylcarbamazine (DEC) at 3 and 6 mg/kg. Six months later, half of the carriers initially treated with ivermectin 100 mcg/kg or DEC 3 mg/kg were given a second similar dose while the rest were given a placebo. By day 360 (6 months after retreatment), comparison of adjusted geometric mean mf counts per group indicated that (i) among the 3 treatments given once a year the DEC 6 mg/kg dose resulted in the highest efficacy, (ii) nevertheless, regarding either ivermectin 100 mcg/kg or DEC 3 mg/kg, 2 successive doses resulted in higher efficacy than one annual dose and (iii) though no significant difference could be evidenced between efficacy of ivermectin 100 mcg/kg and DEC 3 mg/kg given twice a year, DEC seemed to sustain the mf reduction for a longer period of time. During the 3 days following retreatment, adverse reactions (mild to moderate) were observed in 46% of carriers treated with microfilaricidal drugs and in 20% of those treated with placebo. These results suggest that single dose therapy with either DEC or ivermectin is safe and effective for prevention of lymphatic filariasis due to Wuchereria bancrofti in French Polynesia. The real impact on transmission by the vector, Aedes polynesiensis, of the complete negativation of microfilaremia observed during the previous part of the trial in carriers treated with ivermectin should be evaluated in a community-based trial including entomological study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Diagnostic values of ELISA-IgG4 as compared to ELISA-IgG and indirect immunofluorescence, for the routine diagnosis of bancroftian filariasis in the South Pacific. Application on capillary blood collected on filter paper.

For the serodiagnosis of lymphatic filariasis, serological assays restricted to the detection of specific IgG4 antibodies enhanced the specificity. In French Polynesia, Wuchereria bancrofti is the sole human filaria and other pathogenic parasites are infrequent. In order to define a simple and cheap serological test, we have compared the diagnostic value of indirect immunofluorescence test (IFI-WBp), ELISA-IgG and ELISA-IgG4 assays. The specificity, sensitivity, R.O.C. curves of each test have been analyzed. No significant difference was found between those 3 tests, except that the reproducibility and the predictive value were lower using IFI-WBp than using the two ELISAs. Significant correlation was found between IgG and IgG4 anti-Brugia malayi antibody titers (r = 0.512, p less than 10(-5)). For large scale seropidemiological studies, ELISA-IgG can be performed with finger prick blood absorbed on filter paper, but not ELISA-IgG4. In conclusion, ELISA-IgG a less expensive and less time consuming method than ELISA-IgG4, can be used for the routine serodiagnosis as well as for seroepidemiological studies on bancroftian filariasis in the South Pacific islands.

Animals↗
PubMed1991

Cumulative mortality rates in Aedes polynesiensis after feeding on polynesian Wuchereria bancrofti carriers treated with single doses of ivermectin, diethylcarbamazine and placebo.

During a therapeutic trial, batches of 672 to 1979 laboratory-bred Aedes polynesiensis, the mosquito vector of lymphatic filariasis in French Polynesia, were fed on Wuchereria bancrofti carriers one, three and six months after they had been treated with either single doses of ivermectin at 100 mcg/kg, diethylcarbamazine (DEC) at 3 and 6 mg/kg or placebo. High mortality rates were observed during the 15-day period following the blood-meal in mosquitoes fed on carriers treated with microfilaricidal drugs and were significantly higher in mosquitoes fed on carriers treated with ivermectin than in those fed on carriers treated with DEC. Though its intensity decreased with the passage of time, the phenomenon was observed in mosquitoes fed on carriers up to six months after treatment, especially in those fed on carriers treated with ivermectin. By decreasing the number of mosquitoes able to transmit the infection, this lethal effect on Ae. polynesiensis might represent an additional advantage of ivermectin in lymphatic filariasis control programs.

Aedes↗
PubMed1991

[Respective importance of vertical and horizontal transmission of hepatitis B in the Australian archipelago (French Polynesia). Preliminary results of the vaccination of newborns].

A seroepidemiological survey of hepatitis B was conducted in 1988 in the Austral archipelago (French Polynesia) in a randomly selected sample of 957 persons, has showed an infection rate (at least one positive marker) with HBV of 64.1% for the entire archipelago. Among women of child-bearing age, HBs Ag carriage rate was 11.45% of whom 19.1% were so HBe Ag carriers. Among infants HBs Ag carriage rate was 2.1% and among juveniles it was 10.6%. In this area horizontal transmission of HBV is essential. An immunization program was implemented in August 1988 using a recombinant vaccine (GenHevac BTM). At one year of the program, 97% of the children had received at least one dose of vaccine, 90% had HBs-antibodies titer higher than 10 mUI/ml, 96% had seroconverted for at least one of the two antibodies (anti-HBs and/or anti-preS2) and any of them was neither HBs Ag carrier nor anti-HBc IgM antibodies carrier. Finally, among 7 neonates whose mother were positive for both HBs Ag and HBe Ag, 6 were immunes and the last one, aged of 1 month (one dose received only), was not HBs Ag carrier. These preliminary results show that vaccination with GenHevac BTM to be immunogenic and effective in field conditions.

Adolescent↗
PubMed1991

[The usefulness of systematic follow-up of tuberculosis for the diagnosis of relapse in French Polynesia between 1971 and 1984].

Standard chemotherapy for one year was proposed for the treatment of tuberculous patients in French Polynesia between 1971 and 1978, and for nine months with the addition of pyrazinamide from 1979 to 1984. After treatment, the patients were followed up systematically for a period of 5 years. The aim of this study was to evaluate the value of the follow up measures to detect relapses. Of 1,065 patients treated between 1971 and 1984 at the centre for the control of tuberculosis 35 (3%) presented with a relapse, of whom 30 were confirmed either by bacteriological examination or histological examination. The level of relapse seen was not linked to age, sex, nor type of treatment received (one year or nine months). However, the level of relapse in non compliant patients to the initial treatment (7%) was significantly greater than those observed in patients who were totally compliant (2%) (p less than 0.0001). Of the 35 relapses 9 (26%) were discovered during routine follow up visits, of whom 8 were detected during the first year. The median delay separating apparent recovery from relapse was 8 months. 28 patients (80%) presented with symptoms suggestive of a relapse. Over 5 years 5773 consultations were carried out, which meant 642 consultations to detect one relapse. The authors suggest that in French Polynesia a systematic follow up limited to one year after apparent cure should be adequate.

Adult↗
PubMed1991

The treatment of microfilaremia due to Wuchereria bancrofti var. pacifica: ivermectin versus diethylcarbamazine.

In October 1989, a controlled, double-blind parallel group trial was implemented to compare both efficacy and tolerability of single doses of ivermectin and diethylcarbamazine (DEC). Fifty eight apparently healthy Wuchereria bancrofti carriers were hospitalized and randomly allocated to treatment with ivermectin 100 mcg/kg, DEC 3 or 6 mg/kg. Six months later, half of those initially treated with ivermectin 100 mcg/kg and DEC 3 mg/kg were given a second similar dose while the rest were given a placebo. After initial treatment, clearance of microfilaremia was complete in 22 of the 23 carriers treated with ivermectin and in one only of the 35 treated with DEC. Adjusted geometric mean microfilaremia was significantly lower (p less than 0.01) in carriers treated with ivermectin than in those treated with DEC at one, but neither at 3 (p = 0.26) nor at 6 months (p = 0.63). The comparison of adjusted geometric mean microfilaremia per group indicated that (i) regarding either ivermectin 100 mcg/kg or DEC 3 mg/kg, 2 successive doses resulted in higher efficacy than one annual dose and (ii) efficacy of 2 successive doses of ivermectin 100 mcg/kg or DEC 3 mg/kg were not significantly different. During the 3 days following initial treatment, adverse reactions were observed in 80% of the treated carriers of whom 14% suffered a grade 3 reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Double blind study on efficacy and safety of single doses of ivermectin and diethylcarbamazine for treatment of Polynesian Wuchereria bancrofti carriers. Results at six months.

In 1989, a double-blind trial was implemented in Tahiti to compare both efficacy and tolerability of single doses of ivermectin and diethylcarbamazine (DEC) for treatment of Wuchereria bancrofti carriers. Of 58 carriers, in whom microfilarial (mf) density was greater than or equal to 100 mf/ml, 23, 24 and 11 were randomly allocated to treatment with respectively ivermectin 100 mcg/kg, DEC 3 and DEC 6 mg/kg. One week after treatment, clearance of microfilaremia was complete in 22 of the 23 carriers treated with ivermectin and in one only of the 35 treated with DEC. Adjusted geometric mean for mf densities was significantly lower (p less than 0.001) in carriers treated with ivermectin than in those treated with DEC at one, but neither at 3 (p = 0.26) nor at 6 months (p = 0.63). At 3 and 6 months, mf levels were 14 and 28%, 21.6 and 19.4%, and 10.2 and 8.4% of pretreatment mf levels in carriers treated respectively with ivermectin 100 mcg/kg, DEC 3 and DEC 6 mg/kg. Side effects were experienced by 51 carriers (88%) of whom only 8 (14%) suffered a grade 3 reaction. Onset and intensity of side effects were significantly associated (p less than 0.01) with both pretreatment mf densities and peripheral blood parasite clearance. Efficacy of ivermectin single dose was superior to that of DEC single dose in terms of immediate mf clearance but not in terms of sustained mf decrease at 6 months.

Adult↗
PubMed1990

Differential expression of low molecular weight form of Gs-alpha in neostriatum and cerebellum: correlation with expression of calmodulin-independent adenylyl cyclase.

Adenylyl cyclase of neostriatal plasma membranes is far less responsive to stimulation by Ca2+/calmodulin than is the enzyme from cerebellum. When these tissues were investigated with antibodies against known G-proteins, no difference could be detected in any G-protein species, other than Gs. Whereas the cerebellum expressed predominantly the large form of Gs-alpha, the neostriatum expressed mainly lower molecular weight forms. The possibility is considered that there is selective association between lower molecular weight forms of Gs and calmodulin-independent forms of adenylyl cyclase.

Adenylyl Cyclases↗