The evaluation of analgesic effects of milnacipran and sertraline in tail-flick test.

INTRODUCTION: Antidepressant drugs are used in the treatment of pain as an adjuvant or alone. It has been shown that antidepressant drugs have analgesic effects in various diseases (diabetic neuropathy, low back pain, cancer pain etc.) Sertraline is a potent serotonin re-uptake inhibitor. Some antidepressant drugs inhibited both of the reuptake of serotonin and of noradrenaline. These drugs are called serotonin-noradrenaline re-uptake inhibitors (SNRIs). Milnacipran is a serotonin-noradrenaline re-uptake inhibitor. We have studied the analgesic effects of sertraline and milnacipran after acute and chronic application in tail-flick test in mice. METHODS: The analgesic effects of milnacipran (10, 30, 50 mg/kg) and sertraline (10, 20, 50 mg/kg) were measured after acute and chronic application in tail flick test. The analgesic effects of milnacipran (30 mg/kg) or sertraline (50 mg/kg) were evaluated after the application of L-NAME (10 mg/kg), naloxone (5 mg/kg), prazosin (1 mg/kg), ondansetron (0.1 mg/kg) in tail flick test. RESULTS: Milnacipran (30 mg/kg) and sertraline (50 mg/kg) produced statistically significant analgesic effect compared to their control values after acute and chronic application in tail-flick test. The analgesic effects of both milnacipran (30 mg/kg) and sertraline (50 mg/kg) in the presence of L-NAME (10 mg/kg), naloxone (5 mg/kg), ondansetron (0.1 mg/kg) and prazosin (1 mg/kg) were inhibited in tail-flick test. CONCLUSION: These results indicate that the analgesic effects of milnacipran and sertraline are related to nitrergic, opioidergic, serotonergic and adrenergic system (Fig. 8, Ref. 23).

The evaluation of analgesic effects of simvastatin, pravastatin and atorvastatin in hot plate test.

OBJECTIVES: Simvastatin, pravastatin and atorvastatin have been evaluated whether to have analgesic effects in mice in hot plate test. MATERIALS AND METHODS: Simvastatin (5, 10, 30 mg/kg), pravastatin (5, 10, 30 mg/kg) and atorvastatin (5, 10, 30 mg/kg) were administered acute and chronically by oral gavage in mice. Control (pretreatment value) and posttreatment (after drugs application) values in 60th and 120th minutes were measured in hot-plate test. RESULTS: All three drugs at 10, 30 mg/kg doses produced analgesic effects compared with their control values in 60th and 120th minutes on acute and chronic application in mice. The analgesic effects of drugs were evaluated after the application of L-nitro arginine methyl ester (L-NAME) (10 mg/kg) or naloxone (0.5 mg/kg). L-NAME (10 mg/kg) has no effect compared to the control value on both minutes. The analgesic effects of both atorvastatin (30 mg/kg) and simvastatin (30 mg/kg) in the presence of L-NAME (10 mg/kg) were not inhibited. However, the analgesic effect of pravastatin (30 mg/kg) in the presence of L-NAME (10 mg/kg) was inhibited significantly on both minutes (p < 0.05). Naloxone (0.5 mg/kg) has no effect compared to the control value on both minutes. The analgesic effect of atorvastatin (30 mg/kg) in the presence of naloxone (0.5 mg/kg) was partially (43%) but significantly inhibited only on 60th minute (p < 0.05). The analgesic effect of pravastatin (30 mg/kg) in the presence of naloxone (0.5 mg/kg) was partially (48-40%) but significantly inhibited on both minutes (p < 0.05). However, the analgesic effect of simvastatin (30 mg/kg) in the presence of naloxone (0.5 mg/kg) was inhibited significantly on both minutes (p < 0.05). CONCLUSIONS: These finding indicated that the analgesic effect of pravastatin was related to nitrergic systems and partially opioidergic system; analgesic effect of simvastatin was related to opiodergic system in hot plate test. However, the analgesic effect of atorvastatin was not directly related to both system.

A modified posterior pelvic exenteration technique in a woman: (a simplified method with using transvaginal way).

We represent a simplified surgical method for posterior pelvic exenteration in a woman by using the transvaginal way in addition to classic abdominal approach. A modified posterior pelvic exenteration technique was performed in a patient with bulky pelvic tumor. The transvaginal way was used for the deep perineal dissection when the abdominal dissection was arrested. An ultralow coloanal anastomosis was completed by using the transvaginal way. After the recovery period, the patient was discharged from hospital without any complication. The transvaginal access should be reminded in the circumstances of the abdominal dissection arrested in posterior pelvic exenteration operations in women.

Urinary tract infections in unplanned pregnancies and fetal outcome.

AIM: Many pregnant women are exposed to antibiotics for urinary tract infections during pregnancy. Our aim is to bring attention to antibiotherapy in unplanned pregnancies. METHOD: Among the 511 cases followed by our 'Toxicology Information and Follow-up Service' for drug exposure during pregnancy, 101 cases, unaware of their pregnancy, had been prescribed antibiotics and urinary antiseptic drugs in the first trimester of their unplanned pregnancies. The data on the outcome of these pregnancies and the babies were evaluated in this study. RESULTS: Of the 511 cases, 101 pregnant women were exposed to nine kinds of drugs. Seventy-five cases had healthy babies; two had babies with major malformations; one had a baby with congenital hypothyroidism; five had spontaneous abortions; and eight cases underwent induced abortions. The outcomes of eight pregnancies are unknown. Two pregnancies are still continuing without any problem. One baby had a fetal renal anomaly; however, the physical examination did not reveal any other malformations. The baby died 4 hours after delivery. Another baby had atrial septal defect, a major malformation, and one baby had congenital hypothyroidism. CONCLUSION: Urinary tract infection is one of the most frequently seen complications of pregnancy. Our study indicated that the possibility of pregnancy should be considered when prescribing antibiotics for urinary tract infections in women of reproductive age.

A randomized trial of intracervical prostaglandin gel and intravenous oxytocin in prelabor rupture of membranes with unripe cervix at term.

In order to compare the efficacy of immediate intravenous oxytocin administration and intracervical prostaglandin E2 gel application in premature rupture of membranes with unfavorable cervices at term, 45 term pregnant patients with premature rupture of membranes were randomized into two groups. Twenty women received immediate intravenous oxytocin after cleansing enema while the rest were treated with intracervical prostaglandin E2 gel. Means of maternal age, gestational age, Bishop score at admission and the rates of nulliparity did not show any significant differences between the two groups (p > 0.05). The mean rupture to delivery time was 12.6 +/- 4.4 hours in the oxytocin group and 16.5 +/- 4.5 hours in the prostaglandin group (p < 0.01). Mean birth weights and Apgar scores were insignificant. Cesarean section rates were 24% in the oxytocin group and 5% in the other (p < 0.05). No infectious morbidity was seen in any case. In conclusion, although delivery is delayed with the intracervical prostaglandin approach, cesarean section rate is lowered without an increase in infectious morbidity.