Statins and left ventricular function.

BACKGROUND: Statins are a well-established class of drugs in both preventing coronary events and treating cardiovascular atherosclerotic disease, however their use in heart failure is still in debate. OBJECTIVES: To establish whether statins' pleiotropic actions in endothelium, inflammation, remodeling of the heart and anti-arrhythmic potential may be in favorable of heart failure patients. METHODS: We proceed to literature search of English bibliography under the terms heart failure, statins, 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors. RESULTS: Various experimental and clinical trials on the use of statins in the different subtypes of heart failure according to the ejection fraction of the left ventricle have been conducted to conclude whether statins should be part of their patients' treatment. The evidence shows that the subgroup of patients with ischemic heart disease and those with preserved ejection fraction seems to have better results from the use of statins although randomized control trial in the total heart failure population did not show any benefit in mortality, Conclusion: Statins may be beneficial act to left ventricle systolic and diastolic performance of heart failure patients however their result in mortality cannot be established based on current evidence.

Plate osteosynthesis of condylar fractures: a retrospective study of 45 patients.

OBJECTIVE: This retrospective study presents the type of osteosynthesis used for the fixation of condylar fractures and the postoperative results and complications observed. METHOD AND MATERIALS: Forty-five patients with fractures of the mandibular condyle underwent open reduction and osteosynthesis with plates and screws. The surgical approach was, in most cases, via a submandibular incision. Stabilization was achieved in the majority of the cases with a 2.0-mm single or double miniplate, but 2.0-mm mini dynamic compression plates were also used. RESULTS: The complications were mainly inadequate reduction, screw loosening, and limitation of mouth opening. No plate fractures or infections were observed. CONCLUSION: The use of a single plate (miniplate or dynamic compression plate) often produces inadequate stability and reduction postoperatively. The placement of two 2.0-mm zygomatic dynamic compression plates demands great tissue dissection and detachment and can lead to limitation of mouth opening. The use of two 2.0-mm miniplates seems to produce better stability and fewer complications.

Effects of propranolol or paracetamol on lidocaine concentrations in serum and tissues.

PURPOSE: The goal of this study was to determine the interaction of lidocaine after paracetamol or propranolol administration. MATERIALS AND METHODS: Group A rats received a mixture of cold lidocaine and (14)C lidocaine into the masseter muscle. Group B rats received lidocaine and paracetamol 7.5 mg/kg orally, whereas group C received lidocaine intramuscularly and propranolol 1.5 mg/kg orally. Five consecutive doses were administered. The levels of these drugs were estimated in serum and the total concentration and the percent protein binding of lidocaine in tissues (liver and mandible) were determined. The rats were killed 2 hours after the last dose. RESULTS: The results suggest that lidocaine concentrations in serum were significantly increased after either paracetamol or propranolol administration. Additionally, the combined therapy of propranolol and lidocaine resulted in a significant decrease in the total concentration and the percent protein binding of lidocaine in tissues. CONCLUSIONS: The coadministration of lidocaine with paracetamol or propranolol interferes with the metabolic profile, resulting in pharmacokinetic interactions that may be significant for the determination of the correct dose of lidocaine in clinical applications.