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Biomedical subjects

M Gentilini

Publications and source records attributed to M Gentilini.

At least 19 recordsLinked to original sources
PubMed2006

[French sanitary cooperation in developing countries].

In the face of a worsening public health situation throughout the world, French know-how in the field of sanitary cooperation warrants a far more active commitment from our country. Instead there have been only a few initiatives and we are witnessing a programmed decline of our presence. The statement issued by the Economic and Social Council in 2006--the highlights of which will be presented at this meeting--strongly advocates a voluntary program to revive sanitary cooperation by encouraging civic-spirited young people to express international solidarity through public service in impoverished areas. By compensating the shortage of human resources in developing countries, this program would allow immediate implementation of measures to promote action, training and research not as a replacement operation but rather as a genuine partnership. Deployment of our public aid for development in the field of health-care must not have a detrimental effect on the bilateral dimension of the relationship that indeed requires urgent strengthening. In addition tighter coordination of all parties involved in cooperation activities is needed to ensure greater efficiency and consistency. New funding sources (starting with the airline ticket tax) and greater mobilization of the European Union is necessary to ensure that developing countries have more financial resources to wage the "health-care battle". Reducing the "health-care gap" that cripples development and destabilizes societies must be the first priority of French Cooperation.

Developing Countries↗
PubMed2000

[Role of spleen cells in protection against malaria].

IMMUNITY: The anti-infectious effect of the spleen in general and its anti-malarial effect has been known for a long time. This effect is associated, among other functions, with the spleen's capacity to filter and destroy erythrocytes parasitized by plasmodies or altered by various physical (heat...) or chemical factors. In addition, splenic immunity, which associates specific and nonspecific humoral and cellular effector mechanisms is no longer a question of debate. OPEN QUESTIONS: There remains nevertheless one aspect of the question to be elucidated: the probable interaction between this immunity and other (genetic...) factors of the malarious host. CELL FUNCTIONS: This article summarizes current knowledge in connection with: a) participation of various cell populations in the mechanisms of splenic filtration and phagocytosis and b) genesis of a repertory of B and T lymphocytes, plasmodio-specific memory cells. During an infection, lymphocytes, monocytes and macrophages are recruited from peripheral blood and, in cooperation with cells known as "barrier" cells, increase the capacity of splenic filtration/purge and phagocytosis. In addition, the appearance of B and T lymphocytes with specific memory of P. falciparum result from hypermutation in VH genes (for B lymphocytes) or from clonal selection (for T lymphocytes). The folicular dendritic cells accomplish a reserve function. By constantly releasing the antigen, these cells would contribute to maintaining immune memory or to stimulating naive cells. Further studies are necessary to better understand the role of the splenic microcirculation and to identify parasite components which stimulate the protective response of the spleen against plasmodies.

Animals↗
PubMed1998

[Malaria, a worldwide scourge].

Malaria, mostly caused by Plasmodium falciparum, continues to take its toll throughout the world's tropical zone. The last report of the World Health Organization indicates renewed activity of this endemic disease, with 300 to 500 million cases per year per 2.3 billion persons at risk, and 1.5 to 2.7 million death. Africa is the most affected, with an estimated incidence of 700 cases per 1000, while in South America and Asia, the incidence varies around 4 to 5 cases per 1000. Using treated mosquito nets will probably not lower transmission sufficiently to decrease mortality. Early treatment, particularly in the child, is as important and combating transmission.

Endemic Diseases↗
PubMed1998

[Apropos of 1 case of hepatogastric fascioliasis in Cape Verde].

The authors report a case of Fascioliasis sp. distomiasis with a double hepatic and gastric location primitively associated with a gastric cancer metastazed to the liver. The parasitic origin of the lesions suspected from the histological specimen of the gastric biopsy (the presence of eggs) was confirmed by serology with the presence of the arc 2 specific to immunoelectrophoretic analysis, while the parasitological examination of the stools was always negative. The patient grew well after a day's cure of triclabendazole (375 mg x 2). Although the ectopic locations of Fascioliasis are classic, they are usually in the abdominal wall, less frequently in the gastric or colic wall. The fact that the contamination originated on the Cape Verde is indiscutable, since the patient had never left the island. It is the 5th case described in medical literature, thus confirming the presence of Fasciola hepatica (or gigantica) on the islands of the Cape Verde, whose population is of both Portuguese and African origin and has kept the eating habits of the former colonial power (Portugal is a zone of high endemicity for human fascioliasis). It would be interesting to look for Limnaea and contaminated bovine on the Cape Verde islands.

Africa, Western↗
PubMed1997

[The health of prisoners].

In twenty years, the prison population, from the mother country and the overseas departments, has more than doubled, in spite of reprieve and amnesty decisions. This increase is more a consequence of longer penalties than of a rise in the number of imprisoned people The law no. 94-43, dated january 18th 1994, concerning the prisoners' medical care and welfare is an unprecedented health revolution. It comes in addition to provisions from 1986 and 1987 for the programme "13,000" prisons and those endowed with a regional medical and psychological service (SMPR). The prisoners' health must urgently be dealt with and particularly as regards infectious diseases, vaccination check-up, campaign against drug addiction health and nutrition education and dental care. As soon as incarceration has begun, the exist must be prepared and taken into consideration by the different interveners inside and outside the prison, in order to make sure of an efficient medical follow-up. As the number of intervening medical and social personnel, is increasing in prisons, a coordination inside the their walls as well as on the regional and national levels, would prove useful.

Delivery of Health Care↗
PubMed1997

Encephalomyeloradiculopathy associated with Epstein-Barr virus: primary infection or reactivation?

INTRODUCTION: Encephalomyeloradiculopathy (EMR) is a new syndrome, characterized by extensive involvement of the nervous system at different levels, including brain, medulla and spinal roots. We describe a patient presenting with prodromal febrile illness, followed by a wide infection of the nervous system with transverse myelitis and less severe meningitis, encephalitis and polyradiculopathy. The patient was treated with high-dose corticosteroids, antibiotics and acyclovir; in spite of therapy his condition improved very slowly, with severe neurological sequelae. MATERIAL AND METHODS: Antiviral antibodies were searched for in serum and cerebrospinal fluid (CSF) by commercially available ELISA kits. Viral investigations were performed by cell culture isolation and search for viral antigens, and genomic nucleic acids were investigated by polymerase chain reaction (PCR). RESULTS: Virological and serological studies evidenced a primary infection by cytomegalovirus (CMV), possibly responsible for the prodromal illness, persisting in the course of the disease. PCR performed in the peripheral blood mononuclear cells (PBMCs), DNA collected early and in the CSF drawn 30 days after the onset of the disease showed Epstein-Barr virus (EBV) DNA. The serum panel of EBV antibodies was typical of an intercurrent virus reactivation, more than of a primary infection. CONCLUSION: EBV is known to be highly infectious for the nervous system, in this case of EMR the presence of DNA sequences in the PBMCs and CSF suggests that EBV plays a role in the development of this newly described syndrome.

Adult↗
PubMed1997

[Apropos of 5 new cases of onchocerciasis edema].

We report 5 cases of onchocerciasis presenting as limb's swelling collected in the tropical disease unit of a parisian hospital between 1982 and 1993. They are 5 men which have lived between 3 weeks and 4 years in forested areas of Cameroon in four cases and Côte d'Ivoire in one case. The incubation period varied from 5 months to 2 years. The limb oedema was always located to one arm. It was associated with a blood eosinophilia above 2000/mm3 in 4 of 5 patients. The skin detection of microfilaria of Onchocerca volvulus was positive in every case. The serodiagnostic tests were negative for indirect immunoflurescent assay and immunoelectrophoresis with exception of one patient. These patients were cured with ivermectine and/or diethylcarbamazine. In addition, 26 other cases described in the literature are discussed.

Animals↗
PubMed1996

Guidelines on artificial nutrition versus hydration in terminal cancer patients. European Association for Palliative Care.

Whether a terminally ill cancer patient should be actively fed or simply hydrated through subcutaneous or intravenous infusion of isotonic fluids is a matter of ongoing controversy among clinicians involved in the care of these patients. Under the auspices of the European Association for Palliative Care, a committee of experts developed guidelines to help clinicians make a reasonable decision on what type of nutritional support should be provided on a case-by-case basis. It was acknowledged that part of the controversy related to the definition of the terminal cancer patient, since this is a heterogeneous group of patients with different needs, expectations, and potential for a medical intervention. A major difficulty is the prediction of life expectancy and the patient's likely response to vigorous nutritional support. In an attempt to reach a decision on the type of treatment support (artificial nutrition vs. hydration) which would best meet the needs and expectations of the patient, we propose a three-step process: Step 1: define the eight key elements necessary to reach a decision; Step II: make the decision; and Step III: reevaluate the patient and the proposed treatment at specified intervals. Step I involves assessing the patient concerning the following: 1) oncological/clinical condition; 2) symptoms; 3) expected length of survival; 4) hydration and nutritional status; 5) spontaneous or voluntary nutrient intake; 6) psychological profile; 7) gut function and potential route of administration; and 8) need for special services based on type of nutritional support prescribed. Step II involves the overall assessment of pros and cons, based on information determined in Step I, in order to reach an appropriate decision based on a well-defined end point (i.e., improvement of quality of life; maintaining patient survival; attaining rehydration). Step III involves the periodic reevaluation of the decision made in Step II based on the proposed goal and the attained result.

Fluid Therapy↗
PubMed1996

Canine visceral leishmaniasis: successful chemotherapy induces macrophage antileishmanial activity via the L-arginine nitric oxide pathway.

Following successful chemotherapy in canine visceral leishmaniasis, monocyte-derived macrophages can induce antileishmanial activity via a gamma interferon-dependent mechanism in the presence of autologous lymphocytes. The killing of leishmania correlated with the induction of the NO synthase pathway, because it correlated with the generation of nitrogen derivative production and was abrogated in the presence of NG-monomethyl-L-arginine, a competitive inhibitor of the NO synthase pathway. The level of L-citrulline in serum, which was produced after activation of the NO synthase pathway, was markedly enhanced in dogs receiving successful chemotherapy. Taken together, these data indicate that following successful chemotherapy of visceral leishmaniasis, leishmania parasites are killed by macrophages activated by gamma interferon-producing lymphocytes via an NO-dependent mechanism.

Animals↗
PubMed1996

Antigenic components of partially purified antigens of Leishmania donovani infantum recognized by sera from dogs with asymptomatic or active visceral leishmaniasis.

The antigenic components of a semipurified fraction of Leishmania donovani infantum were determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot analysis using 14 serum samples from dogs with symptomatic visceral leishmaniasis and 11 serum samples from apparently healthy dogs collected in an area endemic for canine visceral leishmaniasis (CVL). It was found that these antigens were composed of many polypeptides, among which seven components recognized by symptomatic CVL sera, had molecular weights of approximately 18, 28, 30, 33, 63, 70, and 72 kilodaltons (kD); two components of 63 and 70 kD were recognized by three of 11 healthly dog sera. These findings suggest that specific antigens induce humoral immune response in dogs with asymptomatic or active visceral leishmaniasis. Infected dogs are not readily identifiable by their symptoms. The potential interest of the immunoblot test for CVL diagnostic purposes is discussed.

Animals↗
PubMed1996

Specific detection of the microsporidia Encephalitozoon intestinalis in AIDS patients.

The microsporidia Encephalitozoon intestinalis is an opportunistic pathogen responsible for severe gastrointestinal diseases and disseminated infection in AIDS patients. No light-microscopical method allows the specific detection of this unicellular parasite and up to this date, only electron microscopy could confirm the diagnosis of the species. We propose a method combining the non specific labelling of microsporidian spores by the fluorochrome Uvitex 2B and an indirect immunofluorescent assay with a polyclonal antibody specifically directed against E. intestinalis. Preliminary data demonstrate the specificity of this antibody. This method enables the distinction between E. intestinalis and Enterocytozoon bieneusi an other microsporidian also associated with gastrointestinal infection. Due to the precocious detection of E. intestinalis patients will be treated earlier with albendazole which is potentially active against this species.

Acquired Immunodeficiency Syndrome↗