Adrenaline in pulp capping treatment of reversible pulpitis

BACKGROUND The role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis is not clear.AIM To explore the role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis.METHODS A total of 100 patients with reversible pulpitis who were treated in Anhui Jieshou People's Hospital from January 2020 to December 2021 were included in the study.They were categorized into an observation group(n=50;treatment with adrenaline)and a control group(n=50;treatment with zinc oxide eugenol paste).The 24-h postoperative pain,regression time of gingival congestion and redness,clinical efficacy,and incidence of adverse reactions were compared between the groups.Patients were further categorized into the ineffective and effective treatment groups based on clinical efficacy.Logistic multiple regression analysis explored factors affecting the efficacy of pulp capping treatment.RESULTS A significant difference in 24-h postoperative pain was observed between the groups(P<0.05),with a higher proportion of grade I pain noted in the observation group than in the control group(P<0.01).The regression time of gingival congestion and swelling was lower in the observation group(2.61±1.44 d and 2.73±1.36 d,respectively)than in the control group(3.85±1.47 d and 4.28±1.61 d,respectively)(P<0.05).The 2-wk postoperative total effective rate was lower in the control group(80.00%)than in the observation group(94.00%)(P<0.05).The incidence of adverse reactions was not significantly different between the control(14.00%)and observation(12.00%)groups(P>0.05).The proportion of adrenaline usage was lower(P<0.05)and that of anaerobic digestion by Streptococcus and Fusobacterium nucleatum was higher in the ineffective treatment group than in the effective treatment group(P<0.05).Logistic multiple regression analysis revealed adrenaline as a protective factor(P<0.05)and anaerobic digestion by Streptococcus and F.nucleatum as risk factors for pulp capping in reversible pulpitis(P<0.05).CONCLUSION Adrenaline demonstrated therapeutic efficacy in pulp capping treatment for reversible pulpitis,reducing pain and improving clinical symptoms safely.It is a protective factor for pulp capping,whereas Streptococcus and F.nucleatum are risk factors.Targeted measures can be implemented to improve clinical efficacy.

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.

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.

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.

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.

Hedonism and Adrenaline-Emotional Relation With Rafting

The success of each enterprise is finding, working on it, promoting, and obviously offering what the consumers really love and enjoy. Albania is very useful if you have this mission： Reconciling all the nature components with favorable weather conditions, we can really offer an adventure business, where everyone can discover the beauty of Albania through an unforgettable trip. The key word that summarizes all the elements mentioned is without a doubt “Rafting”. Introducing rafting both as a sport and as a touristic outdoor activity, in that way we develop a new touristic market and a strong promoter of sustainable adventure tourism in Albania. When a person takes pleasure but in an unhealthy extent, how does this affect his personality？ The adrenaline as happiness, meaning and pleasure…The topics that this study is about, are two key terms that will guarantee the success of this “adventure project”： The first is the satisfaction of consumers, which gives us a feedback about the product/service and the second part deals with the term adrenaline （pleasure supreme customer）; hedonic consumer features, part of their character, the main approaches and a study conducted with customers who have attended at least once rafting, customers attending characteristic of emotions, adrenaline, and adventure to take the pleasure of life. A company should always try and please its consumers. Usually, pleased consumers will always come back for more; they will also spread the word and bring new potential consumers into your business that will pay a fair amount of money for a new upcoming product that set company offers. The measurement of consumer satisfaction is a pure indicator of the consumers repurchases intentions, an indicator of the actual performance and differentiation from the current competition. The consumers mind will always remember the name of the company that they had a bad experience rather than the onethey have been satisfied with. Often when we receive a fixed service, our mind tends to create a very close emotional connection to set service. Often we find that the smallest things bring the greatest joy, regardless of the price. For the majority part, following the adrenaline passion is more than just a need. Lately, the traditional notion of purchasing is left behind and everyone is focusing on providing themselves with pleasure and emotions. The definition of the word “hedonic” comes from Ancient Greece, meaning “taking the maximal pleasure from life” being our primary goal.

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.

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

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.

Effect of Xylazine-Ketamine Anesthesia on Blood ACTH, Cortisol, Adrenaline, Insulin and Glucose in Ovariohysterectomized Cats

A study has been carried out with fourteen healthy mature cats in order to determine the effect of a xylazine-ketamine anesthetic protocol （group X/K） on blood concentrations of adrenaline, ACTH （adrenocorticotropic hormone）, cortisol, insulin and glucose in comparison with a control group （group K--no anesthesia and surgery）. The animals were randomly allocated in two groups （n = 7）. The premeditation in the experimental group was made with xylazine 2 mg/kg intramuscularly. Induction and maintenance of anesthesia were made with ketamine 10 mg/kg intramuscularly. Ovariohysterectomy was performed upon occurrence of deep anesthesia. Blood specimens were obtained at 0, 30, 60, 120 min and 24 h from the two groups. Pronounced decrease in blood ACTH, cortisol, and adrenaline in group X/K was determined by the 30 min. Significant hyperglycemia together with hyperinsulinemia in the X/K group was established at the 120 min from the beginning of the anesthesia. Anesthesia with xylazine and ketamine led to reduction of the blood levels of stress hormones immediately after the beginning of anesthesia and caused a remarkable hyperglycemia with hyperinsulinemia.

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.

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.

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.