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Biomedical subjects

C Manuel

Publications and source records attributed to C Manuel.

At least 19 recordsLinked to original sources
PubMed2002

[Mandatory notification of HIV infection. Epidemiologic justifications and ethical questioning].

Since the appearance in May 1999 of the two decrees on the application of the law relative to the reinforcement of sanitation quality control established in July 1998, the disclosure of HIV infection "irregardless of the stage" has become mandatory. This is the first time that it is imposed that one must declare a serologic diagnosis, that is to say an infection in the asymptomatic stage. The sensitive nature of all of the information available on AIDS provides an explanation for the numerous contradictory reactions linked to this decision. We attempt to organise the arguments brought forth according to two approaches: 1) the epidemiological arguments that justify the compilation of the precise data thought to be necessary for the follow-up of the disease and for the implementation of well-targeted prevention actions; and 2) the ethical reservations concerning such an imposed measurement, as well as the questions related to anonymity and confidentiality.

Disease Notification↗
PubMed2001

Transport theory for a two-flavor color superconductor.

QCD with two light-quark flavors at high baryonic density is a color superconductor. The diquark condensate breaks the SU(3) gauge symmetry down to an SU(2) subgroup. We study thermal fluctuations of the superconductor for temperatures below the gap. These are described by a simple transport equation. In the collisionless limit and close to equilibrium, it gives rise to the "hard superconducting loop" effective theory for the SU(2) gauge fields. This theory describes Debye screening and Landau damping of the gauge fields in the presence of the diquark condensate. We explain how our effective theory follows to one-loop order from quantum field theory. Our approach provides a convenient starting point for the computation of transport coefficients of the two-flavor color superconductor.

Journal Article↗
PubMed2000

[The drama of blood contamination in France. An approach to public health].

The tragic HIV contamination of hemophilics and transfusion recipients between 1980 and 1985 in France led to low court proceeding the same events. In addition, last June a state minister was arraigned for not recalling transfused patients before 1985. This involves later events and announces other court actions. France is the only country where these dramatic events have take on the dimension of a major political scandal. Based on the scientific elements (reactions and articles in the international medical literature) and an analysis of the decisions made by France, a chronological examination of the disease and the risks for hemophiliacs and transfusion recipients offers helpful insight into possible options for reducing these risks. The interval between these the court proceeding allows time for further thought focusing on a serious deviation of public health in France.

Blood↗
PubMed1999

[Anti-hepatitis B vaccination: after the health authorities' decision].

In 1991, the WHO proposed that the antihepatitis B vaccine be included in national vaccination programs. In France, it was decided in 1994 to move on from a selective immunization scheme aimed at high-risk subjects to a general vaccination policy aimed first at adolescents in school and secondly infants. During this period, several cases of demyelinizing diseases after vaccination led to court actions and were magnified in the popular press, interfering with this new vaccination policy. On October 1, 1988, the French Secretary of Health decided to interrupt the school vaccination programs. This decision, taken as a precautionary measure, had some unexpected consequences. As had been feared by the WHO, there was an overall drop in the public's confidence in the vaccine. Health care professionals highly criticized the spectacular nature of the decision and the absence of scientific argumentation. These events lead us to raise a certain number of questions concerning the use of the public press in the management of health information, the notion of medical responsibility, and the rationality of political decisions in public health.

Adolescent↗
PubMed1999

[Multidrug resistant bacteria in a psychiatric milieu].

Isolation rates of multiple-drug resistant (MDR) bacteria were evaluated retrospectively in a psychiatric care facility. Over the six-year study period, 66 MDR bacterial strains were found. Methicillin-resistant Staphylococcus aureus contributed half of all MDR strains and 31% of all S. aureus strains. Among Pseudomonas aeruginosa strains, 22% were resistant to ticarcillin or imipenem, and among Enterobacteriaceae, 4.1% were MDR strains (production of a derepressed cephalosporinase or of an extended-spectrum beta-lactamase). Although most MDR strains were probably acquired during hospitalizations in short-term care facilities outside our institution, patient-to-patient transmission, either direct or via other individuals, cannot be ruled out. These data indicate that psychiatric care facilities should adopt the MDR strain monitoring strategies already used in other hospitals.

Bacteria↗
PubMed1998

AIDS talks for adolescents.

The authors discuss how to conduct information sessions on AIDS prevention for adolescents on the basis of experience gained in Marseilles secondary schools. Precautionary messages have to be conveyed without encouraging irrational fear and intolerance.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Mass screening programs for breast cancer in France--average values of assessment criteria.

Breast cancer is the most common cancer in women worldwide. Many studies have been performed worldwide to assess the effectiveness of screening in terms of reduced mortality due to breast cancer. Since the end of 1989, 10 breast cancer mass screening programs using mammography have been carried out in France under the sponsorship of the National Fund for Health Prevention, Education, and Information (FNPEIS) from the National Health Insurance of Salaried Workers (CNAMTS). These 10 campaigns, which are on a district scale, are organized according to variable methods and are assessed using a common procedure. Four groups of criteria are measured in this procedure, which investigates the impact, quality, effectiveness, and costs of screening programs. The average and extreme values of each criterion as calculated from the campaigns are presented in this paper. In order to enlighten the judgment on the French results, a comparison with the international standards in force and with the results of foreign screening programs is proposed.

Aged↗
PubMed1997

[Risk factors for postmenopausal osteoporosis. Review of the literature 1990-1995].

The steady increase in the prevalence of post-menopausal osteoporosis and the associated rise in mortality make this disease a serious threat to public health. Further research and a consequently greater understanding of the risk factors of this disease should make it possible for preventative strategies to be put into operation. Although the literature relating to these risk factors is particularly abundant, the conclusions are often inconsistent if not contradictory. The present survey aims to review all the data published on the subject over the past five years. When the main classically suspected risk factors are examined separately--age, weight, ethnic factors, family antecedents, physical activity, nutritional factors (e.g. calcium, vitamin D), tobacco smoking, consumption of alcohol or coffee--the results are generally inconclusive and inconsistent from one study to another. Several major multi-risk studies have been attempted to investigate in greater depth the factors associated with fractures, to identify the most important among them and to determine whether their effects are cumulative. Certain authors have examined the predictive value of the detection of these risk factors and the possible use of such signs for the prevention of osteoporosis, since this is the ultimate objective.

Age Distribution↗
PubMed1997

[Mass screening programs for breast cancer in France. Comparative evaluation].

OBJECTIVE: The purpose of this work was to comparatively assess the results of mass screening programs for breast cancer implemented in six French departments in 1986, within the scope of the National Fund for Health Prevention, Education and Information of the National Health Insurance Office of Salaried Workers. MATERIAL AND METHODS: The data collected by the screening centres were analyzed by ten assessment teams that were independent from the program promotion staff, all using the same evaluation form. A complementary population study performed in eight French districts then, allowed assessing the frequency of self-referred screening (mammography performed out of program). RESULTS: The rate of participation in screening programs, in relation to the invited population, ranged from 21 to 48%, according to the district (36% in average). This low participation was probably related to the extent of self-referred screening. In fact, 19 to 40% of women, according to the district, had previously had a screening mammographic coverage: rate was around 68% in women aged 50 to 69 years. Positive findings with mammography ranged from 4.5 to 15.8% (10.1% in average), while intervention rates ranged from 0.7 to 1.6% and detection rates from 3.8 to 6.2%. The ratio between benign tumors and cancers ranged from 0.7 to 2.1 according to the district. In order to enlighten the judgement on French results, we propose a comparison with the international standards in force. CONCLUSION: The various experiences with breast cancer screening in France show that this screening is technically feasible on the basis of existing medical structures. However, some criteria are still below the expected values, especially if compared with international standards. This result is probably accounted for by the high rate self-referred screening before age 40 in France. In these conditions, the question is whether extending breast cancer screening programs in France is an appropriate course of action.

Breast Neoplasms↗
PubMed1996

[Digestive amines of bacterial origin and behavior disorders. Apropos of a case].

Implication of amines in central nervous system diseases such as migraine, Parkinson disease, epilepsy and depressive illness, is well established. On an other hand, intestinal flora is responsible for the production of specific metabolites such as amines, particularly histamine, tyramine, putrescine and cadaverine. These amines can be absorbed in situ and, through unknown mechanisms, may affect the host's behavior. Most of the data about the pathological activities of bacterial amines concern animals. The concentrations of histamine, tyramine, putrescine and cadaverine in the feces of the studied "controls" appeared steady over time. For the patient presenting clastic crisis without any starting factor, variations appear to overcome the "controls" values, with a great variability. At least tyramine, putrescine and cadaverine concentrations variations are striking by superposed and seem associated to the arising hyper agressivity crisis.

Adrenergic Agents↗
PubMed1995

Cadaver kidney transplantation: ethics and consent.

Organ transplantation began to develop soon after the Second World War. The constant progress made in organ transplantation has resulted in an increase in the number of operations carried out. The laws governing transplantation are often drawn up to deal with the de facto situation in a particular country. The study focuses on Guideline 1 adopted by 44th World Health Assembly (resolution WHA 44-25) concerning consent in cadaver kidney transplantation. The discussion of the question of consent is based on a comparative study of the laws regarding kidney transplantation in the countries of what is known as Greater Europe. The points of discussion presented are not offered with a view to advocating a system where soliciting the consent of the family would be considered as ethically necessary. Given the current legal constraints, the presumed consent procedure, with consultation of the family would appear to be more appropriate.

Cadaver↗