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Biomedical subjects

J M Olivé

Publications and source records attributed to J M Olivé.

At least 19 recordsLinked to original sources
PubMed2002

[Tobacco brand-related headache].

INTRODUCTION: Tobacco smoking has been considered a risk factor for headache by some authors, while others disagree because of contradictory data. PATIENTS AND RESULTS: We describe the clinical aspects of eleven patients (four men and seven women) who presented to us with tobacco brand-related headaches. Clinical history help us to discover that headache of each patient was directly related with certain cigarette brands smoking. The cigarette brands implicated were diverse and different for each patient. Headaches were migraine-like in seven cases, cluster-like in three, and non-specific in the other one. They disappeared after switching brand or stopping smoking. CONCLUSIONS: In our patients, headaches were clearly related to smoking certain brands of cigarettes, which has never been reported before. This type of headache has characteristics that suggest that it could be a particular form of chemical odour intolerance, previously described. The number of possible responsible substances is large. More studies will be necessary in order to discover the mechanism leading patients to tobacco brand-related headache. It is important to ask our patients which cigarette brand they smoke, so it is possible to solve the problem.

Adolescent↗
PubMed2001

Measles vaccination in Africa: by how much could routine coverage be improved?

Assuming that the level of Bacille Calmette Guerin (BCG) coverage gives a measure of access to immunisation services, it is possible to derive what fraction of infants are not immunised against measles due to under-utilisation of existing services (rather than unavailability of services). According to the most recent official statistics, the overall coverage for measles vaccine is 53% in Africa (10% lower than for BCG). This difference amounts to 3 million African children who will not be vaccinated against measles this year even though they probably have access to immunisation services.

Africa↗
PubMed2000

Wernicke's syndrome after bariatric surgery.

Two young females with severe morbid obesity presented with Wernicke's syndrome after Roux-en-Y gastro-jejunum bypass had been performed. The first patient had recurrent vomiting and dyplopia two months post-surgery. Physical examination indicated bilateral ophthalmoparesia with conserved convergence and ataxia. The second patient had frequent vomiting episodes over the previous three months together with lower limb hypotonia, myoclonia and generalised tonicoclonic seizures on two occasions within one year of surgery. In both cases routine blood test, ion levels (sodium, potassium, calcium, phosphates), electroencephalogram and CT scan were normal. Thiamine therapy was instigated on the basis of clinical intuition and the first patient achieved complete remission within 24 hours while the second improved gradually in that two years later only mild lower limb hypotonia and a slight cognitive deficit remains. Erythrocyte transketolase activity determinations were abnormal on two separate occasions for this second patient. Vitamin B1 determinations were not available for the first patient. In conclusion, the restriction in energy intake and the persistent vomiting together with malabsorption induced by the surgical intervention could explain the vitamin deficiency causing Wernicke's encephalopathy. This indicates a need for close monitoring and systematic vitamin supplementation in those patients who undergo bariatric surgery.

Adult↗
PubMed2000

When is a disease eradicable? 100 years of lessons learned.

Since the 1915 launch of the first international eradication initiative targeting a human pathogen, much has been learned about the determinants of eradicability of an organism. The authors outline the first 4 eradication efforts, summarizing the lessons learned in terms of the 3 types of criteria for disease eradication programs: (1) biological and technical feasibility, (2) costs and benefits, and (3) societal and political considerations.

Communicable Disease Control↗
PubMed2000

Disease eradication as a public health strategy: a case study of poliomyelitis eradication.

Disease eradication as a public health strategy was discussed at international meetings in 1997 and 1998. In this article, the ongoing poliomyelitis eradication initiative is examined using the criteria for evaluating candidate diseases for eradication proposed at these meetings, which covered costs and benefits, biological determinants of eradicability (technical feasibility) and societal and political considerations (operational feasibility). The benefits of poliomyelitis eradication are shown to include a substantial investment in health services delivery, the elimination of a major cause of disability, and far-reaching intangible effects, such as establishment of a "culture of prevention". The costs are found to be financial and finite, despite some disturbances to the delivery of other health services. The "technical" feasibility of poliomyelitis eradication is seen in the absence of a non-human reservoir and the presence of both an effective intervention and delivery strategy (oral poliovirus vaccine and national immunization days) and a sensitive and specific diagnostic tool (viral culture of specimens from acute flaccid paralysis cases). The certification of poliomyelitis eradication in the Americas in 1994 and interruption of endemic transmission in the Western Pacific since March 1997 confirm the operational feasibility of this goal. When the humanitarian, economic and consequent benefits of this initiative are measured against the costs, a strong argument is made for eradication as a valuable disease control strategy.

Developed Countries↗
PubMed1999

Measles elimination: progress and challenges.

The accelerating progress in reducing measles incidence and mortality in many parts of the world has led to calls for its global eradication during the next 10-15 years. Three regions have established goals of elimination of indigenous transmission of measles. The strategy used in the Americas of a mass 'catchup' campaign of children 9 months to 15 years of age, high coverage through routine vaccination of infants, intensive surveillance and follow-up campaigns to prevent excessive build-up of susceptibles has had great success in reducing measles transmission close to zero. However, while these developments are impressive, much remains to be done to reduce measles-associated mortality in western and central Africa, where less than half of children are currently receiving measles vaccine and half a million children die from measles each year. The obstacles to global measles eradication are perceived to be predominantly political and financial. There are also technical questions, however. These include the refinement of measles elimination strategies in the light of recent outbreaks in the Americas; the implications of the HIV epidemic for measles elimination, issues around injection safety, and concerns about the possibility that secondary vaccine failures will contribute in sustaining transmission in highly vaccinated populations. The global priorities are to improve measles control in low income countries, increase awareness among industrialized countries of the importance of measles, and conduct studies to answer the technical questions about measles elimination strategies.

HIV Infections↗
PubMed1998

Disease eradication and health systems development.

This article provides a framework for the design of future eradication programmes so that the greatest benefit accrues to health systems development from the implementation of such programmes. The framework focuses on weak and fragile health systems and assumes that eradication leads to the cessation of the intervention required to eradicate the disease. Five major components of health systems are identified and key elements which are of particular relevance to eradication initiatives are defined. The dearth of documentation which can provide "lessons learned" in this area is illustrated with a brief review of the literature. Opportunities and threats, which can be addressed during the design of eradication programmes, are described and a number of recommendations are outlined. It is emphasized that this framework pertains to eradication programmes but may be useful in attempts to coordinate vertical and horizontal disease control activities for maximum mutual benefits.

Communicable Disease Control↗
PubMed1997

The impact of immunization control activities on measles outbreaks in middle and low income countries.

BACKGROUND: The World Health Organization recommended strategy for responding to measles outbreaks in developing countries does not promote the use of immunization campaigns due to their high cost, disruptive nature and limited impact. Given the substantial morbidity and mortality associated with such outbreaks, a literature review was conducted as a basis for re-evaluating this policy. METHODS: Reports of supplementary immunization activities that were performed to control measles outbreaks in middle or low income countries were identified. The impact of the immunization activities on the course of each outbreak was evaluated by examining the data provided. RESULTS: Of 66 reports detailing a measles outbreak in a middle or low income country, 17 described supplementary immunization activities which included seven 'non-selective' immunization campaigns, three 'selective' campaigns and one use of an early 2-dose schedule. Eight of the reports commented on the impact of the response, five of which reported a reduction in outbreak morbidity. Only one of the reports, from an isolated island outbreak, provided sufficient data to support a possible reduction in outbreak-associated morbidity. CONCLUSIONS: There are limited data on the impact of measles outbreak immunization activities from developing countries. The available data do not support a change in the WHO recommended strategy for conducting a limited, if any, immunization response to such outbreaks. Immunization strategies which aim to prevent outbreaks may be more effective than campaigns to interrupt transmission of an outbreak which has already begun.

Child↗
PubMed1997

Epidemiologic study of Guillain-Barré syndrome in children <15 years of age in Latin America.

In 1986, surveillance of acute flaccid paralysis (AFP) cases among children <15 years of age was implemented in Latin America as part of the initiative to eradicate poliomyelitis from the Western Hemisphere. Data on AFP, including Guillain-Barré syndrome (GBS), could be analyzed from a regional registry system and from specific GBS studies in seven countries. Between 1989 and 1991, 3112 cases of GBS were reported in Latin America, representing 52% of all nonpolio AFP cases. From the studies in seven countries, a total of 1527 GBS cases (49%) were studied, representing an overall annual incidence rate of 0.91/100,000 children <15 years old. Follow-up investigations showed a persistent muscular weakness at 60 days, 6 months, and 1 year after onset in 61%, 14%, and 10% of children, respectively. This study confirms that with the disappearance of polio, GBS arises as the most common cause of AFP.

Adolescent↗
PubMed1997

National immunization days: experience in Latin America.

Organization of national immunization days (NIDs) in all countries in Latin America in which polio was endemic has been one of the key elements that led to the interruption of the circulation of the wild poliovirus in 1991 from the Americas. National initiatives for control or elimination of measles using similar strategies have emerged from the successful organization of NIDs for polio eradication and lead the way to the eventual global eradication of this major killer of children. The major reasons for the success of polio eradication in the Americas were the commitment of national authorities, well-defined strategies, sustainable effort, and the participation of all sectors of society.

Humans↗
PubMed1997

Eradication of wild poliovirus from the Americas: acute flaccid paralysis surveillance, 1988-1995.

In May 1985, the Pan American Health Organization proposed the goal of interruption of wild poliovirus transmission in the Western Hemisphere. An important component of the polio eradication strategy was conducting surveillance for cases of acute flaccid paralysis. Reported cases were thoroughly investigated, including the collection of stool samples for testing for the presence of wild poliovirus. The last patient with poliomyelitis due to wild poliovirus in the Americas had onset of paralysis on 23 August 1991 in Peru. Since then, >9000 cases of acute flaccid paralysis have been reported and thoroughly investigated; none has been confirmed as paralytic poliomyelitis due to wild poliovirus. On 29 September 1994, the International Commission for the Certification of Poliomyelitis Eradication declared the Americas to be polio-free.

Americas↗
PubMed1997

Disease eradication as a public health strategy: is measles next?

Following the failure of disease eradication efforts in the first half of this century, the success of smallpox eradication and the ongoing initiatives against poliomyelitis and dracunculiasis are re-establishing eradication as a viable disease control strategy. The perpetual benefits of eradication, together with the positive impact that such initiatives can have on health services in general, are changing the world's perception of these endeavours. Among the most obvious examples of this changing trend is the recent enthusiasm in both industrialized and developing countries for re-exploring the eradicability of measles. Increasingly, it appears that measles, the single leading cause of vaccine-preventable childhood morbidity and mortality worldwide, may be the next major organism targeted for global eradication.

Child, Preschool↗
PubMed1997

Current status of the global eradication of poliomyelitis.

Substantial progress towards the global eradication of poliomyelitis by the year 2000 has been achieved since May 1988 when WHO Member States adopted this goal at the Forty-first World Health Assembly. Virtually all polio-endemic countries have begun to implement the WHO-recommended strategies to eradicate polio and it is expected that, by the end of 1997, all endemic countries in the world will have conducted full National Immunization Days (NID), providing supplemental oral polio vaccine (OPV) to nearly two-thirds of all children < 5 years. In contrast, although globally acute flaccid paralysis (AFP) surveillance was being conducted in 126 (86%) of 146 countries where polio is or recently was endemic, surveillance remains incomplete and untimely. A global network of polio laboratories, capable of detecting wild poliovirus when and where it occurs, has been developed. Furthermore, in countries where polio virus circulation has been limited to focal areas, and surveillance is adequate, mopping-up campaigns are being conducted to eliminate the final chains of transmission. The process for certification of polio eradication has been established in each WHO region as well as at the global level. The impact of the eradication initiative is evident, with an 88% decrease in the number of reported cases globally since 1988. In order to achieve the goal of eradication, the rapid development of complete and timely AFP surveillance and the continuation of effective NIDs constitute an urgent priority. This is of particular relevance in the remaining polio-endemic countries, especially in those that are affected by war or politically isolated and are important remaining reservoirs from where wild poliovirus continues to spread into bordering or even distant polio-free countries. External support will continue to be required by those countries and regions where the incidence of polio has reached low levels to ensure that final chains of poliovirus transmission are interrupted and to permit the eventual certification of eradication. The year 2000 objective for achieving poliomyelitis eradication remains a feasible target.

Adolescent↗
PubMed1996

Measles elimination in the Americas. Evolving strategies.

The strategy currently used to control measles in most countries has been to immunize each successive birth cohort through the routine health services delivery system. While measles vaccine coverage has increased markedly, significant measles outbreaks have continued to recur. During the past 5 years, experience in the Americas suggests that measles transmission has been interrupted in a number of countries (Cuba, Chile, and countries in the English-speaking Caribbean and successfully controlled in all remaining countries. Since 1991 these countries have implemented one-time "catch-up" vaccination campaigns (conducted during a short period, usually 1 week to 1 month, and targeting all children 9 months through 14 years of age, regardless of previous vaccination status or measles disease history). These campaigns have been followed by improvements in routine vaccination services and in surveillance systems, so that the progress of the measles elimination efforts can be sustained and monitored. Follow-up mass vaccination campaigns for children younger than 5 years are planned to take place every 3 to 5 years.

Americas↗