Plantes et dysfonction érectile

Résumé: La dysfonction érectile est un phénomène de santé relativement important dont les conséquences sont néfastes pour lhomme et son entourage. De nombreux traitements par des molécules de synthèse sont actuellement proposés pour pallier ces troubles, mais leur coût élevé, ainsi que les effets secondaires quils engendrent, redonnent un nouvel élan aux substances naturelles. Certaines préparations dorigine végétale nont pourtant aucun effet et ne sont pour la plupart que légendes. Dautres, peu nombreuses, ont une activité réelle prouvée sur le plan scientifique. Par ailleurs, de nombreuses plantes prometteuses dans le traitement des dysérections nont fait lobjet que de rares investigations et mériteraient une étude pharmacologique plus approfondie.     

Phyto News

Phyto News est la revue commentée de communications dans le domaine de la plante médicinale (recherche pharmacologique et clinique), qui nous semble présenter un intérêt médical ou pharmaceutique tel quil puisse permettre de faire progresser dautres études qui aboutiront à une application thérapeutique. Il est cependant important davertir les lecteurs que dune découverte ou dune démonstration pharmacologique ne découle pas immédiatement la justification de lutilisation médicale.

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Phyto News is a commented review of papers about medicinal plant research all around the world. The papers must contain information leading to medicinal progress in phytotherapy practice or development in the pharmaceutical area. The reader is reminded that not all discoveries will have immediate use in medicine, but each may give ideas for further investigations.

     

Serum MIP-1α and IL-8 in septic patients

We studied blood MIP-1 and IL-8 in 38 septic patients and 5 healthy volunteers. Both chemokines were undetectable in the healthy volunteers. In sepsis, serum MIP-1 was detected in 45% of the patients and IL-8 in 84%. The levels of MIP-1, but not of IL-8, correlated with CRP, IL-6 and TNF levels. Complication, including various organ failures and mortality, showed no correlation with serum MIP-1 levels. In contrast, we found increased levels of serum IL-8 in septic patients with disseminated intravascular coagulation, central nervous system (CNS) dysfunction or renal failure, and the mortality rate was higher in the IL-8-detectable group than in the IL-8 undetectable group (50% vs 0%,p<0.05). In conclusion, the production of both MIP-1 and IL-8 was increased and initially detectable levels of circulating IL-8 predicted high mortality in sepsis.Objective To determine the significance of the C-C chemokine MIP-1 and the C-X-C chemokine IL-8 in sepsis.Design Prospective study.Setting Clinical investigation, emergency department and general intensive care unit of university hospital.Patients and participants 38 septic patients and 5 healthy volunteers were studied. Sepsis was diagnosed following the criteria formulated by ACCP/SCCM.Interventions 10–20 ml of blood was drawn from each patient at the time of initial diagnosis of sepsis.Measurements and results MIP-1 and IL-8 were determined by sand-wich ELISA. Both chemokines were undetectable in the healthy volunteers. In sepsis, serum MIP-1 was detected in 45% of the patients and IL-8 was detected in 84%. The levels of MIP-1, but not of IL-8, correlated with CRP, IL-6 and TNF levels. Complications, including various organ failures and mortality, showed no correlation with serum MIP-1 levels. In contrast, we found increased levels of serum IL-8 in patients with disseminated intravascular coagulation (DIC) (p<0.05), central nervous system (CNS) dysfunction (p<0.05), renal failure (p<0.01) and the mortality rates were higher in the IL-8 detectable group than in the IL-8 undetectable group (50% vs 0%,p<0.05).Conclusions The production of MIP-1 and IL-8 was increased in sepsis. Furthermore, an initially detectable level of circulating IL-8, but not MIP-1, predicted a high mortality in sepsis diagnosed according to the ACCP/SCCM criteria.This study was supported in part by a Grant-in-Aid from the Japanese Ministry of Education, Science and Culture, the Waxman Institute Research Fund and the Keio Fukuzawa Fund     

The sex killer

Thirteen sex killers were compared to 13 nonsex killers and 13 nonhomicidal sexually aggressive men on sexual history, substance abuse, history of violence, mental illness and personality, brain pathology and endocrine abnormalities. There were more similarities among the three groups than differences. Among the findings, the presence of transvestism and the early appearance of sadism differentiated the sex killers from the other two groups. Sex killers also killed by strangulation more often than nonsex killers and more often victimized a female stranger. The sex killer was more often diagnosed as antisocial personality and sadist than the other two groups. They were more often considered psychotic at the time of their offence and more often considered not guilty by reason of insanity. Directions for future research are noted.     

Oxygenation remains unaffected by increased inspiration-to-expiration ratio but impairs hemodynamics in surfactant-depleted piglets

Objectives Prolongation of inspiratory time is used to reduce lung injury in mechanical ventilation. The aim of this study was to isolate the effects of inspiratory time on airway pressure, gas exchange, and hemodynamics, while ventilatory frequency, tidal volume, and mean airway pressure were kept constant.Design Randomized experimental trial.Setting Experimental laboratory of a University Department of Anesthesiology and Intensive Care.Animals Twelve anesthetised piglets.Interventions After lavage the reference setting was pressure-controlled ventilation with a decelerating flow; IE was 11, and PEEP was set to 75% of the inflection point pressure level. The IE ratios of 1.51, 2.31, and 41 were applied randomly. Under open lung conditions, mean airway pressure was kept constant by reduction of external PEEP.Measurement and results Gas exchange, airway pressures, hemodynamics, functional residual capacity (SF₆ tracer), and intrathoracic fluid volumes (double indicator dilution) were measured. Compared to the IE of 11, PaCO₂ was 8% lower, with IE 2.31 and 41 (p0.01) while PaO₂ remained unchanged. The decrease in inspiratory airway pressure with increased inspiratory time was due to the response of the pressure-regulated volume-controlled mode to an increased IE ratio. Stroke index and right ventricular ejection fraction were depressed at higher IE ratios (SI by 18% at 2.31, 20% at 41; RVEF by 10% at 2.31, 13% at 41;p0.05).Conclusion Under open lung conditions with an increased IE ratio, oxygenation remained unaffected while hemodynamics were impaired.This study was supported by the Swedish Medical Research Council (project 4252), the Swedish Heart-Lung Foundation, Stockholm, Sweden, and the Laerdal Foundation for Acute Medicine, Stavanger, Norway     

Transthoracic electrical impedance during extracorporeal hemodialysis in acute respiratory failure (“Shocked lung syndrome”)

The alteration (Z ₀ ) of transthoracic electrical impedance (TEI) during extracorporeal hemodialysis (EHD) was investigated in two Groups of patients with acute renal and acute respiratory failure, that differed with respect to the severity of respiratory insufficiency. Group I had moderate respiratory failure (Fi _{O 2} 0.31±0.10, Pa _{0 2} 84±14 mmHg), and Group II had severe respiratory failure (Fi _{0 2} 0.75±0.17, Pa _{O O} 77±14 mmHg). There was a significant correlation between increase in TEI (Z₀) and decrease in body weight (BW) in each individual patient, but the slope of regression lines was remarkably flattened in Group II. In Group I, TEI was 1.9±0.9 , the calculated TEI for 500 gr decrease in BW (Z_{0–500 gr}) was 0.59±0.21 , and a significant correlation existed between pooled data of Z₀ and BW. In Group II TEI increased less significantly, TEI was 0.6±0.3 (P<0.001), Z_{0–500 gr} was 0.26±0.27 (P<0.01), and there was no correlation between pooled data of Z₀ and BW. Increase of TEI in Group II could be completely attributed to increase in hematocrit. It is concluded that patients of Group I with acute renal failure and moderate respiratory failure lost intrathoracic fluid during EHD, whereas patients of Group II with severe respiratory failure did not. TEI during EHD may serve as a test for detection of fixed fluid within the pulmonary interstitium indicating a poor prognosis of the acute respiratory failure.     

Self-efficacy expectancies versus outcome expectancies as determinants of performance deficits and depressive affect

To compare the depression etiologies specified by self-efficacy theory versus the revised learned helplessness theory, 108 male and female undergraduates were assigned randomly to either high, low, or no self response expectancy manipulations and high, low, or no response outcome expectancy manipulations. Expectancies were modified by combinations of easy or difficult anagrams and graphs showing that most or few students solved the anagrams. Males exhibited performance deficits and depressed affect following manipulations only if self response expectancy had been set low and other response expectancy had been set high. Contrary to revised learned helplessness theory, no performance deficit or depressive affect occurred when both self response and response outcome expectancies were low. Females' performance and affect were not changed by combined low self response and high response outcome manipulations. Repeated subject ratings of self response and response outcome expectancies during manipulations suggest that females set their self response expectancies low before manipulations to avoid depression. Expectancy ratings also showed that self response expectancies correlated more strongly with performance than did response outcome expectancies.We thank Katherine Acosta, Michael Davis, Larry McFarland, and Janine Tronolone for their assistance as experimenters.     

Plantes médicinales d’Amérique du Nord: apport à la phytothérapie française du traitement des affections des voies respiratoires

Résumé: Lanalyse des données littéraires, comme la constatation sur le terrain, permettent dapprocher une phytothérapie traditionnelle des États-Unis et du Canada avec des plantes des contrées nord-américaines. Lexamen des données ethnobotaniques, pharmacologiques et cliniques dun certain nombre de drogues utilisées dans les affections de la sphère respiratoire permet de proposer aux phytothérapeutes européens un complément dans leur pratique thérapeutique. Seront passées en revue des plantes classiques comme le polygala de Virginie, la grindélie, le lédon du Groenland, la médecine oshá, lyerba santa, qui sadressent à différents états pathologiques de larbre respiratoire.     

Stories from doctors of patients with pain. A qualitative research on the physicians’ perspective

Goal of work .The aim of this study was to explore the physicians internal representation of the doctor–patient relationship in the dramatic field of the patient with pain.Methods Using an open narrative format, 151 physicians were asked to Tell us about an episode during your professional experience in which you found yourself in difficulty whilst confronting a patient who was in pain. The narrations were examined in accordance with a clinical-interpretive method.Main results Three perspectives of observation were identified, namely: the biological perspective, the professional perspective, and the personal perspective. The biological perspective is about the biological model and the depersonalization of pain. In the professional perspective, the narrative concerns the patient as a person and the reattribution of the pain to the suffering person. The personal perspective is about the emotional-relational explosion within the meeting between the doctor as human being and the patient as human being. Most of the narrations did not strictly connect to one or another of the perspectives, but each story seemed a journey without peace back and forth among the perspectives.Conclusions The professional perspective seemed to be the only place in which physicians could stop, a space not extreme in which they seemed to express the need for education about the management of the professional relationship with the other person.     

Surfactant adjunctive therapy forPneumocystis carinii pneumonitis in an infant with acute lymphoblastic leukaemia

We report successful treatment of adult respiratory distress syndrome (ARDS) with artificial surfactant (40mg/kg, Colfosceril Palmitate, Exosurf, Wellcome) in an infant with severePneumocystis carinii pneumonitis.     

Plantes et vieillissement, données actuelles*

Résumé: Le vieillissement résulte dune suite de mécanismes biologiques sacconpagnant de modifications physiologiques, anatomiques et psychologiques.Après avoir rappelé ses manifestations physiologiques (cérébrales, hormonales, cutanées, cardio-vasculaires, troubles de lappareil locomoteur), lauteur sélectionne, daprès des critères scientifiques, différentes plantes capables de contribuer à ralentir le processus de sénescence de lorganisme ou de combattre les effets du vieillissement. Ces végétaux ont fait lobjet de publications dans des revues scientifiques internationales principalement au cours de ces cinq dernières années. Dossier: Phytothérapie et vieillissement* Communication présentée lors du 5^e colloque de la revue Phytothérapie: les Avancées en Phytothérapie, janvier 2004.     

Prostacyclin counteracts the increase in capillary permeability induced by tumour necrosis factor-α

Objective To analyse how prostacyclin interferes with the short-term local circulatory effects of tumour necrosis factor- (TNF) in a skeletal muscle.Design An autoperfused sympathectomised cat gastrocnemius muscle enclosed in a plethysmograph.Interventions Arterial blood flow, total and segmental vascular resistances (large-bore arterial vessels, arterioles and veins), hydrostatic capillary pressure, tissue volume and capillary filtration coefficient were followed during local intraarterial infusion of TNF at various rates (2.5, 5.0 and 7.5 g/kg per min) and during intra-arterial infusion of prostacyclin simultaneously with the highest dose of TNF. The capillary filtration coefficient reflects the capillary surface for fluid exchange.Results Arterial infusion of TNF had no influence on vascular resistance up to 5.0 g/kg per min but induced vasodilation at 7.5 g/kg per min. No effects on the recorded hydrostatic capillary pressure were observed. The capillary filtration coefficient and the capillary filtration increased with the infusion rate of TNF the former by 55%. Simultaneous arterial infusion of prostacyclin (350 ng/kg per min) caused further vasodilation and an increase in hydrostatic capillary pressure and completely restored the capillary filtration coefficient to control. The TNF-induced filtration was partly restored.Conclusions The local circulatory effect of TNF is small apart from a graded increase in the capillary filtration coefficient, most likely reflecting an increase in capillary permeability. The prostacyclininduced decrease in capillary filtration coefficient most likely reflects a restoration of capillary permeability. The TNF-induced transcapillary filtration is not fully reduced by prostacyclin due to a simultaneous increase in hydrostatic capillary pressure.     

Left ventricular function after acute myocardial infarction

10 patients with their first AMI were studied within the first 48 hours and again after 3 weeks. Central and peripheral haemodynamics (CI, SV, SW, TPR) were examined, including indices of contractility (dp/dlmax) and wall stiffness (P/V, relation P/V to P) of the left ventricle.In the early phase CI and SW, as well as LV dp/dt_max were depressed in accordance with symptoms of LV failure. P/V was increased. Elevation of LVEDP correlated well with ventricular gallop rhythm, but less consistently with LV functional disturbance.During convalescence CI increased uniformly, both in digitalized and non-digitalized individuals. In contrast heart rate, aortic pressure, LVEDP and dp/dt_max remained unchanged. The increase of CI, SV and SW was accompanied by a fall of TPR and P/V. LV wall stiffness was still elevatedabove normal after 3 weeks. The improvement of cardiac pumping during infarct convalescence may have been effected through a fall of TPR and LV wall stiffness. Recovery of depressed contractile performance was generally not observed, and does therefore not seem to contribute to recuperation.Herrn Prof. Dr. med. P. Schölmerich zum 60. Geburtstag.     

Phyto News

Phyto News est la revue commentée de communications dans le domaine de la plante médicinale (recherche pharmacologique et clinique), qui nous semble présenter un intérêt médical ou pharmaceutique tel quil puisse permettre de faire progresser dautres études qui aboutiront à une application thérapeutique. Il est cependant important davertir les lecteurs que dune découverte ou dune démonstration pharmacologique ne découle pas immédiatement la justification de lutilisation médicale.

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Phyto News is a commented review of papers about medicinal plant research all around the world. The papers must contain information leading to medicinal progress in phytoterapy practice or development in the pharmaceutical area. The reader is reminded that not all discoveries will have immediate use in medicine, but each may give ideas for further investigations.

     

Histoire du ginseng en Occident: introduction,représentations et usages*

Résumé: Lauteur propose une analyse historique de lintroduction du ginseng en Occident. Originaire dAsie, où elle est connue et utilisée depuis les temps immémoriaux, cette plante a dabord été décrite aux Occidentaux par des missionnaires jésuites à la fin du XVII^e siècle et au début du XVIII^e siècle. Dès son introduction en Occident, elle a été utilisée par les grands de ce monde, avant de nourrir un fructueux commerce entre lOccident et la Chine. Au XIX^e siècle, les botanistes sefforcèrent de la classer et son analyse a commencé après 1850 pour se développer surtout dans la seconde moitié du XX^e siècle. De nos jours, les usages de cette plante restent influencés par les représentations et les croyances qui ont accompagnés son introduction à lépoque moderne.* Communication présentée lors de la 12^e Journée universitaire de lAMPP, septembre 2003: Ginseng et autres plantes adaptogènes.     

The activity of grepafloxacin in two murine models of <Emphasis Type="Italic">Mycobacterium avium</Emphasis> infection

The activity against Mycobacterium avium complex (MAC) of varying doses of grepafloxacin (GRE; 25mg/kg, 50mg/kg, 100mg/kg, and 200mg/kg) were compared to clarithromycin (CLA; 100mg/kg and 200mg/kg), ethambutol (EMB; 100mg/kg), and rifabutin (RBT; 10mg/kg) using an intranasal (IN) infection model compared to an intravenous (IV) infection model. Beige mice (C57BL6/J-Lyst bg J/+) were infected intranasally with about 10⁶ organisms and for the IV model about 10⁷ organisms. Treatment for both models was started 1 week postinfection and given by gavage 5 days/week for 4 weeks. At the initiation of therapy, an early control group was killed to determine the initial organism load. Three days following the completion of therapy, drug-treated groups of mice and the late control group were killed and the response to therapy measured. The most effective agents were CLA and RBT. GRE and EMB had modest activities in both the IN and the IV models. A matched comparison between IN and IV challenges for each of the agents used revealed greater suppression of MAC in the IN model compared to the IV model.     

Phytothérapie et Internet

À lheure dune mise en question des politiques de santé publique et dun regain de faveur pour des thérapeutiques jugées plus naturelles, la phytothérapie suscite un intérêt croissant qui se mesure au nombre des sites Internet consacrés à la médecine par les plantes. Mais aujourdhui la masse dinformations disponibles et labsence totale de contrôle de la qualité de ces informations rendent de plus en plus difficiles les recherches documentaires sur les «autoroutes de linformation». Dans cette nouvelle rubrique Phytothérapie & Internet seront signalés les sites qui semblent présenter le plus dintérêt pour nos lecteurs.

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At a time when the politics of public health are being challenged and natural treatments are witnessing a popularity revival, phytotherapy is arousing a growing interest that can be measured by the number of Internet sites devoted to plants based medicine.However, the large amount of available information and the total absence of quality controls concerning the information these sites give, make documentary research increasingly difficult on these information motorways. In this new section, Phytotherapy & Internet, the sites that present the most interest for our readers are mentioned.

     

Phyto News

PHYTO NEWS est la revue commentée de communications dans le domaine de la plante médicinale (recherche pharmacologique et clinique) qui nous semblent présenter un intérêt médical ou pharmaceutique tel, quil puisse permettre de faire progresser dautres études qui aboutiront à une application thérapeutique. Il est cependant important davertir les lecteurs que, dune découverte ou dune démonstration pharmacologique, ne découle pas immédiatement la justification de lutilisation médicale.

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Phyto-News is a commented review of papers about medicinal plant researches all around the world. The papers must contain information leading to medicinal progress in phytotherapie practice or development in the pharmaceutical area. The reader is advised that not all discoveries will have immediate use in medicine, but each may give ideas for further investigations.