Cardiovascular effects of the aqueous extract of Moringa pterygosperma

The aqueous extract of stem bark of Moriga pterygosperma (Family Moraingaceae) was investigated for its effect on various pharmacological parameters. In cardiovascular profile at lower concentrations (1–10 ng) it produced a dose dependent positive inotropic effect (n = 3, 1.29 ± 0.021 for 10 ng) and at higher concentrations (0.1–1 μg) a dose dependent negative inotropic effect (n = 3, 0.53 ± 0.033 for 1 μg) on the isolated frog heart. It also produced a dose dependent hypotensive effect on dog blood pressure (n = 3, 82 ± 0.98 for 20 mg/kg). It failed to elicit any effect on isolated guinea-pig ileum, rat stomach fundus or frog rectus abdominis muscle.     

The effect of acute autonomic denervation on pulmonary vascular resistance

Experiments were performed on 13 dogs to study the effects of acute denervation on pulmonary vascular resistance. Limited systemic circulation was maintained by cardiopulmonary bypass. Pulmonary blood flow rate was altered serially and pressure measurements were made to compute pulmonary vascular resistance. Other variables of systemic and pulmonary circulation were held constant. Denervation seemed to produce either no change or a reduction in pulmonary vascular resistance. These data, along with previous work, absolve denervation as an etiological factor for higher vascular resistance in pulmonary transplantation.     

Bariatric barosensor: a new paired structure in the paravetebral region of the iliac crest

A new anatomical entity, which we have decided to name bariatric borosensor, is described. It represents a paired structure under the skin, supero-lateral to the posterior superior iliac spine, overlying the iliac crest at the level of the fourth lumbar vertebra. Each of the paired structure is about the size of an enlarged lymph node; 0.5-2.0 cm in the largest diameter, spherical or ovoid in shape and firm in consistency. They are easily palpated clinically and can be demonstrated objectively by ultrasound examination. A hypothesis is put forth, conjecturing that this new structure may have relevance to the problem of obesity in modern, civilised western societies.     

Interaction of bretylium and guanethidine on the relaxations of the rat isolated fundal strip preparation, evoked by indirect stimulation

1. Isolated rat stomach fundal strip bathed in Krebs solution containing atropine (1 mug/ml), responded to indirect stimulation by a relaxation which was frequency dependent. These responses were blocked by phenoxybenzamine (6 mug/ml) or phentolamine (8 mug/ml).2. Strips obtained from rats previously treated with reserpine did not show relaxation to indirect stimulation. These responses were therefore adrenergic in nature.3. Bretylium (0.1-100 mug/ml) failed to block the relaxations produced by indirect stimulation, in fact relaxations were potentiated by the drug.4. Guanethidine (10 mug/ml) blocked the relaxations induced by indirect stimulation.5. Guanethidine may be taken up by adrenergic nerves actively since its action is not seen at 12 degrees C.6. Bretylium (10 mug/ml) prevented the actions of guanethidine at 37 degrees C.     

Bilateral mastectomies: can a co-surgeon technique offer improvements over the single-surgeon method?

Purpose

Bilateral mastectomy (BM) is traditionally performed using a single-surgeon (SS) technique (SST); a co-surgeon (CS) technique (CST), where each attending surgeon concurrently performs a unilateral mastectomy, offers an alternative approach. We sought to compare the CST and SST for BM with respect to operative times and complications.

Methods

Patients undergoing BM without reconstruction at our institution between 2005 and 2015 were identified using operative caselogs and stratified into CS- and SS-cohorts. Operative time (OT; incision to closure) was calculated. Patient age, cancer presence/stage, hormone receptor/BRCA status, breast weight, axillary procedure, and 30-day complications were extracted. Differences in OT, complications, and demographics between cohorts were assessed with t tests and Chi-square tests. A multivariate linear regression model was fit to identify factors independently associated with OT.

Results

Overall, 109 BM cases were identified (CS, n?=?58 [53.2%]; SS, n?=?51 [46.8%]). Average duration was significantly shorter for the CST by 33 min (21.6% reduction; CS: 120 min vs. SS: 153 min, p?<?0.001), with no difference in complication rates (p?=?0.65). Demographic characteristics did not differ between cohorts except for total breast weight (TBW) (CS: 1878 g vs. SS: 1452 g, p?<?0.05). Adjusting for TBW, CST resulted in a 27.8% reduction in OT (44-min savings, p?<?0.001) compared to SST.

Conclusions

The CST significantly reduces OT for BM procedures compared to the SST without increasing complication rates. While time-savings was <?50% and may not be ideal for every patient, the CST offers an alternative BM approach potentially best-suited for large TBW patients and those undergoing axillary procedures.

     

Vertical displacement of the precordial leads alters electrocardiographic morphology

BACKGROUND: The present study was undertaken to assess whether the vertical displacement of electrodes affects the waveforms of precordial leads. METHODS AND RESULTS: Two hundred forty healthy, adult volunteers had a standard 12-lead electrocardiogram, a 12-lead electrocardiogram with the precordial leads displaced 2 cm cranially, and another with the precordial leads displaced 2 cm caudally from the standard positions. All the three sets of electrocardiograms were visually compared, and changes noted. One hundred twenty male and 120 female volunteers, 20-68 years of age, were analyzed. Fifty-four males (45.0%) and 2 females (1.7%) showed no difference between the 3 sets of electrocardiograms, while 66 males (55.0%) and 118 females (98.3%) had some changes. R wave amplitude changes were noted in 63 male (52.5%) and 111 female (92.5%) volunteers; S wave amplitude changes were seen in 59 males (49.2%) and 99 females (82.5%,); T wave changes in 5 males (4.2%) and 3 females (2.5%); ST segment changes in 1 male (0.8%) and none of the females; and ORS morphologic changes in 1 male (0.8%) and 12 females (10.0%). CONCLUSIONS: Precordial electrocardiographic waveform changes were seen with the vertical displacement of the precordial leads. This will have implications on the interpretation of serial electrocardiograms. Healthcare providers should take into consideration this deviation when interpreting serial ECGs.