Cardiovascular & Haematological Disorders - Drug Targets - Volume 16, Issue 1, 2016

Ceftriaxone and linezolid are commonly used antibiotics in infective endocarditis. Here we present a rare case of severe anemia caused by both the drugs via different mechanisms. Drugs have shown significant contribution in inducing anemia via hemolysis and bone marrow suppression in an infective endocarditis patient.

Objective: To investigate the occurrence of ischemic stroke in patients with congenital bleeding disorders. Patients and Methods: Patients with congenital bleeding disorders who presented an objectively proven ischemic stroke were obtained by means of a time unlimited Pubmed search. Appropriate key words and Medical subject headings were used. Cross-checking of the references was also carried out. Results: There were four cases of Fibrinogen defects or Factor VII deficiency; seven patients had Hemophilia (6 hemophilia A and 1 hemophilia B); eight cases of FXI deficiency and six patients with von Willebrand Disease. One patient had a congenital platelet disorder. Age varied from 7 to 80 (mean age 38.6). 15 were male and 11 female. In four patients gender was not reported. The ratio of Myocardial Infarction to Ischemic stroke was 12.28 for the hemophilias, 7.83 for vW Disease and 2.75 for the Rare Bleeding Disorders. Risk factors were present in most patients, replacement therapy and old age being the most frequent. Conclusions: The differences in the prevalence of ischemic stroke vs coronary arterial disease seen in patient with congenital bleeding disorders indicate that clotting defects assure an uneven protection from atherothrombosis. Since the mechanisms underlying these differences are unknown, they represent a field of potential future investigation.

Antioxidants offer protection against the damage potentially caused by free radicals, which usually involve an oxygen or nitrogen moiety, in living organisms. An antioxidant can be defined as a molecule that has the capability to inhibit the oxidation of another molecule, so, in other words, it is a reducing agent that is sufficiently stable to donate an electron to a circulating free radical and thereby result in its neutralization. Free radicals can be defined as any chemical species that has one or more mismatched electrons; these free radicals can cause a sequential reaction resulting in damage to multiple components of the organism, functioning either as an oxidant or a reductant by accepting or donating an electron, respectively. Oxidative stress can be defined as an imbalance between the production of free radicals and necessary antioxidant defenses. Therefore protection of the organism from these potentially damaging entities, when appropriate, is essential. Potential damage involves lipids, proteins, cell membranes, deoxyribonucleic acid (DNA), carbohydrates, and various enzymes, which can lead to cell death. Antioxidant protection from free radical-induced damage occurs via the donation of an electron with subsequent conversion of a free radical to a harmless chemical configuration that can no longer damage a cell and its components. Classes of antioxidants include, natural, nutrient, and supplemental. When antioxidant levels are low, there is a resultant increase in oxidative stress with a harmful increase in free radicals that can be associated with an increased risk for cardiovascular (CV) disease including atherosclerosis, various inflammatory diseases, and cancer. Major issues for the clinician to consider are what can be done to naturally increase antioxidants when deficient or when a directed increase might be beneficial such as in aging and degenerative disease, how nutrients can be altered or provided to increase antioxidant protection, and when or if to consider the use of supplements, frequently classified as alternative medicines.

Hematologic primary prohylaxis is the gold standard of treatment in persons with hemophilia (PWH). The goal is to reduce or prevent joint bleeds and subsequent joint degeneration (hemophilic arthropathy). In acute hemarthroses, early treatment with factor (VIII or IX) replacement and rest of the joint (4 to 5 days) are paramount. In patients with inhibitors (antibodies against factor VIII or IX) we can use bypassing agents such as activated prothrombin complex concentrate (aPCC) and recombinant factor VIIa (rFVIIa). The goal is to get the rapid resolution of the joint bleed that must be confirmed by means of ultrasonography (US). This way the risk of long-term complications will be minimized. Ice therapy could help, although its current role in hemophilia remains controversial. Pain killers (paracetamol) may also be needed. Arthrocentesis (joint aspiration) should be performed in very tense and painful joints. The procedure should always be performed under factor coverage and in aseptic conditions. Rehabilitation (physiotherapy) will help recovering the pre-bleeding full range of motion of the joint. In recurrent joint bleeds, radiosynovectomy (RS) and arthroscopic synovectomy (AS) can break the vicious cycle of hemarthrosis-synovitis-hemarthrosis. If joint damage is not avoided, it will compromise the health-related quality of life (HRQoL) of PWH.

Atrial fibrillation (AF), a common cardiac arrhythmia associated with increased risk of heart failure, thromboembolic phenomena and death, is a leading cause of hospitalization of adults. A major complication of AF is an increased risk of ischemic stroke leading to long-term disability and in severe cases, death. Historically, Coumadin has been the drug of choice for chronic anticoagulation and stroke prevention in AF patients however, given the need for constant monitoring and multiple drug interactions, newer anticoagulants have been developed. One such drug is dabigatran, with the promise of less frequent monitoring and decreased bleeding tendencies as compared to Coumadin. The main disadvantage of dabigatran has been the lack of a reversal agent in case of severe bleeding or emergent surgical intervention. This was until the recent The Food and Drug Administration approval of idarucizumab, a potential reversal agent for dabigatran. In this article, we discuss the evidence addressing idarucizumab safety, tolerability and its efficacy for reversing effect of dabigatran.

Curcumin, the major phenolic compound in turmeric, shows preventive effects in various diseases. Curcumin is commonly found in rhizome of the Curcuma species and traditionally used in herbal medicine. Numeros studies has indicated that curcumin posses protective effects against toxic agents in various systems including cardiovascular. This study found that curcumin may be effective in cardiovascular diseases induced by toxic agents including Streptozotocin, Doxorubicin, Cyclosporin A, Methotrexate, Isoproterenol, Cadmium, Diesel exhaust particle, Nicotine, Hydrogen peroxide, and tert- Butyl hydroperoxide. However, due to the lake of information on human, further studies are needed to determine the efficacy of curcumin as an antidote agent. The present study aimed to critically review the recent literature data from that regarding the protective effects of curcumin against agents-induced cardiovascular toxicity.

Background: Stevioside is one of the most important food additives that has become well known for its sweetness. The aim of this study was to evaluate the impact of Stevioside on the heart. Methods: 4-day-old embryonated chickens eggs were inoculated with Stevioside and kept until hatching. Shortly after, the heart tissue samples were taken to examine organ Oxidative stresses by measuring Malondialdehyde (MDA) and glutathione (GSH) levels, ferric reducing /antioxidant power (FRAP) and cupric ion reducing assay (CUPRIC). Results: There was no significant difference in glutathione level, lipid peroxidation, FRAP, and cupric assay. Conclusion: It was suggested that stevioside did not cause marked damages to heart tissues in chicken embryo model.

Background: The present study evaluated the effects of Zataria multiflora (Z. multiflora) ethanolic extract on the hyperglycemia induced by bisphenol A (BPA). Method: In the present research, mice were randomly selected into the following categories of 6 mice in each group: group one, control (C); group two, in which mice received 0.5 mg/kg of BPA, group three, in which mice received 2 mg/kg of BPA, group four, which was exposed to 0.5 mg/kg of BPA and received Z. multiflora and group five, which was exposed to 2 mg/kg of BPA and received Z. multiflora. The two doses of BPA were intraperitoneally administered to the positive control, however, the negative control injected only vehicle for 28 days. Z. multiflora (900 mg/kg) was administered orally to animals during injection of BPA exposure. After 28 days, the modulation of malondialdehyde (MDA), CAT (catalase), SOD (superoxide dismutase), glutathione (GSH), TAS (total antioxidant status), lipid profile, glucose, and total protein was evaluated in pancreas and serum. Results: The analyzed data showed that Z. multiflora caused considerable decrease in glucose, total cholesterol (TC), triglyceride (TG) and MDA content with increase in GSH and total protein content in the serum of treated mice exposed to BPA (2 mg/kg/day), as compared to untreated mice exposed to BPA (2 mg/kg/day) (p<0.001). The MDA, TAS, and SOD levels were ameliorated in the pancreas of mice exposed to BPA (2mg/kg/day) after Z. multiflora administration (p<0.001). Conclusion: These results suggest that Z. multiflora ameliorates hyperglycemia and hyperlipidemia in adult male mice exposed to BPA via inhibition of oxidative stress.

This study aims to evaluate the cardiovascular effect of Nigella sativa L. aqueous extract (NSAE) in normal rats. The in vivo experiment showed that the intravenous injection of NSAE at the doses of 50, 100 and 200 mg/kg of body weight produced a dose dependent reduction in the mean arterial blood pressure (MABP) (p<0.001) accompanied by a significant fall in heart rate (p<0.01). In the in vitro experiment, incubation of NSAE during 30 min caused a right shift of the contraction response curve of aortic ring to Norepinephrine (NE) with a reduction of the maximal contraction response (p<0.01). Endothelium destruction significantly reduced the vasorelaxant effect of NSAE at a dose of 30 mg/ml (p<0.01). Furthermore, Nitric oxide synthase inhibitor: Nω-Nitro-L-Arginine Methyl Ester (L-NAME) produced a significant reduction (p<0.01) of the in vitro vasorelaxant effect of NSAE at a dose of 30 mg/ml. We conclude that NSAE possess a rapid and dose dependent in vivo hypotensive effect in normal rats which may be probably due to the inhibition of parasympathetic tone. In isolated aortic ring, NSAE possess a potent inhibitor of contractile response to NE which may be probably due to an increase in the endothelial nitric oxide synthesis.