Effect of ranolazine on cardiac microcirculation in normal and diabetic rats.

UNLABELLED: Ranolazine is a new antianginal drug that is postulated to act through blocking of cardiac late sodium channels and improvement in cardiac blood flow. The present study has been carried out to investigate its possible effect on microcirculation of normal and diabetic rats' cardiac muscle. METHODS: Normal and diabetic rats were anesthetized.The chest was opened and a surface laser Doppler flowmeter probe was sutured on the left ventricle next to the left anterior descending branch of the coronary artery. After 30 minutes of animal adaptation, baseline flow was recorded.Thereafter, ranolazine was injected intravenously (10 mg/kg) through the jugular vein and the changes in the cardiac blood flow were measured every 5 minutes for 30 minutes. Systolic blood pressure and heart rate were also recorded. RESULTS: Although, injection of ranolazine resulted in some reduction of cardiac blood flow, no significant changes were observed in normal and diabetic animals. Ranolazine had no significant effect on systolic blood pressure of either groups studied. Nevertheless, it caused a mild but statistically significant increase in the heart rate of diabetic and normal rats. CONCLUSION: In conclusion, in normal and diabetic rats, no evidence of improvement in intramyocardial blood flow by ranolazine was obtained.

The effect of oral verapamil on the visual evoked potentials in multiple sclerosis patients.

BACKGROUND & AIMS: Ionic channel rearrangements through demyelinated axons or supporting media play a significant role in remission of neurological deficits in multiple sclerosis (MS) patients. The role of calcium channel blockers on the MS demyelination sequels is controversial. We studied the change of visual evoked potential (VEP) P100 induced by verapamil in MS patients. MATERIALS & METHODS: We conducted a randomized double blind, placebo controlled, clinical trial on two groups of 20 clinically definite MS patients who had no relapse during the previous one year. Changes in P100 latency were compared between subjects taking 3 dosages of oral verapamil 40 mg, every 8 hours and subjects taking placebo. RESULTS: In the verapamil group, the P100 latencies shortened an average of 6.1 +/- 4 ms compare to placebo group 1 +/- 0.5 ms (P<0.05). Verapamil had no significant effect on the VEP duration. CONCLUSION: The present study suggests pharmacological manipulation of calcium-dependent process, possibly at the level of demyelinated axon, can rapidly facilitate conduction of electrical impulses in visual pathways of stable MS patients.

Treating patients like customers. Just-in-time inventory control for patient-centered care.

Managing change in health care is a complex, poorly studied process that's even more poorly understood. We do not have a clear model to visualize as we contemplate just what it is we are changing. Explore how modern hospitals are "warehousing" patients like excess inventory, and examine the changes needed to escape this morass. A strong physician/hospital alliance is the key to establishing more efficient, patient-centered care.

Diagnosis of aseptic necrosis of the talus by bone scintigraphy. Case report.

Bone scintigraphy is a very useful technique for detection of aseptic necrosis. We have used this diagnostic tool in a patient to detect aseptic necrosis of the talus, a common complication stemming from foot injuries. The scintigraphic pattern is rather typical and antedates any other radiographic changes. This technique appears to be very useful for diagnosis and follow-up of aseptic necrosis occurring during talar injuries.