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Biomedical subjects

J L Rey

Publications and source records attributed to J L Rey.

At least 163 records · Page 9Linked to original sources
PubMed1978

[Comparison of echocardiography and phonomecanography in adult aortic valve stenosis. 55 cases].

The results of echocardiography and phonomecanography were compared in 55 cases of adult valvular aortic stenosis. Although the most reliable echocardiographic sign of the severity of stenosis is the systolic separation of the aortic valve echos, it should be amphasised that: -- this cannot be measured in 25 % cases; --in 10 % cases the values obtained vary with the angle of the transducer. In these cases, the finding of a left ventricular posterior wall thickness greater than or equal to 15 mm is specific for severe aortic stenosis. On the other hand, the left atrial, left ventricular and aortic internal dimensions and the morphology of the mitral leaflets do not help in the estimation of the severity of adult aortic stenosis. The best correlations between echo and phonocardiography are the values of aortic valve opening and : --hemi-ascension time (r = 0.67); --left ventricular ejectiontime (r = 0.93) when patients in cardiac failure are excluded. The complementary nature of these two investigations is notable, and should, in pure aortic stenosis without angina, spare patients who are often elderly and fragile from heamodynamic investigation.

Aged↗
PubMed1978

[Controlled tests of anti-meningococcal polysaccharide A vaccine in the African Sahel area (Upper Volta and Mali) ].

After the first tests of this vaccine in Egypt (1972) and in the Sudan (1973), two controlled tests in the field were performed in two high-risk areas for meningitis: --firstly, in the region of Koudougou (Upper-Volta), in November-December 1973 (17,300 vaccines). Its major aim was to solve operational and logistical problems; --secondly, in the Koutiala (Mali) area, according to a very strict schedule, in November-December 1975 and December 1975 (37,979 vaccines). The complete innocuousness of the vaccine was proven and excellent seroconversion was observed after its administration. On the individual level, it was confirmed that the vaccine ensures excellent protection for a period of at least three years. This new prophylactic weapon inspires the authors to suggest a new strategy in the fight against meningitis epidemics caused by meningococcus in the African Sahel area, taking into account the current increase there in serogroup C, against which there is also a vaccine whose efficacy has already been demonstrated.

Adolescent↗
PubMed1978

Killed poliovirus antigen titration in humans.

To establish the antigen content of a killed poliovirus vaccine sufficiently potent to induce immunity with one or two doses and to establish a reference standard vaccine which has been tested under field conditions, a titration was carried out in infants to determine the amount of each of the three antigenic types of poliovirus vaccine required to induce seroconversion with a single dose. It has been observed that over a critical range of antigen concentration there is an essentially linear relationship between antibody response and quantity of antigen administered. More than 90 percent of the groups studied had detectable antibody after receiving single injections of 80, 8 and 64 D-antigen units of Types I, II and III, respectively. Four-fold less antigen for each of the three types was less effective. The implications of these findings for an efficient immunization procedure are discussed.

Antibodies, Viral↗
PubMed1977

[Changes in left ventricular function with effort in the coronary patient. l].

The altered haemodynamics of the coronary patient have been investigated in 30 patients both at rest and under conditions of maximal effort as carried out on the bicycle ergometer under the usual conditions for an exercise electrocardiogram. Patients with angina of effort but no previous infarction have normal left ventricular function at rest; under the ischaemia induced by exercise there is acute dysfunction of the left ventricle as witnessed by a reduction in maximal cardiac output, a raised end-diastolic pressure, and changes in compliance which are more marked than those in contractility. Patients with a healed infarct but without sequelae have a rigid left ventricle, but it is not failing; they show normal changes in dP/dt max and in the indices of left ventricular work, but a pathological form of negative peak of dP/dt, of end-diastolic pressure, and of deltaP/deltaV (which reflects myocardial compliance). Patients who have had an infarction with sequelae such as angina or attacks of left ventricular failure have filling pressures which are already elevated at rest, and cardiac failure, which becomes evident on exercise.

Angina Pectoris↗
PubMed1976

[Value of readaptation after myocardial infarction. Apropos of 100 cases].

The short-term and mid-term readaptation of 10000 patients has been studied by means of 400 follow-up exercise tests and a very detailed questionnaire. The effects of physical training are at their maximum at between 9 and 12 months, with an increase in exercise capacity of 26% occuring between one and a half and nine months post-infarction. This improvement in capacity for work seems to be due exclusively to a peripheral mechanism originating from an economy in the work of the heart. Although it does not totally relieve them of their anxiety, a training programme gives the patients an attitude of mind which helps them to regain their socioprofessional position. 82% of the trainees who still had a professional position were able to restart work within an average period of 5 months. Since we have not been able to make up an adequate control group, we have not been able to assess the effect of training on the natural history of coronary artery disease.

Adaptation, Psychological↗
PubMedDate not supplied

[A study on antiretroviral treatment compliance in Casablanca (Morocco)].

OBJECTIVE: Compliance in HIV infection treatment is a major stake to give worldwide access to antiretroviral (ARV) treatment and especially in Africa. In September 2003, we undertook a study on compliance among HIV positive patients under antiretroviral treatment. These patients were included in a therapeutic educational program in the infectious diseases department of the Casablanca University Hospital (Morocco). The main objective of the study was to assess obstacles to compliance and to find possible solutions. DESIGN: A transversal investigation was made, based on questionnaires for patients under ARV treatment, chosen consecutively. The physician's and the educator's opinion on patient compliance was collected. RESULTS: Patients were between 21 and 65 years of age. Ninety-two patients were questioned and 89 analyzed. Treatment duration lasted from 2 to 67 months. Compliance according to educators was good (>90%) for 78 patients. The main obstacles for a good compliance were difficulty to respect administration schedule and the long distance between home and hospital, or the presence of adverse effects and other diseases. CONCLUSIONS: The role of the therapeutic educational program in improving compliance was largely highlighted.

Adult↗
PubMedDate not supplied

Clinical significance of intracavitary spontaneous echo contrast in patients with dilated cardiomyopathy.

To assess the occurrence rate and major determinants of spontaneous echo contrast and to examine its impact on thromboembolic events and mortality in patients with dilated cardiomyopathy, 86 hospitalized patients (73 men and 13 women, mean age 63 +/- 11 years) with dilated cardiomyopathy who underwent transthoracic and transesophageal echocardiographic examinations were followed up for a mean of 20 +/- 13 months. Spontaneous echo contrast was observed in 36 patients (42%) and was detected only with the transesophageal approach. It was seen in the left atrium in 33 patients, in both right and left atria in 1 patient, in both left atrium and left ventricle in 1 patient, and in the descending aorta in 1 patient. Spontaneous echo contrast was more frequent in the presence of atrial fibrillation (p < 0.05), left atrial enlargement (p < 0.02) and severely depressed left ventricular function (p < 0.01), but was less common in patients with moderate to severe mitral regurgitation (p < 0.05). This imaging phenomenon was the only significant independent predictor of intracardiac thrombus formation and previous and subsequent thromboembolic events. During follow-up, there were 26 deaths, and survival in patients with spontaneous echo contrast was significantly lower than in those without it (p < 0.02). A spontaneous echo contrast is commonly detected with transesophageal echocardiography in patients with dilated cardiomyopathy especially in the presence of atrial fibrillation, left atrial enlargement and severe left ventricular dysfunction. This imaging phenomenon represents an important marker for thromboembolic risk and may influence the treatment and clinical outcome of these patients.

Adolescent↗
PubMedDate not supplied

[Competition for the promotion of essential generic drugs in Africa].

STATEMENT OF THE PROBLEM: in most sub-Saharan countries, an extensive economic crisis coupled with a low level of existing resources has put most pharmaceuticals beyond the reach of the general public. This situation was worsened by the devaluation of the Franc CFA in 1994. The supply of lowprice drugs and the improvement of rational drug use is now a priority. Unfortunately, essential generic drugs are little known and used in Africa. OBJECTIVE: 1. To improve the knowledge of and confidence in essential and generic drugs among providers, prescribers and consumers, through the participation of the general public in an incentive-based, creative competition; 2. To collect locally-adapted promotional material, to be used in the future promotion of essential and generic drugs in Africa. Design, setting and method: a competition was announced in June 1995, via various networks, in French-speaking Africa: the population was invited to create one or several items promoting essential generic drugs. These items included slogans, posters, songs and short plays. Over 550 entries were received before the deadline (15 October 1995), from 22 countries (mostly Sub-Saharan and French-speaking). The entries included 387 slogans, 94 posters, 22 plays, and various (photos, comic strips, songs, poems). RESULTS: 1. Greater awareness of essential generic drugs in Western Africa, through the publicity given to the competition; 2. Selection of a pool of approximately 200 promotional items, produced by the target populations, to be published in a catalog and distributed in African countries; 3. Insights into popular practices and representations of Western medications, and local re-interpretation of the concept. CONCLUSION: this public competition was effective at achieving three important goals: 1. Dynamic promotion (the competition was the opportunity for school projects, radio talkshows, etc. on generic drugs); 2. Re appropriation of a policy, thanks to a participative approach; 3. Analysis of the population's general comprehension of pharmaceuticals, through analysis of competition entries.

Advertising↗
PubMedDate not supplied

[The transmission of maternal measles antibodies to newborn infants in the Ivory Coast].

Authors studied the disappearance of mothers measles antibodies among 286 babies from Ivory Coast 250 of which were living in Adzopé, a town with 30,000 inhabitants at 100 km up North from Abidjan and the 36 other babies in Abidjan. The study of antibodies by IHA showed a higher serum incidence rate of mother antibodies among 4 months aged babies in Abidjan. The more sensitive study of antibodies by the Mann serum neutralisation, shows that when 6 months aged, 60% babies from Adzope still have antibodies and when 10 months aged, none of the babies is positive. Serum negativation is late compared to Brazzaville when antibodies level is lower.

Age Factors↗
PubMedDate not supplied

[Infant mortality and its causes in a sub-district of the Ivory Coast].

The authors studied the infant mortality, between 0 and 30 months of age, in a sub-district in an eastern part of Ivory Coast with a population of 240,000 inhabitants. They recorded 103 deaths, i.e. an infant mortality rate of 29,4 p.c.. Tetanus is the main factor in 10 cases, 8 of them being neonatal. These deaths are caused by the lack of care at the umbilical cord, but not by the lack of medical infrastructure. Other causes are malaria (21), undernutrition (12), meningitidis (10), diarrhea (9), pneumopathy (7), endogenous and obstetrical causes (24).

Child, Preschool↗
PubMedDate not supplied

[Massive poisoning by naftidrofuryl with severe disorders of rhythm and conduction].

The authors report the case of a 35-year old woman with normal heart who voluntarily poisoned herself by swallowing 6 grams of naftidrofuryl. She developed disorders of atrioventricular conduction and a ventricular-like arrhythmia with collapse which resolves after mechanical ventilation. Data from the literature indicate that naftidrofuryl possesses class I electrophysiological properties which must not be ignored and which account for the cardiac effects observed in this particular case and in cases of parenteral overdosage already reported. By analogy with class I antiarrhythmic agents, treatment of naftidrofuryl poisoning with disorders of conduction could include the administration of molar sodium lactate.

Adult↗
PubMedDate not supplied

[Evaluation of the health status of 0-to-4-year-old children in an urban community of Abidjan].

During summer 1985 a survey was realized in an administrative territorial division of Abidjan (2 M. residents) in Ivory Coast. Four thousand households were randomly selected (EPI*/WHO model) including 653 children, from 0 to 4 years old. Mothers were interviewed and children examined. Seventeen per cent of children were below the weight curve standardised for Ivory Coast, 8% had a ratio arm diameter on head diameter lower or level of 0.27 and 54% a ratio between 0.28 and 0.31. Diarrhoea was noted among 10% of children, bronchopneumopathy among 44.7%, rhinitis among 53.6% and otitis 15.4%. The interview of mothers confirmed these results; in addition it appeared that 3% of children have had measles in the preceding month. The diarrhoeas and ORL infections prevalence is linked with the lack of drinking water at home, the IRA prevalence with community habitat; ORL infections are more frequent among children from illiterate mothers. The authors think that an amelioration of this situation is possible only by socio-economic progress for families (the work over lunch generalisation would be already an important progress) and putting the specific accent on measles immunization (the incidence rate of measles didn't changed since 1978 in spite of EPI application).

Anthropometry↗
PubMedDate not supplied

[Epidemiological aspects of meningitis in the north of the Ivory Coast].

Classically, the North of Ivory Coast is not part of the "meningitis belt". However, recent health statistics put in light some recent outbreaks in this part of the country, the last one in the years 1983-1985. The authors have studied this last outbreak and it can be foreseen that these epidemics will appear again as in the more Northern countries. Therefore it is desirable to set up a monitoring system to better organize the fight against this disease.

Adolescent↗
PubMedDate not supplied

[Appearance of human anthrax in Ivory Coast forests].

Eight cases of human anthrax were reported in 1983 from Ivory Coast Republic, all of them in the tropical forest belt (7 degrees 30' N). Clinical forms were: cephalic cutaneous (4 cases), intestinal (1 case) and very likely neurological (3 cases). Human disease was correlated to epizootic anthrax occuring in sheeps and goats within this area. Bacteriological cultures of animal material confirmed the diagnosis. This report of human anthrax is the second one coming from Ivory Coast Republic but the first one from the western Africa forest belt.

Adolescent↗
PubMedDate not supplied

[Setting-up a system of health statistics collection in a rural environment in the Ivory Coast].

In order to improve the sanitary data collection system from the rural Health Centers, Ivory-Coast has modified it in acting upon the three stages of collection. At the level of rural Health Centers, it has been created, from observations and data collected in a sample of 5 centers, a new classification of diseases including 128 items allowing all male and female nurses to classify 94% of the patients examined. At intermediary level, their monthly reports are collected and checked by the chief Medical Practitioner of the Rural Health Sector, who is responsible for all medicine not pertaining to hospital centers. At central level, computerised data treatment and exploitation make possible national data spreading and back-up during the third month after the writing of their report by the nurse.

Cote d'Ivoire↗
PubMedDate not supplied

[Chemotherapy trial in the battle against Schistosoma haematobium in an irrigated sahelian zone in Niger].

This study of S. haematobium infection in communities associated with irrigated schemes shows that prevalence rates are unusually high in adults, especially in men; and distribution disease is probably associated with at least the following three factors: (i) distance of the place of residence from the main transmission sites (ii) the dynamics of transmission in the waterbody and (iii) the human/water contact and contamination patterns. During this chemotherapy trial, at the first survey, only a little more than half (57.47%) of the people recorded in the census was present. Five visits of the survey team were necessary to obtain a compliance rate of 80.51% of the entire population. The indifference of the local people to seek diagnosis and treatment increased with succeeding surveys. It is only, during a subsequent treatment survey, carried out during the season of low agricultural activity and following an official written convocation, that a compliance rate similar to that of the first survey was recorded. If treatment is not given immediately after diagnosis as many as a fifth of positive cases do not appear for treatment. Oltipraz and praziquantel were administered. Their effectiveness could not be truly compared as there was a time lag of six months separating the administration of the treatments. However, based on the results of this trial both drugs gave good results especially in egg output intensity. But, a decrease of this parameter was also observed in non treated people. Seasonal variations of egg output or decrease of transmission could be involved.

Clinical Trials as Topic↗