PubMed Health⌕ Search

Biomedical subjects

J Bourland

Publications and source records attributed to J Bourland.

At least 19 recordsLinked to original sources
PubMed1992

Ambulatory treatment of multibacillary leprosy with a regimen of 8 months duration.

An ambulatory treatment regimen for multibacillary leprosy, of 34 weeks duration composed of 8 weeks daily supervised rifampicin, ethionamide (ETH), dapsone (DDS) and clofazimine (CLO) followed by 26 weeks of unsupervised ETH, DDS and CLO, introduced in 1983 has been evaluated; 268 patients were followed for a mean of 4.4 years and a total of 1188 patient years. The relapse rate was 0.33 per 100 patient years of follow up. The reduction of the duration of the combined administration of RMP + ETH reduced the hepatotoxicity to 1.4%. It is possible that both phases of the regimen studied could still be reduced, however, in the near future ETH will be replaced by alternative bactericidal drugs, avoiding the hepatotoxicity.

Clofazimine↗
PubMed1991

Evolution of the leprosy endemicity in Burundi during the years 1981-88.

Between 1981 and 1988 the detection rate of leprosy in Burundi increased from 2.4 per 100,000 during 1981-84 to 3.09 per 100,000 during 1985-88. The proportion of multibacillary disease remained constant at 30%. The detection rate in children decreased significantly from 21 to 9% for paucibacillary disease (PB) but remained constant for multibacillary disease (MB). The proportion of patients with disabilities doubled in both PB and MB patients. It seems thus that the detection rate is high but that cases are diagnosed fairly late. Health education of the public and staff in the Health Centers should stress the importance of better and earlier detection.

Adolescent↗
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↗
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↗
PubMed1985

Leprosy in children one year of age and under.

Information obtained from a review of the literature, the United States Armed Forces Institute of Pathology files, and from a correspondence survey revealed a total of 91 infants one year of age and under in whom leprosy was diagnosed. Biopsy confirmation was available on 19 infants, and in an additional 32 patients the diagnosis of leprosy was considered certain even though biopsy confirmation was not obtained. Although the mother was probably the most common source of the infection (29 infants), it was of interest to note that the father, another relative, or an unknown contact was the source of the infection in at least 43% of the infants. The youngest infant was 2-3 months old and had no known familial contact. The role of intrauterine exposure to Mycobacterium leprae, or to antigens of M. leprae, in infection and pathogenesis is discussed. The diagnosis of leprosy in infants under one year may frequently be missed or early signs disregarded because of a mistaken belief that leprosy is exceedingly rare or non-existent in the very young.

Biopsy↗
PubMed1984

Hepatotoxicity of the combination of rifampin-ethionamide in the treatment of multibacillary leprosy.

During treatment of multibacillary leprosy with the combination rifampin (RMP) 600 mg, ethionamide (ETH) 500 mg, and either dapsone (DDS) or clofazimine (CLO) 100 mg, hepatotoxicity was observed in 4.5% of 596 patients. Hepatitis appeared after 5-186 days, with a mean of 93 days and a median of 76 days. Mortality was 26%. ETH and DDS or CLO were administered daily in all regimens in which hepatitis occurred. RMP was given either daily or daily during the first two weeks or eight weeks, followed by a once-weekly dose. It is concluded that the combination RMP + ETH is the toxic component. In some patient groups there was a high correlation of toxicity with age. A regimen in which RMP was administered only twice a week during three months was not accompanied by hepatotoxicity. Future studies should show if reduction of the daily dose of ETH or reduction of the duration of the administration of RMP + ETH might reduce the incidence of hepatotoxicity while conserving the efficacy.

Adolescent↗
PubMed1977

Streptocerciasis: observation of adult male Dipetalonema streptocerca in man.

In 75 biopsy specimens of skin from 34 patients with streptocerciasis who had been treated with diethylcarbamazine, we found 39 female and six male adult Dipetalonema streptocerca in the dermal collagen. This is the first report of adult male D. streptocerca in man, and identifying features are described.

Animals↗