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Biomedical subjects

J Meijer

Publications and source records attributed to J Meijer.

At least 91 records · Page 5Linked to original sources
PubMed1976

Impact of BCG vaccination programmes in children and young adults on the tuberculosis problem.

There is general agreement that BCG vaccination with a potent strain, when given to previously uninfected subjects, is highly effective in preventing the development to tuberculosis among them. This "direct" effect may be measured in practice in terms of the proportion of cases prevented in the age-groups in which the vaccination has been made. It is also clamined that mass BCG vaccination-especially at school-leaving age-can be expected to yield benefits not only directly, but also indirectly, by breaking the chain of transmission and so preventing the development of tuberculosis in unvaccinated subjects. This "indirect" effect may be measured, by analogy, in terms of the reduction in the numbers of cases in the age groups in which no vaccinations have been performed (the older age groups, and also young children, if BCG vaccination is given, for instance, to school-leavers). The indirect effect will be observed in terms of changes in both smear-positive and smear-negative cases. However, because smear-positive cases are the principal sources of infection, it is more meaningful to measure the indirect effect in terms of the reduction in the numbers of smear-positive (infectious) cases. The present paper falls into three parts: I. A comparison of the trends in the incidence of infectious tuberculosis in Norway, Denmark and The Netherlands. The study confirms that the substantial direct effect of BCG vaccination on the total tuberculosis incidence, which was shown by Bjartveit and Waaler, also applies to the incidence of infectious tuberculosis. II. A comparison of the trends in the incidence of infectious tuberculosis in the three countries and in different age groups over 30, and in the incidence of all forms of tuberculosis in children, in whom BCG vaccination has not been used. These comparisons suggest that the indirect effect of BCG on infectious cases of tuberculosis in persons aged 30 years and over, and on all forms of tuberculosis in children, in whom BCG vaccination has not been used, is not readily detectable, and so may not be large. However, the trends in tuberculosis incidence measure the total effects of all the policies for control used in the three countries under study. The comparisons between the three countries can therefore not isolate the "pure" direct and indirect effects of BCG from the effects of other differences between the control policies. For this reason a theoretical study of the problem has been made. III. A theoretical examination of the maximum likely indirect effect of a mass BCG vaccination policy in diminishing the prevalence of sources of infection in the population. This shows that the effect of BCG in preventing smear-positive cases in developing countries (if a constant risk of infection of about 3 per cent is presumed), is between 0.3 per cent and 2.0 per cent per year. This effect depends mainly upon the efficacy of BCG vaccine, the population covered and the duration of protection from BCG vaccination...

Adolescent↗
PubMedDate not supplied

A double-blind, placebo-controlled evaluation of the efficacy and safety of loreclezole as add-on therapy in patients with uncontrolled partial seizures.

Sixty-two patients with uncontrolled partial seizures participated in a 12-week, double-blind, placebo-controlled add-on-trial. Thirty-two patients received loreclezole and 30 a placebo as add-on therapy. Loreclezole was targeted at a plasma level of 1-2 mg/l. In spite of an antiepileptic therapy, usually with 2 or 3 antiepileptic drugs, these patients had at least 4 seizures a month during the baseline period. At the end of the treatment phase with loreclezole and placebo, individual responses varied widely. The median change in the daily seizure frequency was not significantly different in the 2 groups. However, when individual responses are considered, 6 patients in the verum group (19%) experienced a seizure reduction of 50% or more, compared with no patients in the placebo group. During the trial, only mild adverse events were reported in both the loreclezole and the placebo group, nor were any clinically relevant abnormalities seen in the haematological and biochemical analysis. The efficacy and safety of higher loreclezole plasma concentrations were studied in a long-term follow-up trial, the results of which are presented in the following article.

Adult↗
PubMedDate not supplied

Long-term evaluation of the efficacy and safety of loreclezole as add-on therapy in patients with uncontrolled partial seizures: a 1-year open follow-up.

The effect and safety of loreclezole were evaluated during a long-term follow-up trial targeting higher plasma concentrations than those of the preceding controlled trial. The result is better than in the double-blind trial, in which loreclezole doses were administered to reach plasma concentrations of 1-2 mg/l and 6/32 patients (19%) of the verum group experienced a seizure reduction of 50% or more. None of the 30 placebo-treated patients experienced a similar decrease. At the end of the double-blind trial, 56 patients (29 from the original loreclezole and 27 from the original placebo group) elected to participate in the open follow-up trial. After 12 months' add-on treatment with loreclezole, mean plasma concentrations of 5.53 and 5.97 mg/l for the original placebo and loreclezole group were measured and the median decreases in seizure frequency were -44% and -40. At these concentrations, 22/56 patients (39%) showed a seizure reduction of at least 50%.

Adult↗