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Biomedical subjects

J Millan

Publications and source records attributed to J Millan.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

[Resistance of Mycobacterium leprae to dapsone and rifampicin: apropos of a survey carried out in the Cape Verde region (Senegal)].

Since 1983, primary resistance of M. leprae to DDS and rifampicin has been evaluated in new cases of lepromatous leprosy observed in the Cap-Verde region in Senegal. Out of the 13 strains isolated, 10 (77%) have been found resistant to DDS, 7 at low level, 2 at intermediate level, 1 at high level; all of them have been found sensible to rifampicin. Similar results have been obtained with 57 strains isolated from patients not yet treated coming from different geographical areas, seeing that 37, i.e. 65%, were resistant to DDS, 27 at low level, 5 at intermediate level and 5 at high level; all of them were sensible to rifampicin. Level of resistance to DDS is very different in case of acquired resistance. In 69 lepromatous patients treated for more than 5 years and showing a relapse, M. leprae was 62 times, i.e. 90%, resistant to DDS, 6 times at low level, 21 at intermediate level and 35 at high level; in addition, 13 times M. leprae was resistant to rifampicin. In order to avoid and to solve problems set by resistance of M. leprae to antibiotics, strict application of polychemotherapy of leprosy is compulsory.

Dapsone↗
PubMedDate not supplied

[Anti-BCG antibody titers in healthy and leprous Africans. Value of an indirect immunoperoxidase test].

An immunoperoxidase reaction was used for the titration of immunoglobulins G and M antibodies to BCG in 171 leprosy patients from Dakar. The results show mean titers decreasing from lepromatous to tuberculoid cases. The antibody profiles of some clinical forms such as reverse reactions, erythema nodosum leprosum are discussed. This test associated to the Mitsuda reaction, bacteriology and histology should allow an easier classification of the borderline forms. The main advantages of the technique are simplicity, speed, low cost and the easy availability of the BCG. These qualities are essential in endemic zone.

Antibodies, Bacterial↗
PubMedDate not supplied

[A trial of polychemotherapy of leprosy in the Dakar region. Initial observations on the acceptability of the protocols used].

Since 1982, in Dakar, a controlled essay tests the suitability of several short protocols of multidrug therapy (MDT), some of them being close to those advised by the WHO, others showing a starter stage of a two month daily MDT. In three years, 198 paucibacillary and 123 multibacillary patients have been treated. The short duration of these treatments leads to an important decrease in the load of the Department. The total rate of those who have not attended for the treatment is of 15.2% whereas it was of 52% with DDS monotherapy for a similar treatment duration. Those who gave up don't seem to live in Dakar. To judge by the diligence of the patients, the compliance seems excellent even for the protocols requiring a daily dose of ethionamide: 95% of paucibacillary, 76% of multibacillary patients have maximal attendance. The authors think that any MDT program: must be preceded by a retraining of staffs; must give a priority to the health education of the patients; must involve a home patient search for system.

Adolescent↗
PubMedDate not supplied

[A survey for school screening in Senegal: considerations on the usefulness of this screening method and on the importance of endemicity among the youthful population of leprosy villages].

A mass case-finding survey has been carried out among the pupils as a test measure: in an ordinary rural village: 2204 examined children; prevalence rate of leprosy: 0.90 per 1000; in two leper villages: 333 examined children; prevalence rate of leprosy: 125 per 1000. The authors have emphasized: the difficulty of school survey and the necessity to entrust a skilled staff with this job. The general low prevalence of leprosy cases with children in Senegal: 0.96 per 1000, inferior to the threshold of 4 per 1000 above which school survey is advised to be carried out. The high prevalence rate of leprosy with the children of the leper villages (140 times as much as general prevalence rate). This situation could be the result of: the inefficiency of the chemoprophylaxis by DDS; the existence of primary resistance cases to DDS (some of them clinically proved), consequence of the numerous secondary resistance cases which have already been witnessed in these villages.

Adolescent↗
PubMedDate not supplied

[The value of electromyographic studies in leprosy].

In Dakar, during a definite period of time, all the new leprosy cases have been subjected to an electromyographic examination before treatment: a total of 37 patients and 518 examined nerves including all clinical forms: NCV: 33% of the examined nerves are found to be affected. The sensory nerves are frequently and early involved. In frequency order: sural (54%), posterior tibial (50%), sensory ulnar (35%), sensory median (29%), motor ulnar (28%), lateral popliteal (17%) and motor median (12%). The study of the SCV seems relatively more reliable than the sensory testing in the case of the ulnar and the median (75 comparisons): concordance in 69% of the cases; SCV only abnormal in 19%; sensory testing only abnormal in 12%. The EMG detection is superior to the motor testing and to the motor nerve conduction for the lateral popliteal (32 comparisons): 41% of concordant examination; 59% of differences among which 44% of anomalies revealed only by detection.

Adult↗
PubMedDate not supplied

[Prevention of perforating plantar ulcers: trial directed by a mobile team].

AIMS: to prevent the appearance of plantar ulcerations and then mutilations, by going in the field in order to: make suitable footwear, educate the patients, train the paramedical staff. Means: 1 fitted lorry, 1 physiotherapist, 1 shoemaker, and 1 educator. RESULTS: In one year, 206 patients have been provided with shoes and followed up. Advice have been taken exactly in the leper villages in which the attendance rate is of 98%; this rate varies between 47 to 70% in the all-purpose dispensaries. Paramedical workers of all-purpose Health Centers did not take great interest in this action. After 6-12 months under observation: 84% of good results for the feet without deformity or slightly deformed; 51% for the deformed feet. The results are quite satisfactory for the feet without plantar ulcer at the beginning, and that whatever the food deformity stage. But for the feet wounded by plantar ulcer at the beginning, 33% of recovery have been reported after wearing these shoes.

Foot Deformities, Acquired↗
PubMedDate not supplied

[HLA and leprosy in Dakar: distribution of histocompatibility antigens in leprous patients and their relationship to ENL reactions].

50 lepromatous patients among whom 34 shared repeating ENL reactions and a reference group of 150 blood donors were typed for HLA antigens. In the comparison of the lepromatous group to the reference group, the HLA-B 8 was the only antigen which turned out to be significantly increased within the lepromatous patients. Some changes reported by other authors have also been pointed out (decrease in HLA-A2 and HLA-A3, increase in HLA-AW 23 within the lepromatous patients) but those are not significant in this study. In the lepromatous group itself, not any significant change has been pointed out between the patients sharing ENL and those who did not show any. Nevertheless a non-significant increase in HLA-BW 35 in the patients with ENL is to be pointed out.

Adult↗
PubMedDate not supplied

[Analysis of the results of treatment of Hansen's neuritis].

The authors expose a retrospective study about 133 nervous contingents treated exclusivement by steroid-therapy. The objective is to study the influence on nerve-function recovery of the following parameters: clinic form, function (sensitive or motor) of the nerve, position of the nerve (ulnar, median...), nature of the antibiotherapy. The method is based on the comparison for average progress in relation with the initial score. It appears that tuberculoid nerves recovery is better and faster than the lepromatous one. But lepromatous nerves improvement keeps on the end of the second year. On the other hand, the results are not influenced by the nerve itself or its function. Concerning antibiotherapy, our results show à significant difference, in consideration of a better improvement in PCT-treated nerves. Nevertheless, these results have to be confirmed by a comparative experimentation.

Drug Therapy, Combination↗