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J Millan

Publications and source records attributed to J Millan.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Changing patterns of gastric cancer mortality in Spain.

Time trends and the geographical variation of mortality from gastric cancer in Spain are analysed. The national (1961-1980) and the provincial (1975-1980) crude death rates as well as the age adjusted death rates were calculated using the population census (years 1960 and 1970) and the figures for national and provincial mortality. Mortality increased until 1963-1965 and then decreased significantly (P less than 0.01). Analysis of the geographic distribution reveals that the mortality rate is significantly higher in the interior than in the coastal provinces of the country, and higher in the provinces over 600 m above sea level.

Altitude↗
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Phenolic glycolipid-1 from M. leprae inhibits oxygen free radical production by human mononuclear cells.

We studied the effect of PGL1, a phenolic glycolipid unique to Mycobacterium leprae, on the activation of the phagocyte oxidative respiratory burst, by measuring the chemiluminescence (CL) generated by normal mononuclear cells. PGL1 induced a decrease in oxygen free radical production stimulated by mycobacteria (M. leprae, BCG and M. kansasii) or by phorbol myristate acetate, but did not prevent the binding or ingestion of fluorescein-conjugated mycobacteria. In contrast, mycoside A from M. kansasii, a structurally related compound, did not alter the CL response. In addition, treatment of M. leprae with anti-PGL1 antibodies failed to restore the response to this microorganism. PGL1 could act as an oxygen species scavenger and protect M. leprae from killing by toxic oxygen metabolites.

Adult↗
PubMedDate not supplied

[Dapsone inhibition of the bactericidal action of rifampicin on Mycobacterium leprae in mice].

In the experimental infection of mice by Mycobacterium leprae, the bactericidal effect of 4 weekly doses of rifampicin (RMP) is completely suppressed if this administration is preceded by a daily treatment of dapsone (DDS) during one month then continued in conjunction with rifampicin. The application of this methodology: the delayed adding of rifampicin clearly shows the bacillary persistence induced by dapsone (DDS). The rifampicin appears to be less effective on Mycobacterium leprae when its metabolism is inhibited either by the action of a drug such as dapsone (DDS), or spontaneously. The highlighting of this late-appearing antagonism between rifampicin and dapsone in mice, should not at present lead to the questioning of the therapeutic procedures recommended by the WHO, because of the limits of this experimental model, namely the small size of bacillary populations studied over relatively short periods of time.

Animals↗
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[The campaign against leprosy in an urban African environment: problems encountered at the level of case-finding and of monitoring of patients in Dakar].

The authors first explain the main epidemiological parameters of leprosy in Dakar, their evolution and their differences with those of the rest of the country. The second part deals with case finding and reveals the essential importance of the voluntary detection which appears as rather early: 3.5% of second degree physical disabilities; 37% of monomacular lesions in the paucibacillary lesions. The third part explains the problems encountered on leprosy control with the study of a cohort of 241 patients: 64% were missing in 4 years and half of them during the first year. At the end of 4 to 6 years, only 19% of the patients had a regular attendance at treatment. The defects are significantly more frequent with the male patients, and with the people who have been residing in Dakar for less than two years. In the suggested solutions, the authors insist on the necessity to adopt short multidrug protocols and to make health education for patients so that they care about case finding with their contacts.

Adolescent↗
PubMedDate not supplied

[Blood typing of a Hansen population in Guadeloupe (F.W.I.)].

The target of this survey carried out in Guadeloupe (F.W.I.) is to search for eventual relationship between leprosy forms and ethnic features--Made in people subjected to same environmental factors, such a study avoids usual bias of investigations on the epidemiological aspect of "racial" factors. The 1522 investigated patients have been divided into 2 categories: allergic paucibacillary (Mitsuda +), and anergic multibacillary (Mitsuda -) patients. -). Three parameters were studied: morphological type empirically determined according to cutaneous pigmentation; ABO blood groups; and Rhesus phenotype. The results bring to the fore: Significant linkage between clinical forms and morphotype: the dominant Caucasian morphological typed subjects, with integument poor in melanin, are more numerous among multibacillary patients. This might confirm high sensitiveness of Caucasians to leprosy. No significant linkage between clinical forms and ABO blood groups. Nevertheless, variations are found already reported in more homogeneous populations: predominance of A group in multibacillary patients, of B and O groups in paucibacillary patients. Significant linkage between clinical forms and Rhesus phenotype. But this link does not seem to be imputable to ethnic factors because clinical forms distribution is the same in ccDee sub-population (the most frequent in West Africa), and in ccddee subpopulation (quite frequent phenotype in West Europe). In fact, only the ccDEe phenotype sub-population is significantly different from all the others, because multibacillary forms are particularly frequent (49.3%) and strike evenly women and men in this sub-population.

ABO Blood-Group System↗
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[5-year assessment of daily multi-drug therapy of leprosy in Guadeloupe since 1980].

In Guadeloupe, from January 1980 to December 1984, 420 leprosy patients were put under daily multidrug therapy: 10 mg/kg RMP plus 100 mg DDS during six months for paucibacillary patients, 10 mg/kg RMP plus 100 mg DDS during 24 months supplemented during the 12 first months with 10 mg/kg of a thioamide, ethionamide or protionamide, for multibacillary patients. The approval to the treatment was satisfactory in all the patients with active leprosy, new cases and relapse cases, less in the inactive patients already treated with dapsone only. The patients's compliance to treatment was satisfactory too. The lepra reactions were observed with a 19% frequency which is not different of the 15% frequency of lepra reactions observed in patients treated with DDS only. Hepatitis were observed only in multibacillary patients treated with PTH and RMP with a 14% frequency. Discontinuing treatment with RMP and PTH but not DDS resulted in recovery. When RMP was resumed without PTH, the hepatitis did not recur. All patients responded favorably under multidrug therapy and no relapse was observed among the 45 paucibacillary patients after a four year-surveillance and among the 16 multibacillary patients after a three year-surveillance.

Dapsone↗
PubMedDate not supplied

[Multi-drug therapy trials for leprosy in Senegal: first observations relative to liver tolerance of multibacillary patients. Therapeutic consequences].

The authors have studied tolerance of multibacillary patients to 4 MDT regimens. These 4 regimens consist of: One supervised part in which RMP-ETH combination in once-monthly administered; furthermore, in 2 of these regimens, is included one "starter phase" with daily doses of that combination for 2 months. One self-administered part during which CLO is associated either to DDS for new cases, or to ETH for relapses. Clinical Supervision: Out to 310 multibacillary patients, 7 cases of hepatitis with or without icterus, but no death due to the treatment. Interruptions of MDT have been temporary and have been observed in 0.9 to 5.6% of the patients according to the therapeutic regimen. Checking SGOT: The SGOT were abnormally high in 16.3% of the patients before treatment. These pre-existing liver damages do not favour the appearance of intolerance disorders. During MDT, abnormal increases in SGOT are observed in 27% of the patients but there is no exact correlation between the absorbed doses of ETH and the frequency in SGOT increases. The clinical or biological evidence of liver damages occur rather early (1st, 2nd month) in regimens with "starter phase", and later (4th-8th month) in those without "starter phase". But introduction of "Starter phase" does not increase the global frequency of such intolerance accidents. ETH combined with RMP, must be used under steady clinical and biological supervision. Recalling the results of a previous survey, the authors consider that a long duration of MDT is not necessary. For the multibacillary leprosy treatment, they propose a diphasic regimen, more easily applicable in the field than the WHO protocols. In this diphasic regimen, the only part which must be supervised is the initial "starter phase" of 2 month. It consists of daily administration of 3 antibacillary drug among which RMP and ETH. The second phase is a relay treatment using 2 drugs, CLO combined with DDS or ETH, self-administered until smear negativity.

Adolescent↗
PubMedDate not supplied

[Clinical and bacteriological assessment 8 years after triple-drug therapy for multibacillary leprosy in Senegal].

Increasing resistance to dapsone (DDS) leads to recommend triple drug chemotherapy (TCT) in multibacillary leprosy (ML). To determinate long term evolution, we evaluated patients who received TCT 8 years ago. Between 1974 and 1976, 30 patients with ML received TCT (rifampicin, prothionamid, and DDS) during 6 or 12 months. At this time satisfactory clinical and bacteriological findings were reported, and from then DDS was given alone. Twelve of the thirty patients have been evaluated in 1983. Six patients had bacteriological index greater than or equal to 2+, three of them had clinical relapse. Seven of the twelve patients did not take regularly DDS; the six relapses belong to this group.

Adolescent↗
PubMedDate not supplied

[Practical problems encountered in the multi-drug therapy of leprosy in Senegal].

The authors make an inventory of the difficulties they have met while realizing the different stages of MDT treatment programmes in Senegal. Main problems were: Necessity of complementary training on theoretical, but even more on practical techniques for all the staff: Ridley and Jopling classification, neurological examination, bacteriological examination, data collection. Difficulty to maintain a true supervision. Necessity to settle a quality control of slit skin smears. Necessity to settle a system to trace irregular patients. Heaviness of centralized management, but its necessity to maintain "tightness" of the drugs distribution network. Difficulty to obtain a regular follow up of patients who are released for treatment. The evolution of anti-leprosy activities makes it necessary to adapt the "Service des Grandes Endémies".

Dapsone↗