Cardioprotective effects of Pinus eldarica bark extract on adrenaline-induced myocardial infarction in rats

Objective:To investigate the effect of Pinus eldarica bark extract on adrenaline-induced myocardial infarction.Methods:Hydroalcoholic extract was prepared using maceration method and its total phenolic content was determined using the Folin-ciocalteu method.Pretreatment was done by oral administration of 100,200,and 400 mg/kg Pinus eldarica bark extract for 16 days in male Wistar rats.Injection of adrenaline(2 mg/kg,s.c.)was performed on the 15th and 16th days for induction of myocardial infarction.LeadⅡEEG was recorded.Serum cardiac marker enzymes and antioxidative parameters were evaluated and a histopathological examination of heart tissues was performed.Results:Pretreatment with Pinus eldarica bark extract especially at its high doses significantly lowered the ST-segment elevation,improved heart rate,and decreased RR interval in ECG pattern of rats with adrenaline-induced myocardial infarction.It declined serum markers of heart damage including aspartate aminotransferase,lactate dehydrogenase,and creatine phosphokinase-MB,and also decreased lipid peroxidation marker,and heart weight while raising total antioxidant capacity and considerably improved histopathological alterations of the heart induced by adrenaline.Conclusions:Pinus eldarica bark extract shows beneficial cardioprotective and antioxidant effects against adrenaline-induced myocardial infarction.It can be further explored as a potential treatment for myocardial infarction.

Quantitative Determination of Adrenaline Hydrochloride Injection and Noradrenaline Bitartrate Injection by a New HPLC Method via Substitute for Reference Substance

An HPLC method for quantitative determination of adrenaline hydrochloride injection and noradrenaline bitartrate injection was established and validated with a substitute for the reference substance.Phenylephrine hydrochloride was selected as the substitute for the reference substance of adrenaline and noradrenaline bitartrate.The correction factor of phenylephrine hydrochloride with respect to the reference substance of adrenaline and noradrenaline bitartrate was determined under defined conditions.Adrenaline hydrochloride injection and noradrenaline bitartrate injection were quantified by assaying phenylephrine hydrochloride and a correct factor.The results indicate that the HPLC method with the substitute for reference substance was reliable and feasible for quantitative determination of drugs.

Genomic Analysis of 727 Patients with Ehlers-Danlos Syndrome I: Clinical Perspective Relates 23 Genes to a Maternally Influenced Arthritis-Adrenaline Disorder

A novel medical approach for qualifying DNA variants found by whole exome sequencing (WES) facilitates discovery of new gene-disease relationships and emphasizes that DNA change must be correlated with clinical findings before having utility for diagnosis. Delineation of an arthritis-adrenaline disorder (AAD) process qualified variants in 23 genes as diagnostically useful in 727 patients having WES among 1656 with Ehlers-Danlos syndrome (EDS);these results distinguished them from 102 patients who had qualified gene variants among 728 with developmental disability. Excess maternal transmission of AAD by pedigree analysis plus 167 maternally versus 111 paternally transmitted DNA variants and 75 patients with only mitochondrial DNA variants suggest maternal influence on inheritance of AAD and its subsumed EDS types. Genes grouped by impact on different connective tissue elements showed variation in similar numbers of patients with hypermobile or classical EDS, benign joint hypermobility, or predominant dysautonomia: COL7A1, FLG acting on skin in 21 patients;SCN9A/10A/11A, POLG on nerve in 24;COL6A1/A2/A3, COL12 on muscle in 19;COL5A1/A2, FBN1, TGFB2/3, TGFBR1/2 on tissue matrix in 51;COL3A1, VWF on vessel in 18;COL1A1/A2, COL11A1/A2 acting on bone in 15 patients. Each gene group acts through a postulated articulo-autonomic dysplasia cycle to produce reciprocal tissue laxity and dysautonomia findings that transcend EDS types. This same tissue laxity-dysautonomia cycle acts to produce secondary complications in disorders ranging from distinctive connective tissue dysplasias to developmental disorders with hypotonia and acquired conditions with autonomic imbalance. Several altered genes were previously associated with neuromuscular disorders, foreshadowing a large myopathic EDS category that will incorporate many patients with hypermobility. The importance of muscle for joint constraint supports present exercise and future mesenchymal stem cell therapies, whether AAD is genetic or epigenetic from trauma, surgery, inflammation, or aging.

Study of Complexes Formed by Adrenaline with Nd^(3+),Gd^(3+) and Tm^(3+)

The solution reaction mechanisms,composition,donor atoms,properties of coordinate link and stability of the complexes on the systems of adrenaline with Na^(3+),Gd^(3+)and Tm^(3+)have been studied by pH-potentiometric titration and electronic spectroscopy.Adrenaline perturbs the f-f electronic transition of Nd^(3+)and Tm^(3+)so that the absorption spectra of their complexes are shifted toward longer wavelengths.The absorption spectra of the complexes formed by the three f-block element ions with adrenaline are shifted toward shorter wavelengths with the increase of PH in Δγ=350～650 nm

A comparative study between haemocoagulase and adrenaline in type 1 tympanoplasty

Introduction: Haemostasis is a critical component of ear surgeries, which can be achieved by topical methods including simple manual pressure with gauze or cotton balls soaked with adrenaline, administration of haemostatic agents or vasoconstrictive materials. Objective: To compare efficacy of haemocoagulase and adrenaline in attaining middle ear haemostasis in type - 1 tympanoplasty with or without cortical mastoidectomy. To study the effect of haemocoagulase in middle ear. Materials and method: This is a prospective comparative study conducted in a tertiary care hospital from January 2013 to June 2014. Patients undergoing type 1 tympanoplasty with or without cortical mastoidectomy were divided into two groups. In group A (50 cases), cotton balls soaked in 2ml Haemocoagulase was used and in group B (50 cases) cotton balls soaked in 2 ml Adrenaline (1:1000 dilution) was used for middle ear haemostasis. The efficacy of haemocoagulase and adrenaline was compared. Results: The mean number of cotton balls used in haemocoagulase group in cases with congested middle ear mucosa was more than those used in the adrenaline group. Duration of surgery was more in haemocoagulase group (65 min) with congested mucosa, compared to adrenaline group (50 min). The mean blood pressure was significantly higher in adrenaline group compared to haemocoagulase group. Postoperative hearing improvement in both groups showed no significant difference with p value 0.694. Conclusions: Adrenaline is a better middle ear haemostatic than haemocoagulase. However, haemocoagulase can safely be used in patients with hypertension.

Studies on the Coordination of Pr(Ⅲ) with Adrenaline by Potentiometry and Absorption Spectroscopy

The stability constant for complex of Pr(Ⅲ) with adrenaline has been determined by potentiometric titration under biological conditions (37℃ and 0.15mol/L NaCl). The absorption spectra of the Pr(Ⅲ)-adrenaline system exhibit characteristic bands of Pr(Ⅲ) at lower pH values. However, the charge transfer band which is due to the coordination of Pr(Ⅲ) with adrenaline has been observed at higher pH values.

Copper Phthalocyanine Catalysis to Oxidation of Adrenaline by Oxygen and Its Application in Adrena-line Detection

The oxidation of adrenaline by dioxygen using copper phthalocyanine （CuPc） as the catalyzer was studied. CuPc has the optimal catalytic pH of 8.0 and the optimal catalytic temperature of 55 ℃. It also has good storage and operation stability. The fiber optic adrenaline biosensor based on CuPc catalysis and fluorescence quenching was fabricated and studied. This sensor has the detection range of 7.0 × 10^-5 1.5 × 10^-4mol/L, the response time of 4 rain, good reproducibility and stability.

Stability and Luminescence Properties of Tb (Ⅲ) Complexes with Adrenaline

Stability and luminescence properties of Tb (Ⅲ) complexes with adrenaline have been studied. The Tb (Ⅲ) complexes with adrenalinc are quite stable. The fluorescence spectra of the Tb (Ⅲ) complexes with adrenaline show the characteristic fluorescence bands of Tb (Ⅲ) ions which are attributed to energy transfer from ligands to Tb (Ⅲ) ions.

VOLTAMMETRIC BEHAVIORS OF ADRENALINE AND ITS Be(Ⅱ)COMPLEX

The electrochemical oxidation behaviors of adrenaline(AD)and its Be(Ⅱ)complex have been studied by voltammetric method with a carbon paste working electrode.On the bases of calculation of the atomic net electronic charges of AD molecule by INDO approximate method and results of comparative experiment with dopamine the possible coordination site of Be(Ⅱ)-AD complex is proposed.

Increased Nitrogen Retention after Trans-Operative Intravenous Amino Acid and Glucose Infusion, without Changes in Urinary Amino Acid, Adrenaline and Plasma Urea or Glucose

Objective: Nutritional deficiencies are associated with increased morbidity and mortality during and after surgery. The present study evaluated nitrogen retention after transoperative intravenous infusion of amino acids and glucose. Design: Prospective study. Setting: Large community hospital. Patients: 18 randomly chosen patients undergoing medium or major surgeries. Interventions and Measurements: The experimental design included a 12-hour period before surgery (P1), a trans-operative period of 6 hours (P2), an early postoperative period (P3, 18 hours), and a late postoperative period (P4, 24 hours). Urinary amino acid and nitrogen were analyzed from P1 through P4. Group I, nine patients, received Ringer’s lactate solution with 5% glucose, and Group II, another nine patients, received a 6.6% amino acid and 16.6% glucose solution over a 6-hour trans-operative period (P2) starting from the anesthesia procedures. All surgical procedures lasted a maximum of 3 hours. Results: There was no statistically significant difference in urinary amino acid or adrenaline excretion between P1 and P4 in either group. Nitrogen excretion values were also similar for both groups, i.e., 0.39 ± 0.16 and 0.39 ± 0.28 g/hour, respectively. The nitrogen balance showed greater nitrogen retention (﹣0.25 ± 0.24 g/hour) in the group receiving the amino acid infusion compared to the group receiving Ringer’s lactate solution (﹣0.59 ± 0.26 g/hour) (P < 0.05). Blood plasma urea nitrogen and glycaemia did not increase at the end of the study (P4 period) in either group. Conclusion: These data indicate that trans-operative infusion of glucose and amino acids can be beneficial for patients submitted to surgical stress in terms of nitrogen retention.

Abnormal Change in Arterial Blood Pressure after Adrenaline-Containing in Lidocaine Infiltrated into Oral Submucosa during General Anesthesia

Sudden severe hypotension also occurs in an otherwise stable surgery when adrenaline-containing in lidocaine is infiltrated and care must be taken when using adrenaline-containing in lidocaine because it occasionally induces several adverse reactions. We report the case of a 16-year-old man who scheduled for oral surgery in which abnormal arterial blood pressure changes occurred after adrenaline-containing in lidocaine infiltrated into oral submucosa.

A Retrospective Comparative Study between Levosimendan and Adrenaline as a Pharmacological Protocol for the Management of Coronary Artery Bypass Grafting Patients with Low Ejection Fraction: A Friend or Foe

Background: Left ventricular ejection fraction is an independent determinant of the outcome of coronary artery bypass surgery. Low preoperative ejection fraction requires special care in terms of pharmacological and mechanical inotropic support. Adrenaline is the most widely used inotropic drug, while levosimendan is a relatively new inotropic drug in the field of cardiac surgery. In this study, we aimed to evaluate the relative efficacy of levosimendan in low ejection fraction patients undergoing coronary artery bypass grafting (CABG). Methods: A retrospective comparative study was performed with 63 patients who underwent isolated on-pump elective CABG with a preoperative ejection fraction below 40%. Patients were allocated to the adrenaline group (n = 35) and levosimendan group (n = 28). Patients were further stratified according to ejection fraction above 30% and below or equal to 30%. The primary outcome was cardiac-related mortality, while other parameters were considered secondary endpoints. Results: EuroSCORE of the adrenaline group was 3.34 ± 1.26 and for the levosimendan group 3.15 ± 1.42 (p value 0.576). Nine patients of the adrenaline group had new postoperative atrial fibrillation compared to seven patients in the levosimendan group (p value 0.948). Two patients of the adrenaline group had postoperative ventricular arrhythmia compared to only one patient in the other group (p value 0.691). The adrenaline group had higher doses of inotropic support compared to the levosimendan group 210.84 ± 23.74 and 157.4 ± 22.69 ng/kg/min respectively (p value Conclusions: The levosimendan-based protocol failed to improve overall mortality in low ejection fraction patients undergoing CABG. However, this protocol significantly reduced the dose of inotropic and vasoconstrictor support needed, ventilation hours and duration of ICU stay.

Tako-tsubo syndrome after administration of intravenous adrenaline during atrioventricular block

We describe the clinical case of a 70-year-old woman with complete atrioventricular block that after administration of intravenous adrenaline, developed electrocardiographic changes suggestive of acute coronary syndrome, together with apical dyskinesia of the left ventricle. After ruling out the existence of coronary lesions, and after total recovery of the echocardiographic alterations in segmental contractility, she was diagnosed as Tako-tsubo syndrome induced by administration of adrenaline. This is the first report of this syndrome in the scenario of atrioventricular block treated with adrenaline infusion.

Ab initio Study on the Interaction of La (Ⅲ) with Adrenaline

The interaction of La(III) with adrenaline was studied using Ab initio mathod. The geometry of the complex of La (III) with adrenaline was optimized, and the La(III) bonding site in adrenaline was ascertained

Barriers and challenges affecting parents’use of adrenaline autoinjector in children with anaphylaxis

BACKGROUND Anaphylaxis is a life-threatening condition that develops as a reaction to exposure to an allergen which can be found in common foods such as cow's milk,egg,fish,and nuts in children.The use of an intramuscular adrenaline auto-injector(AAI)is considered the most essential treatment in these situations and parents and caregivers are always encouraged to carry this device for use in an emergency which commonly takes place in public places such as restaurants,schools,and parks,where medical staff are not guaranteed to be available.However,previous studies,in different settings,have reported underuse of the AAI by parents.AIM To explore the reasons for underutilisation of the AAI in our community.METHODS A cohort of parents attending the paediatric allergy clinic at Al Ain Hospital in the United Arab Emirates completed a questionnaire survey aimed at assessing their understanding and knowledge of their child's allergy management,including their aptitude with the use of the AAI,as well as their competence and comfort in providing this treatment in an emergency.RESULTS Of 47 parents participating in the study,39 were Emirati parents(83%and most parents who completed the survey were mothers(66%).As expected,food was the main cause of allergic reactions requiring prescription of the auto-injector device.Tree nuts and peanuts were noted to be the most common offending food in these children(62%and 38%,respectively).A doctor provided demonstrations and training on using the auto-injector device to 94%of the parents.More than two-thirds of the parents and caregivers(79%)were deemed knowledgeable on the indication for use of the device.Reluctance to administer the device was expressed by many of the parents,despite their satisfaction with the coaching they received on using the device in the study.CONCLUSION Ongoing coaching and teaching of parents on use of the AAI is paramount.However,this should be carried out together with psychological support to aid the parents to eliminate their hesitancy and acquire sufficient confidence in using the device when needed.Group teaching and sharing experiences is an excellent educational technique in a non-formal setting.Paediatric clinic play therapists can also have a role in needle phobia desensitisation for parents and children.More research is needed to explore the lack of empowerment and other reasons behind their fear and anxiety in using the device to plan effective interventions.

Uremic Bleeding in 2 Patients with Dieulafoy’s Lesion: Case Report and Literature Review

Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.