Cardiovascular and Hematological Disorders - Drug Targets最新文献

Background & objective: Age-dependent Organophosphates (OPs) toxicity is a controversial topic. The present study was designed to investigate the effect of the sub-acute exposure to diazinon (DZN), one of the main OPs insecticides, on the hematological alterations in adult and aged male rats.

Methods: For the aim of this approach, the adult and aged rats were administered with DZN (15 mg/kg, orally) for 4 weeks. Then, the blood samples were collected from the retro-orbital sinus for measuring red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), platelets (PLT), MCV (mean corpuscular volume), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin (MCHC).

Results: The obtained results indicated that DZN significantly decreased RBCs (4.93 ± 0.41), Htc (28.12 ± 1.21), Hb (10.31 ± 0.36), MCHC (30.51 ± 2.04), MCV (62.86 ± 2.58), and PLT (265.6 ± 34.81) values in the adult and aged rats versus the age-matched control rats. Moreover, RBC, Hb, and Htc levels decreased significantly in the aged rats versus adult rats. However, no significant differences were observed between MCHC, MCV, and PLT levels in adult and aged rats. Moreover, the MCH concentration did not change in any group. Additionally, DZN did not deteriorate the hematological alterations in the aged rats versus adult rats.

Conclusion: the present study showed that the toxicity of DZN is not associated with age. However, more studies should be conducted to confirm this finding.

Aims: The study aimed to investigate the antihyperglycemic activity of Matricaria pubescens.

Background: Matricaria pubescens (Def). Shultz (Asteraceae) is commonly used traditionally for the treatment of diabetes in Morocco.

Objective: The present investigation aimed to assess the antihyperglycemic and antioxidant effects of the aqueous extract of the aerial part of Matricaria pubescens (M. pubescens).

Methods: The effect of a single and repeated oral administration of the aqueous extract of aerial part of M. pubescens (AEAPMP) at a dose of 40 mg/kg on glucose was examined in normal and streptozotocin-induced diabetic rats. Additionally, histopathological examination of the pancreas and liver was carried out according to the Hematoxylin-Eosin method. The antioxidant activity was performed using the DPPH assay.

Results: The results showed that the aqueous extract of M. pubescens (AEAPMP) exhibited a significant lowering activity on blood glucose levels in STZ-induced diabetic rats. In addition, AEAPMP ameliorated the histopathological tissues of the liver and pancreas. Furthermore, in vitro antioxidant activity of AEAPMP has been shown.

Conclusion: In conclusion, this study demonstrates that M. pubescens possesses a beneficial effect against hyperglycemia associated with diabetes.

Introduction: Bivalirudin and heparin are the two most commonly used anticoagulants used during Percutaneous Coronary Intervention (PCI). The results of Randomized Controlled Trials (RCTs) comparing bivalirudin versus heparin monotherapy in the era of radial access are controversial, questioning the positive impact of bivalirudin on bleeding. The purpose of this systematic review is to summarize the results of RCTs comparing the efficacy and safety of bivalirudin versus heparin with or without Glycoprotein IIb/IIIa Inhibitors (GPI).

Methods: This systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statements for reporting systematic reviews. We searched the National Library of Medicine PubMed, Clinicaltrial.gov and the Cochrane Central Register of Controlled Trials to include clinical studies comparing bivalirudin with heparin in patients undergoing PCI. Sixteen studies met inclusion criteria and were reviewed for the summary.

Findings: Several RCTs and meta-analyses have demonstrated the superiority of bivalirudin over heparin plus routine GPI use in terms of preventing bleeding complications but at the expense of increased risk of ischemic complications such as stent thrombosis. The hypothesis of post- PCI bivalirudin infusion to mitigate the risk of acute stent thrombosis has been tested in various RCTs with conflicting results. In comparison, heparin offers the advantage of having a reversible agent, of lower cost and reduced incidence of ischemic complications.

Conclusion: Bivalirudin demonstrates its superiority over heparin plus GPI with better clinical outcomes in terms of less bleeding complications, thus making it as anticoagulation of choice particularly in patients at high risk of bleeding. Further studies are warranted for head to head comparison of bivalirudin to heparin monotherapy to establish an optimal heparin dosing regimen and post-PCI bivalirudin infusion to affirm its beneficial effect in reducing acute stent thrombosis.

Background: Multicentric Castleman Disease (MCD) presents with enlarged lymph nodes in multiple regions and systemic inflammatory symptoms, due to the dysregulation of cytokines, most commonly interleukin-6 (IL-6). Human herpes virus-8 (HHV-8) is strongly related to MCD (HHV-8-associated MCD) and is being implicated in cytokine dysregulation in patients, the majority of whom are HIV positive or immunosuppressed. Preferred treatment of HHV-8- associated MCD depends on the presence or not of concurrent Kaposi sarcoma and on whether the patient has life-threatening organ failure or poor performance status thought to be related to HHV- 8-associated MCD.

Case presentation: Herein, we describe a female patient with HHV-8 positive, HIV negative MCD, who responded well to the administration of rituximab once weekly for four weeks alone for three cycles.

Conclusion: HHV-8 positive, HIV negative MCD treatment modalities are only anecdotal due to the rarity of this form of MCD. Administration of rituximab alone seems to be beneficial among patients with good performance status and the absence of life-threatening organ failure in cases of HHV-8 positive, HIV negative MCD.

A significant percentage of B-cell lymphomas are characterized by bone marrow involvement (BMI) at diagnosis. In most cases, there is a concordance between the type of lymphoma present in the lymph node and the lymphoma present in the bone marrow. Herein, we presented a sixty-seven years old female patient, who was diagnosed with High-Grade B-cell Lymphoma (HGBL) in the bone marrow, while simultaneously, in the peripheral lymph node, the presence of Follicular Lymphoma (FL) was noted. The patient was presented to the hospital with spontaneous tumor lysis syndrome, a finding compatible with the aggressive course of the HGBL. To our knowledge, this is the first case of the co-existence of HGBL in the bone marrow and FL in a lymph node, which might be attributed to merely a coincidence or to the transformation of the cells in the preferable milieu of the bone marrow.

Aims: The aim of this study was to evaluate the antidiabetic effect of Scorzonera undulata.

Background: Scorzonera undulata ssp deliciosa, locally known as "Guiz", is used as a phytomedicine in Morocco and Algeria to treat different health problems. Interestingly, it is used in the Moroccan pharmacopeia to treat diabetes. To our knowledge, this medicinal herb has never been investigated for any pharmacological activity.

Objective: This study aimed to evaluate the antihyperglycemic effect of the aqueous extract of the aerial part of Scorzonera undulata (SUAP) in normal and STZ-induced diabetic rats and to assess the acute toxicity of this extract in Wistar rats.

Methods: This study investigated the effects of SUAP at a dose of 20 mg/kg on blood glucose levels in normal and streptozotocin(STZ)-induced diabetic rats. The acute toxicity of SUAP was examined according to the OECD test guideline; rats were divided into four groups of each sex and orally received the SUAP (1000, 2000, or 3000 mg/kg BW). Post-treatment, body weight, signs of toxicity, and/or mortality were observed during 14 days. Other assays such as histopathological examination, preliminary phytochemical investigation, determination of glycogen content and evaluation of α-amylase were performed according to standard protocols.

Results: The findings of the current study depicted that both single and repeated oral administration of SUAP (20 mg/kg) generated a significant fall in the blood glucose levels in diabetic rats. A single oral administration of SUAP (at the highest dose of 3000 mg/kg BW) had no significant acute toxicological effects, and oral LD50 of SUAP was greater than 3000 mg/kg. Furthermore, repeated oral administration of SUAP during 15 days led to an increase in the liver glycogen content in diabetic rats to improve the histopathological structure of the liver and pancreas in SUAPtreated diabetic rats and to ameliorate some biochemical parameters such as ALT and creatinine. SUAP had no effect on α-amylase activity. In addition, the preliminary phytochemical investigation showed the richness of the roots of SUAP in some phytochemicals, particularly the polyphenols.

Conclusion: The present study demonstrates the antihyperglycemic effect of Scorzonera undulata in diabetic rats which could be involved through the improvement of liver structure and function. In addition, the dose used is not toxic. Finally, the extract contains large amounts of bioactive compounds, mainly polyphenols.

Aims: To study the toxicological profile and anti-hyperlipidemic effects of Spondias mombin leaves methanolic extract in experimental rats.

Background: Preventing high levels of lipids or its recurrence is currently one of the key aims of clinical and experimental studies.

Objective: This study was carried out to investigate the toxicological profile and anti-hyperlipidemic effects of methanolic extract of leaves of Spondias mombin.

Methods: The acute toxicity study was carried out where the limited dose of 2000 mg/kg body weight was administered to five rats at 48 h intervals. The interpretation was prepared and recorded for 24 h. In the sub-acute toxicity study, rats were treated with 250, 500, and 1000 mg/kg doses of the extract every 24 h for 28 days. The hematological, biochemical, and histopathological tests of treated animals were carried out at the end of the test. The anti-hyperlipidemic activity of plant extract (100, 200 mg/kg) was studied on Triton-X-100 induced hyperlipidemia in rats. Histopathological changes in the liver of rats were examined.

Results: For acute and subacute treatment, the extract did not reveal any signs of toxicity or mortality, or any significant effects on hematological, biochemical parameters, and histopathology of organs. The extract demonstrated an important anti-hyperlipidemic result by decreasing the serum levels of cholesterol, TGs, LDL, VLDL, and enhancing HDL.

Conclusion: Taking up the evidence of the experimental study, we can conclude that the methanolic extract of Spondias mombin leaves helps in declining hyperlipidemia in rats and it can be safely used for a period of 28 days to treat hyperlipidemia.

Objectives: Thalassemia major (TM) is one of the most common blood disorders with a high mortality rate due to cardiovascular disease. Vitamin D deficiency has been suggested to implicate in cardiac abnormalities. In this prospective study, we aimed to investigate the relationship between serum levels of vitamin D and tissue Doppler (TD) echocardiographic indices in thalassemia major patients.

Methods: A total of 81 TM patients, including 56 females and 25 males, with a mean age of 27.5± 6.8 years, were enrolled consecutively. Serum levels of vitamin D and other biomedical parameters were measured. Then, all patients were subjected to TD echocardiography. Correlations between the serum parameters and systolic and diastolic indices were examined.

Results: The serum level of vitamin D was correlated with systolic and diastolic indices such as the EF (r= 0.33, P= 0.003) and TD Imaging (TDI)-lateral (r= 0.31, P= 0.005). However, no correlations were observed between vitamin D deficiency and the LV septal and posterior wall thickness, TDIseptal, tricuspid regurgitation peak gradient (TRPG), pulmonary artery systolic pressure (PASP), deceleration time (DT), and propagation velocity (PVcm/s) indices. The results revealed also no linear correlations between serum vitamin D and albumin (r= -0.17, P= 0.06), ALP (r= -0.12, P= 0.14), T4 (r= -0.11, P= 0.16), as well as TSH (r= -0.10, P= 0.19).

Conclusion: It seems that vitamin D deficiency in patients with TM is associated with systolic but not diastolic dysfunctions, possibly as consequences of related biochemical abnormalities.

Background: It is important to discard those practices that do not add value. As a result, several initiatives have emerged. All of them try to improve patient safety and the use of health resources.

Purpose: To present a compendium of "do not do recommendations" in the context of hemophilia.

Methods: A review of the literature and current clinical guidelines has been made, based on the best evidence available to date.

Results: The following 13 recommendations stand out: 1) Do not delay the administration of factor after trauma; 2) do not use fresh frozen plasma or cryoprecipitate; 3) do not use desmopressin in case of hematuria; 4) do not change the product in the first 50 prophylaxis exposures; 5) do not interrupt immunotolerance; 6) do not administer aspirin or NSAIDs; 7) do not administer intramuscular injections; 8) do not do routine radiographs of the joint in case of acute hemarthrosis; 9) Do not apply closed casts for fractures; 10) do not discourage the performance of physical activities; 11) do not deny surgery to a patient with an inhibitor; 12) do not perform instrumental deliveries in fetuses with hemophilia; 13) do not use factor IX (FIX) in patients with hemophilia B with inhibitor and a history of anaphylaxis after administration of FIX.

Conclusion: The information mentioned previously can be useful in the management of hemophilia, from different levels of care. As far as we know, this is the first initiative of this type regarding hemophilia.

The estimated prevalence of AL CA in the US is approximately 8-12 cases per million. Almost 30-50% diagnosed cases of AL amyloid in the US have multisystem involvement, including cardiac involvement. Even with the availability of advanced diagnostic testing and novel therapies, prognosis remains poor. It is overlooked as a cause of heart failure with preserved ejection fraction leading to a delay in diagnosis when management options are limited and associated with poor survival outcomes. Therefore, the education of physicians is needed to ensure that it would be highly considered as a differential diagnosis. The purpose of this manuscript is to review the advances in the diagnosis and management of cardiac amyloidosis with the aim of educating colleagues who provide care in the primary care setting. We have summarized the pathogenesis of amyloidosis, its association with plasma cell dyscrasias, novel diagnostic and surveillance approaches including echocardiography, cardiovascular magnetic resonance imaging, histopathologic techniques, systemic biomarkers, and advanced treatment approaches including supportive symptomatic management and standard of care chemotherapy targeting the amyloid deposits. Given the overall poor prognosis of amyloidosis, we have also discussed the role of palliative and hospice care.