La Revue du praticien
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Intravenous immunoglobulins (IVIg) are therapeutic preparations of normal human IgG that are obtained from pools of healthy blood donors. They can be used at low dose in the substitutive therapy of patients with primary or secondary immune deficiencies, or at high dose as an immunomodulatory agent in a large number of autoimmune and/or systemic inflammatory diseases, particularly in hematologic or neurologic diseases. ⋯ Mechanisms of action of IVIg are multiple and complicated. The development of new therapeutic trials in association with analyses of mechanisms of action should help to define new indication of IVIg therapy.
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Four parasite species, among which one lethal, at least 20 efficient vectors, spread on the most crowded and underdeveloped continents, where first antimalarials and insecticides were so extensively used for decades that they are now inefficient after resistances. It is today the sad medium on which malaria raged, spring of 1 million deaths and 300 millions cases a year, of which 90% in sub-Saharan Africa. ⋯ Waiting vaccines and new drugs, control must be centred on vectors control and multidrug therapy. France is the industrialised country with the highest number of imported cases (approximately equal to 7000 cases yearly), linked mainly to P. falciparum coming from sub-Saharan Africa and recurring in nearly 3/4 of cases in immigrants.