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Wine and Health risks, facts, benefits

Wine and Health


In recent years, work in epidemiology has shown that wine is not bad for your health to the extent that we consume in moderation.


It would lend itself particularly beneficial properties in the prevention of cardiovascular disease.


Professors Andre Vacheron, Pr Ludovic Drouet and Professor David Khayat we are part of the latest studies and observations on moderate wine consumption and health.

Wine and Cardiovascular Disease


Prof. Andre Vacheron: Member of the Academy of Moral and Political Sciences and former president of the Academy of Medicine


Wine is a wonderful drink since we find mention 4000 years before Christ, in the tombs of pharaohs. Hippocrates was the first to boast its medicinal virtues four centuries before Christ, and said that "like love, wine excess could have effects quite deleterious to health." In Ecclesiastes, chapter 40, it says: "Vinum Bonum lactificat cor hominis. "However, it was not until the twentieth century to have work on the beneficial effects of wine, despite the media hype that has befallen the sugar, fat, salt, overweight, wine does not escape.

In recent years, work in epidemiology has shown that wine is not bad for your health to the extent that we consume in moderation. In 1979, St. Leger, in The Lancet, reported an inverse relationship between wine and cardiovascular mortality in 18 countries taking up the death certificates and the concepts of wine consumption. The study is supported by the American Keys in 1980, which shows that wine consumption reduces cardiovascular mortality compared to people who do not consume.

But it's Serge Renaud, a scientist at INSERM in Lyon, which really showed in his study Lyons in The Lancet in 1994, and in Circulation in 1999, the wine was interesting in arterial disease. He studied in 605 coronary mean age of 53 years and having had a myocardial infarction, the effects of a Mediterranean diet based on fruits and vegetables and rich in alpha-linolenic acid margarine, supplemented with a few glasses of wine. He observed the prevention of reinfarction in these survivors by comparing the half who received coronary Mediterranean diet with a little wine and margarine to 300 others who were fed normally.

It was found that, regardless of margarine and other components of the diet, there was a wine and by preventing a reduction in mortality from 73% to 72% and 27 months to 46 months. The study was stopped at 46 months for ethical reasons. However it was the basis of the French paradox. In 1991, Serge Renaud was invited to the United States on CBS and was questioned about his Lyon study. Americans have concluded that the French, despite their diet rich enough in calories and saturated fat, were the people with the lowest blood mortality rate after Japan, thanks in part to the wine consumed.

A large epidemiological study led by the World Health Organization (WHO), the MONICA study, was the subject of several reports between 1994 and 1999, but showed a decrease in cardiovascular mortality among moderate drinkers of wine - one to three drinks per day. Denmark, Copenhagen, Morten Gronbaek conducted a prospective study of 13,285 men between 30 and 70 years followed for 10 to 12 years. For wine drinkers, the risk of dying from a heart attack was significantly lower than among those who never drank wine, but also lower than among drinkers of beer and spirits drinkers. This latest study therefore showed a relative risk of cardiovascular mortality and a decreased risk of overall mortality decreased by 50% among wine drinkers, but increased among drinkers of beer and spirits.

Another epidemiological study was conducted by Serge Renaud in Lorraine. He studied about 34,000 men the effect of moderate wine consumption on cancer mortality by general cause and cardiovascular disease. With moderate consumption of wine, 2 to 4 glasses per day, cardiovascular mortality proves weaker than among abstainers. The beneficial effect also operates in mortality from cancers.

To return to the MONICA study, it also showed a decrease in the prevalence of coronary disease from north to southern Europe with a gradient true north / south. Coronary heart disease are much less common among wine consumers, at the same time that there is a decrease in consumption of distilled liquor, drank more in the countries of northern Europe. Therefore, rather than "French paradox", it would be better to speak of Mediterranean paradox, because the wine is certainly not the only nutrient that is involved in the improvement of cardiovascular risk. The presence of fruit and vegetables participates greatly and we find this Mediterranean paradox in France, Italy, Spain, Greece and Crete.

The wine is superior to beer and other alcohols in cardiovascular protection. Indeed, it is more rich in polyphenols, including resveratrol and quercetin. The latter appears to be the most beneficial polyphenol, red wine containing 5 mg / liter. Resveratrol is an antioxidant LDL, that is to say of low density lipoproteins. There are indeed good and bad cholesterol and it will be deposited in the arterial wall. If the individual does not have enough HDL, that is to say, high-density, bad cholesterol will penetrate tissues and constitute a molehill of fat that will protect in a fibrous shell. Resveratrol is going to prevent these bad proteins go create molehills cholesterol. But resveratrol is also vasorelaxant, that is to say, it relaxes the arterial wall, antiplatelet, anti-inflammatory and anti-atherogenic.

The anti-atherogenic action of resveratrol has been verified in a study of a Chinese working in the United States, Dr. Wang Z. He made hypercholesterolemic rabbits by giving them a diet rich in saturated fatty acids and butter. He then fed red wine without alcohol, but with resveratrol. He observed that there was no development of molehills in these rabbits receiving resveratrol after eating too much butter.

Outside of this action on the arterial wall and the coronary, wine slows and increases durability aging. One study named PAQUID, implementation and Dartiques Orgozozo, focused on 4,000 people over 65, followed between 1988 and 1997, they found that in these moderate wine drinkers and older, the disease of Alzheimer occur so much less common.
Mechanisms of non-wine aging are discussed. Some molecules, sirtuins are activated by the polyphenol. These are from a family of molecules which one of them, the SIRT 1, the active energy producers in cells. In cells that are aging, the SIRT 1 reactive energy battery. Other mechanisms have been invoked as the inhibition of endothelin; activation of the estrogen receptor by a delphinidin which stimulate vasodilation.

In this beneficial effect of wine, the two main mechanisms are decreased atherogenesis, decreased molehills and prevention of thrombosis. These qualities are mostly found in red wine fermentation with several weeks in oak barrels. This will reap rich tannins polyphenols. The wine should be consumed in moderation because a glass provides 100 kcal and 10 g of alcohol on average.

A diet high in wine with chronic excess promotes hypertension. John Steinbeck said thus: "Good wine is like love, too much of one or the other can make a sick man. "
The fatty streaks are deposits of LDL cholesterol which have no deleterious effect on blood flow. But molehills, because of the bad cholesterol, can occur in the arteries open. LDL cholesterol that builds up in the past will grow and thicken and obstruct the flow of blood from upstream to downstream. When the dam is large enough, angina appears. It is due to poor oxygenation of the heart muscle.

Myocardial infarction occurs when a molehill plate forms a blood clot. The crack of the molehill will cause platelet aggregation, which will complete clog the coronary artery. When it is blocked, which was irrigated cardiac muscle necrosis.

These two diseases are the consequences of atherothrombosis and thrombosis. This is why we believe that cardiac drink a little wine may be beneficial in reducing these risks.


Wine and atherothrombosis


Professor Ludovic Drouet: Head of angio-hematology department at the hospital Lariboisière

I take after André Vacheron for you to understand how we can carry out research on this subject. First, we need funding. There are about ten years, the Ministry of Agriculture launched an action named ONIVINS, which was based on a state funding to question the beneficial effects of wine on health, and more particularly cardiovascular disease. Work has been carried out with several French groups from Dijon, Bordeaux, INRA and CNRS in Strasbourg.

In the early 2000s, when the results were regarded, from an epidemiological point of view, studies on the link between wine consumption and cardiovascular disease, all the data proved very consistent: around February-March glasses of wine per day, the risk reduction was 30 to 40%.
An Italian group has recently published an update of these results and showed that when we consume wine, we see a reduction in cardiovascular mortality. However, the curve rises as consumption becomes too strong. The group has also shown a benefit, though smaller and sustainable consumption of beer, reflecting the influence of alcohol in general.

When an artery is cut through, one can observe atherosclerotic plaques - or molehill - that fill the wall and make a lesion ruptures. The latter is breaking, causes coagulation reaction called atherothrombosis mixture of thrombosis and atherosclerosis. Overall, epidemiological studies show a reduction of atherothrombotic events associated with moderate consumption of wine. However, it remains unclear whether this consumption has beneficial effects on the game "thrombosis" or the "athero" section.

Among the animals that we have available to us in our work, the mouse is the most manipulated. By studying the behavior of naturally hypercholesterolemic mice and giving them a wine-enriched diet, the researchers found that there was no effect on atherosclerosis. However, it has effects on the so-called thrombotic component. We have the impression that the wine has an antithrombotic effect and antiathérosclérose.

Other mice with a mutation in the LDL were used and we found that there was no effect on athéroclérose short term, but again an effect on thrombosis. But in the long term, the effect on thrombosis tended to disappear.
We also conducted other experiments with pigs - because the pig is the animal with the most similarities with humans and naturally develops atherosclerotic lesions - and we watched the action on the wine last. But the wine is alcohol and polyphenols and we asked which item was beneficial to health.

We have started our study by looking at the short and long term action in which wine would have removed alcohol. However, we found that there was no effect on atherothrombosis. Yet if we look at the benefits of wine on health, we conclude that a large part comes from polyphenols. After several years of experience, we have found on atherosclerosis that there was no effect on lesion size, but their severity, with a decrease in calcification.

In pursuing the study, we tried to make the much more heterogeneous animals by giving them different diets. But in these conditions, we found that the action of wine phenols was inoperative.
We continued our work truly giving alcohol to our animals. A new study has been conducted using animals for 2 years. We spotted a small effect on atherosclerosis in periphery. We also found a reduction in thrombotic response. The regime in blood sugar and wine limit does not increase the risk of diabetes. We also identified a small antithrombotic effect on a type of platelet aggregation.

As I said, the wine is alcohol and polyphenols. Alcohol has effects on lipoproteins and vascular wall. The wine phenols cause stimulation of the production of nitrogen monoxide. So we watched the vascular reactivity of our animals: wine produces vasodilation of peripheral arteries. Student individually in our animals, we realized that the older animals that have not had the chance to drink wine have arteries dilate hurt as aging. But among those who have had the chance to consume wine in their entire life, vasodilation appears much stronger.


Currently, researchers are trying to understand what happens in the cells to allow protection of the vascular walls. The system of sirtuins will play a role in the maintenance and survival of these cells. A recent study on hypercholesterolemic pigs showed that only wine consumption compared to consumption of vodka or abstinence, resulted in vasodilatation.

I hope I could show you how to search, with its current resources, moves forward in understanding the effects of wine. The most important consequence is the antithrombotic action. Under these conditions, with moderate wine consumption, we find a benefit the cardiovascular system.

Jean-Robert Pitte

I now give the floor to David Khayat, who will speak to us about the relationship between wine and cancer.

Wine and Cancer: Myths and Realities


Professor David Khayat: Chief of Medical Oncology at the Hospital Pitié-Salpêtrière

After cardiovascular diseases, we thought it was good to deal with the other major cause of death in developed and developing countries, namely cancer. It currently affects one in two men and one in three women. In 2012, there were 8,000,000 deaths related to cancer in the world. In 2020, the World Health Organization (WHO) expects 10 million, after the declaration of 20 million new cases this year. The incidence rate of doubling every twenty years cancer in the world, even if it heals better and if the mortality rate remains stable. It represents 150,000 deaths each year, while we record 350,000 new cases in the same time.

Wine is another important issue, it made sense to treat the link between these two items. I will address this topic in a simple way through three channels. The first will deal with the increased risk of cancer among heavy drinkers compared to moderate drinkers. Moderate consumption is estimated at about two to three glasses of wine on average for men, and one to two drinks for women.

For most of the studies that have been done on this subject, more specifically to cancers of the mouth, esophagus, colon, liver, lung or breast, the problem is that 90% of them do not address the link between excessive consumption or moderate wine and increased risk of cancer, but between excessive consumption of alcohol or moderate. But we must understand that they have cases of people that have been followed for decades, and 70% of them were made in the United States, that is to say in a country where alcohol is distilled greatly consumes. These studies are not transferable to countries with strong wine tradition. Indeed, all alcoholic beverages are not good for health, while I think the wine consumed in moderation, has been rather beneficial.

I will not discuss all of the cancer, but I will take emblematic cases such as cancer of the mouth. For this type of cancer, we have studies that examined the relationship between wine and pathology. When I started my classes, I learned that cancer is caused by alcohol and tobacco. There is thus 22 studies published worldwide on the potential increased risk of cancer among heavy users ENT wine and moderate drinkers. However, everyone, including top international experts, consensus that only 14 studies are valid. Some are simply too small or were interrupted hurriedly. Of these 14 studies, nine conclude that excessive consumption of wine increases the risk of head and neck cancer.

However, 5 say, instead, that excessive consumption of wine reduces the risk of cancer compared with moderate consumption. Scientists do in these circumstances? They include the data to create what is called a meta-analysis. The world body, the World Cancer Research Fund, and its experts came to the conclusion that, in heavy wine drinkers compared with moderate drinkers, the increased risk was multiplied by 1.02, which means that increased risk was 2%. But in science, we know that there is a degree of uncertainty in this kind of work, which is called "confidence interval", and in which lies the scientific truth. That is why the 1.02 is between 1 and 1.03, and the increased risk is 1%.

To understand this, we need to revisit the methodology of epidemiological studies. For a study, we follow a procedure called "case-control". We take cases - 1,000 patients who contracted cancer of the mouth, for example - we will compare to controls. The general rule is 1 in 5 for witnesses, that is to say five men to one man, one woman for 5 women, 1 for 5 young young to balance according to the same social, economic criteria, etc. All individuals participating in the work will be asked about the factors related to the study, over a long period.

Indeed, for a cancer spreads in an organization, it takes about 25 to 30 years, because for a cancer cell to become a tumor of one centimeter in diameter comprising 1 billion of these cells, it is necessary that it is divided 33 times, whereby the fact of dividing it takes about 3 to 6 months. To understand the origin of cancer patients, we must ask what they drank there 30 years - 33 times 3 to about 6 months - resulting in inevitable imprecision, because no one is able to remember what he was drinking there so long. Therefore, the finding of the study reveals lapses.

The other problem of this work is that they were all made before 2006, however, this year, a study, since confirmed by others, showed that 70% of oral cancers were caused by papillomavirus ( or HPV), which also give the cervical cancer in women, cancer of the penis in men and cancer of the anus in both. The virus grows in the first oropharyngeal contact. On cancers of the head and neck, excessive or moderate consumption of wine does not increase the risk of disease.

Moreover, doctors agree that there is no increased risk to the consumer or to moderate liver cancer, or cancer of the colon, as it does not exceed 30 40 grams of ethanol per day, that is to say glasses 3-4.
I now turn to my second part: there are two or three years, a study has claimed that alcohol is carcinogenic in the first glass, which strikes the right direction. Another study showed that people drinking 4-5 glasses of alcohol per day had 60% increased risk of skin cancer. However, the researchers did not test the degree of sun exposure of these individuals. This work will therefore reveal little valid.

The question of carcinogenicity of first drink consumed is the work of a great American scholar, Arthur Klatsky, which followed 129,987 volunteers in California between 1978 and 1985 to 2008 and grouped them among abstainers moderate drinkers and heavy drinkers, and sought to understand whether the act of drinking a glass or more resulted in an increased risk of developing a "big cancer" - breast, colon, lung, etc. - About the fact not to drink at all. After publishing his results, all doctors had to recognize that alcohol consumption seemed dangerous from the first drink. But in October 2012, the same researcher found that the study was flawed.

Indeed, an article published in the American Journal of Epidemiology showed that over 50% of returns on wine consumption volunteers for the studies were under-reported. Arthur Klatsky has taken over the files of the 129,987 volunteers and found that among the abstainers over a third had been arrested for driving while intoxicated, assault under the influence of alcohol, ethyl comas, etc. So he rebuilt his study by classifying people between suspects and non-suspects. He then came to apologize to the Congress of Vienna Cancer and explained that removing the suspects, there was no increased risk from the first drink. However, this information was relatively relayed to the public.

Finally, we not only heal more cancer, but, as regards breast cancer, two beautiful studies have established the beneficial link between moderate wine consumption and disease. The first is on 25,000 women with breast cancer followed for 11 years, the second on 13,525 women with breast cancer and followed for 15 years. When doctors looked when, after cancer, is drinking wine increases the risk of relapse and mortality, two studies have shown that drinking 1-2 glasses reduced the risk of dying from 15-16%.

Therefore, drinking wine in moderation or not at all increase the risk of cancer or the risk, when it had a to die faster.

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What vaccine protects against meningitis


Recent news has unfortunately still remembered. The PACA region recorded 15 cases of meningococcal disease including 4 deaths since the beginning of the year. A 12 year old has been touched on March 11 in Nice. A new deaths has recently been observed in Seine-Saint-Denis. So many tragedies for families that could be avoided. !


More and more people are questioning?
"Together against meningitis" brings associations fighting against meningitis. They unite in their struggle to provide support to families, educate the public and health professionals, help promote information and encourage prevention through vaccination.

























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Elongation - Definition torn hamstring, Prevention, Consultation


Definition of hamstrings

The hamstring muscles are located in the back of the thigh (upper leg) and consist of three muscles: biceps femoris, semitendinosus and semimembranosus. This muscle group is involved in flexing the leg at the knee, and the extension of the leg at the hip.


Definition of pulled muscle

Muscular elongation hamstring muscle is torn regards only few fibers; tearing (or breakdown) as it relates to a larger number of fibers. There are three levels of torn hamstrings, until complete rupture.

Risks and origins tears or pulled hamstring muscle

The elongation, or even torn hamstring muscle, usually occur during knee extension with a sudden contraction of the muscle. This injury is common in the context of a sports exercise and inadequate heating can promote it, 90% of muscle accidents involve the lower limbs, especially the elongation or tearing of the hamstring muscle.

Causes tears or pulled thigh

The hamstring muscles allow to walk, run or jump. That these actions are carried out correctly, there must be coordination and regional regulation of all the muscles, tendons and joint leading the movement.
Muscle injuries can occur in the event of default in this regulation. The elongation of the hamstrings occurs for example when the knee extends and the muscle is suddenly contracted. Powerful muscular contraction, with simultaneous stretching and high speed generates two opposing forces responsible for elongation or a tear. The elongation corresponds to muscle micro tears overflow elasticity fibers.
A direct impact on the muscle can also cause damage to the muscle.

Elongation - Prevention

How it does it manifest?

Elongation takes place during the year and is characterized by moderate pain behind the thigh. It is a feeling of stretching the muscle but the pain does not preclude further effort.
Tear Level 1 causes a severe pain in the muscle located in the back of the thigh muscle is sore to the touch, but not bruised.


Tear Level 2 also causes pain to exercise, with a contusion (bruise visible after several hours) where the muscle fibers are torn.

Finally, a tear Level 3 corresponds to a breakdown of muscle fibers. The pain is associated with a snap in the thigh causing them to stop the effort.

With what should we be confused?

Do not stretch the hamstrings to be confused with a simple curvature. Pain related to an elongation occurs during exercise, unlike the stiffness that occurs after exercise. Pain elongation disappears after exercise and reappears in subsequent years.

Will it possible prevention?

Prevention of muscle injury based on a healthy lifestyle with a balanced diet and fight against overweight, to avoid stress on the muscles.

Sports training should be progressive and depending on your physical condition. The equipment must be adapted to correct eg support possible defects with good shoes. Especially, the gradual heating of the muscles and tendons (10 minutes) is essential before and after physical activity: a stretching session, alternating tension and relaxation maintained, allow a better recovery.


Ideally, the advice of a professional trainer help perfect the technique, and to hunt movements or dangerous behavior.

Elongation - Consultation


When you consult?

At the onset of pain during physical exercise, it is imperative to stop the current activity not aggravate injuries. Must be cooled and compressed muscle.
The rest should be continued sporting several days, a medical consultation is needed to determine the extent of damage and consider physiotherapy.
In cases of severe elongation and complete tear of the muscle, immediate care, emergency, is required.

What is the doctor?

The doctor confirms the diagnosis stretching or tearing of the hamstring clinically (palpation, visual inspection). Clinical examination also eliminates another cause (tendon rupture, or avulsion fracture).
Ultrasound is complementary examination to specify the exact location and nature of the muscle injury.
Treatment depends on the severity of the infringement. The acute phase has a glaze (to relieve pain and reduce inflammation), rest, and compression of the muscle. Some analgesic or anti-inflammatory drugs are sometimes prescribed in this phase.
The rehabilitation period (a few days) includes physiotherapy / physical therapy.
Surgery as it relates to the complete muscle ruptures.

How to prepare my next visit?

Sporting activity and muscle load must be taken only when all pain has disappeared, and the strength and mobility have returned to normal. Premature resumption causes a significant risk of relapse. Similarly, do not rub or apply heat to the affected muscle. This can aggravate the pain, injuries and cause bleeding.


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Infant eczema - Definition, Caus, Risks, Prevention, Consultation

Definition of infant eczema

Eczema Infant eczema is called constitutional or atopic. It is a chronic skin disease that begins between the ages of 2-3 months and 2 years and usually resolves spontaneously after a few years.
Eczema keeper however the first years baby (and their parents) manifesting itself by inflammation and the appearance of small bubbles (or vesicles) with severe itching. In children, eczema flares are often triggered by infections, digestive disorders, or the output of a tooth.

Risks and origin of eczema

Eczema is a common skin disease, rising steadily for 30 years in connection with a polluted environment allergens of all kinds. Infants or children predisposed to promote awareness of and develop eczema or later other forms of allergies.

Cause of infant eczema

The main cause of eczema is primarily an allergic phenomenon. Children affected by eczema have a genetic predisposition, family, and awareness to allergens in their environment. Other allergic eczema often accompany such as allergic rhinitis, conjunctivitis or asthma or urticaria.

Infant eczema Prevention

How to manifest infant eczema?

In infants, eczema develops in the first two years. Its evolution is marked by recurrent attacks and improvements red, oozing and crusting plaques, especially on the face. Cheeks and forehead are the first affected infants, the nose being generally respected. Plates itchy, causing scratching, crying and nervousness which only maintain the phenomenon.

After 2 years, the plates often reach the folds of the elbows, wrists or knees.
Between outbreaks, the skin becomes dry (called xerosis) and may facilitate the entry of allergens.
Fortunately, outbreaks gradually decrease with age until it disappears completely in a few years (or puberty) to make room for some other allergies.

With what should we be confused?

Contact eczema is a disease independent of the constitutional or atopic eczema. Contact eczema is manifested on contact with an allergenic product remains highly localized and this contact area. Skin tests performed by a dermatologist or allergist can identify the trigger (nickel costume jewelry, for example). The removal of the product concerned cure.

Will it possible prevention?

The comfort of the skin is enhanced by simple hygiene measures:
- Warm daily bath (36 ° C) with a surgras soap;
- Do not wipe baby but dab the skin to dry, moisturize with an emollient cream;
- Prefer cotton underwear (rather than wool or synthetic) and white (undyed);
- Do not use fabric softener but phosphate-free detergents or soap.

General measures to eliminate mites or allergens from the home are beneficial. Similarly, spa treatments improve symptoms.
In case of herpes (cold sores) in a member of the entourage, proscribe kiss (risk of very serious complication).

Infant eczema Prepare consultation

When you consult?

Eczema is a chronic disease requiring medical treatment at the first signs. Avoid a vicious circle is established and that parents overprotect. Moreover, a serious complication requires medical care in emergency: it is a secondary infection (fever, pustules ...) by the herpes virus called Kaposi's sarcoma-Juliusberg.
What is the doctor?

The diagnosis is easy on the lesions presented and their location, scratching and chronic evolution and outbreaks of eczema. No examination is required, an allergy assessment may be proposed to the age of 5 years to determine the allergens in question if associated symptoms (asthma, rhinitis or conjunctivitis).
During outbreaks, medical treatment based ointments corticosteroids applied locally and in small quantities on the patches of eczema, prescribed and it should never be stopped abruptly but gradually decrease or between doses.
If intense itching, antihistamines improve symptoms. Some spas (Avene, La Roche-Posay) propose, on prescription, children and parents of courses dedicated to the care of the skin with an anti-inflammatory and soothing effect demonstrated.

How to prepare my next visit?

In children, the output of a tooth or digestive disorders are all triggers that should be noted and report to the doctor. Some allergens (animals, dust ...) cause more severe attacks: spot eliminates them more easily.

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Eczema in adults definition, risks factor, signs and symptoms, prevention


Definition of eczema

Otherwise known as atopic eczema or atopic dermatitis, eczema is a chronic skin disease manifested by inflammation and small bubbles (or vesicles) with severe itching.

Eczema appears between the ages of 2-3 months and 2 years in the form of red patches and small vesicles and usually regresses to 5 years to disappear in most cases to 12 years. Outbreaks are often triggered by infections in children and stress in adults.

Risks and consequences of eczema


Eczema is a common skin disease, rising steadily for 30 years. The increasing awareness of environmental allergens and familial predisposition are two major causes of eczema. More common in children, eczema is approximately 2% of adults.

Causes and origins of eczema


Eczema is first and foremost an allergic phenomenon. Children affected by eczema have a genetic predisposition, family, and awareness to allergens in their environment. Other allergic eczema often accompany such as allergic rhinitis, conjunctivitis or asthma or urticaria.

Signs and symptoms of eczema

The rash eczema develops four symptoms: itchy rash, blisters can come together and form a bubble, oozing blisters burst by forming a crust and finally scarring.
Itching is systematic, sometimes very large, creating a compelling envenomed scratching the lesions.

Adult and strength of itching and scratching, the skin becomes dry, rough and talk about xerosis. After several years, the thick skin turns gray and is called lichenification. Pruritus and lichenification are two elements in adults with severely affected areas like the face, neck, flexures and bust.
The development of symptoms is characteristic sawtooth (relapsing, remitting), outbreaks are reducing gradually with age.

Eczema in adults Prevention


With what should we not confuse eczema in adults?


Contact eczema is a disease independent of atopic eczema or atopic. Contact eczema manifested on contact with an allergenic product remains highly localized and this contact area. Skin tests performed by a dermatologist or allergist can identify the trigger (nickel costume jewelry, hair dyes or colorings among professionals ...). The removal of the product concerned cure.

Will it possible prevention of eczema?


The comfort of the skin is enhanced by simple hygiene measures:

- Toilet or bath daily with soap surgras;

- Dab the skin dry (do not wipe) and moisturise with an emollient cream;
- Prefer cotton wool and synthetic clothing;
- Do not use fabric softener but phosphate-free detergents or soap.
General measures to eliminate mites or allergens from the home are beneficial. Similarly, spa treatments improve symptoms.


To reduce the urge to scratch, it is best to stay cool (avoid differences in body temperature), use moisturizers when itching and refrigerate (placing the tubes in a refrigerator), and if the desire is too strong, better rub or pinch the skin rather than scratching.
Eczema in adults Prepare consultation

When you consult?


Eczema is a chronic disease requiring medical treatment at the first signs. Dry skin in adults should be supported and the vicious circle "scratch-itch-injury" broken.

What is the doctor?

The diagnosis is easy on the lesions presented and their location, scratching and chronic evolution and outbreaks of eczema. No examination is therefore required. Eczema adolescent or adult usually follows a form of the infant, but spontaneous late forms are possible.

The affected areas are reversed compared to infants with pleats (elbow, knee) with head and nipples. During outbreaks, medical treatment based ointments corticosteroids applied locally and in small quantities on the patches of eczema, prescribed and it should never be stopped abruptly but gradually. If intense itching, antihistamines improve symptoms. The fight against dry skin is a priority.

How to prepare my next visit?


Stress, anger, but also outside temperature are all triggers that should be noted and report to the doctor. Some allergens (animals, dust ...) cause more severe attacks: spot eliminates them more easily.

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Uterine cervical dysplasia definition, prevention, treatment



Definition of cervical dysplasia


Cervical dysplasia are precancerous lesions of the cervix that can lead to cancer after a few years. This is why it is imperative to detect and monitor.

Origin of cervical dysplasia

Cervical dysplasia can occur in all age groups from 25-30 years. It is not related to hereditary factors, but to infection by a virus of the family papillomavirus (HPV). HPV is an extremely common sexually transmitted virus. A number of subtypes (but not all) can cause dysplasia.

Screening for cervical dysplasia


All women should receive at least one gynecological exam per year, at the beginning of their sexual lives. This review is an opportunity to make a Pap smear: Using a small brush or spatula, the doctor takes a sample of cells in the cervix and the vagina. The levy is very quick and painless. It is spread on a glass slide and sent to a laboratory for analysis. The blade is then observed under a microscope by experts who examine cells collected, type and quantity. Normally receive a Pap smear is the best way to identify precancerous lesions such as dysplasia and early cancer lesions, easily treated. It is recommended to perform a Pap smear every two to three years (after the first two regular examinations a year apart), this early in his sexual life and up to 65 years.

Prevent dysplasia and cervical cancer vaccine


Preventive vaccines "HPV" lead the body to synthesize neutralizing antibodies capable of protecting us when meeting with the majority of HPV responsible for cervical dysplasia and cancer of the cervix.
The High Council of Public Health recommends vaccination "all girls aged 14 years to protect them before they are at risk of infection." Similarly, "the vaccine is also offered to girls and young women aged 15 to 23 years who have not had sex or at the latest within one year after the beginning of their sexual lives." However, vaccination against HPV infections do not replace screening with Pap smear.

The treatment of dysplastic cervical


Some dysplasias regress spontaneously and do not degenerate into cancer. They just need to be monitored. But others must be processed.

- The injury surveillance is done through a painless test called "colposcopy". This examination can view lesions and monitor their progress. It is played using a colposcope, an instrument that magnifies the image of the vaginal and uterine lining.

- When dysplasia requires treatment, three main approaches can be used, depending on the type and extent of the lesion. The first method is to locally apply a laser vaporization that will burn injury. The second method, cryotherapy, aims to destroy the lesion by freezing. Sometimes it is necessary to perform a minor surgical procedure called cervical conization (see box).
After treatment of dysplasia, there will simply be an earlier gynecological monitoring to verify the absence of recurrence.

Conization of the cervix


Conization is to surgically remove a portion of the cervix. The procedure to confirm the exact type of cervical lesion and its extent. It also allows to completely remove the lesions and thus prevent their progression to cancer of the cervix.
Conization is done by natural means. It can be achieved using electrocautery (électroconisation), a laser, or a "conventional" knife. The procedure can be performed under local anesthesia, locoregional (epidural) or general, depending on the choice of the patient and the decisions of the surgeon and the anesthetist.
Conization does not cause virtually no post-operative pain. This procedure is compatible with subsequent pregnancies.

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Dyslipidemia definition, risks, symptoms, prevention, consultation


Dyslipidemia: definition

Dyslipidemia are abnormal lipids (fats) in the blood. By definition these are figures: assays of biological indicators.

These indicators are part of lipid cardiovascular risk factors. They relate to different forms of blood cholesterol and triglycerides. Cholesterol is not soluble, it is transported as LDL (Low Density Lipoprotein) or bad cholesterol, and HDL-cholesterol (High Density Lipoprotein) or good cholesterol. Their transporter proteins are Apolipoprotein B for LDL-cholesterol and apolipoprotein A1 in HDL-cholesterol.

Deficits in blood lipids are rare in industrialized West, there is little talk of hypolipidemia (or hypolipemia). However, excesses are legion. Hyperlipidemia (or hyperlipidemia) refers to the overall excess blood lipids. One distinguishes excess cholesterol, hypercholesterolemia, of excess triglycerides, hypertriglyceridemia. The different varieties of hyperlipidemia make the rather complex domain there is a medical specialty Lipidology.


Dyslipidemia: risks and challenges

Dyslipidemia is a cardiovascular risk factor, especially the bad cholesterol (LDL-cholesterol). Other risk factors are hypertension, smoking, diabetes, alcohol, obesity (especially abdominal), age, sedentary lifestyle, hormonal contraception and hormone therapy for menopause. The latest recommendations of the European Society of Cardiology (ESC, 2011) add to this already long list HDL-cholesterol in insufficient quantities.

The combination of these factors quickly increases the overall cardiovascular risk, determines the management of dyslipidemia. It can be calculated by using tables to several parameters, refined according to the national level of risk in Europe (SCORE tables).

Overall cardiovascular risk is often responsible for fatal diseases always disabling: atheroma (clogged arteries), aggravation of hypertension, coronary heart disease (angina, myocardial infarction), stroke ( AVC), arteritis of the lower limbs ...

Dyslipidemia are silent for the patient for many years, but present. The proportion of pure hypocholesterolemias (without elevated triglycerides) population would be 30% from Ferrieres et al. (Archives of Diseases of the heart and vessels, 2005).


Dyslipidemia: running

Triglycerides are the reflection of the feed, but not cholesterol depends to 25%. Three quarters of blood cholesterol is produced by the body (liver) mainly under the influence of genetic inheritance. Drugs, endocrine diseases such as hypothyroidism or diabetes also have an impact on blood lipids.

LDL cholesterol is a soluble lipoprotein that transports cholesterol from the liver, where it is produced continuously, bodies in need. These requirements are important because the cell membranes of many hormones are manufactured based cholesterol. Cholesterol is an essential molecule.

LDL cholesterol is called "bad cholesterol" because it is not consumed rapidly by the tissue is deposited in the arteries. There form atherosclerotic plaques, rigid, inflammatory, capable of causing local blood coagulation. The clot can block the artery at the site of its formation, or migrate to the butcher elsewhere (frequent phenomenon in stroke).

HDL transports cholesterol in excess cholesterol to the liver organ which degrades the bile salts and the evacuated in the stool. It is essential to clean the excess cholesterol and therefore called "good cholesterol."

Atherosclerosis combines atheroma (plaques LDL) cholesterol and arterial damage of smoking, diabetes, for example. It is a disease due to cardiovascular risk factors and family history.


Dyslipidemia: symptoms

Dyslipidemia have the distinction of being long silent, that is to say not manifest any symptoms. When symptoms occur cardiovascular (myocardial infarction, angina pectoris, arteritis ...), arterial atherosclerosis and cardiac lesions are already significant.


However, a large excess cholesterol is expressed by fatty deposits around the eyes (xanthelasma) or around the iris of the eye (corneal gerontoxon or arc). This applies especially familial hypercholesterolemia due to a particular genetic profile. Family history of cardiovascular disease, particularly those occurring before age 50, justify the consultation for a full assessment.

The silence of dyslipidemia justifies a regular Blood tests of the population. But how often? In the USA, considerable prevalence of obesity in children (almost 30%) did pediatricians recommend a routine blood screening between ages 9 and 11. The blood test is recommended based on specific clinical situations.

Dyslipidemia Prevention

With what should we be confused dyslipidemia?

The diagnosis of dyslipidemia is a biological definition encrypted, which can not be confused with another disease.


However, it is not a disease in itself until you have verified that dyslipidemia is not part of another disease, or that it is a particular genetic profile.


Will it possible prevention of dyslipidemia?

Yes, before any incident prevention (primary prevention) is possible and desirable for a healthy lifestyle, effective but demanding. A Finnish study showed that anti-cholesterol and adequate exercise regime fell cardiovascular mortality by 65% ​​in men. (Progress in Cardiovascular diseases, November 2006).

Weight loss in overweight people lowers blood fats, the sugar and the blood pressure. After a stroke, the lifestyle changes and medication are significantly lower risk of recurrence (secondary prevention).

National campaign to promote good health habits established by the Ministry of Health (National Health NFHP or nutrition program) aimed at reducing cardiovascular risk according to the public health laws passed since 2004.

Dyslipidemia Prepare consultation

When did you consult?

As dyslipidemia are long silent must carry out regular assessments. Screening every five years from age 40 for men (50 years or menopause for women) is usually recommended when there is no other known cardiovascular risk factors that will require the practice earlier. Family history of dyslipidemia warrant early detection, sometimes from childhood.


How to prepare the consultation with the doctor?

Gather family history of cholesterol, triglycerides and cardiovascular disease.
Bring his blood tests with the determination of cholesterol and triglycerides.


Finally, a summary of its power gives valuable insights.


What is the doctor?

He practices a blood test as recommended best practices, in addition to the comprehensive review of the patient, particularly when advancing age. He is looking for an organ by atherosclerosis reached.


The lipid laboratory tests used to assess cardiovascular risk. The controversy over the levy fasting or not was decided by the European Society of Cardiology (Recommendations on dyslipidemia, 2011). Triglycerides should be measured fasting. But total cholesterol, apolipoproteins A1 and B, and HDL-cholesterol can be assayed at any time.

Then the doctor makes the counting of cardiovascular risk factors and place the patient in a European risk tables: SCORE. The European Society of Cardiology has updated in 2011. Cardiovascular risk is expressed in percent, this risk is at least a cardiovascular event within 10 years. Between 1 and 5%, the person is said to moderate risk between 5-10% high risk (high risk), beyond 10% the risk is very high (very high risk).

This explains why we can not set standards for assembly without cardiovascular risk. For a healthy young adult without further risk, total cholesterol should be less than or equal to 2 g / l, greater than or equal to 0.4 g HDL cholesterol / l, less than or equal to 1.5 g triglyceride / l. These values ​​are more severe with the confirmation of the adverse impact of hyperlipidemia on health, and especially as life expectancy is high.


Support depends on the risk


In patients at very high risk, LDL-cholesterol (LDL-C) should ideally be less than 0.7 g / l. If this goal can not be achieved, it must be reduced by at least 50% of the initial value of LDL-C. In patients at high risk, it is an LDL-C less than 1 g / l. In patients at moderate risk, is an LDL-C less than 1.15 g / l.

Various measures are taken by successive additions, or immediately when the whole cardiovascular risk is high or very high. The first is the implementation of SUITABLE lifestyle and dietary measures, the second is the disappearance or reduction of other modifiable risk factors: smoking, obesity, hormonal contraception ...


The treatment of hyperlipidemia by lipid-lowering drugs may be necessary. He never taught the proper treatment of associated diseases: hypertension, metabolic syndrome, diabetes ...

Regular monitoring is essential because it determines the success of follow-up care.

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Sickle Cell Definition, Prevention, Consultation


Definition of SCD

Sickle cell disease is a genetic disorder, hereditary, characterized by abnormal hemoglobin in the red blood cells. The hemoglobin is to carry oxygen and abnormal sickle cell hemoglobin (hemoglobin S) prevents the cells to perform this function.

For a child to be reached by the disease, it is necessary that both parents have transmitted the S gene: it is then homozygous SS. In case of transmission of a single S gene (heterozygous patients AS), the child will not develop the disease but it may transmit to their offspring.

Screening and risk of SCD

In France, 300 SS homozygous sickle cell children were born in 2003. The geographical distribution is concentrated in Ile-de-France and the Caribbean.
The people carrying the sickle cell gene are mostly from sub-Saharan Africa, the Caribbean and North Africa.



Screening for sickle cell disease at birth has been generalized by the French Association for the detection and prevention of disability (AFDPH) and is targeted to infants whose parents are from "country risk".
Anti-infective treatments and education is now possible to handle the complications of sickle cell disease.

Causes and origins of sickle cell disease

To develop the disease and the symptoms of sickle cell disease, it is necessary to have both SS genes: this is called homozygous SS.
The patient homozygous hemoglobin SS is changed and when oxygen is scarce (cold, fever, dehydration, altitude), red blood cells change shape ("sickle"). They rigidify and become unable to circulate throughout the body, causing the occlusion of painful crises and premature destruction.

Signs and symptoms of sickle cell disease


Patients with only one abnormal gene S are asymptomatic.
If both genes are defective, the abnormal hemoglobin causes several symptoms. Anemia (low hemoglobin) is chronic because red blood cells are fragile: fatigue, yellow whites of the eyes are usually the only well tolerated signs.


However crises punctuate the evolution of the disease and are associated with red blood cells that form plugs in blood vessels: it is called "vasoocclusives crises." These crises affect the limbs (hands, feet), spleen (which can not fulfill its role antiinfection), but potentially all organs.

They are responsible for pain, redness members, increase the volume of the abdomen, fever ...
Bone and lung infections are the most frequent, especially in children under 3 years ssignes.
The frequency of attacks is very variable.

Sickle Cell Prevention

With what should we be confused?


Do not confuse "sickle cell trait" which means that the patient has sickle cell gene and sickle regards the holders of two genes. Only the latter are affected by sickle cell crises.

Will it possible prevention?


With relatives may be carriers of the sickle cell gene, genetic counseling can be offered for prenatal diagnosis during pregnancy.


With sickle cell disease proved (homozygous SS), preventive measures aimed at reducing the frequency of seizures. Cold exposure should be minimized (remain in the classroom at recess, after drying the pool ...). Sports and violent efforts are to be avoided, as all situations at risk of dehydration, altitude above 1500 m is prohibited (skiing holidays cons-indicated).


No special diet is recommended but drinks must be abundant.
Vaccinations (including pneumococcal) are to be followed scrupulously.
The school child will receive an individualized home Project (PAI) related to parents, teachers and doctors.

Sickle Cell Prepare consultation

When you consult?


Any fever above 38 ° C requires special vigilance and a medical consultation in case of pain, it is advisable to stay hydrated and take a pain medication until the medical consultation.
If you have chest pain, high fever, pallor important or unusual pain, immediate hospitalization is recommended (UAS Centre 15).

What does the doctor in case of sickle cell anemia?

Theoretically, the diagnosis is made ​​during the screening at birth. Consultation between the parents and the doctor (hematologist, pediatrician) can explain the disease, which manifests itself yet. An assessment is recommended during this first consultation with essentially a blood (red cells, blood group, G6PD assay, determination of iron, hemoglobin S research ...).
There is no treatment for the genetic cause of this disease. Treatment is symptomatic crisis (oxygen, analgesic against the pain ...). Blood transfusion is a resort of emergency deep anemia.

How to prepare my next visit?


Therapeutic education of parents is fundamental. Between visits, you must monitor the occurrence of fever or behavior changes (irritability, crying ...), first witnessed a vasoocclusive crisis.

Drugs against pain are given by the environment, but in case of high fever or abnormal reaction, a quick reference is needed. Identify triggering circumstances will better avoided.

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Degenerative Disc Disease - Definition, Origin, Causes, Symptoms, Prevention, Consultation


Definition of degenerative disc disease


Degenerative disc disease is a major cause of back pain. It corresponds to a loss of flexibility and elasticity of intervertebral discs, which lose their capacity to absorb shocks. The ligaments surrounding the discs are also affected, as the bones (vertebrae). The most common and lumbar degenerative disc disease is also called lumbar osteoarthritis.

Origin of degenerative disc disease


Degenerative disc disease is a process linked to natural aging. It is estimated that 80% of French people suffer from back pain, the causes are variable.


Some predisposing factors, such as genetic predisposition, but poor posture or incorrect movements can accelerate the process.

Causes of degenerative disc disease


Age is the main factor for degenerative disc disease. The intervertebral discs are the cushions shock absorbers between the vertebrae, and are used to absorb shock when walking, running or any other movement seeking the spine. By drying with aging, these discs lose their flexibility qualities, the ligaments that surround become brittle and ultimately degenerative disc disease causes pain, including nerve root compression. Some back injuries can also promote the alteration of records.

Symptoms of degenerative disc disease

Low back pain, or pain in the lower back are the most common symptoms. They are linked to the development of degenerative disc disease that can even lead to nerve root compression, with pain in the legs and a feeling of weakness. The stiffness of the spine, especially the lumbar stiffness, is also common, especially in the late afternoon.

Degenerative Disc Disease - Prevention

With what should we be confused?

It should not be confused degenerative disc disease and herniated discs. The herniated disc is a protrusion of the intervertebral disc, the latter out of its shell and compresses the nerve roots, producing the classic sciatic pain.
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Another differential diagnosis of infectious spondylitis, that is to say, the infection of an intervertebral disc. This rare condition is characterized by constant pain, inflammatory pain is called because they occur during the day and night, and are not related to movement. Inflammatory pain is a major pain in the evening and early night and decreases after heating, it is a pain stiffness, unlike mechanical pain that is aggravated by ous support and rest.

Will it possible prevention?

As with any back pain, from simple lifestyle advice to prevent or reduce pain. Regular exercises, abdominal muscles and dorsal satisfactory (support of the spine) and the fight against overweight are essential.


Gestures and postures are the basic steps of prevention: back straight, look right, squat by bending the knees to lift a load, to provide rest periods to stretch or expand when station sitting, use straight-backed chairs and possibly swivel to avoid twisting.


Wearing backpacks is preferred to handbags and high heels more than 5 cm are recommended.

Degenerative disc disease - Consultation

When consulted?

Some advanced discopathies can cause a significant narrowing and neurological cuts. In case of very severe pain, signs of muscle weakness in the lower or even paralysis members should be consulted in an emergency.

What is the doctor?

The doctor suspects the diagnosis of degenerative disc disease on examination data (age, type of pain, rate of pain ...) and full consultation with a complete physical examination. Neurological examination eliminates one complication, and test muscle strength and reflexes. The rheumatological examination checks the mobility and flexibility of the spine.

X-rays or even a CT scan or MRI are often used to visualize lesions. The radiography and for example in case of degenerative disc disease, narrowing of the spaces between the vertebral body is visible, as well as bone defects from osteoarthritis, or "caps parrot".


Regarding remedies, most people are relieved by non-surgical treatments (exercises, physiotherapy). Medicines and injections are sometimes necessary to relieve pain.

Surgical treatment is reserved for advanced forms. A disc prosthesis with an artificial disc may come to replace the damaged disc. Another technique, spinal fusion is to weld two vertebrae together to stabilize the spine and relieve pain.

How to prepare for my next visit?

It is desirable to identify the circumstances or movements that trigger pain. In fact, your doctor or physical therapist can offer you accommodation of position or posture.


At work, the occupational physician can also help you in terms of ergonomics.

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Acute diarrhea Prevention, Prepare consultation

Acute diarrhea Prevention

With what should we not confuse acute diarrhea?

With diarrhea called "chronic" (persisting for more than six weeks with at least one liquid stool per day), which may manifest as episodes that the patient does not connect them.


Chronic diarrhea resulting in weight loss and fatigue is always suspect.

These signs may indicate serious chronic parasitosis, colorectal, Crohn's, celiac disease, overactive thyroid disease or cancer ... sustainable food intolerance (lactose in cow's milk, sorbitol, gluten, fruits, alcohol, spicy foods or too, etc.).


Is there a possible prevention of infectious diarrhea?

It is very effective but little practiced! To prevent infectious diarrhea, strict hand hygiene and health is necessary and largely sufficient.


Wash your hands frequently with soap and water or with an alcohol-based gel.


Use disposable paper to wipe your hands and not cloth napkins.

To avoid food poisoning, watch what you eat: expiration date and proper storage of food. Keep perishable food in the refrigerator and check there.

To prevent traveler's diarrhea (Montezuma), do not drink tap water or ice. Do not eat raw food. Prefer baked or fried foods prepared before your eyes and immediately consumed: germs do not have time to grow it.

To prevent gastroenteritis in infants and young children, all of the above advice is good. Under certain circumstances (family instability) vaccines are available (against rotavirus for example).

Acute diarrhea Prepare consultation

When did you consult?

Quickly when the diarrhea is accompanied by so-called gravity signs: blood in the stool or pus, mucus (substances like egg white). But as fever, vomiting preventing feed and rehydrate, general malaise imposing bed, confusion and delirium, coma.

In general, any acute adult diarrhea that lasts more than 48 hours without any improvement should be seen by a doctor.

For infants, do not wait, because their dehydration is very fast (a few hours). The alarm is in the child's general health and weight loss. A weight loss of 4% requires the urgent hospitalization must act before! A child who does not respond is in great danger.

The elderly are also at the first signs of dehydration to avoid sequelae sensitive organs: kidneys, brain, heart. And prevent death.

Diarrhea that lasts for several weeks is never normal, consult your doctor immediately weight loss.

How to prepare the consultation with the doctor?

List your eating habits and your recent meal, epidemics occurring in the environment, as well as medications taken, including those taken without a prescription.

Children and the frail elderly should be immediately rehydrated with oral rehydration solutions (ORS) sold in pharmacies.


What is the doctor?

After general examination and weighing of the patient, the doctor distinguishes transient mild diarrhea that resolves spontaneously, a worrying diarrhea requiring special treatment or hospitalization explorations.
He may prescribe a blood, urine, and stool analysis.


Persistent diarrhea without clear explanation, or requiring an assessment justifies a colonoscopy (endoscopic examination of the intestine) and specific research (testing a gluten intolerance or celiac disease).

Faced with a bacterial or parasitic infectious diarrhea, targeted antibiotic treatment is usually necessary, sometimes pitting initially. Adequate rehydration treatment with complete rest at home. Hospitalization is required when an infection toxigenic (toxin-producing E. coli) because the toxins severely affect organs.

Faced with an epidemic viral diarrhea, says symptomatic treatment (relieving the signs) can wait for spontaneous recovery in 3-4 days: Regular rehydration, antispasmodic, digestive buffers, anti-diarrheal, and rest at home. This second objective is to prevent the spread of epidemic virus in school or professional circle.

Strict hand hygiene and sanitation is essential in all cases.


The persistence of acute diarrhea 48 hours despite appropriate treatment is suspected, should be consulted again.


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