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Biomedical subjects

R Laroche

Publications and source records attributed to R Laroche.

At least 19 recordsLinked to original sources

Lesser metatarsal stress fractures.

Stress fractures continue to be a fact of military life. With appropriate attention to training issues, shoe gear, and physical training activities, however, their effect can be minimized.

Fractures, Stress↗

[Current status of dengue virus infections. Epidemiologic and pathogenetic aspects].

The epidemiology of dengue fever is changing dramatically. The worldwide incidence is rising and clinical symptoms are worsening. Reports describing forms associated with hemorrhage or shock syndrome involving both children and adults are increasingly frequent in regions beyond Southeast Asia where the first cases were observed. Many mechanisms could be implicated in these changes including modifications of the virus, host, vector, or socioeconomic factors. Since no current model allows laboratory analysis of these mechanisms, observation of epidemics is still a major source of data. The findings of well conducted epidemiological studies allow not only assessment of morbidity and mortality in endemic areas and early detection of epidemic outbreaks but also evaluation of socioeconomic impact and effectiveness of control measures. Surveillance techniques must be chosen in function of prevailing local conditions. To ensure reliable results studies should be carried out in collaboration with an international network and a simple and accurate method of disease identification should be used.

Adult↗

[Malaria epidemic during a military-humanitarian mission in Africa].

A malaria epidemic broke out among French servicemen during a humanitarian military mission carried out in Central Africa in 1996. The purpose of this study was to determine compliance with drug prophylaxis for malaria by measuring blood levels of antimalarial drugs (combination treatment using chloroquine-proguanil or treatment with doxycycline) as well as to assess the conditions of vector control. The incidence density rate of malaria over a 60-day period was 3.1 cases per month per 100 men. Only reinforcement troops were affected. The risk of developing malaria was 5 times higher among new arrivals than in servicemen who had been in the zone for several months (95% CI relative risk = [2.9-7.8]). Type of prophylactic treatment had no effect on the incidence density rate. Study data showed that 40.2% of those treated for malaria were not in compliance with prophylactic treatment at the time of the malarial attack and that those who were in compliance with prophylaxis, i.e. the remaining 59.8%, presented a strain of plasmodium that was resistant to the prophylactic drugs at doses used. Findings also indicated the epidemic occurred mainly because operating conditions prevented implementation of proper vectorial control. The risk of epidemic could probably have been reduced by improving compliance with prophylactic treatment and changing standard vectorial control techniques, e.g. by using insecticide-treated uniforms.

Africa, Central↗

[Drinking water for troops in the field].

To provide for Armed Forces' water wants, drinking water is only used. Its production is not an easy thing in military operations. Armed Forces must use their own production means. Four new individual and collective field purification systems adapted to manpower, will been soon in use in the French Army. Filtration or distillation processes always with chlorine addition are used. The results give satisfaction in bacterial epuration; nevertheless chemical and nuclear risks are not controlled except in case of distillation mechanism associated with ion resins exchanging and charcoal filtration.

France↗

[In vitro production of specific antibodies: preliminary results].

In vitro production of specific antibodies or IVPA is a technique that involves isolating mononuclear cells from blood, placing them in culture, and detecting antibodies in the culture supernatant. The presence of antibodies confirms active production by B lymphocytes and is proof of ongoing infection. To validate this technique for routine laboratory use, we tested 16 subjects: 11 for toxoplasmosis and cytomegalovirus and 5 for viral hepatitis type A or B. The results obtained using IVPA were compared with those obtained using conventional serologic methods. IVPA documented IgM for cytomegalovirus in the only subject in whom serology showed IgM for that virus. The test was also positive in 2 subjects undergoing vaccination for viral hepatitis type B and suffering from acute viral hepatitis type A. These concordant results demonstrate that IVPA is a valuable adjuvant technique for diagnosis of ongoing infection especially insofar as it avoids the need for antibody kinetic studies or isolation of the virus. It also provides a simpler and less expensive alternative to gene amplification and cell culture.

Acute Disease↗

Exocrine pancreatic secretion in normal controls and chronic calcifying pancreatitis patients from Burundi: possible dietary influences.

Pure pancreatic juice composition was studied, after secretin and cerulein stimulation in 29 people from Burundi (Central Africa): 17 controls and 12 alcoholic chronic pancreatitis (CP) patients. Results were compared to similar data in France. African controls had a similar pancreatic response to hormones apart from a much lower lipase secretion than French controls. In the early non-calcified stage of African CP water and bicarbonate secretion were markedly diminished while protein and lipase concentrations were enhanced. In the late stage, secretion was exhausted except that of calcium. Nutritional data were obtained under the same conditions in 40 African controls and in 34 CP patients (including all patients tested for secretion). African controls had a very low fat intake (35.2 +/- 2.6 g/day), and patients had a higher protein and fat intake (144.7 +/- 5.9 and 66.2 +/- 4.8 g/day, respectively) than local controls: as in other countries, CP was associated with a diet enriched in alcohol, fat and protein.

Adult↗

[Current role of doxycycline in the chemoprophylaxis of Plasmodium falciparum malaria].

In countries where chemoresistance of Plasmodium falciparum is high (group III), mefloquine must be advocated for malaria prophylaxis for a stay less than 3 months. If it is more and particularly in Indo-china peninsular countries (Thailand, Birmania, Kamputchéa, Laos, Vietnam) and in Amazonia, advocated chemoprophylaxis is doxycycline 100 mg per day. Authors remind action mechanism, contraindication and side effects of this drug. Others publications underline the good tolerance of doxycycline now used by 1,400 french soldiers staying for 6 months with United Nations Organisation in Kamputchéa. An evaluation of tolerance and efficiency of this chemoprophylaxis is now in progress.

Asia, Southeastern↗

[Acute necrotizing eosinophilic myocarditis. Favorable clinical course after heart transplantation].

A case of acute eosinophilic myocarditis without hypereosinophilia, presenting as hypokinetic dilated cardiomyopathy in a 24-year old man is reported. Sudden worsening of subacute cardiac failure required heart transplantation 3 months after the onset of the disease. Only pathological examination provided the diagnosis of acute necrotizing eosinophilic myocarditis of undetermined origin. Two years after transplantation, the patient had no clinical or histological sign of recurrence. Seldom described in the literature, acute eosinophilic myocarditis is a dangerous form of eosinophilic heart disease which often follows a fulminant course beyond all therapeutic resources. This case, which is particular in its clinical presentation, in the lack of hypereosinophilia and above all in its cure after heart transplantation, enables the authors to discuss the mechanisms and various manifestations of the cardiotoxicity of eosinophils.

Acute Disease↗