[Quinquina and man].

Many great discoveries have been made by chance but some have been the result of human perseverance and ingenuity. A sterling example of the second case is quinquina that was discovered in Peru and is now produced in Java. Quinquina has gone through centuries without losing its medical efficacy that efficacy allowed the exploration and colonization of Africa and played a key role in the ability to conduct overseas military campaigns.

[Urinary tract infection in an urban population: etiology and antibiotic sensitivity as a function of patient history].

Objective: The aim of this study was to explore the relationship between etiological factors, bacterial isolates and Escherichia coli susceptibility to antibiotics in ambulatory patients with urinary tract infection.

Patients And Methods: A prospective study was conducted in 13 private medical laboratories in France in March 1998. Data were collected on 658 cases involving 679 strains in ambulatory patients with urinary tract infections.

[Importance of the "Personal Serologic Immunization Card" among travelers].

The "Personal Immunization Card" is entering more and more in practice, even though its existence is not yet acknowledged. One of his advantages is to consider the travel medicine counsellor on one hand and the travelling adult on the other hand, being able to take a licit decision in account to informative data. That means to give the two actors-guarantors of the compliance--the responsibility in Public Health, in a domain considered until now in the same way as that of vaccinations in Infancy.

Antibodies directed against a variable and neutralizable region of the HTLV-I envelope surface glycoprotein.

The majority of neutralizing antibodies of HTLV-I are directed against linear epitopes of the envelope surface glycoprotein (gp46) in the immunodominant region 175-199. Although gp46 presents a remarkable degree of conservation, the substitution of the proline at position 192 by a serine is described for 10 isolates among the 54 sequenced ones. This amino acid substitution is known to induce an important change in the orientation of the exposed residues of this region and has drastic consequences on the immunogenicity of the neutralizable epitopes located in this region.

[Information communication to travelers, the French and Belgian experiences].

Providing relevant and up-to-date information to professionals and the general public is possible through many existing as well as developing means of communication including telephone and faxing, databases, answering machines and internet. Professionals may use information networks in order to harmonize advice given to their patients or clients. An exchange may also be established among all types of travel medicine professionals for keeping up with the latest relevant news and information or for sharing new ideas.

[Recent evolution of travel medicine in France and in the world].

The purpose of this study is to show the different steps which have to led to the individualization of this discipline. The necessity of Travel Medicine is a result of the rapid expansion in international and intercontinental travel, in the development of means of prevention of risks linked to this increased travel, in modification made in the doctor-traveler relationship, and in the updating of everchanging epidemiological data. A strategy was developed in France, taking into account all components involved, leading to the creation of the French Travel Medicine Society in 1993.

Arguments against Chemoprophylaxis in Areas at Low Risk for Chloroquine-Resistant Plasmodium falciparum.

Chemoprophylaxis of malaria prevents the disease not the infection (suppressive chemoprophylaxis) with "high levels of confusion and low levels of compliance." The magnitude of danger of contracting malaria for travelers varies in several endemic zones. In West Africa, without prophylaxis, malaria is estimated to have an incidence of 1.

Diaphragmatic function in severely malnourished patients with anorexia nervosa. Effects of renutrition.

The effects of malnutrition and refeeding on nutritional indices, pulmonary function, and diaphragmatic contractile properties were studied in severely malnourished patients with anorexia nervosa. Fifteen patients were evaluated upon hospital admission (Day 0) and on Days 7, 30, and 45 after starting feeding. Spirometry, lung volumes, and arterial blood gases were measured at each time interval, as were contractile properties of the diaphragm as assessed by transdiaphragmatic pressure generated during electrical phrenic nerve stimulation (Pdistim) and a maximal sniff maneuver (Pdisniff).

Three-week hepatitis B vaccination provides protective immunity.

To determine whether a 3-week hepatitis B (HB) vaccination could achieve protective immunity, 89 healthy non-immunized young adults received three doses of 20 micrograms each of HBs antigen (GenHevac B, Pasteur) and were randomly assigned to schedule A (n = 44): two doses at day 0, one dose at day 21; or schedule B (n = 45): one dose at days 0, 10 and 21. Seroprotection rates (anti-HBs > or = 10 mIU ml-1) for groups A and B respectively were: 23 and 40% at day 21; and 77 and 91% at day 82 (not significant). Anti-HBs geometric mean titres were higher in group B than in group A (p < 0.

Acute effects of zolpidem, triazolam and flunitrazepam on arterial blood gases and control of breathing in severe COPD.

Patients with severe chronic obstructive pulmonary disease (COPD) commonly complain of insomnia, but hypnotic drugs are generally not recommended due to their depressant effect on the respiratory centres. The aim of this study was, therefore, to compare the effects of a single dose of the benzodiazepine hypnotics, triazolam 0.25 mg and flunitrazepam 1 mg, and a new imidazopyridine compound, zolpidem 10 mg, in hypercapnic COPD patients.

[Development and trends from 1986 to 1993 of the attitude of intercontinental travellers on departure from France, with respect to malaria prophylaxis].

Simultaneously to information campaigns on malaria prevention in France, 5 successive surveys were performed from 1986 to 1993 on the knowledge and attitudes of travellers regarding malaria prevention. French travellers (principally towards Sub Saharan Africa) know the risk of malaria and the measures of prevention (96%). Chimioprophylaxis using chloroquine has been progressively replaced by mefloquine and then by the association mefloquine-proguanil; 25% of travellers know mosquito prevention measures (repellents and impregnated bed nets) and 27% know the stand-by treatment.

[Real information needs of the traveller before his departure. Results of a survey by questionnaire].

This study is based upon 727 questionnaires completed by French travellers 10 days after intercontinental travel. The response rate was 40%. Two out of 5 travellers had generally mild health problems: fever (12%), diarrhoea (36%).

[Infectious disease observed upon travel return. Retrospective and prospective investigation conducted in 1992 with 15 hospitals].

We report 1,302 cases of patients observed in the Department of Infectious Diseases in 15 French hospitals: 1,036 in a retrospective study in 1991; 266 in a prospective study in 1992. 48% of patients suffered from malaria, diarrhoea or hepatitis; 50% were admitted in the hospital. We have numbered 191 cases of non tropical diseases, 14 cases of HIV seropositivity and 14 cases of adverse events due to antimalarial chemoprophylaxis.

[Travel medicine].

Travel Medicine was inherited from Tropical Medicine and was organised around the development of intercontinental travels. It concerns all types of travellers, especially tourists, migrants and expatriates. It must be universal, scientific, but first of all preventive.

HIV-associated non-Hodgkin's lymphomas: clinical characteristics and outcome. The experience of the French Registry of HIV-associated tumors.

From 1/87 to 12/89, the French Registry of HIV-associated tumors recorded 131 cases of intermediate- and high-grade non-Hodgkin's lymphomas (NHL). There were 47 small non-cleaved Burkitt-type lymphomas (SNCL), 32 immunoblastic lymphomas (IL) and 52 diffuse large-cell or predominantly large-cell lymphomas (LCL). There were differences in the clinical patterns of the histological subtypes.

[Diaphragmatic paralysis after puncture of the internal jugular vein].

Two cases of paralysis of the diaphragm occurring after puncture of the internal jugular vein are reported. Both were old cancer patients, requiring an internal jugular venous catheter for intravenous feeding. Although the catheter was easily placed in both cases, the diagnosis of diaphragmatic paralysis was made postoperatively.