Search PubMed⌕ Search

Biomedical subjects

S R Pattyn

Publications and source records attributed to S R Pattyn.

At least 55 records · Page 3Linked to original sources
PubMed1990

The reduction of the leprosy endemicity in northeastern Zaire 1975/1989.

The leprosy endemy in Uele, North Eastern region of Zaire has declined considerably since the 1950's, particularly since 1975. The hypothesis is advanced that the most important causal factor has been the distribution of dapsone for many years, through a vertical programme. The gradual increase of dapsone resistance has been taken care of by the introduction of combined, multidrug therapy in the 1980's. The cost per patient detected and treated rises in inverse proportion to the decline in endemy; therefore, the time has come for the integration of a leprosy control in the primary health care strategy. However, central specialized teams financed by voluntary organisations should be maintained to assure training of personnel, to give advice in diagnosis, prevention and treatment of complications, to provide drugs and to assist in rehabilitation.

Dapsone↗
PubMed1990

Influence of N substitution on antimycobacterial activity of ciprofloxacin.

Ciprofloxacin analogs with various substitutions on the piperazine nitrogen were tested against several mycobacteria. In contrast to what has been found with other gram-positive and gram-negative bacteria, alkyl analogs such as N-isopropylciprofloxacin were shown to be significantly more active than ciprofloxacin. MICs of 0.125 microgram/ml against Mycobacterium tuberculosis were found.

Ciprofloxacin↗
PubMed1990

Evaluation of the LOGIC system for the rapid identification of members of the family Enterobacteriaceae in the clinical microbiology laboratory.

The LOGIC identification system (J.D. Perry, M. Ford, N. Hjersing, and F.K. Gould, J. Clin. Pathol. 41: 1010-1012, 1988) for gram-negative rods, performed with microdilution plates instead of tubes, was evaluated for strains isolated from all tested specimens except those obtained from stools (for which a different strategy was followed). Systematically extended with the oxidase test and lactose fermentation, it proved to be very reliable and extremely simple and economical.

Bacteriological Techniques↗
PubMed1990

Evaluation of five treatment regimens, using either dapsone monotherapy or several doses of rifampicin in the treatment of paucibacillary leprosy.

The objective of the present study was to define short-course treatment regimens for PB leprosy and to compare them with the 'classical' dapsone treatment and the WHO-PB regimen. Five treatment regimens were studied and evaluated by the histologic evolution. The regimens were: (1) dapsone 100 mg daily, non-supervised for 3 years; (2) RMP 900 mg supervised, once weekly, 8 doses; (3) idem 12 doses; (4) RMP 600 mg, once monthly, supervised, 6 doses and during this treatment dapsone 100 mg daily unsupervised; (5) RMP 600 mg together with dapsone 100 mg daily, supervised for 6 days. For each of these regimens there were between 114 and 195 person-years of follow-up. Results are comparable for the 5 treatment regimens, and reach 65-75% cure rates at 36 months and 80-90% at 48 months after the start of therapy. The relapse rate for all groups is about 0.5% per year. The difficulty for the diagnosis of relapse in PB leprosy is discussed. It is concluded that treatment of PB leprosy can be relatively simple but that a relatively long time is needed to evaluate its effect.

Dapsone↗
PubMed1990

Therapeutic regimens in leprosy.

Insight into the bacteriology, general pathology, pharmacology of the treatment of leprosy has increased most significantly during the last 30 years, through numerous studies, starting with the demonstration by Shepard, of the multiplication of Mycobacterium leprae in the mouse foot pad. Our studies showed that the treatment of the disease can be considerably shortened. The introduction of more drugs, highly bactericidal for M. leprae, provided toxicity and antagonism do not constitute a problem, can only improve the results in terms of length of treatment and absence of relapses. Only when the public realizes that leprosy can indeed be treated "like any other disease" will the fear for it decrease, will patients show up in earlier stages of the disease, will transmission and endemicity decline and will a situation be reached comparable to that of tuberculosis in the western world. In the meantime there is an increasing need for better understanding, prevention and treatment of the complications of the disease: reversal reactions and erythema nodosum leprosum. In endemic regions there will remain for some time to come a great need for rehabilitation activities.

Anti-Bacterial Agents↗
PubMed1990

Herpes simplex virus type 1 colitis: an unusual cause of diarrhea.

Herpetic infections of the gastrointestinal tract are a well-recognized entity. Involvement of the colon seems to be very rare. A 78-yr-old woman developed bloody diarrhea and abdominal discomfort 2 months after surgical treatment for adenocarcinoma of the transverse colon. Colonoscopy revealed diffuse hemorrhagic, erosive, aphtoid, and ulcerative lesions. Histology showed nonspecific inflammatory changes. Herpes simplex virus type 1 (HSV-1) was isolated from endoscopic biopsy and stool specimens. The patient responded rapidly to symptomatic treatment with loperamide. This case demonstrates the potential for HSV-1 to induce infectious colitis; failure to obtain microbiologic evaluations and the rapid response to empiric, symptomatic treatment may be responsible for the rarity of diagnosis of this infection. The implications of this diagnosis are probably more relevant in immunosuppressed individuals, and may be important in the elderly population.

Aged↗
PubMed1990

A longitudinal study of the incidence of leprosy in a hyperendemic area in Zaire, with special reference to PGL-antibody results. The Yalisombo Study Group.

Between 1984 and 1988, yearly surveys for leprosy were done among the 1500 people living in a previous leprosy segregation village in Zaire. In 1984 lepromin tests and phenolic glycolipid (PGL) antibody tests were done in a significant part of the population. The prevalence of the disease at that time was 16.1%, the proportion of multibacillary cases was 11.3% overall and 22% among active cases. Prior to 1984, 23% of paucibacillary cases and 56% of multibacillary cases had presented themselves spontaneously to the Leprosy Service. The exposure to the infection is uniform, but there is a suggestion of family clustering of cases. In spite of a rapidly bactericidal treatment of all known cases in 1984 and thereafter, the annual incidence of 0.34% did not decrease during the 4 years of the study. The PGL antibody test did not contribute to the diagnosis, classification or prognosis of the disease.

Age Factors↗
PubMed1989

In vitro activity of amoxycillin plus clavulanic acid and ticarcillin plus clavulanic acid compared with that of other antibiotics against anaerobic bacteria.

The activity of amoxycillin/clavulanic acid (Augmentin) and ticarcillin/clavulanic acid (Timentin) was tested against 303 unselected clinical anaerobic isolates recently collected in seven Belgian university hospitals and compared with that of 11 other antimicrobial agents. Bacteroides spp. accounted for 52.1% of the isolates, Clostridium spp. for 23.4%, anaerobic cocci for 15.5%, nonsporeforming gram-positive bacilli for 4.6% and Fusobacterium spp. for 3.3%. Ticarcillin/clavulanic acid (fixed clavulanic acid concentration of 2 mg/l) was the most active drug with an overall susceptibility rate of 99.7%. Amoxycillin/clavulanic acid (fixed ratio of 2:1) and chloramphenicol inhibited 97.4% of the isolates, metronidazole 95.4%, piperacillin 92.4%, ticarcillin 91.4%, clindamycin 87.8%, cefotetan 81.2%, cefazolin 63.0%, cefuroxime 60.4%, erythromycin 57.8%, penicillin 57.1% and doxycycline 52.1%. beta-lactamases were detected exclusively in Bacteroides spp. isolates (79.1% positive).

Amoxicillin↗
PubMed1989

Combined regimens of one year duration in the treatment of multibacillary leprosy--I. Combined regimens with rifampicin administered during one year.

In 1981, 1982 and 1983, 216 multibacillary patients in Anjouan (Comores) and Burundi were treated for 8 weeks with daily rifampicin (600 mg) ethionamide (500 mg) and dapsone (100 mg) or clofazimine (100 mg) followed for 44 weeks by once weekly rifampicin (600 mg) and daily ethionamide (500 mg) and dapsone (100 mg) or clofazimine (100 mg). There were 109 previously untreated patients and 107 patients who had dapsone monotherapy, 16 of whom were infected with proven dapsone resistant Mycobacterium leprae. Clinical and bacteriological results were excellent but hepatotoxicity of this regimen remains a problem. No relapses were observed during a 2 to 6 years (mean: 4.29 years) follow-up period after the end of treatment (upper 95% confidence limit of 0.40 per 100 persons years). It is concluded that multibacillary leprosy can be successfully treated with a regimen of one year duration, but less toxic regimens, more easily applicable in the field, are necessary.

Clinical Trials as Topic↗
PubMed1989

Combined regimens of one year duration in the treatment of multibacillary leprosy--II. Combined regimens with rifampicin administered during 6 months.

From 1981 to 1983 all multibacillary patients presenting at the collaborating centres in Zaire and Rwanda were treated with one of the following regimens: 6 months supervised daily RMP 600 mg, ETH 500 mg and DDS 100 mg or CLO 100 mg followed by 6 months unsupervised daily DDS 100 mg or CLO 100 mg with ETH 500 mg added or not. These regimens gave rise to hepatotoxicity, reversal and erythema nodosum leprosum reactions as described previously. Bactericidal activity was excellent. Among the 289 patients in the trial, with a mean follow-up period of 3.88 years, no relapses were observed, with an upper 95% confidence limit of 0.35 per 100 person years. Because of the hepatotoxicity, alternative short-course therapies need to be tested.

Clinical Trials as Topic↗
PubMed1988

The incubation time of relapses after treatment of multibacillary leprosy with rifampicin containing regimens.

In order to determine the duration of follow-up needed to evaluate the efficacy of short-course bactericidal regimens for multibacillary leprosy, information is needed on the incubation time of relapses after stopping treatment. Several groups of patients, who had been on rifampicin-containing regimens, were followed up for periods ranging from 4 to 10 years. Two groups of relapses were observed: early relapses occurring within 3.5 years after stopping treatment, with a median incubation time of 1 year and 10 months (upper limit of 95% confidence interval: 2 years); and late relapses occurring more than 3.5 years after stopping treatment, with a median incubation of 5 years. Early relapses are probably due to insufficient treatment, and late relapses to persisting bacilli or to reinfection. It is concluded that the efficacy of short-course RMP-containing therapeutic regimens can be evaluated by observing the occurrence of early relapses, 50% of which occur before 2 years after the end of therapy.

Drug Therapy, Combination↗
PubMed1987

The use of fluoroquinolones in chronic otitis suppurativa.

The present review covers fluoroquinolone usage in chronic otitis suppurativa (COS) in case of chronic otitis media, cholesteatoma, radical mastoid cavity infection and chronic or relapsing otitis externa. A total of six publications were included in the final evaluation. Enoxacin was effective in 35%; ciprofloxacin (five publications) was used in 82 patients with 67% effectivity in otitis externa and otitis media and 61% effectivity in radical mastoid cavity infection. No serious adverse reactions were reported. The promising efficacy of otitis media and otitis externa and safety profile needs further confirmation in double blind prospective clinical studies, that will provide a firm basis for changing the current treatment schedules of COS.

Cholesteatoma↗