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A De Muynck

Publications and source records attributed to A De Muynck.

17 recordsLinked to original sources
PubMed1990

Assessment of patients' health status in family medicine.

General Practitioners feel increasing pressure from Public Health authorities to evaluate their work but generally accept outcome indices such as morbidity and mortality are too far away from GP practices to allow direct evaluation conclusions. A simple instrument is needed to assess the evolution in the health status of the populations the GP serves. To design such an instrument we developed a short, inexpensive questionnaire, to be filled in by the GP, that covers as many fields of health care as possible and reflects as closely as possible the specific approach in family practice. To construct this instrument five Guttman scales were first developed that refer to the five frameworks of though that a general practitioner uses, and submitted them to a process of validation. A composite index (SAMI) was mathematically derived from these five scales; it proved to be a valid instrument for measuring health status. To field test the SAMI index, a prospective cohort study was carried out in two subpopulations, Belgians and migrants, consulting seven GP practices. The evolution of four reasons for encounter (low back pain, pregnancy, diabetes and epigastralgia) were monitored by means of the five scales and the SAMI index. The evaluative conclusion that, despite special efforts of the GPs, their approach to migrants has to be reconsidered, is drawn. Above all the field test has shown that the five measurement scales and the global SAMI index are valid instruments, of easy use in general practice, that allow to assess the global health status of patient populations and give opportunities for evaluation of PHC services.

Back Pain↗
PubMed1989

Migration, acculturation and utilization of primary health care.

This study explored the roles of acculturation, urban-rural provenance and length of residence as determinants of the utilization pattern of first line health services by Moroccan, Turkish and Italian migrants in Belgium. Concurrently, utilization characteristics were recorded in Belgian reference patients. With increasing acculturation the demand for preventive care decreased, vague complaints became more prevalent, the delay before consulting for a curative problem shortened and the prognosis improved. There was no correlation between the occurrence of psychological problems and acculturation but, except for 15-44 year old female migrants, the rate of social problems was negatively associated with this study factor. Migrants with an urban background consulted earlier and presented more frequently vague complaints than migrants from rural provenance. We observed no significant influence of length of residence on utilization characteristics and only a marginal influence on morbidity pattern. Although acculturation seems to be a strong determinant of the migrant's utilization pattern of primary health care services, it does not consistently lead to a decrease of utilization differentials with the Belgian reference population. This may imply that there is a need for public health interventions targeted at ethnic minorities.

Acculturation↗
PubMed1989

Can the causal model approach contribute to the study of the epidemiology and the control of sleeping sickness?

A causal model links together, in an hierarchical manner, a set of hypotheses about the causes of, and mechanisms leading to, a phenomenon under study. Initially used in nutrition studies for identifying the variables to be observed, such models have proven useful in the choice and evaluation of interventions, as well as in the selection of relevant special studies to be carried out inside a broader research programme. The authors describe a technique of model building used by nutritionists, and argue that this approach could be of benefit in the study and control of african trypanosomiasis. Their hypothesis is that although causal models do not substitute for mathematical models, the latter ones, and epidemiological models in general, would be (1) more correct logically; (2) fitting reality more closely; and (3) more useful for the analyst, the decision maker and the field worker, if they were built from an preceding causal model.

Humans↗
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↗
PubMed1988

Selective isolation of mycobacteria from soil: a statistical analysis approach.

We compared four decontamination methods for the isolation of mycobacteria from soil specimens. Different media were used: Löwenstein-Jensen, Ogawa and various modified Ogawa media. Statistical analysis demonstrated that the best results (low contamination and high positivity rates) were obtained when the specimens were incubated in trypticase soy broth, treated with solutions containing malachite green and cycloheximide, then decontaminated with sodium hydroxide and inoculated onto Ogawa media. The lowest contamination rates were obtained with Ogawa medium containing 500 micrograms cycloheximide ml-1. The use of these techniques is proposed for the isolation of mycobacteria from heavily contaminated clinical specimens as well as from soil.

Culture Media↗
PubMed1988

Effects of freezing and thawing on the viability and the ultrastructure of in vivo grown mycobacteria.

The influence of different frequencies of freezing-thawing cycles on the viability of in vivo grown mycobacteria was investigated. Pieces of armadillo tissues naturally or experimentally infected with Mycobacterium leprae were analyzed. The viability of M. leprae was determined by mouse foot pad titration. The viability of cultivable mycobacteria, sometimes present in armadillo tissues, was determined by culture. Electron-microscopic studies were performed on fresh or frozen-thawed armadillo tissues with natural leprosy and on livers of C57BL/6 mice experimentally infected with M. avium or M. lepraemurium. We found that the percentage of viable M. leprae bacilli is identical for naturally infected and experimentally infected tissues, frozen and thawed once. When the tissues were subjected to a second freezing-thawing cycle, a considerable loss of viability was observed (65%-97%). A third freezing-thawing cycle was lethal for most of the M. leprae cells, and after four freezing-thawing cycles no viable bacilli were found. The cultivable mycobacteria present in some armadillo tissues were found to be more resistant than M. leprae to freezing-thawing since these mycobacteria could still be cultivated after four freezing-thawing cycles. The results of the electron-microscopy study support the conclusion that M. leprae is more sensitive to freezing-thawing than the cultivable mycobacteria and show that the cytoplasmic membrane appears to be the target for the lethal action of freezing-thawing on mycobacterial cells. These results emphasize the importance of avoiding repeated thawing and refreezing of M. leprae-infected tissues when viable M. leprae cells need to be studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

[Childhood malaria in Kinshasa (Zaire). Influence of seasons, age, environment, and family social conditions].

Frequency of malaria in children was evaluated from march 1986 to February 1987 in six districts of Kinshasa by paludometric survey with multiple visits. The six districts were selected according to their geographical situation and their degree of urbanisation. Each month, two stocks of children from 0 to 10 years old dwelling in a street were selected district and visited twice randomization in each selected district and visited twice at 2 weeks of interval. 5,541 children were examined at the occasion of the second visit. Influence of seasons, age, district, socio-economic level of the family and level of education of the parents was determined by analysing the following parameters: plasmodial index, parasitic density, incidence of fever attacks, conversion rate of thick smear, antimalaria drug consumption. Parasitic prevalence is 50 p.c. annual incidence of fever attacks is 50 p.c. and annual frequency of antimalaria drugs is 3,64 per child. Dry seasons (June-September and January-February) ease the pathophoresis and pathogenicity of plasmodia. The age group of less than one year is relatively less parasitized but from 2 years, contact with parasites is very high and without any significant evolution up to 10 years. The district where a child is living plays a predominant role on paludometric indices. Transmission is deeply influenced by geographical situation in the center of the town or in outlying districts and by the socio-economic environment (basic equipment, streets conditions, quality of accommodation). The socio-economic level of the child's family is also important in regard to malaria prevention. The level of education of the parents and mainly the mother has the greatest influence.

Age Factors↗