The effect of intraspinal bupivacaine versus levobupivacaine on the QTc intervals during caesarean section: a randomized, double-blind, prospective study.

The aim of this study was to describe whether or not spinal anaesthesia with bupivacaine versus levobupivacaine has any effects on the QTc interval during caesarean section. Sixty healthy pregnant women scheduled for elective caesarean section were randomized to spinal anaesthesia with either bupivacaine (the bupivacaine group) or levobupivacaine (the levobupivacaine group). ECG recordings were performed prior to spinal anaesthesia at baseline (T1), 5 min. after spinal anaesthesia, but before uterine incision (T2), and after skin closure (T3). QT intervals were calculated and corrected with the patients' heart rate according to the Bazett formula. Compared with baseline values, mean maximum QTc intervals at T2 and T3 were significantly longer in the levobupivacaine group, but only at T2 in the bupivacaine group. In addition, compared with the bupivacaine group, the QTc maximum interval at T3 was significantly longer in the levobupivacaine group. At T2, the QTc maximum intervals were longer than baseline in both groups. By the end of the surgery, the prolongation of the QTc interval had disappeared in the bupivacaine group but not in the levobupivacaine group.

A randomized pilot study of acupuncture treatment for primary dysmenorrhea.

OBJECTIVE: To compare the therapeutic effect of acupuncture and non-steroidal anti-inflammatory drug (NSAID) therapy in primary dysmenorrhea patients. STUDY DESIGN: Thirty-five young women with a diagnosis of primary dysmenorrhea were recruited for the study. Their dysmenorrhea severity was rated by visual analog scale (VAS) immediately prior to entry into the study. They were randomly divided into two groups; and the following month they were given NSAID (group 1, n=24) or acupuncture treatment (group 2, n=11). Pain was rated again using VAS during menstruation in both groups. RESULTS: After one month's treatment, pain scores were significantly lower in both groups (p<0.05). Mean pain scores decreased by 52.2% and 69.5% in the NSAID and acupuncture groups, respectively. CONCLUSION: Acupuncture was as effective as NSAID therapy for patients with primary dysmenorrhea. Since this was a pilot study with a small sample size and short follow-up period, larger studies are needed to clarify the effect of acupuncture in the treatment of primary dysmenorrhea.

Comparison of transforming growth factor ß1 concentrations in the ovaries of rats stimulated by human menopausal gonadotropin or recombinant follicle-stimulating hormone.

OBJECTIVE: To compare the effects of human menopausal gonadotropins (hMG) and recombinant follicle stimulating hormone (rFSH) on transforming growth factor (TGF) ß1 concentration in the rat ovary. STUDY DESIGN: Twenty-one fertile Wistar-Albino rats were divided into 3 groups of 7. Groups 1, 2 and 3 were injected with saline, hMG or rFSH, respectively, over 5 days, after which they underwent ovariectomy. Hematoxylin and eosin (H&E) staining was used for histological examination. TGF ß1 staining levels in ovarian stroma, vessel walls, granulosa cells of Graafian follicles and corpus luteum cells were investigated immunohistochemically. RESULTS: On histological examination, the number of smaller antral follicles was higher in the control group, while there were more and larger antral follicles in the hyperstimulated groups. There were statistically significant differences in staining in vessel walls and granulosa cells between the control and stimulated groups. Both stimulation protocols caused an increased TGF ß1 concentration in vessel walls, while there was weak staining in granulosa cells in the treatment groups compared to the control group (p<0.05). There were no significant differences in staining scores between the two treatment groups (p>0.05). CONCLUSIONS: The effects of two different gonadotropin preparations on TGF ß1 concentrations in different localizations in the rat ovaries are comparable. It may be postulated that the luteinizing hormone (LH) content of hMG contributes little or nothing to the TGF ß1 mediated angiogenesis.