The long-term use of garlic in ischemic heart disease--an appraisal

The hypocholesterolemic and fibrinolysis-enhancing properties of garlic were assessed in patients with ischemic heart disease (IHD) and in healthy control subjects. The peak of blood fibrinolytic activity (BFA) achieved at the 4th week of garlic therapy was not sustained despite its continuous use and returned to about the pre-garlic values at the 12th week. Garlic withdrawal did not cause any further change in BFA. Under the same conditions serum total cholesterol (STC) values did not show any significant change. Both of the foregoing features were observed in the IHD as well as in the control group. Garlic therapy for 12 weeks did not cause any appreciable changes in serum triglyceride, beta-lipoprotein, plasma fibrinogen levels or coagulation time in either IHD or control subjects. The evidence cited above does not appear to substantiate the prevalent popular belief in the efficacy of garlic in the management of IHD either as a hypocholesterolemic or as a fibrinolytic agent.

Comparative effect of clofibrate, garlic and onion on alimentary hyperlipemia

The effect of clofibrate on the same subjects in similar test conditions were used as a control to verify the alleged beneficial effects from garlic and onion on alimentary hyperlipemia in normals and in cases with ischemic heart disease. The results showed that clofibrate checked the fat-induced (a) rises of serum triglyceride and plasma fibrinogen, and (b) falls of coagulation time (CT) and blood fibrinolytic activity (BFA). Only garlic had a clofibrate-like effect on CT but both garlic and onion checked the postprandial fall of BFA. Clofibrate, however, increased BFA even above the fasting level. Serum cholesterol and beta-lipoprotein were not appreciably affected by fat with or without any drug. Thus, surprisingly, the so-called beneficial effects of garlic and onion were not seen in subjects who had shown significant changes after clofibrate.

Delayed-onset pulmonary insufficiency in primates resuscitated from hemorrhagic shock

Forty-one unanesthetized cynomolgus monkeys were subjected to 2 hours of hemorrhagic hypotension at various mean arterial pressures (MAP) between 40 and 60 mm Hg. Resuscitation and maintenance of MAP were provided by lactated Ringer's solution and homologous blood. Thirty-eight per cent (57% of those surviving greater than 24 hours) developed a delayed-onset (18 to 24 hours) pulmonary insufficiency in spite of good urinary output, and which did not respond to furosemide. The group in which this caused death (24%) showed significantly decreased PaO2, PaCO2, dynamic compliance, and FECO2, and increased minute volume, Qs/Qt, pulmonary artery pressure, and VD/VT before death. Their lungs were heavier, with abnormal pressure/volume curves and increased minimum surface tension. During the entire post-resuscitation phase, this group remained in a high-output, low-resistance hemodynamic state in contract to survivors and those dying of shock. The implications regarding current practices of monitoring and resuscitating patients with traumatic shock are discussed.

Reverse arterial blood flow as a pathway for central nervous system toxic responses following injection of local anesthetics

In baboons, lidocaine HCl was injected into the lingual (3 mg/kg), brachial (7 mg/kg), or femoral (7 mg/kg) arteries. Blood samples were taken from the internal carotid artery (ICA), internal jugular (IJV), external jugular (EJV), brachial (BV), or femoral (FV) vein, depending on the injection site, 6, 30, and 180 seconds after injection. Subsequently, radioactive microspheres (20 micron in diameter) were injected into the lingual artery, and the brains were obtained 48 hours later at postmortem to locate the microspheres. Six seconds after injection into the lingual artery, lidocaine concentration in ICA was 28 microgram/ml, whereas peak levels in IJV and EJV occurred at 30 seconds, being 51 and 25.7 microgram/ml, respectively. After injection into the brachial artery, peak average ICA levels were 105.5 microgram/ml at 6 seconds, while only 20.6 microgram/ml concentration was noted in ICA after injection into the femoral artery. Seventy-four precent of the Sr90 labeled microspheres were found lodged in the ipsilateral cerebral hemisphere. Local anesthetic drugs accidentally injected into arteries may reach the cerebral circulation following a centripetal pathway and thus produce central nervous system toxic responses.