Pouvoir antimicrobien des flavonoïdes extraits des feuilles de Marrubium vulgare L. en provenance du mont de Tessala (Algérie occidentale)

Five flavonoic extracts obtained from the leaves of Marrubium vulgare L. were tested on four bacterial strains (Pseudomonas aeruginosa ATCC 27835, Escherichia coli ATCC 25922, Bacillus cereus ATCC 1306 and Staphylococcus aureus ATCC 13565) and two fungal strains (Penicillium digitatum ATCC 201167 and Aspergillus niger ATCC 16404). They present a remarkable antibacterial effect on the Gram+ bacteria and a moderate antifungal activity. The minimal inhibitory concentrations (MICs) vary between 6.25 and 50 μg/ml according to the flavonoic extract and microbial strain. The phytochemical screening and the thin layer chromatography (TLC) showed the existence of some classes of flavonoids being able to be responsible for the antimicrobial power of Marrubium vulgare L.     

Die epifasziale Elektrostimulation des N. occipitalis bei therapierefraktärer Okzipitalisneuralgie

BACKGROUND: The term "neuralgia of the occipital nerve" in clinical work includes different kinds of pain in the occipital region. Correctly, this diagnosis should be reserved for such pain syndromes which, corresponding to the definition of neuralgia, are due to damage of the cervical roots C1-C3 or of the major occipital nerve arising from those roots. We introduce an operative method to treat chronic therapy-resistant headaches in the area of the major and minor occipital nerve. The courses of three of the first patients operated in our hospital are described. METHODS: An electrode with four poles is positioned epifacially in the area of the affected nerve in local anaesthesia. In cooperation with the patient the correct position of the electrode and the right poling have to be found. Afterwards, the electrode is externalized after subcutaneous tunneling. For several weeks, the patients stimulate while being at home. If they report about a satisfactory reduction of pain, a subcutaneous receiver for use with an external stimulator is implanted. RESULTS: Most of the patients who received an electrode had a satisfying reduction of pain of 50-100% during the testing period so that the receiver was implanted. We had no success in two patients whose occipital nerves were destroyed by previous operations so that the system was explanted. CONCLUSIONS: The epifacial stimulation of the occipital nerve is an effective method to treat neuralgia of this nerve. Patients with destruction of the nerve have to be excluded, because in their cases the stimulation does not work.     

étude des activités anti-inflammatoire, analgésique et antipyrétique des décoctés aqueux des feuilles et des racines de Pterocarpus erinaceus Poir. (Fabaceae)

Pterocarpus erinaceus Poir. (Fabaceae) is a medicinal plant used in the treatment of several diseases including inflammatory diseases. The aim of this work was to carry out the anti-inflammatory, analgesic and antipyretic activities of aqueous decoction of the leaves and roots barks of Pterocarpus erinaceus in order to enhance its use in folk medicine. At 200, 400 and 600 mg/kg aqueous decoctions of leaves and roots bark significantly reduced edema induced by carrageenan and writhing produced by acetic acid injection. These extracts inhibited both phases of pain induced by formaldehyde injection. Hyperthermia induced by the yeast was reduced by aqueous decoction of leaves and roots bark but leaves aqueous decoction showed more strong activity than roots bark. Phytochemical screening of extracts allowed the identification of tannins/polyphenols, flavonois, saponins, triterpenes and steroids, which may responsible for pharmacological properties.     

Klinische Untersuchung des Hüftgelenkes des Erwachsenen

Complaints in the region of the hips and pelvis are often difficult to classify. This is due to the fact that pain projection and overlapping can occur; therefore, the complete region of the lumbar spine, pelvis and hips must be considered as a single entity in which alterations can result in radiation throughout the whole region. There are many different anatomical structures within the pelvic region so that the function of various muscle components can be impaired and cause pathological alterations to positional relationships of bony structures or even alterations to other soft tissues, such as ligaments, tendons and labra. In terms of differential diagnostics the groin must be seen as the weak point of the peritoneum and vascular system and taken into consideration. Therefore, a detailed and targeted medical history, functional testing and specific examinations and tests are necessary to narrow down the pathology in question and reach a definitive diagnosis. Orthopedic surgeons must know which conspicuous features can lead to which problems and which anatomical structures are likely to be affected by irritation. The results of the clinical examination are the basis for targeted imaging diagnostics and subsequent therapy.     

Effets comportementaux des cannabinoïdes Données animales

Résumé  Deux sous-types de récepteurs cannabino?des (CB-R) sont identifiés à présent, les CB1-R, essentiellement localisés dans le SNC, et les CB2-R, périphériques. Le Δ9-tétrahydrocannabinol (Δ9-THC) est le composé actif essentiel de Cannabis sativa, l’anandamide est un ligand endogène, le WIN 55,212-2, le CP55,940, le HU-210, sont de puissants agonistes synthétiques, mais tous sont non sélectifs CB1/CB2. Chez l’animal, ils induisent l’association caractéristique de quatre sympt?mes: hypothermie, analgésie, hypoactivité et catalepsie, qui sont annulés par le SR 141716, antagoniste sélectif CB1. L’anandamide présente plusieurs différences par rapport aux autres agonistes puisque l’hypothermie, l’analgésie et la catalepsie qu’il induit ne sont pas atténuées par le SR 141716. Un processus cannabino?de semble également intervenir dans la cognition, la mémoire, l’anxiété, le contr?le de l’appétit les vomissements, la pression intra-oculaire, l’inflammation et les réponses immunitaires. Bien que le Cannabis ait un usage récréationnel chez l’Homme, rares sont les études qui indiquent un potentiel appétitif chez l’animal. Au contraire, le Δ9-THC et les autres agonistes ont des effets aversifs dans divers tests. Le SR 141716 altère la perception par les animaux du caractère plaisant de différentes substances appétitives (nourriture, coca?ne, morphine) et réduit la consommation de sucre, de bière et d’alcool, suggérant que des mécanismes dépendant des CB1-R pourraient exercer un contr?le permissif sur les processus motivationnels positifs. Les systèmes cannabino?des ne semblent pas activés dans des conditions basales. Cependant, une étape dépendant d’une activation tonique des CB1-R a été mise en évidence dans le cas de douleurs chroniques et chez des animaux confrontés à des stimuli anxiogènes ou à des renforcements très motivants. Des mécanismes CB1 pourraient également exercer un contr?le tonique sur certains processus cognitifs.      

Prévention des lésions des cartilages de croissance des doigts chez les jeunes grimpeurs

Introduction

Epiphyseal stress fractures of the second phalanx base of the fingers are predominant in young climbers. The objectives of the study were 1) to determine the incidence of these injuries among young French competitive climbers (9–18 years old); 2) to determine injury risk factors during training.

L’évaluation des pratiques addictives des douloureux chroniques

Résumé  La clinique des pratiques addictives des douloureux chroniques est complexe et a longtemps fait l’objet de publications contradictoires. Une mise au point s’avère d’autant plus nécessaire que le r?le étiopathogénique, de l’abus médicamenteux dans l’aggravation et la chronicité de certains types de douleurs est largement reconnu. Différents auteurs soulignent que l’évaluation des comportements addictifs des patients douloureux chroniques pourrait être améliorée, si l’on utilisait les définitions standardisées appliquées classiquement à la toxicomanie, celle de l’Association Américaine de Psychiatrie (dépendance et abus), et celle de l’Organisation Mondiale de la Santé (dépendance et usage nocif pour la santé). Le recours à des définitions standardisées (abus, dépendance) ne peut rendre que plus lisibles les données recueillies. Les comparaisons deviennent possibles et l’examen des études publiées fournit une approximation de la prévalence de l’abus et de la dépendance médicamenteuse des sujets consultant pour une douleur chronique (entre 10 à 20%). Mais, l’inadaptation partielle de ces définitions lorsqu’elles sont appliquées à la population des douloureux chroniques est discutée. Leur inconvénient principal est que les comportements addictifs de la majorité de ces sujets douloureux chroniques n’entrent pas dans la catégorie de la dépendance ni même de l’abus de médicaments. Cette évaluation, bien qu’utile, s’avère être réductrice face à la complexité de la psychopathologie des conduites addictives et de ses intrications multiples avec la pathologie douloureuse.

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Summary  Addiction in chronic pain patients is a complex topic and the studies published have long been contreversial. Some authors suggested that the use of standardized diagnostic criteria for addiction developped in the population of substance abusers could improve the assessment of addiction in chronic pain patients. Operational diagnostic criteria have been defined by the World Health Organization (for substance dependence and harmful use) and the American Psychiatric Association (for substance dependence and abuse). A review of studies using these criteria indicated that drug dependence or abuse occurred in a minority of chronic pain subjects (10 to 20%). These definitions should be interpreted caustiously when applied to chronic patients and the limitations are discussed. It appeared that the categorical model of substance use disorder could be applied to a subset of chronic pain patients but that clinical observations and quantitative evaluations indicated that a larger subset of addictive behaviors were not captured by this kind of evaluation.

     

La responsabilité médico-légale des médecins des Samu et des Smur

A study on the legal liability of physicians working for the SAMU and SMUR emergency medical services was carried out based on a retrospective assessment of all the accidents involving the intervention of medical staff, recorded between 1994 and 1999 by the Sou Médical. During this period, a total of 15 claims were made concerning physicians who acted either in a transporting capacity (ten claims) or in a regulatory capacity (five claims). In the majority of cases (12 out of 15 cases), the claim followed legal proceedings. In two other cases, it was submitted after a verbal or written complaint, in one case, it was spontaneously submitted by a physician following the accidental death of a patient during transport, without any complaint being made by the victim's family. The medico-legal repercussions of the 15 accidents reported in the study were only known in 11 cases, as in the remaining cases there were ongoing legal proceedings. None of the 11 cases involved conviction for any of the doctors concerned. In particular, the criminal lawsuits brought against three regulators and three transporters led to closure of the file (two instances) or to dismissal of the case (four instances). In contrast to the high ratio of criminal lawsuits initiated by the patients, in this series of 15 accidents the fact that no doctor was sentenced by the court reflects a degree of partiality on the part of the judges towards the doctors involved in emergency medical service activity.     

Efficacité et tolérance des capsaïcinoïdes topiques dans le traitement de la douleur neuropathique. Une revue systématique et méta-analyse des essais cliniques randomisés

Introduction

Neuropathic pain is frequent and its management can be difficult in case of unsuccessful treatment and side effects. An alternative to systemic treatments is the topical use of capsaicinoids. The goal of this work is to evaluate the efficacy of the topical use of capsaicinoids to treat neuropathic pain.

Method

In agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic research of clinical trials published between 1/1/1990 and 31/08/2014, in English and French, was performed in PubMed/Central and the Cochrane Database. The indications, modalities of treatment and therapeutic results were registered. Qualitative and quantitative (meta-) analyses of the data were performed.

Results

Seventeen studies were included, from 153 identified works. The extracted data permitted us to conclude that capsaicin is efficient in treating post-herpetic neuropathic pain as distal HIV-associated polyneuropathy. The data are insufficient to conclude whether the indications may be broadened.

Conclusion

Topical capsaicin is effective in treating postherpetic and HIV-associated neuropathic pain. Further studies are needed to evaluate other indications and the potential place of other capsaicinoids.

     

Activité antimicrobienne des huiles essentielles de Pistacia atlantica Desf. de l’Algérie

Antimicrobial activity of essential oils of Pistacia atlantica Desf. resin, collected in three localities from the western and south-western of Algeria was tested in vitro on clinical isolates of seven species of bacteria (Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Xanthomonas maltophila, Enterococcus feacalis, and Staphylococcus aureus) and three species of fungi (Candida albicans, Candida albicans ATCC20027 and Candida albicans ATCC20032). Diffusion method was used for antibacterial and antifungal activities testing. All of the extracts showed strong antimicrobial activity against both fungi and bacterial strains at the concentration of 10⁵ µg/ml. The essential oils exhibited strong antibacterial activity against Staphylococcus aureus and Enterococcus feacalis with MIC lower than 10 µg/ml. Candida albicans showed resistance to all volatile oils tested.