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Sleep medecine

Francesco Checchi, Sebastian Funk, Daniel Chandramohan, François Chappuis, Daniel T Haydon
Gambiense Human African Trypanosomiasis (HAT), or sleeping sickness, is a vector-borne disease affecting largely rural populations in Western and Central Africa. The main method for detecting and treating cases of gambiense HAT are active screening through mobile teams and passive detection through self-referral of patients to dedicated treatment centres or hospitals. Strategies based on active case finding and treatment have drastically reduced the global incidence of the disease over recent decades. However, little is known about the coverage and transmission impact of passive case detection...
April 6, 2018: PLoS Neglected Tropical Diseases
M Kherbouche, D Bendaoud, R Bali, F Mouassaoui, A Meziane Tani
OBJECTIFS: Nous exposons un recueil de 2 cas cliniques montrant les différences de thérapeutiques entre un syndrome d'apnée du sommeil avec Hypertension artérielle systémique seule versus un autre cas de syndrome d'apnée du sommeil avec à la fois une hypertension artérielle systémique et une hypertension pulmonaire. le suivi tant clinique qu'écho-cardiographique du syndrome d'apnée du sommeil bien que parait simple, cache de multiples pièges qu'il faut savoir les rechercher d'une façon méthodique...
December 2015: Annales de Cardiologie et D'angéiologie
Haruki Yamada, Fumiko Hirabayashi, Chris Brünger
The Drugs for Neglected Diseases initiative (DNDi), with headquarters in Geneva, is a non-profit drug research and development (R&D) organization and Product Development Partnership (PDP) which was established in 2003 by 7 founding organizations such as Médecins Sans Frontières (MSF), the Pasteur Institute, The Specific Programme for Research and Training in Tropical Diseases (WHO-TDR), etc. DNDi has worked mainly on the development of new treatments for neglected tropical diseases (NTDs), which is difficult to achieve under market economy conditions...
2016: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
T Albuquerque, P Isaakidis, M Das, P Saranchuk, A Andries, D P Misquita, S Khan, S Dubois, C Peskett, M Browne
BACKGROUND: Mumbai has a population of 21 million, and an increasingly recognised epidemic of drug-resistant tuberculosis (DR-TB). OBJECTIVE: To describe TB infection control (IC) measures implemented in households of DR-TB patients co-infected with the human immunodeficiency virus (HIV) under a Médecins Sans Frontières programme. METHODS: IC assessments were carried out in patient households between May 2012 and March 2013. A simplified, standardised assessment tool was utilised to assess the risk of TB transmission and guide interventions...
March 21, 2014: Public Health Action
G Bettega, P Breton, P Goudot, F Saint-Pierre
No abstract text is available yet for this article.
February 2015: Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Charles Dussault, Nathalie Saad, Johanne Carrier
Since 1 July 2012, as a result of a labour arbitration ruling in the province of Quebec and the subsequent agreement negotiated by the Fédération des médecins résidents du Québec, all 3,400 medical residents training in Quebec have been on a 16-hour duty schedule for in-house calls. This is a major change within medical teaching sites, as well as a professional and educational challenge for physicians-in-training and their supervisors. The Quebec ruling now raises similar issues for all medical residents in Canada because of its legal basis, namely the Canadian Charter of Rights and Freedoms...
2014: BMC Medical Education
Cara S Kosack
In medical humanitarian assistance, the diagnosis of diseases plays a crucial role. Laboratory investigations are one of the main diagnostic tools utilized in Médecins Sans Frontières' (MSF) programs. Currently MSF supports and/or operates more than 130 laboratories in approximately 45 countries. The variety of analysis offered depends largely on the context of the program and the availability of context adapted tools and ranges from sophisticated laboratories specializing in tuberculosis culture to small laboratories within a primary health care program or operating as mobile clinics...
July 2012: Clinical Chemistry and Laboratory Medicine: CCLM
Francesco Checchi, Andrew P Cox, François Chappuis, Gerardo Priotto, Daniel Chandramohan, Daniel T Haydon
BACKGROUND: Active case detection through mass community screening is a major control strategy against human African trypanosomiasis (HAT, sleeping sickness) caused by T. brucei gambiense. However, its impact can be limited by incomplete attendance at screening sessions (screening coverage) and diagnostic inaccuracy. METHODS: We developed a model-based approach to estimate the true prevalence and the fraction of cases detected during mass screening, based on observed prevalence, and adjusting for incomplete screening coverage and inaccuracy of diagnostic algorithms for screening, confirmation and HAT stage classification...
2012: Parasites & Vectors
Francesco Checchi, François Chappuis, Unni Karunakara, Gerardo Priotto, Daniel Chandramohan
BACKGROUND: Algorithms to diagnose gambiense human African trypanosomiasis (HAT, sleeping sickness) are often complex due to the unsatisfactory sensitivity and/or specificity of available tests, and typically include a screening (serological), confirmation (parasitological) and staging component. There is insufficient evidence on the relative accuracy of these algorithms. This paper presents estimates of the accuracy of five algorithms used by past Médecins Sans Frontières programmes in the Republic of Congo, Southern Sudan and Uganda...
July 2011: PLoS Neglected Tropical Diseases
Jacqueline Tong, Olaf Valverde, Claude Mahoudeau, Oliver Yun, François Chappuis
BACKGROUND: Human African trypanosomiasis (HAT), or sleeping sickness, is a fatal neglected tropical disease if left untreated. HAT primarily affects people living in rural sub-Saharan Africa, often in regions afflicted by violent conflict. Screening and treatment of HAT is complex and resource-intensive, and especially difficult in insecure, resource-constrained settings. The country with the highest endemicity of HAT is the Democratic Republic of Congo (DRC), which has a number of foci of high disease prevalence...
2011: Conflict and Health
Andreas K Lindner, Gerardo Priotto
BACKGROUND: Children with human African trypanosomiasis (HAT) present with a range of generally non-specific symptoms. Late diagnosis is frequent with often tragic outcomes. Trypanosomes can infect the foetus by crossing the placenta. Unequivocal cases of congenital infection that have been reported include newborn babies of infected mothers who were diagnosed with HAT in the first 5 days of life and children of infected mothers who had never entered an endemic country themselves. METHODS: This review systematically summarizes the literature on the vertical transmission of HAT, to our knowledge for the first time...
2010: PLoS Neglected Tropical Diseases
Sarah-Gabrielle Béland, Michel Préville, Marie-France Dubois, Dominique Lorrain, Philippe Voyer, Cindy Bossé, Sebastien Grenier, Yola Moride
BACKGROUND: Sleep disturbances are frequently reported in the older adult population and benzodiazepines are the drugs most often prescribed to treat these problems. Nearly 25% of the older adult population uses these drugs and 83% of benzodiazepine users report sleep problems. Although the Collège des Médecins du Québec suggests a maximum length of use of 3 months, according to most studies the mean length of benzodiazepine use is longer. The goal of this study was to document the association between length of benzodiazepine use and sleep quality as reported by adults 65 years older and over...
September 2011: International Journal of Geriatric Psychiatry
, , , , , et al.
No abstract text is available yet for this article.
September 2010: Revue des Maladies Respiratoires
Sibylle Gerstl, Sophie Dunkley, Ahmed Mukhtar, Peter Maes, Martin De Smet, Samuel Baker, Jacob Maikere
OBJECTIVE: Médecins Sans Frontières (MSF) runs a malaria control project in Bo and Pujehun districts (population 158 000) that includes the mass distribution, routine delivery and demonstration of correct use of free, long-lasting insecticide-treated nets (LLINs). In 2006/2007, around 65 000 LLINs were distributed. The aim of this follow-up study was to measure LLIN usage and ownership in the project area. METHODS: Heads of 900 randomly selected households in 30 clusters were interviewed, using a standardized questionnaire, about household use of LLINs...
April 2010: Tropical Medicine & International Health: TM & IH
Gerardo Priotto, Serena Kasparian, Wilfried Mutombo, Daniel Ngouama, Sara Ghorashian, Ute Arnold, Salah Ghabri, Elisabeth Baudin, Vincent Buard, Serge Kazadi-Kyanza, Médard Ilunga, Willy Mutangala, Gabriele Pohlig, Caecilia Schmid, Unni Karunakara, Els Torreele, Victor Kande
BACKGROUND: Human African trypanosomiasis (HAT; sleeping sickness) caused by Trypanosoma brucei gambiense is a fatal disease. Current treatment options for patients with second-stage disease are toxic, ineffective, or impractical. We assessed the efficacy and safety of nifurtimox-eflornithine combination therapy (NECT) for second-stage disease compared with the standard eflornithine regimen. METHODS: A multicentre, randomised, open-label, active control, phase III, non-inferiority trial was done at four HAT treatment centres in the Republic of the Congo and the Democratic Republic of the Congo...
July 4, 2009: Lancet
E d'Alessandro
In this article, we propose a history of Médecins Sans Frontières's control activities to fight human african trypanosomiasis. Through this history are enlightening medical innovations in the scope of diagnostic and treatment of the disease. MSF investing will focus successively on (1) epidemiological and clinical diagnosis, (2) existing drugs evaluation and (3) development of new therapeutic protocols. After a period of isolation, MSF will have to cooperate with others international health organizations...
February 2009: Bulletin de la Société de Pathologie Exotique
Manica Balasegaram, Heather Young, François Chappuis, Gerardo Priotto, Marie-Eve Raguenaud, Francesco Checchi
This paper describes the effectiveness of first-line regimens for stage 2 human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense infection in nine Médecins Sans Frontières HAT treatment programmes in Angola, Republic of Congo, Sudan and Uganda. Regimens included eflornithine and standard- and short-course melarsoprol. Outcomes for 10461 naïve stage 2 patients fitting a standardised case definition and allocated to one of the above regimens were analysed by intention-to-treat analysis. Effectiveness was quantified by the case fatality rate (CFR) during treatment, the proportion probably and definitely cured and the Kaplan-Meier probability of relapse-free survival at 12 months and 24 months post admission...
March 2009: Transactions of the Royal Society of Tropical Medicine and Hygiene
Francesco Checchi, João A N Filipe, Daniel T Haydon, Daniel Chandramohan, François Chappuis
BACKGROUND: The durations of untreated stage 1 (early stage, haemo-lymphatic) and stage 2 (late stage, meningo-encephalitic) human African trypanosomiasis (sleeping sickness) due to Trypanosoma brucei gambiense are poorly quantified, but key to predicting the impact of screening on transmission. Here, we outline a method to estimate these parameters. METHODS: We first model the duration of stage 1 through survival analysis of untreated serological suspects detected during Médecins Sans Frontières interventions in Uganda and Sudan...
2008: BMC Infectious Diseases
Gerardo Priotto, Serena Kasparian, Daniel Ngouama, Sara Ghorashian, Ute Arnold, Salah Ghabri, Unni Karunakara
BACKGROUND: Human African trypanosomiasis caused by Trypanosoma brucei gambiense is a fatal disease. Current treatment options for patients with second-stage disease are either highly toxic or impracticable in field conditions. We compared the efficacy and safety of the nifurtimox-eflornithine drug combination with the standard eflornithine regimen for the treatment of second-stage disease. METHODS: A randomized, open-label, active-control, phase III clinical trial comparing 2 arms was conducted at the Sleeping Sickness Treatment Center, which was run by Medecins Sans Frontieres, in Nkayi, Bouenza Province, Republic of Congo...
December 1, 2007: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Natacha Protopopoff, Michel Van Herp, Peter Maes, Tony Reid, Dismas Baza, Umberto D'Alessandro, Wim Van Bortel, Marc Coosemans
BACKGROUND: African highlands often suffer of devastating malaria epidemics, sometimes in conjunction with complex emergencies, making their control even more difficult. In 2000, Burundian highlands experienced a large malaria outbreak at a time of civil unrest, constant insecurity and nutritional emergency. Because of suspected high resistance to the first and second line treatments, the provincial health authority and Médecins Sans Frontières (Belgium) decided to implement vector control activities in an attempt to curtail the epidemic...
2007: Malaria Journal
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