[Articular manifestations of dyslipidemia. Apropos of 2 personal cases].
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Adult↗
Biomedical subjects
R Meyer
Publications and source records attributed to R Meyer.
[Control of onchocerciasis vectors in West Africa: description of the logistics adapted for a large-scale public health program].
The Onchocerciasis Control Programme (OCP) in West Africa, launched in 1974, includes 11 participating countries and covers more than one million square kilometres. The aim of the OCP is to control blinding onchocerciasis (river blindness) which is caused by the savannah strain of Onchocerca volvulus transmitted by the Simulium damnosum complex. There is no effective macrofilaricide, so vector control to prevent the transmission of the parasite remains the method of choice, despite the availability of ivermectin, a drug which controls ocular morbidity. The potential value of vector control has been demonstrated by the original programme: 14 years activity has eliminated the disease as a public health problem in the areas included. This strategy requires adapted logistical support involving (i) widespread insecticide coverage (27,000 km of river are treated by the OCP during the rainy season), (ii) frequent (weekly) application of larvicide and (iii) prolonged intervention due to the life-span of the worm in the human reservoir, estimated to be approximately 14 years. We describe the vector control operations and their organisation 20 years after the initiation of the OCP. The OCP can be divided into 5 areas of logistic activity. The first covers activities involving insecticide and fuel management for the OCP as a whole: assessment of the requirements for the following year, ordering from insecticide and petrol suppliers, stocking fuel and insecticide at the depots covering the area. The second activity is the treatment of rivers with insecticide. This includes treating the ground with larvicide, the aerial operations run by an independent company supplying 12 helicopters on contract to the OCP, and use of satellite beacons for retransmitting of hydrological data. The third activity is monitoring the impact of larvicides on both the target (adult and larval S. damnosum) and on other fauna (fish, crustaceans and other insects). The fourth activity is field data collection and its processing. This involves a data transmission network to facilitate stock management insecticide application and entomological and hydrological surveillance using computer systems. The fifth activity is the coordination of vector control operations, technical and administrative staff and estimations of the funds available to the Vector Control Unit. The logistic aspects of other large-scale-insect-control programmes world-wide are considered, and the possibility of using the OCP as a model for such programmes (both public health and agricultural) is assessed.
Africa, Western↗
Detection of pork in heated meat products by the polymerase chain reaction.
A new method for the specific, sensitive, and semiquantitative detection of pork (Sus scrofa) in heat-treated meat products has been developed. DNA was isolated from meat samples by using a DNA-binding resin and subjected to polymerase chain reaction (PCR) analysis. First, oligonucleotides yielding a specific 137-base-pair (bp) fragment from eucaryotic DNA amplified from a highly conserved region of the 18-S ribosomal gene was used to assess DNA quality. Second, the presence of pork DNA was determined with specific oligonucleotides yielding a 108-bp fragment amplified from the porcine growth hormone gene. The test detected pork in fresh or heated meat mixtures of pork in beef at levels below 2%. This approach was superior to commercially available immunological tests that were not able to detect levels of pork less than 20% in cooked meat or less than 10% in fresh meat.
Animals↗
[Subtotal reconstruction of the larynx].
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Adult↗
[The combined esthetic and functional treatment of microtia].
In the treatment of unilateral microtia, most authors give precedence to external reconstruction, neglecting a middle ear surgery. On the other hand, in bilateral microtia more importance is given to the functional component which has to be dealt with before a child begins his school career in order to facilitate optimal harmonious psychophysical development. One author in particular has been attempting to solve the problem in its entirety, for more than 20 years. In the last years, thanks to the close collaboration with otologists, results which confirm the existing hypothesis have been obtained. This was possible because plastic reconstruction was done before the functional procedure and also because of improvement in surgical techniques of the latter. Thus it appears that collaboration between both specialists is basically mandatory. Authors tend to aim for complete aesthetic and functional solution in bilateral microtia as well. However in these cases, external reconstruction has to performed before a child begins his school cancer.
Adolescent↗
Polymerase chain reaction-restriction fragment length polymorphism analysis: a simple method for species identification in food.
The polymerase chain reaction (PCR) technique was applied to meat species identification in marinated and heat-treated or fermented products and to the differentiation of closely related species. DNA was isolated from meat samples by using a DNA-binding resin and was subjected to PCR analysis. Primers used were complementary to conserved areas of the vertebrate mitochondrial cytochrome b (cytb) gene and yielded a 359 base-pair (bp) fragment, including a variable 307 bp region. Restriction endonuclease analysis based on sequence data of those fragments was used for differentiation among species. Restriction fragment length polymorphisms (RFLPs) were detected when pig, cattle, wild boar, buffalo, sheep, goat, horse, chicken, and turkey amplicons were cut with AluI, RsaI, TaqI, and HinfI. Analysis of sausages indicates the applicability of this approach to food products containing meat from 3 different species. The PCR-RFLP analytical method detected pork in heated meat mixtures with beef at levels below 1%, and the method was confirmed with porcine- and bovine-specific PCR assays by amplifying fragments of their growth hormone genes. Inter- and intraspecific differences of more than 22 animal species with nearly unknown cytb DNA sequences, including hoofed mammals (ungulates), and poultry were determined with PCR-RFLP typing by using 20 different endonucleases. This typing method allowed the discrimination of game meats, including stag, roe deer, chamois, moose, reindeer, kangaroo, springbok, and other antelopes in marinated and heat-treated products.
Animals↗
The National Depressive and Manic-Depressive Association consensus statement on the undertreatment of depression.
OBJECTIVE: A consensus conference on the reasons for the undertreatment of depression was organized by the National Depressive and Manic Depressive Association (NDMDA) on January 17-18, 1996. The target audience included health policymakers, clinicians, patients and their families, and the public at large. Six key questions were addressed: (1) Is depression undertreated in the community and in the clinic? (2) What is the economic cost to society of depression? (3) What have been the efforts in the past to redress undertreatment and how successful have they been? (4) What are the reasons for the gap between our knowledge of the diagnosis and treatment of depression and actual treatment received in this country? (5) What can we do to narrow this gap? (6) What can we do immediately to narrow this gap? PARTICIPANTS: Consensus panel members were drawn from psychiatry, psychology, family practice, internal medicine, managed care and public health, consumers, and the general public. The panelists listened to a set of presentations with background papers from experts on diagnosis, epidemiology, treatment, and cost of treatment. EVIDENCE: Experts summarized relevant data from the world scientific literature on the 6 questions posed for the conference. CONSENSUS PROCESS: Panel members discussed openly all material presented to them in executive session. Selected panelists prepared first drafts of the consensus statements for each question. All of these drafts were read by all panelists and were edited and reedited until consensus was achieved. CONCLUSIONS: There is overwhelming evidence that individuals with depression are being seriously undertreated. Safe, effective, and economical treatments are available. The cost to individuals and society of this undertreatment is substantial. Long suffering, suicide, occupational impairment, and impairment in interpersonal and family relationships exist. Efforts to redress this gap have included provider educational programs and public educational programs. Reasons for the continuing gap include patient, provider, and health care system factors. Patient-based reasons include failure to recognize the symptoms, underestimating the severity, limited access, reluctance to see a mental health care specialist due to stigma, noncompliance with treatment, and lack of health insurance. Provider factors include poor professional school education about depression, limited training in interpersonal skills, stigma, inadequate time to evaluate and treat depression, failure to consider psychotherapeutic approaches, and prescription of inadequate doses of antidepressant medication for inadequate durations. Mental health care systems create barriers to receiving optimal treatment. Strategies to narrow the gap include enhancing the role of patients and families as participants in care and advocates; developing performance standards for behavioral health care systems, including incentives for positive identification, assessment, and treatment of depression; enhancing educational programs for providers and the public; enhancing collaboration among provider subtypes (eg, primary care providers and mental health professionals); and conducting research on development and testing of new treatments for depression.
Antidepressive Agents↗
[Psychodynamics of psychogenic fever].
In this study we aimed to formulate a psychological framework on the origins of vegetative fever. Our sample comprised 13 patients. Concerning the structure of personality we found, that all the patients came from broken homes, that they showed pronounced disturbances in their inter-personal relationships, that they had developed an extremely exigeant ideal ego and that they strongly suppressed their aggressiveness. We were able to define two characteristic situations which can trigger vegetative fever; the break-down of the ideal ego due to external traumatic circumstances and the threat of the disolution of a symbiotic relationship. Beside the vegetative fever all our patients showed a great number of other psychological or functional disturbances. Only a few of the psychologically severely affected patients could be treated with psychotherapy. The pronounced tendency to somatize with a strong libidinal cathexis of the whole organism can be interpreted as an attempt to restore the feeling of coherence of the ego in order to avoid it's psychotic break-down (Meng).
Adolescent↗
State health department and university evaluation of North Carolina's Maternal Outreach Worker Program.
INTRODUCTION: The Maternal Outreach Worker (MOW) Program is a social support intervention using lay helpers to provide support, health education, and outreach to Medicaid eligible women at risk for poor pregnancy and parenting outcomes. State Health Department and University collaborators designed a two-pronged evaluation comprised of programwide and interview study components to assess the impact of the program on pregnancy outcomes, health behaviors, and infant health status. METHODS: Programwide evaluation data are based on 1992-1995 N.C. birth files for the original 24 participating counties and include 1,726 MOW participant births and 12,988 comparison births whose records were linked to birth files and met the study criteria. For the interview study 373 MOW participants and 332 comparison women were personally interviewed three times: during pregnancy, one month postpartum, and one year after delivery. RESULTS: Risk factors associated with poor pregnancy and parenting outcomes were greater among MOW participants than comparisons in both the programwide and intensive study components. Caucasian MOW participants had slightly higher rates of adequate prenatal care. African Americans were found to have less adequate prenatal care. Fewer than expected LBW and VLBW births were observed for African-American MOW participants. MOW Program participation did not affect the utilization of health and social services for infants. African Americans, regardless of whether they received MOW services, fared better than Caucasians in terms of having their pregnancy needs fulfilled. CONCLUSIONS: Findings show the need to further explore appropriate measures of maternity support program outcomes and indicate inconsistent program benefit among subpopulations.
Adolescent↗