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Biomedical subjects

G Brucker

Publications and source records attributed to G Brucker.

At least 19 recordsLinked to original sources
PubMed1995

[Focus on the role of ventilation and ultraviolet rays in preventing nosocomial transmission of tuberculosis in health care facilities. Groupe de travail sur la prévention de la transmission nosocomiale de la tuberculose (Direction Générale de la Santé)].

Recent episodes of nosocomial tuberculosis, sometimes due to multiresistant strains, in HIV infected patients in the USA has led to the need for new prevention measures against the transmission of Mycobacterium tuberculosis in health care facilities. Tuberculosis is transmitted in Pflügge droplets generated when contagious persons cough. After drying, the droplets become aerosolized solid particles which are rapidly dispersed by air flow within the patient's room. People exposed to the same air are thus at high risk of being contaminated. If the air pressure in the patient's room is higher than the rest of the facility, the air coming form the room may contaminate personnel and other patients elsewhere in the facility. Infecting particles can be eliminated rapidly if the room air is ventilated outdoors. If the ventilation is strong enough so that air constantly circulates from the corridor into the room, infecting particles can no longer diffuse to the rest of the ward. It is also possible to use ultraviolet C light to disinfect the air, either within the room or within the ventilation system. These two basically simple systems are the fundamental environmental and prevention measures needed to limit tuberculosis spread in health care facilities. These methods are however technically complex, costly and require constant evaluation and maintenance by specialized personnel. In addition the potential side effects of ultraviolet waves could considerably reduce their application. These environmental methods, which are complementary methods, only have a meaning if the elementary measures for preventing the transmission of tuberculosis are correctly applied.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross Infection↗
PubMed1991

[Diseases observed after return from travels outside Europe. 109 cases].

We report a prospective study of travel-associated illnesses observed after their return in 109 French travellers, including 86 tourists. Sixty-three were returning from Africa and 84 percent had been abroad for less than 4 weeks. The percentages of travellers immunized against tetanus, poliomyelitis and typhoid fever were 70, 63 and 36 percent respectively. Malaria prophylaxis was well adjusted to current recommendations in only 19 patients; for 9 patients it was a routine visit. One hundred patients reported 105 diseases. The diagnosis was undetermined in 31 patients, including 19 with diarrhoea and 8 with fever, and it was determined in 74 patients who were found to have malaria (14), cutaneous myiasis (12) or bacterial skin infections (12).

Adolescent↗
PubMed1991

Imported and autochthonous kala-azar in France.

OBJECTIVE: To study the epidemiological, clinical, and biological features of imported and autochthonous kala-azar in France. DESIGN: Prospective survey of all patients in France with kala-azar diagnosed over the two years 1986-7. Information was obtained from parasitology laboratories in regional hospitals and all hospital laboratories and haematology departments capable of diagnosing leishmaniasis in the south of France. SETTING: 107 public hospitals in France. PATIENTS: 89 patients with kala-azar. INTERVENTIONS: All patients were treated with drugs. In the first instance meglumine antimonate was given to all but two patients. MAIN OUTCOME MEASURES: Prevalence of the various clinical and biological features of kala-azar; proportion of patients with HIV infection. RESULTS: Half (44) of the patients were children under 8 years old. Seventy patients acquired the disease in France. Imported kala-azar was acquired mainly in Mediterranean countries (9/18 cases). Only 46 (52%) of the patients had all three of the classic associated clinical features of fever, splenomegaly, and hepatomegaly. Anaemia was the commonest biological sign, and the association of the four usual biological signs--anaemia, leucopenia, thrombocytopenia, and hypergammaglobulinaemia--was present in only 14 (33%) of the children under 8 and 26 (60%) adults. Fourteen of the patients over 8 years old were infected with HIV. CONCLUSION: Doctors must be aware of kala-azar in Mediterranean areas, especially as patients often present without the characteristic features and the disease affects young children preferentially.

Adolescent↗
PubMed1989

Study of 39 documented relapses of multibacillary leprosy after treatment with rifampin.

Among 39 strains of Mycobacterium leprae isolated from patients with multibacillary leprosy who relapsed after treatment with rifampin (RMP), 22 strains were resistant to RMP and 17 were susceptible. All of the RMP-resistant strains were recovered from patients who had been treated with more than 50 doses of RMP, usually given as monotherapy. RMP-susceptible strains were recovered from only six patients who had received more than 50 doses of RMP, and from 11 patients who had received no more than seven doses. The median time to relapse after the beginning of RMP therapy was 9 years (range 1-12 years) among the patients harboring RMP-resistant strains of M. leprae, and the median time to relapse after discontinuation of RMP treatment was 7 years (range 1-11 years) among the patients harboring RMP-susceptible strains. These data suggest that monotherapy with more than a few doses of RMP can be responsible for the emergence of RMP-resistant strains of M. leprae, thus emphasizing the need to employ RMP only in combination with other effective drugs in the chemotherapy of multibacillary leprosy.

Animals↗
PubMed1987

[Development of drug resistance in cases of P. falciparum malaria of African origin in a Parisian hospital. Comparison with field data and therapeutic consequences].

The number of P. falciparum malaria cases, contracted in Africa, diagnosed by the department of Parasitology and Tropical diseases of the Pitié-Salpêtrière Hospital Group has shown a significant increase in 1985-1986 when compared with the 15 past years (+23%). This fact is related to the spread of chloroquine or amodiaquine resistant falciparum malaria from East Africa (1980-1983: 54%) to Central Africa (1985: 54.5%) and now to a country of west Africa (Benin 1986).

Africa↗
PubMed1987

Primary and secondary dapsone resistance of M. leprae in Martinique, Guadeloupe, New Caledonia, Tahiti, Senegal, and Paris between 1980 and 1985.

Primary and secondary dapsone resistance were studied among lepromatous patients living in Martinique, Guadeloupe, New Caledonia, Tahiti, Senegal, and Paris. Four hundred fifteen biopsies were taken from clinically active and bacteriologically positive (bacterial index greater than 2) patients in the 6-year period of 1980-1985. Among these, 280 biopsies that contained 5 x 10(4) acid-fast bacilli per ml with a morphological index of at least 0.10 were inoculated into the mouse foot pad, and 229 harbored infective Mycobacterium leprae. Among the 129 infective M. leprae isolated from new cases, 54% had some degree of dapsone resistance, a low degree being prominent in all cases. Among the 100 infective M. leprae isolated from relapsed cases, 79% had a high or an intermediate degree of dapsone resistance. The annual incidence of secondary dapsone resistance was estimated to be about 0.55% in Guadeloupe.

Dapsone↗
PubMed1986

[Estimation of the impact of the principal diseases in rural Mali].

The authors assess the health impact of major diseases in the circles of Kita, Bafoulabé and Kenieba (Western Mali) by measuring, for each of them, the number of healthy days of life lost through illness, disability and death. Malaria, birth diseases, infant gastro-enteritis and pneumopathies, measles, malnutrition and hemoglobinopathies account for 58.1% of healthy life lost due to all studied diseases. Parasitic diseases (except malaria), tuberculosis, leprosy are less important than usually said; on the contrary, the impact of hepatic, cardiovascular, and eyes diseases is great. In developing countries assessing the number of healthy days lost by the community due to different diseases is usefull to choose the health priorities and to compare the cost/effectiveness ratio of different health programs.

Adult↗
PubMed1986

[Clinical and biological consequences of human immunodeficiency virus (LAV) infection in 15 Congolese subjects].

We report 15 cases of symptomatic HIV infection seen in Paris between June 1983 and June 1985 in Congolese patients. The first signs were diarrhea, weight loss, fever, pruritus. Disseminated lymphadenopathy was frequent. Twelve patients had AIDS, and the opportunistic infections were: isosporosis, oesophageal candidiasis, cerebral toxoplasmosis, Kaposi's sarcoma, CNS' cryptococcosis, cutaneo-mucosal.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[Fasciolar hepatic abscesses: value of hepatic ultrasonography. Apropos of 3 cases].

Hepatic abscess is a rare complication of fasciolasis. The ultrasonographic appearances of these abscesses are not well known. The finding of nodular echodense images in the hepatic parenchyma may cause diagnostic confusion. We report three cases in which abdominal ultrasonography demonstrated hepatic abscesses complicating fascioliasis. Follow-up examination showed regression of these lesions after treatment.

Adult↗