Search

Introduction: The control of conjunctival microbial load is crucial for patients receiving intravitreal injections (IVTs) in order to reduce the risk of endophthalmitis. The purpose of this work was to assess the antimicrobial activity of a new commercial ocular spray containing Biosecur citrus extract (Oftasecur ® , Off Health, Florence, Italy)., Methods: This prospective cross-sectional pilot study included patients receiving IVTs who were instructed to apply Oftasecur spray onto the eye to be injected four times daily starting 4 days before surgery. The contralateral eye was considered the control. A conjunctival swab for microbiological analysis was performed in both eyes before starting study treatment and at the time of the injection. The Brief Ocular Discomfort Inventory (BODI) questionnaire was administered to patients based on an 11-point scale (0 for no discomfort and 10 for maximum discomfort)., Results: Thirty patients (15 male, 15 female; mean age 64.7 ± 11.6 [standard deviation, SD] years) were included. Before starting treatment, 53.3% of the total eyes tested positive during the microbiological analysis. After the treatment period, only 20% of the eyes tested positive at the time of injection, showing a significant reduction in the microbial load (p < 0.01). Moreover, in the treated arm, the positive swabs before and after the prophylactic treatment with Oftasecur ocular spray showed a significant reduction (from 70.4% to 29.6%; p = 0.003, McNemar's test). Oftasecur ocular spray was well tolerated, with an average BODI score of 1.2 (± 0.70 SD)., Conclusion: Oftasecur ocular spray showed antimicrobial activity that significantly reduced the microbial load in patients receiving intravitreal injections. Therefore, it may have a role in the prophylaxis of infection in the setting of IVTs., (© 2021. The Author(s).)

Purpose: To review and analyze abstracts presented at American Association for Pediatric Ophthalmology and Strabismus (AAPOS) annual meetings, and to identify publication rates and potential predictive factors for better outcomes., Methods: All abstracts accepted for presentation at AAPOS annual meetings from 2013 to 2017 were examined. A comprehensive literature search via PubMed and Scopus was conducted to identify whether the abstracts had been published as full text. A multivariate analysis was achieved to assess the factors related to successful publication, and a Kaplan-Meier analysis was performed to evaluate the publication time course of abstracts., Results: Of 819 analyzed abstracts, 437 (53%) were published in peer-reviewed journals with a median impact factor of 2.7. The overall mean time to publication was 3 ± 2.2 years. The multivariate analysis revealed that abstracts were more likely to be published if they were accepted at an AAPOS annual meeting as an oral paper ( P < .001), if they were prospective ( P > .001) and multicenter ( P = .013) studies, and if they had strabismus, retina, and vitreous disorders and diagnosis as main topics ( P = .022). The Kaplan-Meier analyses revealed significant differences in the publication time distribution for multicenter versus single-center abstracts and paper versus poster and e-poster ( P < .05)., Conclusions: More than half of the abstracts accepted for presentation at the AAPOS annual meetings were published in peer-reviewed journals within 3 years from submission to the meeting. The factors associated with a higher publication rate were the prospective study design, multicentricity, and presentation at the meeting as an oral paper. [ J Pediatr Ophthalmol Strabismus . 20XX;XX(X):XX-XX.] .

Introduction: Single coronary artery is a rare condition characterized by the origin of a coronary that supplies the entire heart from a single coronary ostium., Patient Concerns: A 45-year-old woman with an altered exercise testing was addressed to a computed tomography coronary angiography (CTCA) to rule out coronary artery disease (CAD)., Diagnosis: CTCA examination showed the absence of the right coronary artery (RCA). The left anterior descending artery and the left circumflex artery (LCX) presented regular origin and course and LCX provided the posterior interventricular artery and the posterolateral artery., Interventions: As CTCA highlighted the absence of potentially life-threatening features related to coronary anomaly, no surgical treatment was advised., Outcomes: The patient was dismissed, kept under pharmacological control and monitored over time., Conclusion: CTCA is the first-choice imaging modality in patients with ECG abnormalities properly allowing the differential diagnosis between CAD and congenital heart disease.

Background: Common clinical practice recommends dual antiplatelet therapy (DAPT) for transcatheter aortic valve implantation (TAVI). The aim of the study was to evaluate, in a double blind randomized study, the safety of TAVI, with adjunctive pharmacotherapy consisting of single antiplatelet therapy., Methods and Results: From April 2010 to April 2011, 120 consecutive patients, undergoing TAVI, have been enrolled in the study. Patients were randomly assigned to DAPT group (aspirin and clopidogrel 75 mg/qd or ticlopidine 500 mg/bid) or ASA group (aspirin only). TAVI device was the Sapien XT-Novaflex Delivery System (Edwards Lifesciences, Inc.). All patients were followed up to 6 months. Device success was achieved in 100% of patients. No difference in the VARC combined 30 day safety endpoint, all cause and cardiovascular mortality was observed. At 30 days vascular complications were reduced in the ASA group (p<0.05). No differences in the clinical status were detected between the groups up to 6 months., Conclusions: This study suggests that TAVI procedures can be performed without DAPT without increasing the morbidity and mortality. These findings, if confirmed in a larger multicenter randomized trial, will no longer support the use of DAPT for TAVI., (Copyright © 2014. Published by Elsevier Ireland Ltd.)

Objectives: An optimized metabolic control during delivery is mandatory to prevent maternal-neonatal complications. The primary aim of this study was to evaluate the efficacy and safety of continuous subcutaneous insulin infusion (CSII) during delivery in pregnant women with type 1 diabetes. The secondary aim was to assess the impact of real-time continuous glucose monitoring (RT-CGM) added to CSII versus CSII alone., Research Design and Methods: This was a multicenter observational retrospective study. A standardized protocol, to use CSII throughout pregnancy and delivery, foresaw three different insulin basal rates according to blood glucose level: profile A, the last basal rate in use; profile B, preventive 50% reduction of the last basal rate in use; and profile C, 0.1-0.2 U/h for blood glucose level <70 mg/dL, activated just before anesthesia or at the beginning of active labor. An alternative intravenous protocol (IVP) was given in case of complications and relevant metabolic deterioration. Blood glucose in the target range (70-140 mg/dL) throughout delivery and percentage of activation of the IVP were primary outcomes., Results: Sixty-five pregnant women with diabetes included in the study (56-86% cesarean section; 9-14% spontaneous/stimulated vaginal delivery). Mean blood glucose level was 102 ± 31 mg/dL at 0 min, 109 ± 42 mg/dL at 30 min, 120 ± 48 mg/dL at 60 min, and 99 ± 34 mg/dL at 24 h. Mean basal rate during delivery was 0.6 ± 0.4 U/h (profile B). Mean capillary blood glucose (CBG) level was lower in the RT-CGM group relative to the CSII-alone group: 80 ± 14 mg/dL versus 111 ± 32 mg/dL at 0 min (P<0.01), 79 ± 11 mg/dL versus 109 ± 42 mg/dL at 30 min (P<0.02), and 98 ± 20 mg/dL versus 125 ± 51 mg/dL at 60 min (difference not significant). Eleven newborns experienced transient neonatal hypoglycemia. None of the women switched to IVP. No major differences were observed according to delivery procedure., Conclusions: CSII is possible and safe in different types of delivery in selected and educated women. RT-CGM helps to obtain better outcomes in terms of maternal peripartum CBG level.

Background: To assess whether dipyridamole therapy exerts a significant anti-inflammatory effect in heart failure patients., Methods: We performed a retrospective analysis of the stored bio-samples of 3 groups of patients: 1) 25 normal healthy controls (N); 2) 25 heart failure patients (HF) under standard optimal therapy, including aspirin; 3) 17 HF patients with previous stroke and under clinically-driven therapy with A (Aggrenox, long-acting dipyridamole 200 mg + aspirin 25 mg, twice daily) for at least 1 month (HF-A). In all, we evaluated interleukin (IL)-6, adiponectin and C-reactive protein (CRP) as well as NT-proBNP. The same laboratory measurements were performed in the 17 HF patients with recent or previous stroke, both before and 1-month after clinically driven administration of A., Results: All laboratory inflammatory indices were significantly higher in HF patients compared to N: IL-6 (N = 0.68 (0.3 - 12.7) vs. HF = 3.10 (0.5 - 16.7) vs. HF-A = 1.24 (0.3 - 3.3) pg/mL; p < 0.001 N vs. HF, p < 0.01 N vs. HF-A, p = ns HF vs. HF-A); CRP (N = 0.12 (0.01 - 0.45) vs. HF = 0.58 (0.04 - 2.7) vs. HF-A = 0.72 (0.02 - 4.8) mg/dL; p = ns N vs. HF, p = 0.05 N vs. HF-A, p = ns HF vs. HF-A); Adiponectin (N = 8.8 (3.0 - 31.4) vs. HF = 12.16 (4.9 - 27.3) vs. HF-A = 10.0 (4.8 - 15.6) pg/mL; p < 0.05 N vs. HF, p = ns N vs. HF-A p = ns HF vs. HF-A). NT-proBNP was also increased (N = 42.2 (13 - 93) vs. HF = 1907 (18.1 - 8038) vs. HF-A = 497.9 (7.8 - 3686) pg/mL; p < 0.001 N vs. HF, p = 0.01 N vs. HF-A, p = ns HF vs. HF-A). In 17 subjects, the intra-patient assessment (before and 1-month after starting of Aggrenox therapy) did not show a decrease in inflammation markers., Conclusions: HF patients show an increase in inflammatory indices independently of underlying A therapy.

Carcinoid heart disease is a rare cause of heart failure with or without right valvular heart impairments. In this study, we showed a case of carcinoid tumour with hepatic metastases inducing carcinoid heart disease. Neuroendocrine heart involvement happens for severe tricuspid valve insufficiency and plaques on right ventricular (RV) walls produced by a release of serotonin (5-HT). A patient affected by primitive ileal tumour with 5-HT-secernent hepatic metastases inducing tricuspid insufficiency is showed. Transthoracic 2-D echocardiography showed tricuspid valve regurgitation and both right atrium, RV-walls plaques and RV dilation. Continue-wave Doppler showed a characteristic "dagger shaped" spectrum of tricuspid systolic flow. RV function was evaluated with 3-D transthoracic echocardiography. In particular, RV volumes, RV ejection fraction and stroke volume were defined by this technique. 2, 3-D echocardiography and Doppler method are useful techniques to show heart valves' derangements and RV function to non-invasively detect RV impairments in carcinoid heart disease.

Only few insulin-treated (IT) people with diabetes mellitus (DM) reach the target due to poor compliance and/or to sedentary lifestyle and/or to inadequate treatment regimen. The latter may be also brought about by often overlooked factors including insulin injection into altered skin areas, often brought about by incorrect habits, namely needle reutilization or poor compliance to the suggestion to continuously rotate skin injection areas. The aim of our study was to evaluate the rate of skin lesions within the sites commonly used for insulin injection in our IT DM patients and to verify whether a short-acting insulin analogue yielded different metabolic effects when injected in altered vs. normal skin areas. One hundred and eighty well-trained IT people with type 1 and type 2 DM (64 ± 15 years of age) consecutively referring to our unit underwent a standard clinical examination involving an accurate skin inspection protocol meant at looking for any alterations eventually affecting all possible injection sites, including bruising, multiple needle pricks and lipodystrophic nodules (LN). They were also tested for HPLC HbA1c determination and asked to fill in a standard questionnaire on injection habits. Furthermore, seven male, T1DM glulisine-glargine basal-bolus-treated patients in this group were randomly injected 10 IU glulisine into either normal skin (NS) or an LN by a nurse before a standard, 405 kcal breakfast, for blood glucose and free insulin determination at 0, 30, 45, 60, 75, 90, 120 and 150 min. More lesions were found in people over sixty (P < 0.01) and in women (P < 0.05). A higher prevalence of HbA1c >7.5% was found in patients with lesions (with an O.R. of 3.74) and further confirmed by data obtained from head-to-head comparison of insulin injection into an LN and NS. In fact, injection into an LN proved to impair and slow down insulin absorption, resulting in a higher absolute value and a larger variability of blood glucose levels than those observed by utilizing NS. This suggests us to pay more attention to all aspects of patient-team relationship to try and obtain good metabolic control in all people with diabetes and even more in the elderly.

Aims: Transcatheter aortic valve implantation (TAVI) is becoming a safe and effective technique for treating symptomatic aortic valvular stenosis (AVS) as an alternative to surgery in very high-risk patients. A possible consequence of valve implantation is the obstruction of coronary ostia., Methods and Results: Here we report five cases of angiographically confirmed left main (LM) obstruction, occurred immediately after balloon expandable aortic valve implantations at our institution. In four of these cases, LM obstruction was resolved with an emergency percutaneous coronary intervention (PCI). In the remaining case, obstruction transiently occurred only at the time of balloon valvuloplasty and did not required treatment. During this type of intervention, performing an aortography at the time of balloon valvuloplasty could help to identify patients at risk for coronary obstructions., Conclusions: These cases illustrate that obstruction of the coronary ostia following TAVI is a possible complication. As the use of TAVI becomes widespread, the operators should be aware of this dangerous complication in their case preparation should it arise.

Transcatheter aortic valve replacement is an emerging therapeutic alternative for patients with severe aortic valve stenosis and high surgical risk. The inability to reposition the current prosthesis is a limiting feature of these devices. Here we report on a case of a 74-year-old woman, in which a balloon expandable aortic valve malpositioning was treated with a second transapical transcatheter aortic valve implant., (Copyright (c) 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Tako-tsubo syndrome (TTS) in its typical (apical) and atypical (non-apical) forms is being increasingly recognized in the West owing to early systematic coronary angiography in acute coronary syndromes (ACS)., Aim of the Study: To assess the incidence, the clinical characteristics and the outcome of TTS in a single high volume cath lab in Southern Italy over the last 6 years., Methods: Among 1674 consecutive patients (pts) referred to our coronary care units in the last 6 years (2001-2006) for ACS we selected 6 (0.5%) pts (6 women; age 57 +/- 6 years) who fulfilled the following 4 criteria: 1) transient left ventricular wall motion abnormalities resulting in ballooning at contrast ventricolographic or echocardiographic evaluation; 2) normal coronary artery on coronary angiography performed 5 +/- 9 hours from hospitalization; 3) new electrocardiographic ischemic-like abnormalities (either ST-segment elevation or T-wave inversion) and 4) emotional or physical trigger event., Results: At admission all pts had presumptive diagnosis of ACS and ECG revealed ST elevation in 3 (50%) and T wave inversion with QT elongation in 3 (50%). In the acute phase cardiogenic shock occurred in 2 (33%) and heart failure in 1(16%). Presenting symptoms were chest pain in 6 (100%), dyspnoea in 2 (33%) and lipotimia in 1 (16%). At echocardiographic-ventricolographic assessment, the mechanical dysfunction (ballooning) was apical in all 6 pts ("classic" TTS). In all patients wall motion abnormalities completely reversed within 4.5 +/- 1.5 days. The region of initial recovery was the anterior and lateral wall in 4 cases and the lateral wall in 2 cases. Ejection fraction was 35 +/- 8% in the acute phase and increased progressively at discharge (55 +/- 6%) and at 41 +/- 20 months follow-up (60 +/- 4%, p < 0.001 vs. baseline). All patients remained asymptomatic with minimal (aspirin, beta blockers, antihypertensive and antidislipidemic therapy) treatment., Conclusion: Classic TTS is a frequent serendipitous diagnosis after coronary angiography showed "surprisingly" normal findings in a clinical setting mimicking an ACS. Despite its long-term good prognosis life threatening complications in the acute phase can occur.

Background: Little is known regarding the long-term performance of coronary sinus (CS) leads, which have an effect on the longevity of cardiac resynchronization therapy (CRT) systems., Methods: This study included 109 patients (79 men) whose mean age was 68 +/- 9 years, New York Heart Association (NYHA) functional class 3.2 +/- 0.5, and left ventricular ejection fraction 25.6 +/- 6.6%, and who underwent CRT (n = 45) or CRT-D (n = 64) systems implants for management of idiopathic (53%), ischemic (40%), or miscellaneous (7%) dilated cardiomyopathy. Unipolar (n = 57) or bipolar (n = 52) leads were placed into the CS venous system., Results: At implant, no significant difference was observed between unipolar and bipolar leads with respect to mean sensing performance (14 +/- 6 mV vs 14 +/- 8 mV, P = 0.97), pacing impedance (875 +/- 234 ohms vs 943 +/- 331 ohms, P = 0.24), and stimulation energy threshold (2 +/- 3.2 muJ vs 1.13 +/- 1.5 muJ, P = 0.08). At a median follow-up of 33 months, a significant decrease in stimulation impedance and increase in stimulation energy threshold was observed with unipolar (689 +/- 122 vs 875 +/- 234 ohms, P < 0.01, and 8.34 +/- 10.4 muJ vs 2 +/- 3.2 muJ, P < 0.001, respectively) as well as with bipolar (735 +/- 268 ohms vs 943 +/- 331 ohms, P < 0.01, and 4.81 +/- 9.92 vs 1.13 +/- 1.5 muJ, P = 0.02, respectively) leads. No significant difference in sensing performance was observed with either type of lead (10 +/- 5 mV vs 14 +/- 6 mV and 10 +/- 6 mV vs 14 +/- 8 mV, respectively). At long-term follow-up, no significant difference among any sensing or stimulation parameter was observed between unipolar and bipolar leads., Conclusions: At long-term follow-up, a significant increase in the energy required for stimulation was observed, whereas sensing performance remained unchanged. The increase in energy capture threshold was less marked with bipolar than with unipolar leads.

Obesity and overweight have been associated with increased carotid intima-media thickness and stiffness in adults and children. Overweight and obesity have also been associated with an increased prevalence of the metabolic syndrome (MS). The aim of the study was to test the hypothesis that obese children with the MS have increased rigidity of their arteries compared with obese children without the MS. We studied 100 obese children (age range 6 to 14 years; 61 males, 39 females) consecutively seen in the outpatient clinic of a hospital department of pediatrics. Anthropometric measures and biochemical tests were performed in all children. Quantitative B-mode ultrasound scans were used to measure intima-media thickness and diameters of the common carotid artery. Common carotid arterial stiffness was significantly higher in the group of obese children with the MS (n = 38) at 1.29 +/- 0.06 mm (values log transformed) versus 1.12 +/- 0.04 mm (p <0.03) compared with those without the MS (n = 62). These differences persisted even after adjustment for age, gender, and C-reactive protein. Obese children with the MS had significantly higher plasma concentrations of C-reactive protein (1.57 +/- 0.06 microg/L, values log transformed) compared with obese children without the MS (1.38 +/- 0.05 microg/L, p <0.03). In conclusion, obese children who met the diagnostic criteria for the MS had higher common carotid artery stiffness and higher C-reactive protein plasma concentrations than obese children without the MS.

Background: High-rate pacing is a valid stress test to be used in conjunction with echocardiography; it is independent of physical exercise and does not require drug administration. There are two main applications of pacing stress in the echo lab: the noninvasive detection of coronary artery disease through induction of a regional transient dysfunction; and the assessment of contractile reserve through peak systolic pressure/ end-systolic volume relationship at increasing heart rates to assess global left ventricular contractility., Methods: The pathophysiologic rationale of pacing stress for noninvasive detection of coronary artery disease is obvious, with the stress determined by a controlled increase in heart rate, which is a major determinant of myocardial oxygen demand, and thereby tachycardia may exceed a fixed coronary flow reserve in the presence of hemodynamically significant coronary artery disease. The use of pacing stress echo to assess left ventricular contractile reserve is less established, but promising. Positive inotropic interventions are mirrored by smaller end-systolic volumes and higher end-systolic pressures. An increased heart rate progressively increases the force of ventricular contraction (Bowditch treppe or staircase phenomenon). To build the force-frequency relationship, the force is determined at different heart rate steps as the ratio of the systolic pressure (cuff sphygmomanometer)/end-systolic volume index (biplane Simpson rule). The heart rate is determined from ECG., Conclusion: Two-dimensional echocardiography during pacing is a useful tool in the detection of coronary artery disease. Because of its safety and ease of repeatability noninvasive pacing stress echo can be the first-line stress test in patients with permanent pacemaker. The force-frequency can be defined as up- sloping (normal) when the peak stress pacing systolic pressure/end-systolic volume index is higher than baseline and intermediate stress values, biphasic with an initial up- sloping followed by a later down-sloping trend, or flat or negative when peak stress pacing systolic pressure/end-systolic volume index is equal or lower than baseline stress values. This approach is certainly highly feasible and allows a conceptually immaculate definition of contractility with prognostic usefulness, but its therapeutic implications remains to be established. Bowditch treppe, assessed with pacing stress, can be used to assess the optimal stimulation frequency and to optimise the patient's chronotropic response in programming rate-adaptive pacemakers.

Background: Estimating contractility of the left ventricle with noninvasive techniques is an important yet elusive goal. Positive inotropic interventions are mirrored by smaller end-systolic volumes and higher end-systolic pressures. An increased heart rate progressively increases the force of ventricular contraction (Bowditch treppe or staircase phenomenon)., Aim: To assess the feasibility of a noninvasive estimation of force-frequency relation (FFR) during pacing stress in the echo lab in patients with permanent pacemaker (PM)., Methods: Transthoracic stress pacing echocardiography was performed in 26 patients with a permanent pacemaker (age 69+/-11 years; 21 men, 5 women). Seven patients had normal function at baseline and during stress ("normals"); eight had angiographically assessed coronary artery disease (three with and five without induced ischemia with stress echo); eleven patients had dilated cardiomyopathy (DC). To build the FFR, the force was determined at different steps as the ratio of the systolic pressure (SP, cuff sphygmomanometer)/end-systolic volume index (ESV, biplane Simpson rule/body surface area). Heart rate was determined from ECG., Results: The absolute value of the FFR slope was highest in controls and lowest in DC patients. A flat-downsloping FFR was found in 12/19 patients but not for normals (p<0.01)., Conclusions: Noninvasive pacemaker stress echocardiography (PASE) is a simple and efficient option to assess left ventricular (LV) contractility in patients with permanent pacemaker.

Streptozotocin (Stz) diabetes was induced in rats to study the changes in glycosylated hemoglobin. An increase of glycosylated hemoglobin had been found since the first days of the experiment. These results suggest that such a model may be used for the study of changes of glycosylated hemoglobin in diabetes.

The effect of the GABAergic drug sodium valproate (SV) on the exercise-induced release of growth hormone (GH) was investigated in 10 healthy males. The exercise test consisted of using a stationary bicycle ergometer at 450 kg/min for 20 min. SV 600 mg blunted the increase in GH induced by the exercise, suggesting GABAergic regulation of GH secretion in man, at least under certain physiological conditions.

In brain medial-basal areas (midbrain, hypothalamus, striatum) ascorbic acid (AA) content is lower than in the rest of the brain. It has been hypothesized that AA may be involved in brain catecholamine metabolism. To test this hypothesis AA content in medial-basal areas and in the remaining brain areas was measured in rats pretreated with alpha-methyl-paratyrosine (alpha-MpT), a tyrosine hydroxylase inhibitor. The AA content, in brain medial-basal areas, had slightly decreased, without statistically significant differences, in rats treated with alpha-MpT in comparison with untreated animals. Therefore the role of AA in brain metabolism is not clear to.

Effects of sodium valproate, which is believed to act via a gamma-aminobutyric acid mechanism, on basal and exercise-induced rise of growth hormone release have been tested in eighteen healthy volunteers. The exercise test consisted of using a stationary bicycle ergometer at 450 kg/min for 20 min. 600 mg per os of the drug resulted in a significant enhancement in plasma hormonal concentrations, whereas no effects were induced by placebo (p less than 0.005). Conversely, the growth hormone rise stimulated by exercise was markedly inhibited by sodium valproate (p less than 0.001 and p less than 0.01 at time 20, 40 and 60 min respectively). The results of this study are consistent with the hypothesis that a dual GABAergic control of growth hormone secretion is present in man.

Male albino rats of the Wistar strain, without food from 48 h, have been operated with pylorus ligature and treated with cimetidine, at the dose of 30 mg/kg i.m., just after the operation and 12 h later. Cimetidine reduced the size and the number of gastric ulcers induced by pylorus ligature, showing a significant protective effect. This action, due to the inhibition of gastric secretion induced by cimetidine, supports the hypothesis that the staunching of gastric juice (by pylorus ligature) plays a basic role in the pathogenesis of these experimental gastric ulcers.

The effects of cimetidine on experimental stress, induced by a long time fast and pylorus ligature, in male albino rats were investigated. The drug at the dose of 30 mg/kg was administered i.m. just after the operation and 12 h later. To evaluate the interference of cimetidine on the hypothalamo-hypophyseal-adrenal axis were dosed, in the rat, the level of adrenal ascorbic acid and cholesterol as well as corticosterone plasma levels. The results seem to suggest that cimetidine, in this experiment, is unable to modify stress induced changes.

Streptozotocin (Stz) diabetes was induced to study the changes of glycosylated hemoglobin in rats treated with raubasina (R), drug widely used in the vascular compliance of natural human diabetes. Raubasina reduced significantly the increase of glycosylated hemoglobin found in streptozotocin induced diabetes. These results support data obtained in clinical trials.