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Biomedical subjects

P Landry

Publications and source records attributed to P Landry.

At least 19 recordsLinked to original sources
PubMed2006

[Diarrhea and vaccines: current developments].

Diarrhoea is a main concern for travellers, populations of developing countries and children. Causative pathogens are numerous. An efficient vaccine against cholera is available, also offering a 50% cross-protection against E. Coli enterotoxin (ETEC), however its efficacy is only 23% against all-causes traveller's diarrhoea. Rotavirus can be responsible for severe diarrhoea in infants but rarely causes traveller's diarrhoea. Two new vaccines being under development appear effective and well-tolerated but too expensive for developing countries which most need them. To date, the live oral Ty21a vaccine remains frequently prescribed in Switzerland, with limited indications and suboptimal efficacy. A new oral vaccine is under development.

Bacterial Vaccines↗
PubMed2005

Evaluation of an inference-based approach to treating obsessive-compulsive disorder.

This study evaluated an inference-based approach (IBA) to the treatment of obsessive-compulsive disorder (OCD) by comparing its efficacy with a treatment based on the cognitive appraisal model (CAM) and exposure and response prevention (ERP). IBA considers initial intrusions in OCD (e.g. "Maybe the door is open", "My hands could be dirty") as idiosyncratic inferences about possible states of affairs arrived at through inductive reasoning. In IBA such primary inferences represent the starting point of obsessional doubt, and the reasoning maintaining the doubt forms the focus for therapy. This is unlike CAM, which regards appraisals of intrusions as the maintaining factors in OCD. Fifty-four OCD participants, of whom 44 completed, were randomly allocated to CAM, ERP or IBA. After 20 weeks of treatment all groups showed a significant reduction in scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Padua Inventory. Participants with high levels of obsessional conviction showed greater benefit from IBA than CAM. Appraisals of intrusions changed in all treatment conditions. Strength of primary inference was not correlated with symptom measures except in the case of strong obsessional conviction. Strength of primary inference correlated significantly with the Y-BOCS insight item. Treatment matching for high and low conviction levels to IBA and CAM, respectively, may optimize therapy outcome.

Adult↗
PubMed2000

Inactivated hepatitis A vaccine booster given >/=24 months after the primary dose.

We investigated what happens with the immune response when people come back for their booster dose of inactivated hepatitis A vaccine later than the recommended time of 6-12 months after the primary dose. We recruited a group of 124 travellers who received either the primary doses of Havrix 720 (two doses) or of Havrix 1440 (one dose) >/=24 months before study entry. They received a booster dose of Havrix 1440 and blood was drawn 1 month later. As a control group, we recruited a group of 125 travellers who followed a recommended schedule with a primary dose at month 0 and a booster dose at months 6-12. For both study groups, the GMTs increased dramatically and similarly upon the booster immunisation. Although significantly more late travellers (32%) had lost detectable antibodies than controls (11%) before administration of the booster dose, all these subjects showed an anamnestic response to the booster dose. Delaying the booster dose up to 66 months after primary vaccination did not seem to influence the immunogenicity of the booster dose. However, the recommended 6-12-month interval remains if detectable antibody titers are to be warranted constantly.

Adult↗
PubMed1999

Somnambulistic-like behaviour in patients attending a lithium clinic.

The prevalence of somnambulistic-like behaviour related to treatment with lithium alone or in combination with other psychotropic medications was evaluated in patients attending a lithium clinic. A written questionnaire on somnambulistic-like behaviour was completed by 389 patients. Information was provided on the time of occurrence, frequency and severity of the episodes, the presence of childhood somnambulism, and the temporal relationship between psychiatric treatment and somnambulistic-like behaviour. Twenty-seven (27) patients (6.9%) presented sleepwalking behaviour related to the onset of treatment with lithium alone or in combination with other psychotropic drugs. Forty-five patients (11.6%) reported childhood somnambulism and 12 of them (27%) had their childhood somnambulism reactivated by the medication. Most patients had a diagnosis of bipolar affective disorder but somnambulistic-like behaviour also occurred in patients with other axis 1 diagnosis. Sleep-related violence was seldomly reported. Therefore, lithium alone or in combination with other psychotropic drugs may induce somnambulistic-like behaviour. A history of childhood somnambulism may increase the risk of developing sleepwalking behaviour while under psychotropic drugs treatment.

Adult↗
PubMed1998

[Comparative immunogenicity of 2 antirabies vaccines in a 2-1-1 post-exposure vaccination schedule].

Few trials have compared the Purified Duck Embryo Vaccine (PDEV) and the Human Diploid Cell Vaccine (HDCV) in a post-exposure immunization schedule of 4 shots (2 on day 0 and 1 each on day 7 and 21, or 2-1-1 schedule). A retrospective analysis compared 10 patients with PEDV and 20 with HDCV, who had received the 2-1-1 schedule as well as 20 UI mg/kg of immune globulins on day 0. The median neutralizing antibody titers on day 21 (after 3 doses) and the median of maximum titers until day 90 were higher for HDCV than for PEDV (0.6 IU/ml versus 3.5 IU/ml [p < 0.04] and 2.5 IU/ml versus 5.8 IU/ml [p < 0.03] respectively). Seven patients had not reached the seroconversion titer of 0.5 IU/ml after 3 doses (day 21). These results differ from previous studies showing a 100% seroconversion rate on day 21, and suggest that more studies are required before these 2 vaccines can be used in the 2-1-1 schedule after severe exposure.

Adult↗
PubMed1998

[The value of screening serology in anti-hepatitis A vaccination of travelers].

UNLABELLED: To select the travellers most likely to benefit from anti-hepatitis A (HA) antibody testing, the following criteria have been proposed: (A) being born before 1945, (B) a stay over 1 year in a developing country or (C) a history of jaundice. We present a prospective study to assess the practical use of these criteria. Following a recent survey in the general population of Lausanne showing HA seroprevalence of 52.6% in the age group over 45, we included an A1 criterion (A extended to birth before 1950). Anti-HA IgG testing and a questionnaire were proposed to all travellers presenting one or more criteria. RESULTS: Out of 1187 consecutive travellers, 176 (14.8%) had one or more criteria (219 [18.5%] when A1 was used). Criteria A applied to 8.5% of all travellers, A1 to 13.8%, B to 6.3% and C to 3.1%. Only 3% of travellers had more than one criterion. Overall seroprevalence among the selected group was 48.3%. Seroprevalence of travellers below 60 years old was under 30%, unless a second criterion was present in which case seroprevalence was 10% higher. Eighty percent of travellers with a history of jaundice were found to be positive. The use of the recommended criteria spared 94 travellers (46.3% of those tested and 7.9% of all travellers) unnecessary immunisation. Among travellers older than 60 years, a 30% economy on the total sum for immunising all of them, without any prior testing was realised. CONCLUSIONS: Among the population of travelers consulting our travel clinic, the seroprevalence for HA is lower than in the general population. We recommend that testing should be proposed only to travellers aged over 60, or with a history of jaundice, or to those with a combination of 2 out of 3 criteria.

Adult↗
PubMed1997

[Routine cases in intestinal parasitology].

The majority of intestinal parasites isolated in Switzerland is imported by refugees and travellers. Nematodes are more frequently isolated in the first group, whereas Giardia duodenalis and Strongyloides stercoralis predominate in the second. Symptoms are usually mild, but occasionally diarrhea, abdominal pain and weight loss may be encountered. Hypereosinophilia occurs frequently with some parasites. Four cases chosen from the outpatient department of a Swiss medical polyclinic are presented and serve as a basis for discussing persistent and chronic diarrhea, acute traveller's diarrhea, and hypereosinophilia. Differential diagnosis according to type and duration of symptoms, laboratory findings and treatment of the most frequently encountered parasites are reviewed.

Adult↗
PubMed1997

Apoptosis is coordinately regulated with osteoblast formation during bone healing.

The ultimate fate of the expanded pool of osteoblasts formed following a typical bone injury is unclear. Since necrosis has not been described in the latter stages of bone healing, there must be some other mechanism by which obsolete osteoblasts are cleared from an injury site. We therefore evaluated the possibility that their removal is pre-programmed, by investigating the occurrence of apoptosis in rats that received a standardized bone injury. Histological evidence identical to that found in tissues known to exhibit apoptosis was obtained, thereby showing that programmed cell death was a normal concomitant of fracture healing. The concentration of apoptotic bodies reached its maximum after the differentiative response had peaked, suggesting that the two processes were coordinated. The same result was found in a second group of rats that received the same bone injury plus a simultaneous standardized soft-tissue injury. The combined injuries resulted in more osteoblasts and more apoptotic bodies, but an identical temporal relationship between the peak responses in the two parameters. The results suggested that osteoblasts were removed from the injury site via apoptosis, and that the process was coordinately regulated with differentiation. Since the number of apoptotic bodies per osteoblast varied during healing, it is likely that apoptosis was associated with healing and not merely with osteoblast concentration.

Animals↗
PubMed1996

Genital Schistosomiasis After a Missed Diagnosis of Katayama Syndrome.

Schistosomiasis is increasingly reported in travelers to subSaharan Africa.1,2 Bathing in tropical lakes3 or in other fresh waters2,4 is a recognized risk factor for acquiring it. Most cases present with cercarial dermatitis or, 3 to 6 weeks after infection by Schistosoma mansoni1,2 (occasionnally Schistosoma haematobium), with acute schistosomiasis (Katayama syndrome), when the immune response of the body to the larval maturation and migration elicits fever, sweating, arthralgia, urticaria, and digestive or respiratory symptoms. Late and unusual clinical presentations in travelers include features of spinal cord compression5,6 and ectopic dermal or genital localization,3,7 which can result from a missed diagnosis of the early symptoms of the disease. In the following case, a female traveler developed genital schistosomiasis 1 year after a missed diagnosis of Katayama syndrome.

Journal Article↗