Search PubMed⌕ Search

Biomedical subjects

J Grosset

Publications and source records attributed to J Grosset.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Adverse effects of rifampin.

Rifampin has proved to be a valuable antibiotic with relatively few major adverse effects. Its toxicity is predominantly hepatic and immunoallergic in character. While hepatic toxicity is dose related and has been observed mainly in patients with underlying liver disease, the immunoallergic effects are usually associated with intermittent or prolonged therapy. These immunoallergic effects may be minor (a cutaneous, gastrointestinal, or influenzalike syndrome) or major (hemolytic anemia, shock, or acute renal failure).

Animals↗
PubMedDate not supplied

[Multi-drug therapy trials for leprosy in Senegal: first observations relative to liver tolerance of multibacillary patients. Therapeutic consequences].

The authors have studied tolerance of multibacillary patients to 4 MDT regimens. These 4 regimens consist of: One supervised part in which RMP-ETH combination in once-monthly administered; furthermore, in 2 of these regimens, is included one "starter phase" with daily doses of that combination for 2 months. One self-administered part during which CLO is associated either to DDS for new cases, or to ETH for relapses. Clinical Supervision: Out to 310 multibacillary patients, 7 cases of hepatitis with or without icterus, but no death due to the treatment. Interruptions of MDT have been temporary and have been observed in 0.9 to 5.6% of the patients according to the therapeutic regimen. Checking SGOT: The SGOT were abnormally high in 16.3% of the patients before treatment. These pre-existing liver damages do not favour the appearance of intolerance disorders. During MDT, abnormal increases in SGOT are observed in 27% of the patients but there is no exact correlation between the absorbed doses of ETH and the frequency in SGOT increases. The clinical or biological evidence of liver damages occur rather early (1st, 2nd month) in regimens with "starter phase", and later (4th-8th month) in those without "starter phase". But introduction of "Starter phase" does not increase the global frequency of such intolerance accidents. ETH combined with RMP, must be used under steady clinical and biological supervision. Recalling the results of a previous survey, the authors consider that a long duration of MDT is not necessary. For the multibacillary leprosy treatment, they propose a diphasic regimen, more easily applicable in the field than the WHO protocols. In this diphasic regimen, the only part which must be supervised is the initial "starter phase" of 2 month. It consists of daily administration of 3 antibacillary drug among which RMP and ETH. The second phase is a relay treatment using 2 drugs, CLO combined with DDS or ETH, self-administered until smear negativity.

Adolescent↗
PubMedDate not supplied

[Resistance of Mycobacterium leprae to dapsone and rifampicin: apropos of a survey carried out in the Cape Verde region (Senegal)].

Since 1983, primary resistance of M. leprae to DDS and rifampicin has been evaluated in new cases of lepromatous leprosy observed in the Cap-Verde region in Senegal. Out of the 13 strains isolated, 10 (77%) have been found resistant to DDS, 7 at low level, 2 at intermediate level, 1 at high level; all of them have been found sensible to rifampicin. Similar results have been obtained with 57 strains isolated from patients not yet treated coming from different geographical areas, seeing that 37, i.e. 65%, were resistant to DDS, 27 at low level, 5 at intermediate level and 5 at high level; all of them were sensible to rifampicin. Level of resistance to DDS is very different in case of acquired resistance. In 69 lepromatous patients treated for more than 5 years and showing a relapse, M. leprae was 62 times, i.e. 90%, resistant to DDS, 6 times at low level, 21 at intermediate level and 35 at high level; in addition, 13 times M. leprae was resistant to rifampicin. In order to avoid and to solve problems set by resistance of M. leprae to antibiotics, strict application of polychemotherapy of leprosy is compulsory.

Dapsone↗
PubMedDate not supplied

[A trial of polychemotherapy of leprosy in the Dakar region. Initial observations on the acceptability of the protocols used].

Since 1982, in Dakar, a controlled essay tests the suitability of several short protocols of multidrug therapy (MDT), some of them being close to those advised by the WHO, others showing a starter stage of a two month daily MDT. In three years, 198 paucibacillary and 123 multibacillary patients have been treated. The short duration of these treatments leads to an important decrease in the load of the Department. The total rate of those who have not attended for the treatment is of 15.2% whereas it was of 52% with DDS monotherapy for a similar treatment duration. Those who gave up don't seem to live in Dakar. To judge by the diligence of the patients, the compliance seems excellent even for the protocols requiring a daily dose of ethionamide: 95% of paucibacillary, 76% of multibacillary patients have maximal attendance. The authors think that any MDT program: must be preceded by a retraining of staffs; must give a priority to the health education of the patients; must involve a home patient search for system.

Adolescent↗
PubMedDate not supplied

[Present-day difficulties in the campaign against leprosy and proposals for its resumption in French-speaking Africa].

Until recent years the control of leprosy lied over a semi-specific organisation called "lutte contre les Grandes Endémies". Their strategy was based on the facilities of specialists teams practicing systematic medical visits ware the track-down, the treatment by monotherapy and the annual control of the patients. With appearance of social and economic difficulties the activity of these services has greatly decreased and the control of leprosy has known a stop in many countries. Also this organisation is no long a fit to the use of new regimens based on multitherapy. Solutions are proposed having in mind the objectives to follow scientific and logistic demands all the facilities. Summary all the facilities should be used without exception and without hesitation: lights move-over teams, fixed centers, educationals facilities, etc... This combination of this facilities and the wish to fight by the population and the health personals could only assure the success of new programs against leprosy.

Africa↗
PubMedDate not supplied

[Advances in the chemotherapy of leprosy].

The chemotherapy of multibacillary leprosy with dapsone alone has resulted after 15-20 years in the selection and the diffusion of dapsone resistant Mycobacterium leprae. To overcome dapsone resistance, to prevent the selection of organisms resistant to other drugs and to kill the largest proportion of sensitive M. leprae, the chemotherapy of leprosy must rely, as chemotherapy of tuberculosis, upon the combination of several drugs. Rifampicin is included in all drug combinations recommended by WHO. The drug combinations have to be given for at least six months in patients with paucibacillary leprosy and two years in patients with multibacillary leprosy.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Current data on the bacteriology of leprosy].

Microscopic examination and mouse foot-pad inoculation are the main tools in Mycobacterium leprae bacteriology. Microscopic examination enables to calculate bacteriological (IB) and morphological (IM) indexes. The former scores the density of acid-fast organisms in the lesions and the latter scores their viability since only solidly stained acid-fast organisms are likely to be alive. Mouse foot-pad inoculation provides the opportunity for studying the growth curve of M. leprae. Alterations of this growth curve under drug therapy enable to assess the antileprosy activity of drugs and to determine the drug sensitivity of organisms. Acquired and primary drug resistances to DDS are to date the most important events in the chemotherapy of leprosy. Researches are in progress on mice with congenitally reduced immunological capacity (nu/nu mice) and on antileprosy vaccination. Although no decisive advances have been obtained in these fields, researches in progress are promising.

Animals↗