ÖZETAmaç: Atriyal fibrilasyonun (AF) sinüs ritmine döndürülmesi çoğu kez emboli riskini ve hemodinamik bozulmanın azaltılması için yapılır. Bu çalışmada, son 48 saat içinde AF geçirmiş hastalar üzerinde tek oral doz flekainid, amiyodaron ve propafenon ile atriyal fibrilasyonun sinüs ritmine dönüşümü üzerindeki etkileri plasebo ile randomize olarak karşılaştırılmıştır. Yöntemler: Bu çalışma 160 hasta üzerinde yapılmış, hastalara rastgele olmak üzere flekainid (3 mg/kg, n=40), amiyodaron (30 mg/kg, n=40), propafenon (8.5 mg/kg, n=40) veya placebo (n=40) verilmiştir. Amaçlanan nokta ilaç alınımı sonrası 24 saat içinde AF'nin sinüs ritmine dönüşüm hızı olmuştur. AF konversiyon oranı ile 3 antiaritmik ilacın kullanımı ile ilişkiler çoklu lojistik regresyon analiz ile değerlendirilmiştir. Bulgular: Amaçlanan etki, flekainid kullanan hastaların %87.5'inde, amiyodaron kullanan hastaların %85'inde, propafenon kullanan hastaların 85%'inde, plasebo kullanan hastaların ise %17.5'inde (p<0.001 her 3 ilacın plasebo ile karşılaştırılması) gerçekleşmiştir. İlaç alımından 3 saat sonraki dönüşüm hızı, amiodaron (%0) ve plasebo (%10) ile karşılaştırıldığında; Propafenon grubunda (%57.5) ve flekainid grubunda (%45) olmak üzere daha yüksek bulunmuştur. Amiyodaron kullanan hastalar 6 ve 24 saat içinde, flekainid veya propafenon grubu hastalara göre anlamlı olarak daha fazla sinüs ritmine döndürülmüştür. Plasebo ile kıyaslandığında antiaritmik ilaçların kullanımı sinüs ritmine dönüştürmede belirgin derecede üstün bulundu (düzeltilmiş OR=19.53, %95 GA 3.14-121.55, p<0.001). Önemli yan etki gözlenmedi. Sonuç: Atriyal fibrilasyona yakın zamanda girmiş hastalarda oral ilaç alımını izleyen 24 saatlik süreç içinde sinüs ritmine geri döndürmede flekainid, amiyodaron veya propafenon grubu, plasebo grubuna göre üstün bulunmuştur. Propafenon ve flekainid'in oral alım sonrası ilk 3 saat içinde amiyodaron'a göre daha etkili olmakla birlikte her 3 antiaritmik ilaç benzer etkinliktedir. (Anadolu Kardiyol Derg 2011; 11: 600-6) Anahtar kelimeler: Amiyodaron, atriyal fibrilasyon, flekainid, propafenon, sinüs ritm, lojistik regresyon analizi ABSTRACT Objective: In this study, we randomly compared single oral doses of flecainide, amiodarone and propafenone versus placebo for the conversion of recent atrial fibrillation (AF) (within 48 hours). Methods: This is a randomized prospective, placebo-controlled single-blind study that included 160 consecutive patients with recent AF who were randomly assigned to single oral doses of flecainide (3 mg/kg of weight, n=40), amiodarone (30 mg/kg weight, n=40), propafenone (8.5 mg/ kg of weight, n=40) or placebo (n=40). The primary end-point was conversion rate at 24 hours after the drug intake. The association between antiarrhythmic use and conversion rate was tested with multiple logistic regressions. Results: The primary end-point was achieved in 87.5% of patients with flecainide, 85% of patients with amiodarone, 85% of patients with propafenone and 17.5% of patients with placebo (p<0.001 compared with placebo for...

Summary:The active immunization of bone marrow (BM) donors with myeloma immunoglobulin (Ig) results in an idiotypic T cell response that can be transferred to the recipient. Using a murine model we evaluated the effectiveness, side-effects and underlying mechanisms of this approach. Balb/c (H-2 d ) mice were given a dose of HOPC-1F myeloma cells secreting the monoclonal IgG 2a followed by lethal total body irradiation (7.5 Gy) 2 days later and a subsequent transplantation of 2 ؋ 10 7 allogeneic MHC-matched DBA/2-derived marrow cells. Multiple myeloma (MM) remains an incurable malignancy as a result of innate drug resistance at diagnosis. 1 Highdose chemoradiotherapy with either autologous or allogeneic stem cell transplantation has been widely used during the last decade and may improve long-term survival. [2][3][4] Allogeneic BMT, in particular, is attractive because it provides the opportunity to exploit the antitumor effect of the marrow graft as an adoptive immunotherapy against residual tumor cells. This immunologic component, referred to as the graft-versus-tumor (GVT) effect, is mediated by immunocompetent donor leukocytes contained in the transplanted marrow. [5][6][7] Recently, the existence of a graft-versus-myeloma (GVM) effect was indicated by studies documenting remissions after donor leukocyte infusions (DLIs) in patients with relapsed multiple myeloma following allogeneic BMT. [8][9][10][11][12][13] However, the highly beneficial effects of GVM are often offset by the occurrence of severe graft-versus-host disease (GVHD). 9 The induction of tumor-specific T cell reactivity may allow separation of GVM effects from GVHD.Idiotypic immunoglobulin can be used as a tumorspecific antigen, since idiotype determinants are restricted markers for B cell lymphomas including MM. Based on experimental studies showing that immunization with tumor-derived Ig can generate effective anti-idiotype immune responses against several B cell tumor models, [14][15][16][17] clinical trials using id-vaccination strategies in patients with B cell lymphomas, such as follicular lymphoma (FL) or multiple myeloma were performed. Whereas in FL id-vaccination can produce clinical responses, beneficial effects in myeloma patients are scarce. [18][19][20][21] In the allogeneic setting Kwak et al 22 were the first to describe that idiotype protein-specific immunity can be transferred from bone marrow transplant donor to the multiple myeloma recipient. In a murine transplant model the same investigators were able to show that vaccination of the allogeneic donor with the B cell lymphoma idiotype can induce antitumor protection against an otherwise lethal tumour challenge in the recipient. 23 However, no significant long-term survival could be achieved in this model.The objective of the present study was to perform donor vaccination studies in a newly established murine myeloma model. We show that potent GVM effects can be elicited by idiotype-primed marrow grafts. These antimyeloma effects could be further enhanced after additional tra...

AIM:The mains topics of this work are the incidence of patient-prosthesis mismatch and the influence in the early results of isolated aortic valve surgery.METHODS:In 193 patients isolated aortic valve surgery was performed. The study population was divided in three subgroups: 20 patients with severe, 131 patients with moderate and 42 patients without patient-prosthesis mismatch. The indexed effective orifice area was used to define the subgroups. Operative mortality and perioperative complications were considered the indicators of the early results of aortic valve surgery.RESULTS:The incidence of severe and moderate patient-prosthesis mismatch was respectively 10.3% and 67.8%. Hospital mortality and perioperative complications were: mortality 5% vs. 3.1% vs. 2.4% (p = 0.855), low cardiac output 5% vs. 6.9% vs. 4.8% (p = 0.861); pulmonary complications 5% vs. 3.1 vs. 0.0% (p = 0.430); exploration for bleeding 5% vs. 0.8% vs. 2.4% (p = 0.319); atrial fibrillation 30% vs. 19.8% vs. 11.9% (p = 0.225); wound infection 5% vs. 0.8% vs. 0.00% (p = 0.165), respectively for the group with severe, moderate and without patient-prosthesis mismatch.CONCLUSIONS:Patient-prosthesis mismatch is a common occurrence in aortic valve surgery. This phenomenon does not affect the early results of aortic valve surgery.

Latex allergy is a common occupational disease among healthcare workers who use latex gloves. The aim of the present study was to determine the prevalence of allergy to latex gloves among dental students and the role of exposure duration in latex allergy. In this prospective study, a total of 240 students completed a self-administered questionnaire aiming at providing information about glove, working habits, signs and symptoms related to glove use, precautions taken to minimize it, etc. The challenge and patch tests were performed through latex gloves, and skin prick test with commercial extracts. The questionnaire items and diagnostic tests revealed that one-fourth of subjects were suspicious for latex gloves hypersensitivity. Their mean value for skin reactions like contact urticaria, irritant or allergic dermatitis was between 10% and 14%, while for non-cutaneous symptoms the mean value was under 5%. The average latex exposure (in hours) is estimated to be about 214±71 (SE), with a maximum of 11500 hours. The correlation between studied variables and the time exposure to latex gloves revealed weak to moderate relations with respect to reported latex allergy, eczematous reactions, hand erythema after glove wearing, irritant reactions during wash/washout procedures, concentration oscillations during usage of latex gloves, or dyspnea attack during latex exposure. Due to the relationship between allergic reactions to latex gloves and some medical histories during school practice, it seems to be necessary to undergo pre-matriculation evaluation and periodic health surveillance of dental students. 2017 Vol.4, No.3, pp.45-49 ISSN(e): 2313-2752 ISSN(p): 2313-7746 DOI: 10.18488/journal.9.2017.43.45.49 © 2017 Contribution/Originality: AB designed the questionnaire, assisted students to complete them, conducted diagnostic tests and collected the data; DK and SS coordinated and helped with the study design and conduction; DM assisted on students' enrollment in the study and helped with the study design from the stomatological perspective; EP assisted on statistical analysis of the data; ÇM coordinated the students' enrollment in the study; AR assisted on manuscript copyediting, EÇM drafted the manuscript. International Journal of Medical and Health Sciences Research