Treatment of Bacterial Vaginosis: A Multicenter, Double-Blind, Double-Dummy, Randomised Phase III Study Comparing Secnidazole and Metronidazole

Objective. Multiple-dose metronidazole oral therapy is currently the reference treatment for bacterial vaginosis (BV). This double-blind, double-dummy, noninferiority study compared the efficacy of secnidazole, another nitroimidazole with pharmacokinetics allowing a single dose regimen, to this standard treatment. Methods. A total of 577 patients were randomized to receive metronidazole (500 mg, b.i.d for seven days) or secnidazole (2 g, once). Therapeutic cure at D28 was defined as the resolution of vaginal discharge, positive KOH whiff test, vaginal pH >4.5 and Nugent score >7 on Gram-stained vaginal fluid. Results. According to this primary endpoint, the single-dose secnidazole regimen was shown to be at least as effective as the multiple-dose metronidazole regimen (60.1 % cured women vs 59.5% , 95% confidence interval with a noninferiority margin of 10%: [−0.082; 0.0094]). Safety profiles were comparable in both groups. Conclusion. The secnidazole regimen studied represents an effective, convenient therapeutic alternative that clinicians should consider in routine practice

Clinical Study Treatment of Bacterial Vaginosis: A Multicenter, Double-Blind, Double-Dummy, Randomised Phase III Study Comparing Secnidazole and Metronidazole

Objective. Multiple-dose metronidazole oral therapy is currently the reference treatment for bacterial vaginosis (BV). This doubleblind, double-dummy, noninferiority study compared the efficacy of secnidazole, another nitroimidazole with pharmacokinetics allowing a single dose regimen, to this standard treatment. Methods. A total of 577 patients were randomized to receive metronidazole (500 mg, b.i.d for seven days) or secnidazole (2 g, once). Therapeutic cure at D28 was defined as the resolution of vaginal discharge, positive KOH whiff test, vaginal pH > 4.5 and Nugent score > 7 on Gram-stained vaginal fluid. Results. According to this primary endpoint, the single-dose secnidazole regimen was shown to be at least as effective as the multipledose metronidazole regimen (60.1% cured women vs 59.5% , 95% confidence interval with a noninferiority margin of 10%: [−0.082; 0.0094]). Safety profiles were comparable in both groups. Conclusion. The secnidazole regimen studied represents an effective, convenient therapeutic alternative that clinicians should consider in routine practice

Table Ronde : L’Arche de Zoé, dérive unique ou produit d’un système ?

Table ronde organisée le 19 décembre 2007 à l’initiative de Joseph Dato, professeur associé à l’Université de Grenoble, membre du Conseil d’administration de Médecins du Monde. La vidéo du débat est disponible sur www.medecinsdumonde.org Débat animé par Françoise Jeanson, médecin, ancienne présidente de Médecins du Monde. Avec Michel Galy, sociologue, revue Cultures et Conflits, Jean-Paul Ngoupande, ancien Premier ministre de la République centrafricaine, Pierre Micheletti, médecin, président de Médecins du Monde, Rony Brauman, médecin, ancien président de Médecins Sans Frontières, professeur associé à Sciences-Po Paris, Pierre Ganz, rédacteur en chef, Radio France Internationale, et la participation de trois « grands témoins » : Blandine Destremau, Bruno David et Frédéric Tissot

Clarifying the effect of biodiversity on productivity in natural ecosystems with longitudinal data and methods for causal inference

Causal effects of biodiversity on ecosystem functions can be estimated using experimental or observational designs - designs that pose a tradeoff between drawing credible causal inferences from correlations and drawing generalizable inferences. Here, we develop a design that reduces this tradeoff and revisits the question of how plant species diversity affects productivity. Our design leverages longitudinal data from 43 grasslands in 11 countries and approaches borrowed from fields outside of ecology to draw causal inferences from observational data. Contrary to many prior studies, we estimate that increases in plot-level species richness caused productivity to decline: a 10% increase in richness decreased productivity by 2.4%, 95% CI [-4.1, -0.74]. This contradiction stems from two sources. First, prior observational studies incompletely control for confounding factors. Second, most experiments plant fewer rare and non-native species than exist in nature. Although increases in native, dominant species increased productivity, increases in rare and non-native species decreased productivity, making the average effect negative in our study. By reducing the tradeoff between experimental and observational designs, our study demonstrates how observational studies can complement prior ecological experiments and inform future ones

PROCESSUS INTERVENANT DANS LA GENESE DES CALCIFICATIONS CEREBRALES

Ectopic calcifications are engendered by the same factors as bone mineralization, the study of which can serve as a means of approach to the understanding of the physiopathology of cerebral calcifications. The calcification processus consists of the deposit of a mineral phase in the form of hydroxyapatite crystal 3 Ca2 (PO4)3 Ca (OH)2 in a matrix formed of fibrous protein ground substance. The study of bone mineralization shows that the bone cells effect the synthesis of the matrix and play a part in the regulation of the mineral deposit. Collagen is a fibrous protein, the structure of which is characterized by the repetition of certain chemical sequences that are the captation centers for the mineral phase. The mechanism by which phosphate and calcium are precipitated and then crystallize at this site brings several factors into play. The fibrous protein acquires properties that promote mineral accretion at the site (lyotrope). The localized increase of P and Ca concentration has a bearing on the induction of precipitation on the matrix that has become calcifiable. The concentration of the mineral phase at the sites of calcification takes place through osteoblasts. This electrolytic movement is controlled by parathormone, vitamin D, phosphate ion and calcitonin. The role of mineralization inhibitors such as pyrophosphates, and of activators such as some enzymes, is discussed. Cerebral calcifications can be classified into two groups; dystrophic calcifications and those which have a symmetrical effect on the basal ganglions. The dystrophic calcifications are found in the affected tissues in patients with normal biology. Collagen changes probably play a part in the genesis of thse calcifications. Symmetrical calcifications of the basal ganglions are found more especially in conditions characterized by a rise in the blood phosphorus rate, as in hypoparathyroidism. The similarity between bone and ectopic calcification processes is recalled. The etiopathogenesis of the cerebral calcifications must be sought in the modification of one or another of the calcification mechanisms.SCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe

Le dosage sanguin de la parathormone

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Hypocalcemia, osteoblastic metastases and hypoparathyroidism

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Hypercalcaemia in idiopathic rhabdomyolysis

SCOPUS: le.jinfo:eu-repo/semantics/publishe

Assessment of a plasma ADH radioimmunoassay in experimental and physiologic or pathologic conditions

A radioimmunoassay of ADH has been applied to the study of plasma ADH levels in various conditions. The validity of the assay has been evaluated by the usual quality control parameters of RIA and by the measure of plasma levels in 12 upright water deprived normal volunteers (mean 9.5 pg/ml, SEM ± 1.5), in 8 resting and hydrated normal volunteers (1.3 ± 0.4 pg/ml), in a case of diabetes insipidus (1.6 pg/ml), in 8 cases of SIADH Syndrome (range 13-77 pg/ml) and in 4 anesthetized dogs before (33.7 ± 9.2 pg/ml) and after acute haemorrhage (66 ± 9.5 pg/ml, p < 0.02). The osmotic challenge to ADH secretion has been studied in 8 patients with no overt endocrine pathology by salt perfusion and showed a significant rise (p <0.05) of plasma ADH from 6.3 ± 3.1 pg/ml before, to 20.6 ± 7.9 pg/ml during salt infusion corresponding to the significant (p < 0.0001) rise of plasma osmolality from 273 ± 2.8 to 288.2 ± 1.1 mOsm/kg.SCOPUS: ar.jinfo:eu-repo/semantics/publishe