Mechanisms of the antihypertensive effects of Nigella sativa oil in L-NAME-induced hypertensive rats

OBJECTIVES: This study was conducted to determine whether the blood pressure-lowering effect of Nigella sativa might be mediated by its effects on nitric oxide, angiotensin-converting enzyme, heme oxygenase and oxidative stress markers. METHODS: Twenty-four adult male Sprague-Dawley rats were divided equally into 4 groups. One group served as the control (group 1), whereas the other three groups (groups 2-4) were administered L-NAME (25 mg/kg, intraperitoneally). Groups 3 and 4 were given oral nicardipine daily at a dose of 3 mg/kg and Nigella sativa oil at a dose of 2.5 mg/kg for 8 weeks, respectively, concomitantly with L-NAME administration. RESULTS: Nigella sativa oil prevented the increase in systolic blood pressure in the L-NAME-treated rats. The blood pressure reduction was associated with a reduction in cardiac lipid peroxidation product, NADPH oxidase, angiotensin-converting enzyme activity and plasma nitric oxide, as well as with an increase in heme oxygenase-1 activity in the heart. The effects of Nigella sativa on blood pressure, lipid peroxidation product, nicotinamide adenine dinucleotide phosphate oxidase and angiotensin-converting enzyme were similar to those of nicardipine. In contrast, L-NAME had opposite effects on lipid peroxidation, angiotensin-converting enzyme and NO. CONCLUSION: The antihypertensive effect of Nigella sativa oil appears to be mediated by a reduction in cardiac oxidative stress and angiotensin-converting enzyme activity, an increase in cardiac heme oxygenase-1 activity and a prevention of plasma nitric oxide loss. Thus, Nigella sativa oil might be beneficial for controlling hypertension.

A Comparison of the Bleaching Effectiveness of Chlorine Dioxide and Hydrogen Peroxide on Dental Composite

This study was carried out to verify if composites could be bleached using chlorine dioxide as compared with hydrogen peroxide. 3M ESPE Filtek Z350 Universal Restorative discs were prepared (n=40), with dimensions 5 mm diameter x 2 mm thickness. The discs were divided into 4 groups of 10 discs each. Color assessment was performed by CIEDE2000. The discs were stained with coffee, tea, wine and distilled water (control) solutions for 14 days, 5 hours daily. Color assessment was repeated on stained discs and followed by bleaching of 5 discs from each group using chlorine dioxide and hydrogen peroxide in-office systems. Finally, a last color assessment was performed and compared statistically. DE2000 after bleaching was very close to baseline for both the bleaching agents, although chlorine dioxide showed better results than hydrogen peroxide. After staining, there was a clinically significant discoloration (∆E2000≥3.43) for the tea, coffee and wine groups, and discoloration (∆E2000) was seen more in the wine group as compared to tea and coffee. Overall, the control group (distilled water) had the least color change in the three intervals. After bleaching, the color in all specimens returned close to the baseline. The color differences between bleaching and baseline were less than 3.43 for all groups. The obtained results show that chlorine dioxide is slightly superior to hydrogen peroxide in the bleaching of composites, while maintaining the shade of the composite close to the baseline.

Este estudo foi realizado para verificar se resinas compostas podem ser clareadas com uso do dióxido de cloro, em comparação com peróxido de hidrogênio. Foram preparados discos com resina restauradora Filtek Z350 3M ESPE (n=40), com dimensões 5 mm de diâmetro × 2 mm de espessura. Os discos foram divididos em 4 grupos de 10 discos cada. A avaliação da cor foi realizada por meio do CIEDE2000. Os discos foram manchados com soluções de café, chá, vinho e água destilada (controle) por 5 h diárias durante 14 dias. A avaliação da cor foi repetida nos discos manchados e seguida por clareamento de 5 discos de cada grupo, utilizando dióxido de cloro ou peróxido de hidrogênio pela técnica de consultório. Finalmente, uma última avaliação da cor foi realizada e as técnicas comparadas estatisticamente. DE2000 após o clareamento foi muito próxima ao baseline, para ambos os agentes clareadores, embora o dióxido de cloro tenha mostrado melhores resultados do que o peróxido de hidrogênio. Após o manchamento, houve uma descoloração clinicamente significativa (ΔE2000≥3,43) para os grupos de chá, café e vinho, sendo que o clareamento (ΔE2000) foi melhor obtido com o grupo do vinho, em comparação com chá e café. No geral, o grupo controle (água destilada) teve a menor mudança de cor nos três intervalos. Após o clareamento, a cor em todos os espécimes voltou próxima ao baseline. As diferenças de cor entre o clareamento e o baseline foram inferiores a 3,43 para todos os grupos. Os resultados indicam que o dióxido de cloro é ligeiramente superior ao peróxido de hidrogênio no clareamento de resinas compostas, mantendo a cor próxima à escala do baseline.

effect of intraoperative use of esmolol and nicardipine on splanchnic perfusion in functional endoscopic sinus surgery

There are many techniques for reduction of mean arterial blood pressure [MAP] and heart rate [HR] during anesthesia. We designed this prospective, randomized, double-blinded study to test the effect of this technique for maintaining hemodynamic stability during general anesthesia and their influences on splanchnic perfusion. Sixty healthy consenting patients undergoing functional endoscopic sinus surgery [FESS] were randomly assigned to 1 of 3 treatment groups: Group I [control n = 20] received normal saline 5 mL and 1 mL, followed by a saline infusion at a rate of 0.005 mL kg[-1] min[1]; Group 2 [n = 20] received esmolol 50 mg and saline 1.mL, followed by an esmolol infusion 5 micro g kg[-1] min[-1]; and Group 3 [n = 20] received esmolol 50 mg and nicardipine 1 mg, followed by an esmolol infusion 5 micro g kg[-1] min[-1]. The study drugs were administered after the induction of anesthesia with fentanyl 1.5 micro g/kg, and propofol 2 mg/kg IV. Tracheal intubation was facilitated with vecuronium 0.12 mg/kg IV. Anesthesia was initially maintained with sevoflurane 2% end-tidal and N[2]O 50% In oxygen in all 3 groups. After induction of anesthesia a gastric tonometer [TRIP] NGS Catheter and a radial catheter were inserted. Baseline values of gastric intramucosal pH [pHi] were determined before induction of hypotension. The [pHi] values were calculated every 30 min until hypotension was discontinued .The CO2 -gap [i.e., the difference between arterial and gastric Pco2] was registered. Arterial blood lactate levels also were measured. During surgery, the mean arterial blood pressure [MAP] was maintained within +/- 15% of the baseline value by varying the study drug infusion rate and the inspired concentration of sevoflurane. In addition to MAP and heart-rate values, were recorded throughout the perioperative period. Recovery times and postoperative side effects were assessed. None of the [pHi] values calculated was less than 7.35 in the three studied groups. Arterial blood lactate levels did not increase in any of the patients. Compared with the control group, adjunctive use of esmolol and nicardipine attenuated the increase in heart rate [in Group 2] and MAP [in Group 3]. after tracheal intubation. Furthermore, the use of an esmolol infusion as an adjunct to sevoflurane to control the acute autonomic responses during the maintenance period significantly decreased emergence times [4 +/- 2 versus 7 +/- 4 min], decreased the need for postoperative opioid analgesics [35% versus 60%], and reduced the time before discharge [209 +/- 89 versus 269 +/- 100 min]. We conclude that the adjunctive use of esmolol alone or in combination with nicardipine during the induction of anesthesia reduced the hemodynamic response to tracheal intubation. It did not compromise splanchnic tissue oxygen balance in healthy patients nor increased blood lactate. Furthermore, use of an esmolol infusion as an adjuvant to sevoflurane- N[2] O anesthesia for controlling the acute hemodynamic responses during the maintenance period improved the recovery profile after functional endoscopic sinus surgery

[Comparison of oral nicardipine and intravenous magnesium sulfate for preterm labor pain management]

2% of all pregnancies terminate before 32 weeks and 12.5% of them before 37 weeks of gestation. Medical treatment by contraction inhibitors is the most common strategy for management of preterm labor pain. Nicardipine is a dihydropyridine used for inhibition of contractions in animal models. In the clinical setting, the most common medication used for management of preterm labor pain is magnesium sulfate. This study aims to compare the effectiveness and side effects of oral nicardipine and intravenous magnesium sulfate in treatment of preterm labor pain. 125 pregnant women with a gestational age of 24-34 weeks and preterm labor pain were entered into this clinical trial. They were randomly divided into two groups of nicardipine and magnesium sulfate. The medications were administered in loading and maintenance doses. Two groups were not significantly different in terms of gestational age, and cervical dilatation, but their gravity differed significantly. But response to treatment and the time needed for complete inhibition of contractions were significantly different in these groups. In magnesium sulfate group, the response to primary treatment was higher and the time needed to stop the contractions was shorter in comparison to the nicardipine group. But, maternal side effects were higher in the former group

Intravenous nicardipine for the treatment of severe hypertension. A dose-titration infusion to therapeutic response.

Intravenous nicardipine titration, starting with 10 mg/hr and increased slowly every 4 minutes by the rate 1 mg/hr until target supine DBP of 90 mmHg was achieved, was a very effective and safe method for patients with very severe hypertension. All patients had their BP under good control with few adverse effects. Although the heart rate rose significantly there were only four cases with palpitation and one case with chest pain which spontaneously recovered without sequele.

Efecto hemodinámico de la nicardipina intravenosa en el paciente coronario hipertenso / Hemodynamic effects of intravenous nicardipine in hypertensive coronary patients

Se estudiaron 20 pacientes coronarios hipertensos programados para revascularización coronaria, los cuales se dividieron en dos grupos: el grupo I recibió 4.2 mg por hora de Nicardipina intravenosa y el grupo II fue el Control. Todos los pacientes recibieron tratamiento para su hipertensión e insuficiencia coronaria, el cual se continúo hasta el día de la cirugía. Se les monitorizó con electrocardiograma (osiloscopio D2-V5), línea arterial, presión venosa central, catéter de flotación en arteria pulmonar para obtener las variables hemodinámicas: frecuencia cardiaca, presión arterial media, presión arterial pulmonar diastólica, presión venosa central, gasto cardiaco, índice, volumen latido, índice sistólico, resistencias vasculares sistémicas, índice de trabajo del ventrículo izquierdo, resistencia vascular pulmonar y producto presión frecuencia en las mediciones basales, a los 5, 10 min. y después de la laringoscopía, post incisión y post estertomía. Se logró disminución significativa de la frecuencia cardiaca, presión arterial media, resistencias vasculares sistémicas, índice de trabajo ventricular izquierdo y producto presión frecuencia; así mismo aumento del índice cardiaco, volumen latido e índice sistólico en el grupo que recibió Nicardipina 4.2 mg hora; esto cuando se compararon dos diferentes tiempos y con el grupo control. Se concluye que la Nicardipina intravenosa en el paciente coronario hipertenso es bien tolerada y que mejora la función ventricular izquierda, asumiendo esto en forma indirecta

Angioplastía coronaria en pacientes no aceptados para tratamiento quirúrgico: experiencia inicial del Instituto Nacional de Cardiología Ignacio Chávez / Coronary angioplasty in patients nor accepted ofr surgical intervention

La eficacia de la angioplastía coronaria en pacientes con "alto riesgo" para revascularización quirúrgica, está bien demostrada. En este trabajo se realizó un subgrupo de enfermos con afección multivascular, tratados por dilatación coronaria porque fueron descartados de cirugía por lechos coronarios inadecuados que imposibilitaban o dificultaban la inserción de injertos vasculares. la tasa de revascularización, calculada en cada paciente, índica el porcentaje de revacularización obtenida por antioplastía del total de lesiones técnicamente susceptibles de dilatación coronaria. El grupo de estudio estuvo integrado por 10 pacientes (media de 63 años), ocho de ellos tuvieron indicaciónd e angioplastía por angor post-infarto o inestable. De un total de 44 lesiones susceptibles técnicamente de angioplastía se dilataron 35 con una tasa de éxito técnico del 88 por ciento (31/35 lesiones) y con una tasa de revascularización del 71 por ciento (31/44 lesiones). El éxito primario se obtuvo en 9 de los 10 pacientes. el seguimiento varió de 2 a 13 meses (media de 7.8 meses): ocho pacientes han permanecido en clase funcional I, otro presentó angor estable y otro tuvo muerte súbita 6 meses postprocedimiento. En conclusión, esxiste beneficio clínico a corto y largo plazo con una elevada tasa de éxito en un sub-grupo de enfermos con afección multivascular que son descartados de revascularización por lechos coronarios inadecuados

El corazón en hibernación ¿isquemia miocárdica asintomática o no? / Heart at hibernation: asymptomatic myocardium ischemia or not?

Con el propósito de determinar si hay manifestaciones de isquemia en el corazón en hibernación, se estudiaron 11 pacientes con antecedentes de infarto del miocardio de más de 6 meses de evolución y fracción de eyección ventricular izquierda (FEVI) en reposo menor del 50 %, obtenida por ventriculografía nuclear. Todos los pacientes habían tenido un aumento mayor del 5 % de la FEVI, así como incremento del segmento con contractilidad afectada una hora después de recibir 60 mg de nicardipina por vía oral. A cada paciente se le realizó un ECG-Holter de 24 ó 48 horas de duración. Todos presentaron al menos un desnivel asintomático del segmento ST > 1 mm con una duración mayor de 1 minuto. El promedio de episodios de desnivel patológico del segmento ST en 24 horas fue de 2,09. La frecuencia cardíaca aumentó al inicio del desnivel un promedio de 27 latidos/min. La duración total de los desniveles del segmento ST en 24 horas fue de 23 ñ 11 minutos y el promedio de máximo desnivel fur de 1,3 mm. Excepto un episodio de angina, todos los demás fueron asintomáticos