Oats (Avena sativa) reduce atherogenesis in LDL-receptor-deficient mice.

AIM: The cholesterol-lowering properties of oats, largely ascribed to its contents of soluble fibers, beta-glucans, are well established, whereas effects on atherogenesis are less well elucidated. Oats also contains components with reported antioxidant and anti-inflammatory effects that may affect atherogenesis. In this work we examined effects of oat bran on plasma cholesterol, markers of inflammation, eNOS expression and development of atherosclerosis in LDL-receptor-deficient (LDLr(-/-)) mice. METHODS AND RESULTS: Female LDLr(-/-) mice were fed Western diet+/-oat bran. Two concentrations of oat bran (40 and 27%) were compared regarding effects on plasma lipids. There was a dose-dependent reduction of plasma cholesterol by 42 and 20% with 40 and 27% oat bran, respectively. Both concentrations also lowered plasma triglycerides (by 45 and 33%) and relative levels of plasma LDL+VLDL. The reduction of plasma lipids was accompanied by increased faecal excretion of cholesterol and bile acids. Oat bran (40%) efficiently reduced atherosclerotic lesion area in the descending aorta (-77%) and aortic root (-33%). Plasma levels of fibrinogen and soluble vascular cell adhesion molecule-1 (VCAM-1) were significantly lower, and immunofluorescence of aortic sections revealed a 75% lower expression of VCAM-1 in oat-fed mice. The expression of eNOS protein in the aortic wall was increased in mice fed oat bran. CONCLUSIONS: Oat bran supplemented to a Western diet lowers plasma cholesterol, reduces levels of some inflammatory markers, increases eNOS expression and inhibits atherosclerotic lesion development in LDLr(-/-) mice. It remains to be investigated which components in oats contribute to these effects.

Protective effect of breastfeeding against urinary tract infection.

AIM: To assess the possible protective effect of exclusive breastfeeding against first-time febrile urinary tract infection (UTI) in children. METHODS: Two children's hospitals and local child health centres in the Göteborg area, Sweden, participated in a prospective case-control study. In total, 200 consecutive cases (89M, 111F), aged 0-6y, presenting with first-time febrile UTI were enrolled. The mean +/- SD age was 0.98 +/- 1.15 y. As control subjects, 336 children (147M, 189F) were recruited from the child health centre of the case, matched for age and gender and included consecutively for each case during the first days after diagnosis. The duration of exclusive breastfeeding was obtained from the case and controls by a standardized procedure. RESULTS: Ongoing exclusive breastfeeding gave a significantly lower risk of infection. A longer duration of breastfeeding gave a lower risk of infection after weaning, indicating a long-term mechanism. The protective role of breastfeeding was strongest directly after birth, then decreased until 7 mo of age, after which age no effect was demonstrated. CONCLUSION: A protective role of breastfeeding against UTI was demonstrated. The study provides statistical support to the view that breast milk is a part of the natural defence against UTI.

Compatibility of ropivacaine with morphine, sufentanil, fentanyl, or clonidine.

BACKGROUND: Ropivacaine hydrochloride (HCl) ('Naropin') is a long-acting local anaesthetic agent, administered epidurally to patients undergoing various surgical procedures. A combination of local anaesthetic and opioid is often administered for the management of severe pain to ensure that a minimal dose of each is used. Ropivacaine might be used in combination with an alpha2-adrenergic agonist for the management of visceral pain. Stability data have shown that ropivacaine is compatible with the systemic narcotic opioid analgesics morphine sulphate, sufentanil citrate and fentanyl citrate for 14 days in a Polybag (AstraZeneca-AB, Sweden), but no data have been obtained for the longer-term compatibility of ropivacaine with these opioids or with the alpha2-adrenergic agonist clonidine HCl. OBJECTIVE: This study used the Mark II Polybag (AstraZeneca-AB, Sweden) to test the physical and chemical compatibility of these products for up to 30 days. METHODS: Ropivacaine HCl solution for epidural infusion, 2 mg/mL, in 200 mL Mark II Polybag and commercially available additives in glass ampoules or vials were used as starting material. Appropriate admixtures were made and their appearance, pH, and drug concentrations were monitored on days 0, 7, 14, and 30. The appearance of the admixtures was examined with the aid of a stereomicroscope (Olympus, no. 220186, New York, USA) at 10x magnification. Drug concentration and enantiomeric purity were determined using high-performance liquid chromatographic analysis. RESULTS: All combinations at all doses stayed within the compatibility criteria (if no visible signs of physical changes in the admixture appeared throughout the 30 days of storage, and if pH and drug concentrations in each admixture did not vary by more than 10% between day 0 and days 7, 14, or 30 in storage). In addition, there were no important differences in the enantiomeric purity of ropivacaine with each combination. CONCLUSION: The study demonstrated that ropivacaine was suitable for use in combination with the opioids morphine sulphate, sufentanil citrate, and fentanyl citrate, or with the alpha2-adrenergic agonist clonidine HCl, for up to 30 days of storage before the management of severe or visceral pain. From a microbiological point of view, combinations not prepared under aseptic conditions should be used immediately. 'Naropin' is a trade mark of the AstraZeneca group of companies.

A double-blind trial of metoprolol in acute myocardial infarction. Effects on ventricular tachyarrhythmias.

During a double-blind trial in which patients with suspected myocardial infarction received metoprolol or placebo, we analyzed the occurrence of ventricular tachyarrhythmias. Metoprolol (15 mg intravenously) was given as soon as possible after admission, and thereafter 200 mg was given daily for three months. Antiarrhythmic drugs were given only for ventricular fibrillation and sustained ventricular tachycardia (greater than 60 beats per second). Definite acute myocardial infarction developed in 809 of the 1395 participants, and probable infarction in 162. Metoprolol did not influence the occurrence of premature ventricular contractions or short bursts of ventricular tachycardia. However, there were 17 cases of ventricular fibrillation in the placebo group (697 patients) and only 6 in the metoprolol group (698 patients, P less than 0.05). During the hospital stay significantly fewer patients receiving metoprolol (16) than placebo (38) (P less than 0.01) required lidocaine. In a separate analysis of 145 patients, metoprolol did not influence the occurrence of premature ventricular contractions or short bursts of ventricular tachycardia during the first 24 hours of treatment. Despite a lack of effect on less serious ventricular tachyarrhythmias, metoprolol had a prophylactic effect against ventricular fibrillation in acute myocardial infarction.