[Comparative study of artemether and quinine in severe Plasmodium falciparum malaria in adults and older children in Cameroon]. / Essai comparatif de l'artéméther et de la quinine dans le paludisme grave à Plasmodium falciparum de l'adulte et du grand enfant au Cameroun.

From June 1993 to June 1994, a study was carried out to compare artemether and quinine for management of severe falciparum malaria in adults and adolescents in Cameroon. Artemether was administered intramuscularly at a dose of 3.6 mg/kg on the first day and 1.6 mg/kg for the following 4 days. Quinine was administered intravenously at a dose of 1.6 mg/kg for the first 4 hours and 8 mg every 8 hours for the next 3 days. The files of 84 of the 95 patients recruited were validated for inclusion in the final study. There were 40 patients in the artemether group and 44 in the quinine group. The two groups were comparable with regard to all factors at the time of inclusion. Findings showed that artemether was more effective than quinine with regard to total clearance of parasitemia, 90 p. 100 clearance, and fever control and that it was as effective with regard to 50 p. 100 clearance and recovery of consciousness. In view of its good performance and of the simplicity of its administration by intramuscular injection, artemether would appear to be an excellent alternative for treatment of severe malaria and cerebral malaria in areas with poor medical facilities.

Sensibilite in vitro de plasmodium falciparum a l'artemether au Cameroun en 1993

Les auteurs rapportent dans cette etude les resultats des mesures effectuees a Yaounde en 1993. Les objectifs etaient d'etudier in vitro la sensibilite a l'artemether d'isolats de plasmodium falciparum; d'etudier conjointement la sensibilite in vitro de ces isolats aux principaux antipaludiques et rechercher l'existence d'une resistance croisee potentielle entre ces molecules

Quelle alternative a l'echec d'un traitement antipaludique?

Le but de cette reflexion n'est pas de fournir au Medecin praticien du Cameroun des recettes toutes faites; mais de lui proposer des elements de reflexion pour une prescription utile et rapidement efficace contre le paludisme

[Severe malaria attacks in adults in Cameroon: comparison of 2 therapeutic protocols using quinine via parenteral route]. / Accès palustre grave de l'adulte au Cameroun: comparaison de deux protocoles therapeutiques utilisant la quinine par voie parentérale.

Increasing frequency and severity of cerebral malaria have become a major problem in the area of Yaoundé (Cameroon, Central Africa). Based on recent findings in pharmacokinetic parameters in cerebral malaria, a quinine infusion regimen (8 mg of quinine base/kg of body weight over 1 h followed by 8 mg of base/kg over 7 h, then 8 mg/kg over 8 h 3 times daily for 3 days) was randomly allocated to 10 patients; 10 others received a more classical regimen currently used in Cameroon of 8 mg of base/kg over 8 h, 3 times daily for 3 days. In the loading dose group, there was a significant decrease in the duration of coma (48%), and the parasite clearance times were reduced by 33%. This regimen has been safe and effective: it is recommended in Yaoundé.

[What is the potential number of indications for liver grafts in France per year?]. / Quel est le nombre potentiel d'indications de greffes de foie en France chaque année?

The progress recently made in liver transplantation requires an estimation of the potential number of cases per year in France. The study of French Death Rate per age group, compared with either formal, discutable or aleatory indications of transplantation, is a valuable basis for that calculation. It confirms the relative scarcity of the potential number of liver transplantations, which can be estimated at between 2 or 3 per year and per million inhabitants.

[Peroperative radiotherapy. Initial experience at the Red Cross Hospital]. / Radiothérapie per-opératoire. Première expérience à l'Hôpital de la Croix-Rousse.

Intra operative radiation therapy is a new look at an old idea (Rich). In relation with the first experience at the Croix-Rousse Hospital with orthovoltage, a review of technical choices, surgical problems, and biological questions is presented. The analysis of literature about accumulated clinical results suggest that local control in recurrence, residual, or inoperable tumor can be obtained by combined surgery IOR, and external beam irradiation. This short experience demonstrate the feasibility of the treatment as a routine and emphasizes the need for continued study.