Vasodilator Therapy: Nitrates and Nicorandil.

Nitrates have been used to treat symptoms of chronic stable angina for over 135 years. These drugs are known to activate nitric oxide (NO)-cyclic guanosine-3',-5'-monophasphate (cGMP) signaling pathways underlying vascular smooth muscle cell relaxation, albeit many questions relating to how nitrates work at the cellular level remain unanswered. Physiologically, the anti-angina effects of nitrates are mostly due to peripheral venous dilatation leading to reduction in preload and therefore left ventricular wall stress, and, to a lesser extent, epicardial coronary artery dilatation and lowering of systemic blood pressure. By counteracting ischemic mechanisms, short-acting nitrates offer rapid relief following an angina attack. Long-acting nitrates, used commonly for angina prophylaxis are recommended second-line, after beta-blockers and calcium channel antagonists. Nicorandil is a balanced vasodilator that acts as both NO donor and arterial K(+) ATP channel opener. Nicorandil might also exhibit cardioprotective properties via mitochondrial ischemic preconditioning. While nitrates and nicorandil are effective pharmacological agents for prevention of angina symptoms, when prescribing these drugs it is important to consider that unwanted and poorly tolerated hemodynamic side-effects such as headache and orthostatic hypotension can often occur owing to systemic vasodilatation. It is also necessary to ensure that a dosing regime is followed that avoids nitrate tolerance, which not only results in loss of drug efficacy, but might also cause endothelial dysfunction and increase long-term cardiovascular risk. Here we provide an update on the pharmacological management of chronic stable angina using nitrates and nicorandil

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http://www.ester.ee/record=b4678257*es

Eesti keele käänded hiina emakeelega õppijate kasutuses

https://www.ester.ee/record=b5239600*es

Development of items in Acid-Base Identification Experiments Using Natural Materials: Validity Test with Rasch Model Analysis

The development of the test in the form of multiple choice items as 18 questions, aims to measure students' abilities in the experiment of identifying acid-base compounds with natural indicators. The study used descriptive quantitative methods. 79 high school students who have studied acid-base experiment with natural indicators, as the subject of validity test. Validity analyzed by Rasch model in the Winsteps program, including the level of problem difficulty, item validity, construct validity, content validity, and instrument reliability. The results obtained are evenly distributed, so that it can measure students' abilities at various levels of knowledge. Construct validity is evidenced by the raw variance value of 31%, and content validity shows that the questions fit the Rasch model. The feasibility of the instrument can also be seen from its very good reliability value of 0.91. The developed test can be used as a measuring tool for the success of acid-base identification practicum with natural indicators, which have been developed in various researches on the development of environmentally friendly acid-base practicums from natural materials

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https://www.ester.ee/record=b5465201*es

Development of items in Acid-Base Identification Experiments Using Natural Materials: Validity Test with Rasch Model Analysis

The development of the test in the form of multiple choice items as 18 questions, aims to measure students' abilities in the experiment of identifying acid-base compounds with natural indicators. The study used descriptive quantitative methods. 79 high school students who have studied acid-base experiment with natural indicators, as the subject of validity test. Validity analyzed by Rasch model in the Winsteps program, including the level of problem difficulty, item validity, construct validity, content validity, and instrument reliability. The results obtained are evenly distributed, so that it can measure students' abilities at various levels of knowledge. Construct validity is evidenced by the raw variance value of 31%, and content validity shows that the questions fit the Rasch model. The feasibility of the instrument can also be seen from its very good reliability value of 0.91. The developed test can be used as a measuring tool for the success of acid-base identification practicum with natural indicators, which have been developed in various researches on the development of environmentally friendly acid-base practicums from natural materials

PET Imaging of Post-infarct Myocardial Inflammation.

Funder: Department of HealthPurpose of reviewTo examine the use of positron emission tomography (PET) for imaging post-infarct myocardial inflammation and repair.Recent findingsDysregulated immune responses after myocardial infarction are associated with adverse cardiac remodelling and an increased likelihood of ischaemic heart failure. PET imaging utilising novel tracers can be applied to visualise different components of the post-infarction inflammatory and repair processes. This approach could offer unique pathophysiological insights that could prove useful for the identification and risk-stratification of individuals who would ultimately benefit most from emerging immune-modulating therapies. PET imaging could also bridge the clinical translational gap as a surrogate measure of drug efficacy in early-stage clinical trials in patients with myocardial infarction. The use of hybrid PET/MR imaging, in particular, offers the additional advantage of simultaneous in vivo molecular imaging and detailed assessment of myocardial function, viability and tissue characterisation. Further research is needed to realise the true clinical translational value of PET imaging after myocardial infarction

PET imaging of the neurovascular interface in cerebrovascular disease

Cerebrovascular disease encompasses a range of pathologies affecting different components of the cerebral vasculature and brain parenchyma. Large artery atherosclerosis, acute cerebral ischaemia, and intracerebral small vessel disease all demonstrate metabolic processes that are key to pathogenesis. Although structural imaging has been a mainstay of stroke clinical care and research, it has limited ability to detect these pathophysiological processes in vivo. Positron emission tomography (PET) provides a means to detect and quantify metabolic processes in each facet of cerebrovascular disease non-invasively. The use of PET has helped shape the understanding of key concepts in cerebrovascular medicine, including the vulnerable atherosclerotic plaque, salvageable ischaemic penumbra, neuroinflammation and selective neuronal loss after ischaemic insult, and the relationships between chronic hypoxia, neuroinflammation, and amyloid deposition in cerebral small vessel disease. This review considers how the ability to image these processes at the neurovascular interface has contributed to our understanding of cerebrovascular disease and facilitated translational research to advance clinical care.N.R.E. is supported by a research training fellowship from The Dunhill Medical Trust (grant number RTF44/0114). J.M.T. is supported by a Wellcome Trust research training fellowship (104492/Z/14/Z). J.H.F.R. is part-supported by the Higher Education Funding Council for England (HEFCE), the British Heart Foundation, and the Wellcome Trust. H.S.M. is supported by the Medical Research Council (MRC) as a National Institute for Health Research (NIHR) Senior Investigator. E.A.W. is supported by the British Heart Foundation. H.S.M., J.H.F.R., and E.A.W. are supported by the NIHR Cambridge Biomedical Research Centre