B Acad Nat Med Paris
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B Acad Nat Med Paris · Mar 2016
[Malaria is still a leading cause of fever and death among children and pregnant women in Africa in 2015].
The prevalence and morbidity of P. vivax, P. ovale (curisi et wallikeri) and P. malariae remain underestimated. However important progress has been made. According to the WHO World Malaria report between 2000 and 2015 the malaria incidence has decreased by 42% while the incidence of malaria deaths has decreased by 66%. ⋯ Innovative a robust approach is needed with strong government commitment and partners support to lead battle. A new hope is emerging with the development of candidate vaccine from whole sporozoïte, the other candidates vaccines blocking the transmission in phase 1b and the new SMC Plus strategy (AQ-SP+Azithromycine). Conclusion: lessons learnt from the malaria eradication era in the 50s must be factored in while developing the malaria elimination strategy for Africa by 2030.
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Artemisinin resistance in P. falciparum is spreading in South East Asia and threatens the recent progresses made in the fight against malaria. A race against time has started to eliminate P.falciparum in this region before it becomes resistant to all available treatments. ⋯ The slowly eliminated dihydro-artemisinin and piperaquine is the drug of choice in mass drug administration in the foci of high prevalence of sub-microscopic and asymptomatic infections. Initial results after 18 months of activities are promising: the participation of the population was excellent and there was a sharp reduction of P.falciparum incidence without evidence of worsening resistance.
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Due to major advances in the understanding of iron metabolism as well as in the bioche- iuical, imaging, and genetic domains: i) The nosologicalframework of hemochromatosis (HC) encompasses not only HFE-HC, by far the most frequent HC form, but also non-HFE HC diseases which comprise essentially juvenile HC and the ferroportin disease. ii) The diagnostic approach has become totally non invasive, based on clinical, imaging and biological data. iii) The treatment remains, for most forms, based on venesections, but the innovative emerging therapeutic approach is represented by hepcidin supplementation.
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B Acad Nat Med Paris · Jun 2015
Strategy of translational research on Alzheimer's disease: targets, animal models and biomarkers.
Alzheimer's disease causes severe cognitive alterations in humans and is associated with two main pathologic processes: the β-amyloid and tau pathologies. Imaging biomarkers can reveal the natural history of the disease and show an alteration of glucose metabolism and an evolving cerebral atrophy process. The discovery of new therapies against this disease relies on early stages of drug development that can be evaluated precisely only in animals. ⋯ Animal models can also help to validate new hypotheses on disease mechanisms. We focus here on the protein misfolding hypothesis of Alzheimer as it will probably modulate our vision of the disease in forthcoming years. This hypothesis suggests that native Aβ peptides become toxic when their conformation in alpha helices evolves into a beta-sheet conformation and also suggests that misfolded proteins can transmit their misfolded conformation to normal proteins.
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Pain is a real issue of public health, quality and evolution of a system of health test: this is a major social problem. Pain management meets a humanistic, ethical purpose and dignity of man because of the physical and psychological implications. It induces a disability which excludes the patient of society gradually or suddenly. ⋯ The progress of medicine has helped the healing of certain serious diseases, but also favoured acute diseases to turn to chronic diseases. The result is an increase in of lifetime sometimes without disease, but this survival may be also accompanied by disease or disability. Progress, pain and suffering, the end of life, ethics will be the core of the basic thoughts of tomorrow.