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Biomedical subjects

C Roure

Publications and source records attributed to C Roure.

16 recordsLinked to original sources
PubMed1995

Congress objectives.

In 1993, the Viral Hepatitis Prevention Board (VHPB) recognized that selective vaccination of individuals at high risk from hepatitis B had failed to control the spread of hepatitis B. The Action towards Control of Hepatitis B as a Community Health Risk was therefore established to provide information and make recommendations on actions to take to combat hepatitis B in the community. The VHPB supports the World Health Organization (WHO) recommendation that universal hepatitis B vaccination for all infants and/or adolescents should be integrated into the national immunization programme in all countries by 1997. The VHPB met regularly throughout 1993 to consider the issues involved in implementing universal strategies and to develop practical solutions that can help all countries meet the WHO goal. During this congress the feasibility of implementing universal infant and/or adolescent vaccination strategies were explored by reviewing the seroprevalence data in Europe, development of cost-benefit models and progress in countries that have already implemented universal vaccination. With the delegates' input, resolutions were reached that will guide future action towards meeting the WHO goal and combating hepatitis B in the community.

Hepatitis B↗
PubMed1995

Overview of epidemiology and disease burden of hepatitis B in the European region.

The European Regional Office of the World Health Organization (WHO) carried out a survey to collect the available surveillance data on hepatitis B and to determine the preventive strategies and policies in 50 countries in the European region. A questionnaire was sent to every country to obtain data on acute hepatitis B incidence over the past five years as well as estimates of the prevalence of hepatitis B carriage and infection in the general population. Although the surveillance systems vary in their methods and completeness, the pattern of disease is clear. In western Europe, rates vary from north to south. Southern countries have incidence rates of about 6 per 100,000 per year whereas northern countries such as Scandinavia, Ireland and the UK have much lower rates of about 1 per 100,000. Central Europe has markedly higher rates of about 20 per 100,000 per year. The highest rates are found in the Central Asian Republics, where the rates are close to 100 per 100,000 per year. Mortality data on cancer liver diseases are also available. These, together with data on the prevalence of hepatitis B in the general population of each country, provide estimates of the number of deaths attributable to hepatitis B for each country. These estimates, in comparison with other preventable causes of death, illustrate the importance of hepatitis B in Europe. Most countries have some form of selective vaccination policy, although the risk groups targeted vary markedly from country to country. Only Albania, Bulgaria, France, Israel, Italy, Portugal and Spain have implemented national universal hepatitis B vaccination programmes.

Europe↗
PubMed1995

Rapid diagnosis of Mycobacterium tuberculosis infections by an ELISA-like detection of polymerase chain reaction products.

A polymerase chain reaction (PCR) assay was developed for the detection in clinical samples of mycobacteria belonging to the Mycobacterium tuberculosis complex. PCR products were detected with a simple and rapid colormetric method. With this method, 50 fg of M. tuberculosis DNA were detectable with the repetitive DNA-sequence-derived primers, corresponding to 10 genome equivalents. Detection of M. tuberculosis in 258 clinical samples by PCR was compared with detection by culture. PCR was positive for 56 of 57 culture-positive and Ziehl-Neelsen-staining-positive (ZN) samples, 11 of 18 culture-positive and ZN-negative samples. The presence of groEL DNA sequences was also investigated by PCR for all the specimens with the same revelation protocol. Three of the eight false-negative samples with the repetitive element-derived primers were found to contain groEL DNA sequences specific for the Mycobacterium genus. Among the 183 culture-negative samples, 30 were positive by PCR. When clinical data were known, the diagnosis of tuberculosis was established for the patients from whom those samples had been obtained. The results show that the rapid and simplified PCR assay described here is slightly more sensitive than culture and can be used in routine clinical practice.

Bacteriological Techniques↗
PubMed1993

Communicable diseases in the CCEE/NIS.

The European Region is passing through a period of rapid transition with the most dramatic changes in the CCEE and NIS. The provision of adequate vaccine supplies has become a priority for many Member States in their efforts to sustain immunization activities. The Regional Office has therefore launched a special programme on vaccines for CCEE/NIS. New operational targets for the Expanded Programme on Immunization (EPI) in Europe in the 1990s were established by the European Advisory Group in 1993. These operational targets highlight the steps countries need to follow to achieve the European target 5. Immunization coverage generally remains high and stable in the Region. In 1990-1992 pockets of non-immunized individuals in different countries led to out-breaks of disease. Currently, the low coverage with DPT(DT vaccines in many provinces of the Russian Federation is one of the reasons for the epidemic of diphtheria that has affected the country since 1990. Despite the difficulties experienced by many CCEE and NIS, progress has been observed. Morbidity from poliomyelitis declined during 1990-1993. There remain only a few hot spots with endemic transmission of wild poliovirus: the Balkans, trans-Caucasus and central Asia. The diphtheria situation deteriorated in 1990, becoming increasingly dramatic in 1992 and 1993. Almost all cases have been reported from the Russian Federation and the Ukraine. Increasing diphtheria morbidity has been observed in Belarus, Kazakhstan and Uzbekistan.

Adult↗
PubMed1992

Six years of public health surveillance of measles in France.

Data provided by the Sentinel General Practitioners (SGP) to the French Communicable Diseases Computer Network (FCDN) have been used to present the epidemiological characteristics of measles observed during a 6-year period in France. The estimated annual incidence rates per 100,000 population were 376 in 1985, 603 in 1986 and 983 in 1987, then declined during the following 3 years to 297, 258, and 263 per 100,000 population in 1988, 1989 and 1990 respectively. There is a marked seasonal change with a high early summer peak. The mean age among the cases for the 6 years of study varied from 5.4 to 6.0 years. There is an increase in the percentage of cases with a past history of measles vaccination, from 6.7% in 1985 to 12.8% in 1990. This increase may be interpreted as a consequence of a substantial increase of the vaccine coverage during the same period.

Adolescent↗
PubMed1988

Analgesic efficacy of piroxicam in the treatment of postoperative pain.

Two randomized, double-blind, single-dose studies were conducted to assess the analgesic efficacy and safety of piroxicam for the treatment of moderate or severe postoperative pain. Study 1 evaluated the analgesic efficacy of piroxicam 20 mg compared with that of codeine sulfate 60 mg and placebo. A final patient population of 149 subjects rated pain intensity and pain relief at one half hour and one hour following treatment and then hourly for six hours, with a global assessment made at the completion of 24 hours. Piroxicam 20 mg was significantly more efficacious than placebo for all analgesic variables, including the sum of the pain intensity differences (SPID), total pain relief (TOTAL), percent SPID, duration of effect, and time to remedication. Codeine 60 mg was significantly superior to placebo for percent SPID and some hourly measures. Piroxicam 20 mg was significantly more effective than codeine 60 mg for percent SPID and a few hourly measures including time to remedication. Study 2 assessed the efficacy of piroxicam 20 mg or 40 mg compared with aspirin 648 mg and placebo. Sixty patients rated their pain intensity and relief hourly for 12 hours and at 24 hours after administration of study medication. Both doses of piroxicam were significantly more effective than placebo from Hours 2 to 12 for pain intensity difference (PID) and relief scores, as well as for SPID and TOTAL. Aspirin was significantly more effective than placebo from Hours 2 to 8 for relief and Hours 2 to 10 for PID as well as SPID and TOTAL. Piroxicam 40 mg was significantly more effective than aspirin 648 mg for SPID, TOTAL, and hourly measures beginning with Hour 6 through Hour 12. Piroxicam 20 mg was significantly better than aspirin for a few hourly measures: Hours 7 to 9 for relief and Hour 7 for PID. In addition, effects of piroxicam 20 mg had a significantly longer duration than aspirin. Similarly, piroxicam 20 mg had a significantly longer time to remedication compared with aspirin and placebo. The results of these studies provide evidence in support of the longer duration of analgesic efficacy of piroxicam compared with codeine or aspirin in patients with postoperative pain.

Analgesics↗
PubMed1987

Analgesic efficacy of two ibuprofen-codeine combinations for the treatment of postepisiotomy and postoperative pain.

Our purpose was to compare the analgesic efficacy and safety of single oral doses of the combination of ibuprofen 400 mg plus codeine 60 mg and the combination of ibuprofen 200 mg plus codeine 30 mg with ibuprofen 400 mg alone, codeine sulfate 60 mg alone, and placebo. One hundred ninety-five patients with severe pain resulting from episiotomy, cesarean section, or gynecologic surgery completed a randomized, double-blind, stratified, parallel-group study. Patients were observed during a 4-hour period after medication. Based on the sum of the pain intensity differences (SPID), total pain relief (TOTPAR), and most of the hourly direct measures of pain and relief, both doses of the combination and ibuprofen 400 mg alone were statistically superior to placebo. Codeine 60 mg was statistically superior to placebo based on TOTPAR, the global ratings, and a few hourly measures. The mean effect of the combination of ibuprofen 400 mg plus codeine 60 mg was significantly superior to the mean effect of ibuprofen 400 mg alone 1/2, 1, and 2 hours after medication and to the mean effect of ibuprofen 400 mg alone and codeine 60 mg alone for SPID, TOTPAR, and other measures as well. The low-dose combination was significantly more effective than codeine 60 mg for a few hourly measures but was not significantly superior to ibuprofen 400 mg. Based on these findings it appears that the combination of ibuprofen 400 mg plus codeine 60 mg, particularly in the first few hours after medication, is more efficacious than its constituents.

Adult↗
PubMed1987

Diarrheal morbidity and mortality in children in the Central African Republic.

Diarrheal morbidity and mortality in children less than 5 years old were studied in Bangui, Central African Republic, by a cluster survey. We found a high prevalence of diarrheal disease with an estimated annual incidence of 7 episodes of diarrhea per child per year. The estimated annual mortality rate for children less than 5 years old was 28.6 per 1,000 and 85.8 per 1,000 for infants; 51.6% of deaths were reported to be associated with diarrhea. During the survey, stool specimens were collected from 133 children with current diarrhea and 117 control children to study the etiologic agents of diarrheal disease in the community. An enteric pathogen was identified in 58% of diarrheal children's stools and 48% of stools of well children. A statistically significant association between diarrhea and rotavirus was found, with it being isolated from 8 of 33 (24%) of stools of infants with diarrhea compared to 0 of 25 (0%) of control infants. Isolation rates for Campylobacter jejuni, Entamoeba histolytica, pathogenic Escherichia coli, and other bacterial enteropathogens did not differ significantly between children with diarrhea and control children.

Central African Republic↗
PubMed1983

Effect of caffeine on acetaminophen analgesia.

Our objective was to determine the value of caffeine in combination with acetaminophen in the relief of pain from uterine cramping, episiotomy, and third molar extraction. In the dental study, 173 patients received two or four tablets of 500 mg acetaminophen or the combination of 500 mg acetaminophen and 65 mg caffeine. In the three postpartum studies, 1345 patients received one, two, or three tablets of acetaminophen, the combination, or a placebo. The mean scores for the summary variable percent sum of the pain intensity differences (% SPID) were higher in all for the combination than for acetaminophen alone, and in two studies the null hypothesis of no differences was rejected. The relative potency estimates for % SPID were 1.9, 1.8, and 1.3 for the three studies in which bioassays could be performed and the pooled relative potency was 1.7 with a 95% confidence interval of 1.1 to 3.1. The results were essentially the same among pain models and among patient groups with similar habitual caffeine consumption. Onset of analgesia was also faster with the combination. We conclude that caffeine enhances the analgesic efficacy of acetaminophen.

Acetaminophen↗
PubMedDate not supplied

[Evaluation of the health status of nomadic and semi-nomadic populations of the Gourma-Mali: epidemiologic approach. II. Overall results and conclusions].

The authors report the main clues of morbidity, infant mortality, fecundity as well as the main endemic affections detected in the nomadic and seminomadic populations in Gourma that they have noticed during a descriptive epidemiological investigation. The worse clues of general morbidity come from children and among the ethnic groups studied from those of the Tamachèques and the Maures. Malaria, brucellosis, treponematosis (bejel) have a high rate of frequency. The few cases of tuberculosis detected incidentally encourage to search for the real effect of this affection. Urinary schistosomiasis is present in Gossi where durable ponds exist. Intestinal helminthiasis, tineas, and hemoglobinopathies seem not to be problems of public health in the area. Pterygiums and conjunctivitis are frequent while trachoma is absent in Gourma.

Adolescent↗
PubMedDate not supplied

[Evaluation of the health status of nomadic and semi-nomadic populations of the Gourma-Mali: epidemiologic approach. I. Introduction, material and methods].

The authors set out the methodology and the practical way used in transverse epidemiological investigation with a descriptive aim which was made in natural area: Gourma-Mali. This part of the Sahel, hard to reach, is placed deep in the bend of the Niger river. The population is estimated at 100.000. The weather, ecological and human conditions have been unsettled by the drought. Sometimes, it was difficult to collect the data among the nomadic and seminomadic populations (Tamachèques, Peuls, Maures, Bellahs, Sonraïs). This investigation shows well the practical problems that this kind of study sets out in difficult bioclimatological and ethnological conditions.

Blood↗
PubMedDate not supplied

[The regional vaccination program in Europe (1991-1993)].

The European region is passing through a period of rapid transition with the most dramatic changes in the countries of central and eastern Europe (CCEE) and the former USSR. These countries are now facing serious economic problems, a dramatic rise in unemployment and social unrest which has had an impact on the development of the regional immunization programme. The provision of an adequate vaccine supply has become a priority for many States in the region in their efforts to sustain immunization activities. New operational targets for the EPI in Europe in the 1990s were established by the European Advisory Group (Copenhagen, February 1993). These operational targets identify the steps to be followed by countries in order to achieve, by the year 2000, no indigenous cases of poliomyelitis, diphtheria, neonatal tetanus, measles, mumps and congenital rubella. They also include a sustained and continuing reduction in the incidence and adverse consequences of other communicable diseases, notably HIV infection (European target 5). Immunization coverage is generally high and stable in the Region. It was observed in 1990-1992 that pockets of non-immunized persons in any country can lead to outbreaks of disease. Most Member States, however, do not yet use immunization coverage for operational purposes despite being encouraged to monitor by geographical unit. Insufficient protection against pertussis has been observed in countries including Italy, the Russian Federation and Sweden (where pertussis immunization is not obligatory) and represents the build-up of a large susceptible population.(ABSTRACT TRUNCATED AT 250 WORDS)

Diphtheria↗