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Biomedical subjects

J Delmont

Publications and source records attributed to J Delmont.

At least 19 recordsLinked to original sources
PubMed2006

[Popular nosology of infantile diseases in West Côte-d'Ivoire and consequences for malaria care management].

In a rural area of intense and permanent malaria transmission in Southwest Côte-d'lvoire, traditional midwifes of the Yacouba ethnic group, with also an important function for the children health and care, were interviewed in 2002 about their knowledge of the infantile pathologies. Their nosology is greatly based on symptoms and etiologic explanations of the disorder of secretions. The accumulation of a viscous liquid in different parts of the body, especially in the chest, the throat or the head, explains numerous febrile or afebrile diseases, including malnutrition. Some pathologies, particularly convulsions, are described by analogy with animals behaviour Relations between these entities and the biomedical ones are difficult to establish. The traditional care and treatments result from these concepts. A vomiting child or a child suffering from diarrhoea is subject to devices to evacuate his excess of liquid. Yellow brews are used against jaundice. Furthermore, an important mistrust remains towards medical treatments particularly for all parenteral therapies. Health facilities are only used as a the last resort. Their bad reputation is confirmed by the high rate of mortality of patients coming often too late. To improve malaria care management, health-care workers have to take into consideration these concepts and also prove their abilities to ensure good medical practices.

Child↗
PubMed2005

[Imported malaria at the Marseilles Hôpital-Nord, France: a prospective study on 352 cases between 2001 and 2003].

OBJECTIVE: The authors had for aim to study epidemiological, clinical, and parasitological characteristics, as well as regimen received, of imported malaria cases hospitalised at the North University Hospital, in Marseilles, France. DESIGN: The patients presenting with imported malaria included in this study were hospitalised in the infectious and tropical diseases unit and in the pediatrics unit at the North University Hospital, from January 1, 2001 to December 31, 2003. Variables were prospectively collected and recorded. RESULTS: 352 patients including 240 adults and 112 children were included. Most of them (67% of the adults and 92% of the children) were contaminated during a trip to the Comoros Islands. Plasmodium falciparum was the most common species identified. 97.5% of adult and 98% of child patients back from Comoros did not take any chemoprophylaxis against malaria or took inadequate regimens. Halofantrin was the most commonly used drug for children to treat uncomplicated P. falciparum malaria. In adults, atovaquone-proguanil was used as a first line drug in the absence of vomiting, and a 3-day intravenous regimen of quinine-clindamycin in case of vomiting. CONCLUSION: The specificity of imported malaria in Marseilles is the high proportion of Comorian patients who go back home periodically to visit friends and relatives. A better education of the Comorian population in Marseilles, regarding malaria risks and prophylaxis, needs to be implemented.

Adult↗
PubMed2005

Treatment of imported malaria in adults: a multicentre study in France.

BACKGROUND: Data about anti-malarial drugs prescription practices in Europe and the safety of imported malaria treatments are scanty. In 1999, a French consensus development conference published guidelines for the prevention and treatment of imported P. falciparum malaria. The impact of these guidelines has not been evaluated. AIM: To investigate the impact of these guidelines on the prescription of anti-malarials, and to evaluate the incidence of acute drug events (ADEs) leading to discontinuation of treatment. DESIGN: Cross-sectional survey. METHODS: Members of the medical staff in 14 French infectious and tropical disease wards completed a standardized form for each patient treated for imported malaria in 2001. A propensity score matching technique was used to estimate the risk of ADEs leading to discontinuation of the regimen. RESULTS: In the 474 patients studied, quinine was the first-line anti-malarial most often prescribed. Only 3% of patients received halofantrine. Mefloquine was associated with a RR of 4.9 (95%CI 3.2-7.4, p < 0.00001) risk of discontinuation of treatment due to ADEs. DISCUSSION: The very limited use of halofantrine indicates that the main practice recommendations of the guidelines have been taken into account. Mefloquine was associated with a substantial risk of discontinuing the treatment because of ADEs. This is a serious limitation for the use of mefloquine in the treatment of out-patients with imported malaria.

Adult↗
PubMed2005

Pseudo-tumor of the lung, a rare clinical presentation of dirofilariasis.

INTRODUCTION: Pulmonary dirofilariasis is an uncommon entity. Known as a zoonotic disease it can affect humans as a secondary host. A pseudo-tumor of the lung called "coin" lesion is usually detected while performing a chest X-ray for another reason. OBSERVATION: We present a case of pulmonary dirofilariasis due to Dirofilaria sp. in a 72 year old immunocompetent patient who underwent surgery for suspicion of a neoplasm. DISCUSSION: Human pulmonary dirofilariasis should be evoked in asymptomatic patient from endemic area of canine dirofilariasis presenting with a pseudo tumor of the lung.

Aged↗
PubMed2004

Schistosomiasis as an unusual cause of appendicitis.

Millions of people originating from tropical areas now live outside the country of their birth. As a consequence, the number of cases of diseases imported from the tropics and being seen by European physicians in immigrants is growing. As an example of such diseases, schistosomal appendicitis is a specific trait of infection with Schistosoma haematobium and is an uncommon cause of appendicitis in non-endemic areas. Treatment requires anti-schistomal medication in addition to surgery. Physicians, including surgeons, need to be aware of the possibility of seeing atypical presentations of parasitic diseases in immigrant patients.

Adult↗
PubMed2003

[In vivo evaluation of chloroquine therapeutic efficacy in uncomplicated Plasmodium falciparum malaria in Central African Republic ine 1997 and 1998].

The efficacy of oral chloroquine was assessed in 268 children aged from 6 to 59 months attending pediatric services in regional hospitals between September 1997 and December 1998, located in the five county towns of the sanitary regions of the Central African Republic. Chloroquine was prescribed at 25 mg per kg body weight, and administered over 3 days to patients suffering from uncomplicated malaria. Body temperature and blood smears including parasitaemia were recorded on days 0, 3, 7 and 14. The main objective of the present study was to evaluate the therapeutic efficacy of chloroquine in the treatment of uncomplicated malaria using in vivo tests according to the WHO protocol (1996). The secondary objective was to identify the predictive factors of chloroquine relapses. Early relapses rates were under 15% except in Bangui (40%). A recurrence of parasitaemia with fever, sign of late relapse, was noted in 9% of children in Bambari, 9% in Bangassou, 8% in Bangui, 5% in Bossangoa and 4% in Berberati. The rate of successfully treated patients was between 66% and 75% except in Bangui (36%). Only the places of study and anaemia in days 0 were significant predictive factors of therapeutic relapses. Since the emergence of chloroquine resistance cases to P. falciparum in 1983 in Central African Republic, the phenomenon has increased. According to our results, a strong chloroquine resistance appears in the capital Bangui. Therefore, chloroquine should be replaced there for the first line treatment of uncomplicated P. falciparum malaria. In the provinces, it doesn't seem necessary to change the current chloroquine-based first line treatment.

Administration, Oral↗
PubMed2002

[What is the value of the combination atovaquone-proguanil for the clinician?].

Malarone (atovaquone-proguanil) is a new option now available to French clinicians for prophylaxis and treatment of malaria. Administered by the oral route, malarone is almost 100% effective with few side effects. It is indicated for chemoprophylaxis in travelers entering areas with chloraquine-resistant Plasmodium falciparum. Compliance with prophylactic treatment is enhanced by the low frequency of adverse effects and the need to continue chemoprophylaxis for only 7 days after leaving the endemic area. For curative treatment of malaria, malarone is especially useful in patients with uncomplicated forms of Plasmodium falciparum malaria. This drug combination is also suitable as a stand-by treatment.

Animals↗
PubMed2002

[European Center for Humanitarian Health (CESH). Providing operational know-how directly applicable in crisis situations].

Founded in 1997 at the initiative of Charles Mérieux, the European Center for Humanitarian Health Care (French acronym, CESH) is a Public Interest Organization comprising 7 members, i.e., Lyon 1 Claude Bernard University, Aix-Marseille II University of the Mediterranean, the Public Hospital System of Lyon, the Public Hospital System of Marseille, the French Army Health Corps, the Mérieux Foundation, and the National School of Veterinary Medicine in Lyon. The CESH is a multifunctional resource dedicated to providing education, information, and research in the field of humanitarian action. The objectives of the CESH's Educational Program are to increase awareness of the complexity of humanitarian action and teach the principles and methods necessary to integrate experienced teams already in the field. Courses including a three-week study program sanctioned by an Interuniversity Degree in Public Health and several 2-to-3-day training modules are open to all humanitarian actors including field workers and decision-makers, health-care professionals, and governmental or other administrative agents. Thanks to a diverse faculty with academic, humanitarian, training, civilian and military backgrounds and to a wide-ranging curriculum, the CESH helps to promote communication and to open up closed pathways of cooperation between the different groups involved in humanitarian action. The module entitled "Humanitarian Assistance and Civilian and Military Cooperation" exemplifies the effort of the CESH to generate collaborative behavior among civilian and military actors. The CESH's Research Program is aimed at providing practical tools for decision-making in the field. The web site of the CESH [http://cesh.univ-lyon1.fr] presents the mission and activities of the Center as well as information on course enrolment and humanitarian action.

Altruism↗
PubMed2001

Controlled trial of 3-day quinine-clindamycin treatment versus 7-day quinine treatment for adult travelers with uncomplicated falciparum malaria imported from the tropics.

We conducted a randomized, double-blind, placebo-controlled trial to compare a 3-day quinine-clindamycin regimen (group QC) with a 7-day quinine regimen (group Q) for the treatment of uncomplicated Plasmodium falciparum malaria in travelers returning from the tropics. A total of 55 and 53 patients in groups Q and QC were analyzed, respectively. Adverse effects were similar in both groups, although two patients in group Q had severe adverse reactions, leading to the cessation of treatment. The 28-day cure rate for the evaluated patients (per-protocol analysis) was 100% for group QC, whereas it was 96.3% for group Q (P = 0.5). The 28-day cure rate in the intention-to-treat analysis was 96.2% for group QC, whereas it was 94.6% for group Q (P = 1). There were no significant differences between the two regimens with regard to parasite and fever clearance times. Our study shows that the 3-day quinine-clindamycin regimen is well tolerated and compares favorably with a 7-day quinine treatment. This short-term regimen had previously been evaluated only in areas of endemicity. According to our results, the 3-day quinine-clindamycin regimen may be an alternative for the treatment of imported uncomplicated P. falciparum malaria in travelers returning from the tropics.

Adult↗
PubMed2001

[A classical form of actinomycoses involving the mouth, face bones, orbit and base of the cranium in an African patient].

Osteitis due to actinomycosis is now an uncommon clinical entity in industrialized countries. This report describes a classic case of imported actinomycosis involving the buccal cavity, facial bones, orbit and skull base. For two years after the onset, various diagnoses followed by different medical as well as surgical treatments were unsuccessfully attempted first in Senegal then in Italy. Proper diagnosis was finally established in Marseille, France, on the basis of histological findings after extensive surgical biopsy. The patient was treated with high-dose intravenous penicillin G for four weeks followed by daily oral administration of amoxicillin for one year. Surgical reconstruction could not be carried out before the patient's return to Senegal. The pitfalls of diagnosis and treatment of actinomycosis are discussed.

Actinomycosis, Cervicofacial↗
PubMed2001

[Exceptions to malaria chemoprophylaxis for the traveller].

With the increasing development of international travel, the administration of malaria chemoprophylaxis has become very common; however, the pertinence of this prescription may in many cases be questioned. All the available drugs, particularly the more recent ones, for preventing chloroquine-resistant Plasmodium falciparum malaria, can induce adverse effects. Thus, it is better to avoid chemoprophylaxis when not absolutely necessary. It should be remembered that in many tropical and subtropical countries malaria does not occur at all and in others, the level of transmission is insignificant or low. On the other hand, in the regions with a high rate of transmission, lack of chemoprophylaxis can be justified only by extremely brief, repeated exposures (e.g. aircrew). When travelling without chemoprophylaxis to an area with malarial transmission, even at minimal level, one must (i) use rigorous antivectorial prophylaxis, (ii) call immediately to mind the diagnosis of malaria in the case of unexpected febrile illness, and (iii) be in possession of a stand-by treatment if there is no access to emergency advice.

Antimalarials↗
PubMed2000

Influence of highly active antiretroviral therapy on micronutrient profiles in HIV-infected patients.

OBJECTIVES: To assess micronutrient variations in HIV/AIDS patients before and after HAART (highly active antiretroviral therapy). METHODS: We evaluated the nutritional status and micronutrients in 44 patients over 3 years. The first nutritional evaluation was conducted in 1995 before HAART, the second was conducted in 1998 when most patients received HAART. RESULTS: Thirty-four (77%) of the patients were intravenous drug users. In 1995, 35 (80%) were receiving antiretroviral therapy, but none had a protease inhibitor. A comparison made between patients in the group with CD4 <250/mm(3) (group A) and patients in the group with CD4 >250/mm(3)(group B) revealed significantly lower levels of plasma selenium concentrations (p < 0.05). In group A women, zinc was significantly lower than in men of the same group (p < 0.05). On the contrary, selenium plasma concentrations were significantly lower in group A men than in group A women (p < 0.05). No significant differences were noted for other micronutrients. In 1998, when most patients were treated with HAART, differences between the two groups were no more significant, neither for selenium nor for zinc matched with sex. Micronutrient values did not significantly differ between patients with viral load below 5,000 copies/ml and patients with viral load above 5,000 copies/ml. Patients treated with HAART had practically no weight loss. Although patients who did not receive HAART had a good immune status, the mean weight loss was up to 4.6 kg. CONCLUSIONS: Selenium and zinc deficiencies are dependent on immune status and sex in HIV/AIDS patients. Other micronutrients do not seem to be influenced by the immune status in these patients. HAART reduces selenium and zinc deficiencies and may help avoid weight loss independently of the CD4 cell count.

Adult↗