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Biomedical subjects

J L Rey

Publications and source records attributed to J L Rey.

At least 19 recordsLinked to original sources
PubMed2006

[Difficulties of the patients to undergo their ARV treatment at the Libreville outpatient health center, Gabon].

The therapeutic observance is a real issue of chronic diseases. This issue is twice as much important in the case of aids treatment by antiretrovirals as a good observance is essential to avoid emergence of resistances and to improve patients' health. A research was conducted in Libreville, the capital of Gabon, at the ambulatory treatment center of HIV patients. The interviews of one hundred patients of the center, under treatment for more than two months, concerned their problems related to specific drugs intake and have helped to point out some reasons of non observance. The first reason refers to side effects inducing many difficulties in regular drugs intakes, a complete information is requested by the patients. Another main reason of non observance or bad observance is linked to material and financial problems or to treatment's reduced accessibility The research points out the importance of supplementary treatment costs (transportation, sick leave, food). At last, major observations were made on schedule management, drugs intake management, needs for more information and help for prevention, everyday life and diet.

Adult↗
PubMed2006

[Use of antiretroviral drugs invoices for the follow-up of a treatment programme. Example in Abidjan, Côte d'Ivoire].

A retrospective analysis of the prescriptions of the ARV treatment programme in Abidjan, Côte-d'Ivoire enabled the authors to assess the collected anonymous information in order to evaluate the efficacy of the programme. This collection of information helps to supervise each center at a lower cost, to alert on some working problems and to follow the quality of the observance. This supervision is possible regardless of the health care places, it can be carried out systematically from the administrative or financial services. In this study this follow-up reveals some problems.

Anti-Retroviral Agents↗
PubMed2005

[Study conducted at the Yaoundé University Hospital on anti-retroviral treatment compliance (Cameroon)].

To build the knowledge base on anti-retroviral (ARV) treatment compliance in Africa, a study has been carried out at Yaoundé University Hospital. It documented and studied the follow up of 231 patients under tri-therapy at the time of the study (December 2003). Respecting the strict time schedules is a crucial issue, especially for taking the morning and evening doses of medication. This is true for all patients, regardless of their social or economic status. The majority of the patients request more thorough information about their treatment. Some patients face economic problems which are more often related to the indirect costs rather than to the cost of treatment. Finally, the difficulty in confronting the treatment's side effects or the galenic nature of ARV treatment itself is noted. Nevertheless, it seems that the patients could better manage these issues and deal with the ensuing challenges if better communication with more complete information was provided to them at the beginning of their treatment, accompanied by written fact sheets specific to each type of treatment.

Acquired Immunodeficiency Syndrome↗
PubMed2005

[Syphilis test proposed within the context of a programme to reduce mother/child HIV transmission: example of the Wassakara Health Care Center in Abidjan].

During the program MTCT+ set up in Abidjan by the national authorities with the assistance of the FSTI and FGSK, free screening and treatment of the syphilis infection were proposed to pregnant women. One test of agglutination on blades VDRL (Carbon Antigen Biotec the U.K.) and one TPHA test on plates for the positive VDRL (TPHA Nosticon Biomérieux F) were performed. Over the period from June 1999 to December 2001, 4 320 samples were taken. The laboratory observed 84 positive tests VDRL and 59 confirmed by TPHA, that is to say a syphilis seroprevalence (TPHA) of 1.4%. In addition 391 results were not available for various reasons (errors of numbering, haemolysed blood, absence of reagents, etc.) ie. 9.0%. Among the 59 positive women (TPHA), 30 came back for their result and 23 women were correctly treated (3 or 4 penicillin delay injections). In addition 7 partners received a complete treatment and 8 incomplete treatment. The cost of each detected and treated case rose approximately to 150 Euros, which is relatively low except in time/ staff and indirect costs for women. This study confirmed that all the activities of SMI must be integrated to have an efficient PTME programme. The biological assessment must be accessible as a whole, to minimize the additional costs and transportations. A training of all the personnel in 2002 helped to improve in an important way the results of the intervention in the center.

AIDS Serodiagnosis↗
PubMed2004

[Prevention of recurrent amiodarone-induced hyperthyroidism by iodine-131].

Amioradone-induced hyperthyroidism is a common complication of amiodarone therapy. Although definitive interruption of amiodarone is recommended because of the risks of aggravation of the arrhythmias, some patients may require the reintroduction of amiodarone several months after normalisation of thyroid function. The authors undertook a retrospective study of the effects of preventive treatment of recurrences of amiodarone-induced hyperthyroidism with I131. The indication of amiodarone therapy was recurrent, symptomatic, paroxysmal atrial fibrillation in 13 cases and ventricular tachycardia in 5 cases (M = 14, average age 64 +/- 13 years). The underlying cardiac disease was dilated cardiomyopathy (N = 5), ischaemic heart disease (N = 3), hypertensive heart disease (N = 2), arrhythmogenic right ventricular dysplasia (N = 2) or valvular heart disease (N = 2). Two patients had idiopathic atrial fibrillation. An average dose of 576 +/- 184 MBq of I131 was administered 34 +/- 37 months after an episode of amiodarone-induced hyperthyroidism. Amiodarone was reintroduced in 16 of the 18 patients after a treatment-free period of 98 +/- 262 days. Transient post-radioiodine hyperthyroidism was observed in 3 cases (17%). Sixteen patients (89%) developed hypothyroidism requiring replacement therapy with L-thyroxine. There were no recurrences of amiodarone-induced hyperthyroidism. After 24 +/- 17 months follow-up, the arrhythmias were controlled in 13 of the 16 patients (81%) who underwent the whole treatment sequence. The authors conclude that preventive treatment with I131 is an effective alternative to prevent recurrence of amiodarone-induced hyperthyroidism in patients requiring reintroduction of amiodarone to control their arrhythmias.

Adult↗
PubMed2004

[Healthcare: a growing role in international politics].

Since the end of the cold war the tone of international relations has clearly changed. Whereas relations were once defined strictly in terms of more or less armed confrontation, economic and social issues now play a growing role. Healthcare policies in Africa have long been influenced by the policies of countries sponsoring bilateral and even multilateral foreign aid programs. However the last ten years have witnessed an increasing interaction between international policy and healthcare policy. The two main reasons for this trend involve 1) access to drug treatment and the WTO and 2) the extension and impact of the AIDS epidemic. The problem of access to drug treatment for poor populations (fundamental right) has led to the emergence of an increasingly strong and effective civil society. Because of its social and economic effects as well as its geopolitical and security implications, AIDS has become a major factor in international relations. With regard to both these issues the place and role of the USA is demonstrative of the interaction between healthcare and international relations.

Acquired Immunodeficiency Syndrome↗
PubMed2002

[Ectopic atrial tachycardia complicating a congenital left atrial aneurysm: value of an electro-anatomical mapping system].

The authors report the case of a patient with a congenital left atrial aneurysm complicated by ectopic atrial tachycardia treated successfully by surgery. Transoesophageal echocardiography and magnetic resonance imaging provided accurate measurements of the aneurysm and its anatomical relationships. Three-dimensional electro-anatomical mapping with the CARTO, system (Biosense) confirmed the shape and dimensions of the aneurysm. The system showed the electrically mute zones and the ectopic focus situated just beyond the aneurysmal neck. Surgical ablation confirmed the morphological and functional data of the imaging techniques and the patient was definitely cured.

Adult↗
PubMed2002

[Sero-epidemiological study of the hepatitis epidemic in Mitrovica in the aftermath of the war in Kosovo (1999)].

In July 1999, after the return of the Kosovar refugees to their country, an outbreak of acute hepatitis A (HAV) and E (HEV) occurred. Epidemic hepatitis and diarrhoea are closely monitored communicable diseases which had been singled out as priorities by the health authorities of the former Republic of Yougoslavia. Several field surveys were undertaken: description of reported cases, serological study of clinical patients, study of anti-HAV seroprevalence in a school and a case control study to assess risk factors. The analysis of the reports indicates an epidemic peak at the end of September, 2 or 3 weeks after the start of the new school year, with an increase of cases relative to the age of the children in school. In a serologic study of 104 samples, we found an anti-HAV IgM positivity in 88% of the cases. Children were more likely to be positive when compared to teenagers and adults; likewise, consumers of well-water as versus those drinking network water (p = 0.03). The study of seroprevalence showed that transmission had taken place within the school. The case control study, in spite of its imperfections, indicated that consumption of water melon, the only fruit cultivated locally, is a factor which facilitates the HAV transmission. Circulation of the hepatitis E virus was confirmed for 4 sick persons (including 2 co-infected HAV-HEV) and in 4 persons without clinical symptoms. These results show the permanent risk of faeco-oral infections in this area and the need to develop a relevant prevention policy.

Adolescent↗
PubMed2001

[Dissection of the aorta complicated by aorto-pulmonary fistula].

The authors report the case of chronic dissection of the aorta presenting with congestive cardiac failure. The diagnosis was made for the first time by transoesophageal echocardiography which showed both the dissection of the aorta and its fistulalisation into the pulmonary artery. Aortography confirmed the diagnosis. The patient underwent surgery which consisted of suture of the fistula and replacement of the ascending aorta with a prosthetic tube. The outcome was favourable after 8 months follow-up.

Aged↗
PubMed2000

[Pharmaceutical development concerning diseases predominating in tropical regions: the concept of indigent drugs].

When the WHO certified the eradication of smallpox in 1981, there was a general impression that the fight against infectious diseases which began with Jenner and Pasteur was entering a phase of achievement: poliomyelitis, dracunculasis, leprosy, Chagas' disease and neonatal tetanus were also responding to eradication campaigns. However, in 1995, infectious diseases are still an important cause of mortality and morbidity and the rising incidence of emerging or re-emerging diseases remains a matter of great concern. Although this situation can be explained, at least partly, by the deterioration of health care systems and diverse socio-economic and ecological disorders, important changes occurring in the drug industry since 1980 have also played a role due to changes in pharmaco-epidemiology and new policies of drug development. Among the 1061 new drugs developed from 1975 to 1994, less than 2.7% concern tropical diseases. Since praziquantel, novel drugs have issued from veterinary medicine (ivermectin), military research (halofantrine, mefloquine) or fortuitous analysis of pharmacopoeia (artesunate). The cost of investments and the lack of market potential and market security in developing countries have dampened interest in developing drugs for tropical diseases. Observing the combined effect of deficient pharmaceutical development, drug wear due to chemoresistance (chloroquine, sulfadoxine-pyrimethamine, aminopenicillins), the cost barrier (second generation molecules) and the potential abandon of major drugs (eflornithine, melarsoprol) has led us to establish a classification of these "indigent" drugs (in opposition to "orphan" drugs) into five classes: true indigent drugs (eflornithine), indigent drugs by indication (pentamidine), indigent drugs by function (ceftriaxone), indigent drugs by formulation (melarsoprol) and indigent drugs by default (suramin). This analysis can serve as a basis for a search for solutions (regulatory, administrative and financial incentives) favoring a reactivation of drug development for diseases predominating in intertropical regions.

Animals↗
PubMed1999

Meningeal leiomyoma in an adult with AIDS: CT and MRI with pathological correlation.

We describe the imaging features of a meningeal leiomyoma with pathological correlation in an adult with AIDS. On CT the tumour showed a central low-attenuation area and an enhancing peripheral ring. It gave low signal on T1 weighting and on T2-weighted images a central high-signal area was surrounded by a markedly low-signal band, which showed contrast enhancement. As far as we know, this is the first report of this condition in the radiological literature.

Acquired Immunodeficiency Syndrome↗
PubMed1999

[Protective effect of clothing impregnated with permethrin against D. reticulatus and D. marginatus in an open biotope of central western France].

During the period of major tick activity, in April and May 1998, in the Saint-Maixent l'Ecole area of Poitou, a comparative study was carried out in order to evaluate the protective effect of garments impregnated with permethrin cis/trans 25/75. Three groups of soldiers made up respectively of 208, 218 and 427 men were involved for 2 or 3 days in this experiment. Respectively 107, 107 and 215 wore impregnated uniforms. Out of a total of 319 ticks, 3 were lxodes ricinus, 305 Dermacentor marginatus and 11 D. reticulatus. There was a significant difference in both the intensity (number of ticks per individual, P < 0.0001) and prevalence (number of individuals with ticks, P < 0.001) of ticks on individuals between impregnated and non impregnated uniforms. The repellent effect of permethrin on ticks was observed at the site of preferential tick attachment (normally the head of the host for these two species of Dermacentor in France) where the number of ticks was significantly lower in impregnated uniforms.

Animals↗
PubMed1998

Comparative value of Doppler echocardiography and cardiac catheterization in the decision to operate on patients with aortic stenosis.

With the use of Doppler echocardiography, severity of valvular stenosis, etiology and type of valve lesions, and left ventricular function can be assessed accurately in patients with aortic stenosis. The purpose of this study was to compare the value of noninvasive clinical and Doppler echocardiographic findings, with cardiac catheterization, in the management decision-making for patients with aortic stenosis. One hundred and seventy consecutive patients with aortic stenosis who underwent cardiac catheterization and Doppler echocardiography were prospectively studied. A decision to operate, not operate or remain uncertain was made independently by experienced cardiologists given clinical information in combination with either Doppler echocardiographic (group I) or cardiac catheterization (group II) data. The severity of aortic stenosis agreed between Doppler echocardiography and cardiac catheterization in 168 patients (98.8%), and disagreed in two patients. There was agreement on clinical decision to operate or not operate between Group I and Group II in 160 patients (94.1%) and a discrepant decision in only two patients (1.1%). In eight patients (4.7%) with poor echogenecity or with discordance between clinical and echocardiographic data, the decision made by group I remained uncertain. We conclude that in a large majority of patients with aortic stenosis, Doppler echocardiographic assessment provides the same management decision reached by cardiac catheterization findings.

Aged↗