Méningites à pneumocoque : actualités,perspectives

Streptococcus pneumoniae is the most frequent cause of severe meningitis in adults. Effective antibiotic treatment must be given early, before lumbar puncture, even if a CT scan is needed. In France, 40% of pneumococci have a decreased susceptibility to penicillin. As a consequence, the recommended probabilistic treatment is the association of a third-generation cephalosporin and vancomycin. Neurological complications are the consequence of cytotoxic and vasogenic cerebral edema. Until now corticosteroids have failed to improve the prognosis of patients with pneumococcal meningitis. Other treatments, such as anti-TNF antibodies or antioxidants, seem to be able to decrease the risk of cerebral damages in some experimental models.     

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Hypertension Portale Portal Hypertension

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Nouveautés Produits

Nouveautés Produits

Nouveautés Produits     

Nouveautés Produits

Nouveautés Produits

Nouveautés Produits     

Nouveautés Produits

Nouveautés Produits

Nouveautés Produits     

Particularités des polytraumatisés à l’égard des infections nosocomiales

Severe infection is a major cause of late mortality in trauma patients. Devitalized tissues and invasive procedures facilitate entry of pathogens. The increase rate of infections is favoured by the attenuation of innate and acquired immune function. This immune dysregulation follows a systemic inflammatory response syndrome (SIRS), parallels the severity of injury, the magnitude of shock and may be influenced by the choice of resuscitation strategy. The identification of trauma patients with sepsis is rather difficult facing an acute SIRS, making useful some biological indicators of sepsis, such as procalcitonin. Ventilator-acquired pneumonia is the most frequent infectious complication in trauma patients. Early pneumonias within the first few days represent 50 to 80% of the disease and result from aspiration at the time of injury. Upper airways colonization with pathogens represents the reservoir for subsequent lower respiratory tract infection and provides the rationale for selective digestive decontamination which decreases the incidence of pneumonias and reduces the mortality in the critically injured patients. The mortality attributable to post-traumatic nosocomial pneumonia is lower than in other medical and surgical populations. Beside an early detection of at-risk patient, the combination of a high standard of clinical care with some new immunomodulation approaches may be considered as a future rational strategy to reduce septic complications in trauma patients.     

Évaluation des propriétés hémostatiques et hypocholestérolémiantes des feuilles de <Emphasis Type="Italic">Spondias mombin L</Emphasis> (Anacardiaceae)

Postpartum hemorrhage remains health problem observed in maternity. In Sub-Saharan Africa, traditional phytotherapy propose plants reputed to manage postpartum bleeding. Spondias mombin is one of Togolese plant used by rural folk to stop hemorrhage at the time of complicated deliverances. The aim of this present work is to evaluate the effects this plant on some haemostatic parameters and on cholesterolemia in order to justify its traditional use to struggle post-partum hemorrhage. Tests are performed on Sprague-Dawley female rats and show an increase of hematocrit, of formed elements of blood and of hemoglobin level at rats fed with extract compared to their control. The extract exhibits an anti-fibrinolytic property. Cholesterolemia was decreased at immature rats which were fed with extract in relation to their respective control.