Screening of medicinal plants from Reunion Island for antimalarial and cytotoxic activity.

AIM OF THE STUDY: Nine plants from Reunion Island, selected using ethnopharmacology and chemotaxonomy, were investigated for their potential antimalarial value. MATERIALS AND METHODS: Thirty-eight extracts were prepared by maceration using CH(2)Cl(2) and MeOH, and were tested for in vitro activity against the 3D7 and W2 strain of Plasmodium falciparum. The most active extracts were then tested for in vitro cytotoxicity on human WI-38 fibroblasts to determine the selectivity index. Those extracts were also investigated in vivo against Plasmodium berghei infected mice. RESULTS: Most active of the extracts tested were the dichloromethane leaves extracts of Nuxia verticillata Lam. (Buddlejaceae), Psiadia arguta Voigt. (Asteraceae), Lantana camara L. (Verbenaceae), the methanol extracts from Aphloia theiformis (Vahl) Benn. (Aphloiaceae) bark, and Terminalia bentzoe L. (Combretaceae) leaves displaying in vitro IC(50) values ranging from 5.7 to 14.1mug/ml. Extracts from Psiadia, Aphloia at 200mg/(kgday) and Teminalia at 50mg/(kgday) also exhibited significant (p<0.0005) parasite inhibition in mice: 75.5%, 65.6% and 83.5%, respectively. CONCLUSION: Two plants showed interesting antimalarial activity with good selectivity: Aphloia theiformis and Terminalia bentzoe. Nuxia verticillata still needs to be tested in vivo, with a new batch of plant material.

[Transfusional strategy in neurosurgery: preoperative hemodilution by erythrocytapheresis]. / Une stratégie transfusionnelle en neurochirurgie: hémodilution préopératoire par érythrocytaphérèse.

Autologous blood transfusion techniques have been devised in order to decrease the risk of homologous transfusion-related complications. In neurosurgery, preoperative autologous blood collection is difficult because of the rather short time interval before surgery, as well as the risk of increasing cerebral oedema or intracranial hypertension. Therefore erythrocytapheresis has been performed the day before surgery as a preoperative haemodilution in 33 patients, using a discontinuous flow cell separator (PCS + Heamonetics). Patients with anaemia, unstable cardiovascular condition, infections, malignant tumor with a bad prognosis, or a poor peripheral venous status were not included. The mean volume of collected red cells was 526 +/- 176 mL, allowing a minimal colloid perfusion adjusted on this volume, with a simultaneous restitution of plasma and platelets. For a mean peroperative estimated blood loss of 1,040 +/- 52 mL, a homologous blood transfusion was avoided in 29 patients (88%). Four patients who underwent meningioma surgery received homologous red cells units in addition to their autologous blood. Two patients did not require any transfusion. Finally, 88% of autologous red cells units were readministered and 8 units were not retransfused. Preoperative erythrocytapheresis has proven to be a very simple and well tolerated technique. It can be considered for elective neurosurgery, when the time delay before surgery is short and when the blood loss is anticipated as to be moderate. It may also be associated with iterative autologous blood donation programme or the peroperative use of a cell saver.

[Systematic peroperative use of an autotransfusion system in heart surgery. A prospective and comparative study in 283 patients]. / Utilisation peropératoire systématique d'un système d'autotransfusion en chirurgie cardiaque. Etude prospective et comparative sur 283 malades.

A series of 283 patients undergoing cardiac bypass surgery was studied to determine whether intraoperative autotransfusion, haemodilution, and a change in transfusion techniques of the same surgical team could reduce homologous blood requirements. The Cell-Save Haemonetics* system was used systematically in 167 consecutive patients (Group I). This group of autotransfused patients was analysed prospectively and compared with a control group (Group II) of 116 patients operated one year before and analysed retrospectively. During the whole hospitalisation, homologous blood products were required in 40.7% of patients in Group I compared with 73.3% of patients in Group II (p less than 0.0001). The average requirements of packed cells per patient were 2.7 +/- 1.3 in Group I compared with 4.1 +/- 2.5 in Group II (p less than 0.0001). The haematocrit on discharge from the department was 29.9 +/- 4% in Group I compared with 32 +/- 4.5% in Group II (p less than 0.0001). The average volume of blood recovered by the system and then autotransfused was 620.8 +/- 242.6 ml. There was no significant difference in postoperative bleeding in the first 24 hours between the two groups. This study confirms that peroperative autotransfusion during cardiac surgery and the acceptance of a clinically well tolerated normovolumic anaemia are associated with a significant reduction in homologous blood consumption.

Ketoprofen (19.583 R.P.) (2-(3-benzoylphenyl)-propionic acid). Main pharmacological properties--outline of toxicological and pharmacokinetic data.

Ketoprofen possesses the typical pharmacological properties of non-steroidal anti-inflammatory agents i.e. anti-inflammatory, analgesic and antipyretic activity, as well as antibradykinin activity and ability to inhibit prostaglandin synthesis. Ketoprofen is as potent as indomethacin in the tests for anti-inflammatory and analgesic activity, but its antipyretic and antibradykinin activities and its inhibitory activity against prostaglandin synthesis is respectively 4, 8 and 8 times greater than that of indomethacin. It seems very likely that the pituitary-adrenal axis is not involved in the mechanism of the anti-inflammatory action of ketoprofen, since in the carrageenan abscess test, the compound shows the same activity both in adrenalectomized and in normal rats and, when locally applied to the inflamed area, it is more active than when administered systemically. In the mouse the acute oral toxicity of ketoprofen is about one twentieth that of indomethacin. Like all powerful steroidal or non-steroidal antiinflammatory agents, ketoprofen shows some gastrointestinal toxicity, but its effect is mild and distinctly less than that of indomethacin. Pharmacokinetic studies in the rat, dog and monkey have shown that gastro-intestinal absorption of the drug is rapid and almost complete; the compound and its metabolites are excreted from the body fairly rapidly.