Presse Med
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A CONSIDERABLE RISK: Among the infectious agents that might be used as terrorist weapons, the smallpox virus represents a sufficiently high risk, which is difficult to manage and must be seriously taken into account.
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RESISTANCE TO IMIPENEM: The increase in the prevalence of A. baumannii resistance is worrying because of the diversity of the enzymes implicated in the resistance and its epidemic diffusion that is always difficult to handle. BROAD SPECTRUM BETA-LACTAMASE: Still rare in Acinetobacter, a broad spectrum beta-lactamase has been demonstrated in a strain isolated during a urinary infection and at the origin of an outbreak.
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CORTICOSTEROIDS IN BACTERIAL MENINGITIS: A randomised multicentre study on meningitis in adults versus a placebo showed significant benefits of corticoids in terms of reduction in mortality and neurological complications. These results were essentially observed in pneumococcal infections. THE INTEREST IN MONITORING BLOOD CULTURES: Several works on Staphylococcus aureus bacteremia have confirmed the necessity of monitoring hemocultures, 48-72 hours following initiation of treatment. The persistence of bacteremia strongly suggests the poor prognosis and endocardial grafting should be envisaged.
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THE "ANDROPAUSE": Also called the "male menopause" or "partial androgen deficiency of the aging male" etc., corresponds to the age at which the progressive decrease in androgen activity reaches a pathogenic threshold. Surveys made in various countries since the seventies conclude that testosterone blood levels start to decrease after the age of 25 and that 20 to more than 50% of the male population no longer benefit from optimal androgen stimulation after the age of 60. THE CONSEQUENCES OF HYPOANDROGENISM: The subsequent progressive hypoandrogenism participates in inducing the commonly-observed clinical symptoms (fatigue, morosity, weight loss, lack of interest in sexual activity); the most specific of which is the disappearance or rarification of "automatic" nocturnal or matinal erections. ⋯ A COMPLEX BIOLOGICAL DIAGNOSIS: Added to the abnormalities in production and transport of testosterone are the abnormalities in its metabolisation by the target tissues. These abnormalities are often undetected in present day blood controls and may explain the elevation in the hepatocyte of SHBG synthesis, the relative inhibition of GnRH pulses and LH secretion in the hypothalamus and the pituitary gland and, in the arterial wall (including penile vascularisation) and the prostate, some of the frequent functional and histological disorders. In current practice today, the best approximation of androgen potential is obtained by the comparison of total testosterone concentrations and SHBG, measurements that require relatively reliable standardised kits.