B Acad Nat Med Paris
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B Acad Nat Med Paris · Jan 2004
Review[Advances in comparative pathology: some zoonoses threatening man].
The last major human epidemics of infectious diseases have arisen from animals. Some of them are especially threatening. ⋯ They underline the role of animals in the epidemiology of SARS, West Nile virus, hepatitis E, NIPA and Hendra virus, ehrlichiosis and Lyme disease. The authors recommend health surveillance not only in humans but also in animals; the teaching of zoonoses, and research on animal diseases transmissible to humans.
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B Acad Nat Med Paris · Jan 2004
Review[The (pro)renin receptor: biology and functional significance].
Our model of the renin-angiotensin system has become increasingly complex with the identification of new components and additional roles for angiotensin peptides and their receptors. A functional (pro)renin receptor has been cloned. It acts as (pro)renin co-factor on the cell surface, enhancing the efficiency of angiotensinogen cleavage by (pro)renin and unmasking prorenin catalytic activity. ⋯ Immunofluorescence studies have located the receptor on mesangial and vascular smooth-muscle cells in human heart and kidney. This suggests that the renin receptor may represent a mean of capturing (pro)renin from the circulation and concentrating it at the interface between smooth-muscle and endothelial cells. This recent discovery of a functional (pro)renin receptor forces the emergence of a new concept that casts renin as potentially playing a direct role in tissue damage, especially in situations where the tissue RAS is activated.
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Sickle cell disease is an inherited disease characterized by the presence of an abnormal haemoglobin. It is the more prevalent genetic disease at birth in Ile-de France area. Sickle cell disease can be complicated by acute vaso-occlusive crisis, chronic visceral involvement related to ischemic process, and infectious complications. ⋯ It mainly manifests by osteoarticular pain and acute chest syndrome and can be complicated by multiorgan failure. Acute vaso-occlusive crisis can be also manifested by priapism, ischemic or haemorrhagic stroke, or abdominal pain. The main treatment of severe acute vaso-occlusive crisis is based on transfusion.
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B Acad Nat Med Paris · Jan 2004
[Necrotizing soft tissue infections: role of the localization for the antibiotic management].
Necrotizing soft tissue infections (NSTI) are infrequent but life-threatening, and require prompt empirical antibiotic therapy. Current nosologic classifications have limited value because the criteria used are imprecise and their bacteriological specificity is uncertain. The aim of this study was to describe the bacterial flora and its antibiotic sensitivity in a cohort of patients with NSTI, and to derive guidelines for the choice of antimicrobial chemotherapy. ⋯ These results suggest that the choice of antibiotic therapy for NSTI should depend on the anatomical site of involvement rather than the nature of the infection. For abdominal, perineal and limb NSTI, we recommend first-line treatment with a betalactam-inhibitor combination (piperacillin/tazobactam or ticarcillin/clavulanate) plus an agent active on gram-negative species (aminoglycoside or fluoroquinolone). For cervical NSTI, we recommend penicillin G/metronidazole, or amoxicillin/clavulanic acid.
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B Acad Nat Med Paris · Jan 2004
[Prognosis after acute coronary syndrome. Lack of difference according to the sex].
Acute coronary syndromes (ACS) represent a continuum from unstable angina to non-ST-elevation myocardial infarction. ACS is the preferred diagnostic term for non transmural myocardial infarction. The different forms of ACS share a common anatomic substrate consisting of atherosclerotic plaque rupture or erosion, with variable degrees of thrombus formation and compromised blood flow to viable myocardium. ⋯ Previous studies have shown increased morbidity and mortality associated with recurrent ischemia and myocardial infarction in women after acute revascularization for ACS. Our study confirms that aggressive revascularization offers a comparable survival benefit in the two sexes. Women with ACS who are at high risk derive the same benefit as men from early angioplasty and coronary stenting of the culprit lesion, with satisfactory in-hospital and mid-term outcomes.