Les statines dans la prise en charge des dyslipidémies

in Revue du Praticien (La) (2011), 61(8), 1120-1126

Statins, combined with life-style advices, have a key position in the prevention of cardiovascular diseases. By inhibiting HMG-CoA reductase enzyme, these medications reduce total and LDL cholesterol ... [more ▼]

Statins, combined with life-style advices, have a key position in the prevention of cardiovascular diseases. By inhibiting HMG-CoA reductase enzyme, these medications reduce total and LDL cholesterol levels in a dose-dependent manner. They also exert various pleiotropic effects that may contribute to the cardiovascular protection. Although some differences exist between available statins, a class effect seems predominant. Statins have proven their efficacy in numerous controlled randomized trials (recently pooled in meta-analyses), both in primary and secondary prevention, including various specific populations, among them patients with diabetes. Tolerance and safety profile is rather good even if muscular and hepatic adverse events may occur. The prescription of statins should target high-risk individuals and both therapeutic inertia and drug non-compliance should be avoided. [less ▲]

Utilisation thérapeutique de l'érythropoïétine

in Revue du Praticien (La) (2009), 59

Adénome hypophysaire

in Revue du Praticien (La) (2007), 57(8), 881-6

Les offrandes liées à la fécondité et à la maternité dans la Gaule romaine

in Revue du Praticien (La) (2006), 56(7), 804-9

Les marqueurs endométriaux de l'implantation : un nouveau dialogue paracrine

in Revue du Praticien (La) (2000)

Effets de l'interleukine-1 sur les chondrocytes humains cultivés en agrégats

in Revue du Praticien (La) (1996), 46

Autres médiateurs de l'inflammation et du sepsis

in Revue du Praticien (La) (1993), 43(1), 19-25

During sepsis, the systemic inflammatory response is characterized by the release of numerous mediators supporting and dispersing inflammation. In Gram negative sepsis, the endotoxins play a starting role ... [more ▼]

During sepsis, the systemic inflammatory response is characterized by the release of numerous mediators supporting and dispersing inflammation. In Gram negative sepsis, the endotoxins play a starting role, while in other sepsis, the triggering mediators or mechanisms are unknown but lead to a similar inflammatory reaction. Coagulation and complement cascades are activated, with the release of chemoattractive substances, mediators and proteases and the activation of phagocytic cells. Macrophages/monocytes and polymorphonuclear leucocytes produce then active oxygen species and cytokines; they degranulate (releasing active enzymes such as myeloperoxidase), they express an increasing number of membrane receptors able to interact with endothelial cells and release a supplementary lot of inflammatory mediators (prostanoids, platelet activating factor, leukotrienes ... ). Platelets, also activated, produce the same mediators (TXA2, PAF ...) or specific ones such as serotonine, platelet factor 4, growth factors. Last, but not least, the endothelial cells are stimulated, directly (by endotoxins) or undirectly (by cytokines, C5a, PAF ...). These cells play then a main role by their own phagocytic activity, by alteration of their antithrombotic and fibrinolytic potential, by their secretion of inflammatory mediators and by an increased expression of receptors of adhesivity for the activated phagocytes or platelets, what leads to endothelium injury with membrane permeability alterations. These cascades of activation, these extensions of the inflammatory reaction by the mediators and by the phagocytes and platelets can explain the frequency of multiple organ failure during sepsis as well as the difficulty of an adequate pharmacological therapy. [less ▲]