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“Background: A possible mechanism underlying cardiovascular morbidity after major vascular surgery may be the perioperative ischaemia-reperfusion with excessive
oxygen-derived free-radical production and increased levels of circulating inflammatory mediators. We examined the effect of melatonin infusion during surgery and oral melatonin treatment for 3 days after surgery on biochemical markers of oxidative and inflammatory stress.
Methods: www.selleckchem.com/products/Roscovitine.html Patients received an intra-operative intravenous infusion of 50 mg melatonin or placebo. In addition, all patients received 10 mg melatonin or placebo orally the first 3 nights after surgery. Blood samples for analysis of malondialdehyde (MDA), ascorbic acid (AA), dehydroascorbic acid (DHA) and C-reactive protein (CRP) were collected preoperatively, and at 5 min, 6 h and 24 h after clamp removal (recirculation of the first leg).
Results: Twenty-six patients received
melatonin and 24 patients received placebo. No significant differences were observed in any of the oxidative and inflammatory stress parameters. There were significantly more side effects in the melatonin group than in the placebo group.
Conclusions: Melatonin treatment in the perioperative period did not reduce the oxidative and inflammatory parameters measured in this study. (C) 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.”
“Purpose of review
Different transurethral Angiogenesis inhibitor prostatic laser systems are available. In 2011, new Oxford evidence levels (LoEs) were published with significant changes compared with the former version. They are easier to use and incorporate LY3039478 in vivo more clinical aspects. Randomized trials of laser systems used before 2002, except Holmium laser, were not included in this critical evidence analysis, as these techniques are not in clinical use any more.
Recent findings
Twenty-five [18 Holmium enucleation of the prostate (HoLEP) and seven photoselective vaporization of the prostate (PVP)] randomized trials covering transurethral electroresection of the prostate or HoLEP,
PVP or Thulium laser enucleation were identified. According to evidence levels, there is a large gap in terms of long-term follow-up. The majority of randomised controlled trials are of low quality. Typically with HoLEP, many articles were published covering the same patient population (LoE II). Only one randomised controlled trial was published with Tm:YAG prostatectomy (LoE II) and none with diode lasers (9801340 nm, LoE IV-V). Large cohort studies (LoE III-IV) provide additional evidence for PVP and HoLEP, typically for subgroups.
Summary
In 2011, higher evidence on HoLEP and PVP has been published. Evidence levels for HoLEP and PVP are comparable with meta-analysis (LoE II). However, evidence that laser prostatectomy is better than transurethral electroresection of the prostate in terms of efficacy is lacking (LoE II). All lasers are safer in terms of perioperative bleeding (LoE II).