Effects of a single, 24-hour, low-dose intravenous dobutamine infusion on left ventricular myocardial performance index in congestive heart failure: A prospective, nonrandomized study

AbstractBackground:Dobutamine, a predominantly beta-adrenergic sympathomimeticagent, is used for improving left ventricular (LV) systolic performance with different dosing regimens in patients with congestive heart failure (CHF). Myocardial performance index (MPI) is an indicator of LV global function that is correlated with LV end-diastolic pressure, and it is increased in CHF.Objective:The purpose of this study was to examine the effects of a single, 24-hour, low-dose, IV dobutamine infusion on LV systolic and diastolic function and on MPI in CHF as an indicator of LV global function, as well as the adverse effects (AEs) of the infusion.Methods:This prospective, nonrandomized study was conducted at theDepartment of Cardiology, Baskent University Hospital, Ankara, Turkey. Adult patients with LV ejection fraction (EF) <35%, sinus rhythm, and symptomatic CHF were treated using a standard protocol for at least 4 weeks. At the end of this period, patients with symptomatic CHF and EF <35% underwent echocardiography that included measuring isovolumic relaxation and contraction times (IRT and ICT, respectively) and LV ejection time (ET), and calculating LV MPI using the formula MPI = (IRT + ICT)/ET Dobutamine 2.5 μg/kg · min was then infused intravenously for 24 hours. Echocardiography was repeated 24 hours later and values were compared with preinfusion data. Patients were observed and monitored for CHF symptoms and AEs for 24 hours.Results:Forty-three patients were enrolled in the study, and 31 (22 men,9 women; mean [SD] age, 67.55 [11.78] years) continued after the 4-week standard-treatment period. Mean (SD) heart rate (74.93 [20.15] vs 80.23 [13.74] bpm, respectively), systolic blood pressure (129.00 [19.23] vs 126.67 [23.79] mm Hg), and diastolic blood pressure (75.80 [11.26] vs 74.96 [8.30] mm Hg) were statistically similar before and after the infusion. The mean (SD) end-diastolic volume was statistically similar to the preinfusion value (215.87 [76.74] vs 211.08 [65.51] mL); however, the mean (SD) end-systolic volume was significantly reduced (163.80 [63.86] vs 146.74 [53.12] mL; P = 0.01). Mean (SD) EF (25.33% [7.77%] vs 30.45% [7.63%]; P = 0.001) and stroke volume (SV) (54.92 [22.30] vs 63.59 [23.91] mL; P = 0.04) increased significantly. The mean (SD) early:late diastolic flow velocity (E/A ratio) (1.58 [1.36] vs 1.65 [1.27]), IRT (107.03 [35.37] vs 100.42 [34.32] ms), ICT (96.61 [34.27] vs 86.35 [44.80] ms), ET (240.65 [33.28] vs 243.48 [33.54] ms), and MPI (0.81% [0.28%] vs 0.78% [0.31%]) did not change significantly after dobutamine infusion. No AEs were observed.Conclusions:In this study of adult patients with symptomatic CHF, a single, 24-hour, low-dose, IV dobutamine infusion (2.5 μg/kg · min) was associated with decreased LV end-systolic volume and increased SV and EF However, LV diastolic function parameters, isovolumic time intervals, ET, and MPI were statistically similar to preinfusion values. The infusion was well tolerated

The investigation of usability of silica supported FeCl3 in various organic reactions

Organik reaksiyonları katalize etmek için Demir (III)klorür(FeCl3) kullanımı, organik sentezlerde önemli bir yöntem haline gelmiştir. Demir (III)klorür ideal bir Lewis asidi olarak organik sentezlerde yaygın olarak kullanılmaktadır. Katalitik katılma, ikame etme, esterifikasyon, oksidatif bağlanma, siklizasyon, oksitlenmeler, CC bağ oluşumu, Friedel-Crafts reaksiyonları, yeniden düzenlenme ve izomerizasyon reaksiyonları, çeşitli işlevsel grupların korumasının kaldırılması ve doğal ürün sentezi gibi reaksiyonlar için ucuz, verimli, kararlı, çevre dostu ve kullanışlı bir ajandır. FeCl3'ün katalitik etkinliğini artırmak ve geliştirmek için PVP, aktif karbon, silika, polimer (polistiren, polivinil klorür gibi), katyon değişim reçinesi ve polianilin kullanımı gibi FeCl3'ün sabitlenmesi için yaygın olarak kullanılan yöntemleri içeren çok sayıda çalışma vardır. Bu çalışmada, kenetlenme, esterifikasyon, oksidatif kenetlenme, açilleme reaksiyonları gibi farklı organik reaksiyon tiplerini katalizleyen silika destekli FeCl3 katalizörünün kullanılabilirliği incelenmiştir.Abstract ; Using FeCl3 to catalyze organic reactions has become an important method in organic synthesis. Iron (III)chloride is extensively used in organic synthesis as an ideal Lewis acid. It is cheap, efficient, stable, environmentally friendly and a convenient agent for several useful reactions such as catalytic addition, substitution, esterification, oxidative coupling, cyclization, redox, oxidations, C-C bond formation, Friedel-Crafts reactions, rearrangement and isomerization reactions, deprotection of various functional groups, and as a reagent in key steps of natural products synthesis.To effectively carry out and enhance the catalytic activity of FeCl3. There are already a large number of studies using commonly used methods for immobilization of FeCl3, such as the use of PVP, activated carbon, silica, polymer (such as polystyrene, polyvinyl chloride), cation exchange resin, and polyaniline load FeCl3. In this work, usability of silica supported FeCl3 catalyzing in different types of organic reactions such as coupling, esterification, oxidative coupling, acylation reactions has been viewed

Use of Herbal Products in Peritoneal Dialysis Patients

OBJECTIVE: Complementary and alternative medicine practices are perceived by patients, both in pre-dialysis and dialysis periods, to be hopeful and promising. In our study we searched herbal product (HP) use in peritoneal dialysis (PD) patients before dialysis and during dialysis