Presse Med
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Review Randomized Controlled Trial Clinical Trial
[Type 2 diabetes: new therapeutic perspectives].
UKPDS: The results of the United Kingdom Prospective Diabetes Study (UKPDS) were reported in 1998. This multi-center, prospective, randomized, intervention trial of 5102 newly-diagnosed patients with type 2 diabetes mellitus was aimed at determining whether improved blood glucose control can prevent complications and reduce associated morbidity and mortality.
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CAUSAL AGENTS: Several Borrelia burgdorferi sensu lato species have been recently described which cause different clinical forms of Lyme disease. B. garinii is implicated in neurological forms, B. burgdorferi sensu stricto in articular forms and B. afzelii in late cutaneous forms. ⋯ NUMEROUS CLINICAL TRIALS: A recently proposed classification of the European forms of Lyme disease is based on clinical presentation: contagious conditions or erythema migrans, early neurologic or cardiologic complications, late articular, neurologic or cutaneous complications. Therapeutic proposals should be guided by the results of European trials, taking into account this classification.
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TWO WELL-KNOWN AGENTS: Although the activity of amantadin and rimantadin against type A Myxovirus influenzae are well known, use is still limited. These agents only have a moderate curative effect and, though they are more effective for prophylaxis, can only be used in cases with a certain positive diagnosis, which is difficult to obtain. In addition, questions remain concerning tolerance which is not always excellent, particularly for amantadin.
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CHANGING EPIDEMIOLOGY: During the last half of the 20th century, dengue has spread to most countries in the inter-tropical zone and today is the most common cause of human arbovirus infection. In tropical zones, dengue is a frequent cause of fever and can be observed in travellers returning from an endemic zone.
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Paragonimiasis, caused by a lung fluke, is an parasitic disease rarely encountered in France. ⋯ The clinical and radiographic features of paragonimiasis are often similar to tuberculosis with pleuropneumopathy, mild fever and dyspnea. ELISA has now replaced parasitologic diagnosis. Cure is achieved with praziquantel.