scholarly journals Ranolazine: An Old Drug with Emerging Potential; Lessons from Pre-Clinical and Clinical Investigations for Possible Repositioning

2021 ◽  
Vol 15 (1) ◽  
pp. 31
Author(s):  
Sarah Rouhana ◽  
Anne Virsolvy ◽  
Nassim Fares ◽  
Sylvain Richard ◽  
Jérôme Thireau

Ischemic heart disease is a significant public health problem with high mortality and morbidity. Extensive scientific investigations from basic sciences to clinics revealed multilevel alterations from metabolic imbalance, altered electrophysiology, and defective Ca2+/Na+ homeostasis leading to lethal arrhythmias. Despite the recent identification of numerous molecular targets with potential therapeutic interest, a pragmatic observation on the current pharmacological R&D output confirms the lack of new therapeutic offers to patients. By contrast, from recent trials, molecules initially developed for other fields of application have shown cardiovascular benefits, as illustrated with some anti-diabetic agents, regardless of the presence or absence of diabetes, emphasizing the clear advantage of “old” drug repositioning. Ranolazine is approved as an antianginal agent and has a favorable overall safety profile. This drug, developed initially as a metabolic modulator, was also identified as an inhibitor of the cardiac late Na+ current, although it also blocks other ionic currents, including the hERG/Ikr K+ current. The latter actions have been involved in this drug’s antiarrhythmic effects, both on supraventricular and ventricular arrhythmias (VA). However, despite initial enthusiasm and promising development in the cardiovascular field, ranolazine is only authorized as a second-line treatment in patients with chronic angina pectoris, notwithstanding its antiarrhythmic properties. A plausible reason for this is the apparent difficulty in linking the clinical benefits to the multiple molecular actions of this drug. Here, we review ranolazine’s experimental and clinical knowledge on cardiac metabolism and arrhythmias. We also highlight advances in understanding novel effects on neurons, the vascular system, skeletal muscles, blood sugar control, and cancer, which may open the way to reposition this “old” drug alone or in combination with other medications.

Author(s):  
Khalikul Razi ◽  
Yopie Afriandi Habibie ◽  
Zulfan Zulfan ◽  
Rovy Pratama

In recent decades, kidney disease has been documented as a global public health problem. The current challenge is about improving the treatment of chronic kidney disease (CKD) patients in order to provide a longer life expectancy for them. In hemodialysis, there has been a considerable development in finding access to the vascular system, one of which developments was the creation of arteriovenous access by Cimino and Brescia (called an AV shunt). Research on the AV shunt is still limited, so the researchers are interested in conducting this descriptive epidemiological survey study on the profile of patients undergoing AV shunt procedures at Dr. Zainoel Abidin General Hospital in Banda Aceh in 2017. Data were obtained retrospectively from the medical records of the Central Surgery Installation Department of Dr.Zainoel Abidin General Hospital in Banda Aceh, and there were 105 patients have undergone AV shunt, 72 men (68.6%) and 33 women (31.4%). The frequency based on the age was the risking age about 45-54 years as many as 30 people (28.6%). Based on the outcomes obtained 95 people (90.48%) who have used the AV shunt for hemodialysis access, consisting of 66 men (62.86%) and 29 women (27.62). Based on the duration of use, AV Shunt is mostly used for 1 year with the number of 48 patients (50.52%) in the proportion of men and women were 38.95% and 11.57%. With an average duration of use of AV Shunt 2,6 years. From the results of this study, we conclude that the result was obtained that the highest cases in patients who have undergone AV Shunt is man as much as 68.6%. Furthermore, Pertaining to this study, it was obtained that the majority of age who undergo Av shunt is 45-54 years. In addition, the result of this study showed that the success rate of surgery AV shunt in Dr. Zainoel Abidin General Hospital in Banda Aceh was high. It is about 90, 48% with an average duration use of Av shunt is 2.6 years.


Author(s):  
Subrat Kumar Pradhan ◽  
Himansu Prasad Acharya ◽  
Rudra Prasanna Mishra ◽  
Jay Kumar Panda ◽  
Durga Madhab Satapathy ◽  
...  

Background: Injuries are an increasingly recognized global, preventable public health problem and are an important cause of mortality and morbidity in adult population. The major causes of injury related deaths may be intentional and unintentional. The major unintentional or “accidental” causes are road traffic accidents (RTAs), falls and drowning whereas the leading intentional causes are suicide and homicide. A robust Surveillance System for Injury Mortality is almost non-existent in our country due to which the data for the same is not available and haphazard. Keeping these factors in mind, the following study was under taken to identify the various epidemiological factors related to fatal injury cases.Methods: A record based retrospective study was conducted in the Department of Community Medicine, VSSIMAR, Burla, Odisha. The data were collected from the autopsy reports preserved at the Dept of FM & T, VSSIMSAR. Variables like age, sex, number of injury cause of death, place of death etc. were collected. Data were entered in Microsoft Excel and analysed using proportions and percentages.Results: The age group 25-44 years recorded the maximum number of deaths (37.49%). Males suffered the highest casualty accounting for 61.85% of deaths. Unintentional fatal injuries constituted 63.58% of deaths. The most number of fatal injuries resulting in deaths were RTAs (36.41%).Conclusions: The age group 25-44 years recorded maximum deaths. Males were the major death victims. RTAs constituted maximum of deaths among unintentional fatal injuries. Homicidal injuries constituted maximum of deaths due to intentional fatal injuries.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Irfan Mirza ◽  
Ahmad Zeb Khan ◽  
Mufti Baleegh ◽  
Amirullah . ◽  
Tahir Rashid ◽  
...  

Background: Chronic kidney disease is one of the global public health problem. It is a major cause of mortality and morbidity. Endstage renal disease patients will have either option of renal transplant or dialysis. Although dialysis is an effective form of renalreplacement therapy but it also have long term side effects. Pulmonary hypertension is one of them.Objective: To find frequency of pulmonary hypertension among end stage renal disease patients on hemodialysis in our populationMaterial and Methods: In this study a total of 163 patients were included, using 18.8% prevalence of pulmonary hypertension inend stage renal disease patients on hemodialysis, with 95% confidence interval and 6% margin of error, using WHO software. Moreover non-probability consecutive sampling technique was used for sample collection.Results: Our study shows that mean age was 52 years with SD ± 8.21. Fifty five percent patients were male and 73(45%) patientswere female. Forty eight percent patients had pulmonary hypertension.Conclusion: Our study concludes that the incidence of pulmonary hypertension was found to be one of the major contributingfactor among end stage renal disease patients on hemodialysis in our population.


2015 ◽  
Vol 80 (1) ◽  
Author(s):  
Vincenzo Capuano ◽  
Norman Lamaida ◽  
Sergio Torre ◽  
Ernesto Capuano ◽  
Maria Immacolata Borrelli ◽  
...  

Rationale: In Italy the mortality data were obtained almost exclusively from the data RENCAM (Name Causes of Death Register), while there are few prospective surveys. In order to assess whether there are particular epidemiological conditions in the geographical area of Mercato S. Severino, in Southern Italy, we have studied, and reassessed at ten years (1998/99 - 2008/09), a cohort of adult general population in a project of cardiovascular epidemiology and prevention. Materials and Methods: We calculated the rates of mortality and morbidity from cardiovascular events covering the period 1998/99 - 2008/09, in a cohort of 1200 persons (600 men and 600 women) aged 25 to 74 years. Data were standardized using the European standard population. Results: Mortality from cardiovascular causes was 46,5% in men and 48,7% in women; it was mainly concentrated in the age group 65-74 years where it occurred on 62,9% of deaths in men and 66,7% in women. Regarding morbidity, the incidence of events to ten years of non-fatal myocardial infarction was 2,2% in men and of 1,8% in women. PTCA interventions to ten year have been 3,3% in men and 3,4% in women, the interventions of aorto-coronary bypass have been 2,4% and 0,5% for men and women respectively. While all major cardiovascular events have been more frequent in men, in women there was a higher incidence of stroke (1,6% vs 0,9%). Conclusions: Although by comparison with other European countries Italy is among the countries considered at low-risk of coronary heart disease, in Campania cardiovascular diseases reach higher rates than the rest of the country. Our results are in line with the literature data and confirm that cardiovascular diseases are a major public health problem. Local analysis to propose means to provide useful information for planning prevention interventions targeted to their own territory.


2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Arabinda N. Chowdhury ◽  
Sohini Banerjee ◽  
Arabinda Brahma ◽  
Mrinal K. Biswas

Deliberate self-harm (DSH) is a major public health problem in the Sundarban region, India. This study is aimed to develop a DSH-suicide prevention programme based on the principles of community-based participatory research (CBPR). Perception and opinion of community about the problem of pesticide-related DSH and suicide were elicited in a series of facilitated focus group discussions in Namkhana block of Sundarban region. Based on their suggestion, a broad preventive programme was launched involving the development of information, education, and communication (IEC) and training modules and training of the stakeholders of the block. Most of the members of each target group found that the IEC materials were culture fair (message is acceptable, understandable, and meaningful in the local context) and very useful. Analysis of Dwariknagar BPHC, DSH admission data showed a definite reduction of DSH incidents after this CBPR approach to prevention was initiated. Similar model of DSH prevention in the other blocks of Sundarban region or in agricultural community may help to reduce the enormous mortality and morbidity from pesticide-related DSH and suicide.


2013 ◽  
Vol 3 (2) ◽  
pp. 94-98 ◽  
Author(s):  
Sonia Rahman ◽  
Halima Begum ◽  
Zaida Rahman ◽  
Ferdous Ara ◽  
Md. Jalaluddin Iqbal ◽  
...  

Background: Dyslipidemia is one of the important causes of cardiovascular disease related mortality and morbidity. Recently it has become a significant issue in public health problem of developing countries. The purpose of the study was to find a suitable solution for reducing blood lipid in dyslipidemic patients by conducting a research on the effect of cinnamon in hypercholesterolemic rats. Objective: To study the lipid lowering effect of Cinnamomum cassia on experimentally induced hypercholesterolemic rats. Materials and Methods: This study was done on 30 male Long Evans rats weighing about 200--210 gram. For convenience, the study was divided into two experiments --- Experiment I and Experiment II. In experiment I, 12 animals were divided into two groups. One was Group A (n = 6, control group) fed on laboratory diet and the other was Group B (n = 6) fed on laboratory diet and cinnamon for 35 days. In experiment II, the remaining 18 rats were fed fatty mixture diet containing 1% cholesterol and 0.25% cholic acid. The hypercholesterolemic rats were then divided into 3 groups, Group C, D, and E (n=6 in each group). Group D and Group E were additionally fed on cinnamon powder and tablet atorvastatin for 35 days respectively. Serum TC, TG, LDL-C and HDL-C were measured after 35 days. Results: Fatty mixture diet increased TG, TC and LDL-C significantly. Cinnamon treated fatty mixture diet group showed that Cinnamomum cassia decreased plasma TC, TG and LDL-C. Atorvastatin therapy decreased TC, TG and LDL-C levels significantly compared with the lowering effect of cinnamon. Conclusion: The results of this experimental study indicate that Cinnamomum cassia can act as a hypocholesterolemic agent and thereby can improve cardiovascular functions. Journal of Enam Medical College; Vol 3 No 2 July 2013; Page 94-98 DOI: http://dx.doi.org/10.3329/jemc.v3i2.16132


Author(s):  
A.P. Porsteinsson ◽  
E.D. Clark

Alzheimer’s disease (AD) remains one of our greatest unmet medical needs, without any approved disease-modifying therapies. The emotional and financial burden of AD is enormous and predicted to grow exponentially with increasing median population age, posing a major public health problem. The potential to prevent or improve cognitive decline due to AD has important implications. There are medications currently approved for symptomatic treatment of AD, but they have limited clinical benefits and do not change the ultimate trajectory of the disease. The need to find effective treatments for AD that can prevent, slow, arrest, or even reverse the disease is ever more urgent and interventions that delay the symptomatic onset of AD would have a major public health impact (1).


2019 ◽  
Vol 9 (11) ◽  
pp. 316 ◽  
Author(s):  
Neha Madangarli ◽  
Frederick Bonsack ◽  
Rajaneekar Dasari ◽  
Sangeetha Sukumari–Ramesh

Intracerebral hemorrhage (ICH) is a subtype of stroke which is associated with the highest mortality and morbidity rates of all strokes. Although it is a major public health problem, there is no effective treatment for ICH. As a consequence of ICH, various blood components accumulate in the brain parenchyma and are responsible for much of the secondary brain damage and ICH-induced neurological deficits. Therefore, the strategies that could attenuate the blood component-induced neurotoxicity and improve hematoma resolution are highly needed. The present article provides an overview of blood-induced brain injury after ICH and emphasizes the need to conduct further studies elucidating the mechanisms of hematoma resolution after ICH.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Eric B. Fokam ◽  
Kevin T. J. Dzi ◽  
Leonard Ngimuh ◽  
Peter Enyong

Malaria remains a major public health problem in Africa, and its prevalence in Cameroon stands at 29%. Long Lasting Insecticide Nets (LLINs) were distributed in 2011 to reduce malaria mortality and morbidity; however, assessment of this intervention is scanty. The present study in the Tombel health district (THD) investigated the impact of this distribution on malaria prevalence. A total of 31,657 hospital records from 3 health facilities in 3 health areas for 2010–2013 were examined. Records for 2010 and 2011 provided predistribution baseline data, while those of 2012 and 2013 represented postdistribution data. 8,679 (27.4%) patients were positive for malaria. Children below 5 years had the highest prevalence (40.7%). The number of confirmed cases was highest from June to August (peak rainy season). Malaria prevalence was higher in males (25.3%) than in females (23.2%). Malaria prevalence increased in THD from 26.7% in 2010 to 30.7% in 2011 but dropped to 22.7% in 2012 and then increased in 2013 to 29.5%. There was an overall drop in the total number of confirmed malaria cases in 2012; this decrease was significant in Ebonji (p<0.001) and Nyasoso (p<0.015) health areas. The distribution of LLINs led to a short lived reduction in malaria prevalence in THD. LLIN distribution and other control activities should be reinforced to keep malaria prevalence low especially among the 0–5-year group.


2018 ◽  
Vol 8 (2) ◽  
pp. 98-105 ◽  
Author(s):  
Khodayar Oshvandi ◽  
Mehri Safari ◽  
Mahmood Gholyaf ◽  
Abbas Moghim-Beygi ◽  
Farshid Shamsaei ◽  
...  

Introduction: End-stage renal disease (ESRD) is a worldwide public health problem. ESRD reduces health-related quality of life. Quality of life is an important determinant in the mortality and morbidity of hemodialysis patients. However, several studies have suggested that high flux dialyzers increase dialysis adequacy and reduce mortality and morbidity in these patients. Objectives: This study aimed to investigate the effects of high flux and low flux dialyzers on the quality of life in hemodialysis patients. Patients and Methods: In this clinical trial, 93 patients who met the inclusion criteria were randomly assigned to two groups of high flux and low flux dialyzers. Before intervention, both groups filled demographic and quality of life questionnaires. They were undergone dialysis with two dialyzers (one group by high flux and another by low flux) three times a week for 6 weeks. Then quality of life questionnaire was filled by both groups once again. Results: The overall quality of life score was not significantly different in both groups before intervention (P=0.121). After intervention, however, high flux group attained a significantly higher mean score (54 ± 10.4) than low flux group (43.89 ± 11.64) (P<0.001). Conclusion: According to the results of this study, the use of high flux dialyzers can be a useful method to increase the quality of life in hemodialysis patients.


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