Torasemide reduces dilated cardiomyopathy, complication of arrhythmia, and progression to heart failure.

The aim of this study was to analyze the incidence and types of arrhythmia and their relationship with the severity and prognosis of chronic heart failure (CHF) in patients with dilated cardiomyopathy (DCM), and to investigate the therapeutic effect of torasemide versus furosemide on CHF and incidence of arrhythmia. DCM patients with NYHA cardiac function II-IV were continuously monitored using a 24-h dynamic electrocardiogram (Holter), and arrhythmia incidence was analyzed by computer automatic analysis combined with manual assessment. In total, 125 participants were evenly divided into two groups: torasemide group which received 10 mg oral torasemide once daily) and regular anti-heart failure treatment (N=65), and furosemide group which received torasemide (20 mg once daily orally) and regular antiheart failure treatment (N=60). Another 60 normal healthy persons served as the normal control group. Incidence and severity of arrhythmia increased when degree of CHF was elevated. Size of left atrium was related to atrial fibrillation and size of left ventricle was related to malignant arrhythmia. At 3 months after treatment, cardiac function in both groups improved and incidence and severity of arrhythmia in both groups were reduced. However, left ventricular ejection fraction (LVEF) was higher in the torasemide group than in the furosemide group, while incidence of arrhythmia was lower in the torasemide group. Arrhythmias frequently occurred in patients with DCM and HF. Type of cardiac arrhythmia is closely related to ventricular enlargement and cardiac function grade. Torasemide is better for improving cardiac function to reduce arrhythmia and CHF compared to furosemide.

Haemorrhoidectomy by vessel sealing system under local anaesthesia in an outpatient setting: preliminary experience.

AIM: This prospective study was designed to assess the feasibility of local anaesthesia for LigaSure haemorrhoidectomy in an outpatient setting. METHOD: From April 2006 to March 2007, 207 consecutive patients (median age 42, 126 males) with grade III (147) and grade IV (60) haemorrhoids, underwent Milligan-Morgan haemorrhoidectomy with LigaSure under local anaesthesia (lidocaine 1%, mean dose 27 +/- 1.7 ml) in an outpatient setting. Postoperative pain was assessed by a visual analogue scale (VAS). RESULTS: Two, three and four files were removed in 120, 51 and 36 patients. Mean operative time was 12 +/- 5.2 min and mean blood loss was 3.4 +/- 3.9 ml. The mean postoperative pain scores were 6.2 +/- 2.1 for the maximal pain intensity and 6.1 +/- 2.5 for the pain on defecation. All patients left hospital after surgery within 2 h and 33 (15.9%) required analgesics. They returned to normal daily activity after 12.2 +/- 7.9 days including work (12.1 +/- 7.8 days). The wounds had healed by 32.2 +/- 9.1 days. At a follow-up of at least 6 months, only six cases of major bleeding had occurred and 24 patients had skin tags. The median satisfaction score was +2 (-2 to +3). CONCLUSION: LigaSure haemorrhoidectomy under local anaesthesia in the outpatient setting is safe and effective.