Intraoperative cardiac arrest during radical vulvectomy under combined spinal-epidural anesthesia: First among 2500 malignant cases in a single center

Abstract Complications which were related either to radical vulvectomy or to lymphadenectomy have mostly developed in post operative period. Here, we report an intra-operative cardiac arrest case during radical vulvectomy which is under combined spinal and epidural anesthesia. A 78 year-old female patient underwent radical vulvectomy under spinal anesthesia with a diagnosis of vulvar cancer. Intraoperative cardiac arrest developed and after immediate cardio-pulmonary ressusitation, sinus rhythm was restored. Cardiac arrest due to spinal anesthesia is a rare complication with the incidence of 0.063%. Despite, vulvar surgery is known as a relatively safe procedure for complications like cardiac arrest, maximum care should be given both before and during the operation. It can be descriced as "once in a life" experience for a surgeon and instant decisions for the management of this condition will be life saving or mortal

The effects of resveratrol on ovarian hyperstimulation syndrome in a rat model.

The aim of the present study was to investigate effects of resveratrol (RSV) over ovarian hyperstimulation syndrome (OHSS) in rat model

Elevated PAPP-A levels in lean patients with polycystic ovary syndrome

Objectives: This study aimed to evaluate the serum concentrations of PAPP-A (pregnancy associated placental protein-A), a biomarker which is associated with cardiovascular disease, in patients with polycystic ovary syndrome (PCOS). Materials and Methods: A total of 62 women with PCOS, and 68 age and body mass index (BMI) matched controls were eligible for the study. Hirsutism scores, hormonal and metabolic profile as well as PAPP-A levels were assessed in each subject. Results: Women with PCOS and controls yielded similar median serum levels of PAPP-A (1.7 ng/ml versus 1.8 ng/ml, respectively, p = 0.328). However, when patients were compared based on BMI; subgroup analyses found that among women with BMI< 27 kg/m(2), patients with PCOS exhibited higher PAPP-A levels than controls (2.1 ng/ml versus 1.8 ng/ml, respectively, p = 0.018). When women with PCOS were evaluated in their own based on BMI, lean PCOS women showed higher levels of PAPP-A (2.1 ng/ml versus 1.5 ng/ml, p = 0.002). PAPP-A levels were negatively correlated with age (p = 0.031, r = -0.189), BMI (p = 0.002, r = -0.265) and triglyceride levels (p < 0.001, r = -0.3). Conclusion: The data of the present study suggested that PAPP-A might be a clinical indicator in PCOS, in which the risks of metabolic syndrome and cardiovascular event are increased. Especially a group of young patients with BMI < 27 kg/m(2) might benefit from the cardiovascular risk evaluation using PAPP-A, supplying prognostic information for high risk in the development of cardiovascular disease. (C) 2018 Taiwan Association of Obstetrics \& Gynecology. Publishing services by Elsevier B.V

The effects of resveratrol on ovarian hyperstimulation syndrome in a rat model

Objective: The aim of the present study was to investigate effects of resveratrol (RSV) over ovarian hyperstimulation syndrome (OHSS) in rat model. Materials and Methods: 24 female Wistar rats (22 days old) were divided into four groups. Group 1 (control group; n = 6) received 0.1 ml intraperitoneal (IP) saline from days 22-26; group 2 (mildstimulated group; n = 6) received 10 IU pregnant mare serum gonadotropin (PMSG) on day 24 and 10 IU of hCG 48 h later (day 26); group 3 (OHSS group; n = 6) was given 10 IU of PMSG for 4 consecutive days from day 22 and 30 IU hCG on the fifth day to induce OHSS; group 4 (OHSS thorn RSV group; n = 6) was treated the same as group 3, but received 60 mg/kg RSV 2 h before PMSG injection for 4 consecutive days and 2 h before the hCG injection on the fifth day. Results: Weight gain was highest in the OHSS group. Ovarian weights were lower in the treatment group than OHSS group. Peritoneal fluid VEGF levels were lower for RSV group compared to group 2 and 3. Total VEGF immunoreactivity was higher in OHSS group than group 1, 2 and 4. Conclusion: These results indicate that RSV is beneficial for prevention of OHSS by reducing the increases in body and ovarian weight and VEGF activity. These effects may be mediated by anti-inflammatory, antioxidant and anti-angiogenic capacity of RSV. (C) 2018 Taiwan Association of Obstetrics \& Gynecology. Publishing services by Elsevier B.V