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Biomedical subjects

Jean-Marc Garnier

Publications and source records attributed to Jean-Marc Garnier.

5 recordsLinked to original sources

[Mumps].

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Diagnosis, Differential↗

[Children immunization in France: an update].

Vaccines are essential to prevent, control (as for poliomyelitis) or eradicate (as for smallpox) infectious diseases. In some cases, when a curative treatment is not available or efficient, they are the only way to fight the spread of the disease, by prevention. The national recommended childhood immunization schedule may vary each year and in each country (changes in infections characters, outbreaks, new vaccines availability...). In this review, new patterns in childhood vaccination in France are discussed.

Adolescent↗

Liposomal amphotericin B in the treatment of visceral leishmaniasis in immunocompetent patients.

The leishmaniases are protozoan diseases caused by Leishmania parasites. The first-line treatment of its visceral forms is pentavalent antimony (meglumine antimoniate or sodium stibogluconate), but toxicity is frequent with this drug. Moreover antimony unresponsiveness is increasing in Leishmania infantum and L. donovani foci, both in immunocompetent and in immunosuppressed patients. Amphotericin B is a polyene macrolide antibiotic that binds to sterols in cell membranes. It is the most active antileishmanial agent in use. Its infusion-related and renal toxicity may be reduced by lipid-based delivery. Liposomal amphotericin B (AmBisome); Gilead Science, Paris, France) seems to be less toxic than other amphotericin B lipid formulations (Amphocil); Liposome Technology Inc., Menlo Park, CA, USA, Amphotec); Ben Venue Laboratories Inc., Bedford, OH, USA). Optimal drug regimens of AmBisome) vary from one geographical area to another. In the Mediterranean Basin, a total dose of 18 mg/kg (3 mg/kg on days 1-5 and 3 mg/kg on day 10) could be used as first-line treatment of visceral leishmaniasis in immunocompetent patients. In immunocompromised patients, especially those co-infected with HIV, relapses are frequent with AmBisome), as with other drugs.

Amphotericin B↗

Antimosquito precautions and medical chemoprophylaxis in French children with malaria.

BACKGROUND: France is the European country with the highest number of imported malaria cases (7,500 in 2000). The aim of this prospective study was to evaluate the nature and efficacy of prophylactic measures in children under 15 years of age referred for malaria. METHODS: Post travel questionnaires were given to the parents of malarial children in the emergency room. The study took place in two university hospitals in Marseilles, southern France, from August to October 2001. RESULTS: Eighty-eight children under 15 years of age were included in this 3-month period. Most of them had been infected in Comoro archipelago. Almost two-thirds used bed nets, but only 47% did so every night. Sprayed bed nets were used by 23%. Average compliances with cutaneous repellents, bedroom repellents and long-sleeved clothing were 32%, 24% and 26%, respectively. Air conditioners were uncommon. Only 22% of the children used chemoprophylaxis correctly, according to French recommendations. Five percent did not use any chemoprophylaxis, and 61% reported non recommended drug use. Although all the children traveled to chloroquine-resistant areas, chemoprophylaxis with mefloquine was less common than that with chloroquine + proguanil. No child fully complied with French recommendations concerning both anti mosquito measures and chemoprophylaxis. CONCLUSIONS: Insufficient use of antimalaria precautions by traveling families is associated with the high incidence of pediatric imported malaria in southern France. Travelers' education should be increased to allow the optimization of malaria prophylaxis.

Adolescent↗