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Postoperative intravenous amiodarone, followed by oral amiodarone, appears to be effective in the prevention of new-onset postoperative atrial fibrillation. It also reduces ventricular rate and duration of atrial fibrillation after coronary artery bypass grafting. It is well tolerated and decreases the length of hospital stay.

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The purpose of this study is to evaluate the efficacy and safety of direct right atrial catheter insertion for hemodialysis in patients with multiple venous access failure. We retrospectively evaluated the charts of 27 patients with multiple venous access failure who had intra-atrial dialysis catheter placement between October 2005 and October 2010 in our clinic. Permanent right atrial dialysis catheters were placed through a right anterior mini-thoracotomy under intratracheal general anesthesia in all patients. Demographics of the cases, the patency rates of hemodialysis via atrial catheterization, existence of any catheter thrombosis, and catheter-related infections were documented and used in statistical analysis. Seventeen women (63%) and 10 men (37%) with the mean age of 59.0 ± 7.1 years (47-71) were enrolled in this study. Chronic renal failure was diagnosed for the mean of 78.9 ± 24.3 months (33-130). Five patients (18.5%) died. Ventricular fibrillation and myocardial infarction were the causes of death in the early postoperative period in two patients. Two of the remaining three patients died because of cerebrovascular events, and one patient died because of an unknown cause. Ten patients (37%) had been using anticoagulate agents (warfarin) because of concomitant disorders such as deep vein thrombosis, operated valve disease, and arrhythmias. Catheter thrombosis and malfunction was determined in three cases (11.1%). Intra-atrial hemodialysis catheterization is a safe and effective life-saving measure for the patients with multiple venous failure and without any possibility of peritoneal dialysis or renal transplantation.

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Objective: To determine the diagnostic accuracy of D-dimer testing for detection of acute aortic dissection. Methods: This study is a retrospective chart review of patients who had been evaluated with suspicion of acute aortic dissection. All patients' D-dimer levels were determined prior to their further work up in the emergency department. The study was conducted in a tertiary care center between February 2006-August 2008. The D-dimer assay used was the immunoturbidimetric assay, with a normal range up to 0.246 μg/ml. Statistical analysis was accomplished using Chi-square test, Student's t-test and a receiver-operating characteristics (ROC) curve analysis. Results: Ninety-nine patients were included in the study, 30 patients were diagnosed as having acute aortic dissection and 69 patients were evaluated in non-acute aortic dissection group. In comparison of the two groups, positive D-dimer results were found to be significantly higher in acute aortic dissection group than in non-acute aortic dissection group (p<0.001). Sensitivity of the D-dimer test in detection of acute aortic dissection was found as 96.6% and the negative predictive value of the test was 97.3%. Specificity and positive predictive value of the D-dimer test were 52.2% and 46.8%, respectively. The area under the ROC curve yielded an acceptable certainty for excluding acute aortic dissection on base of negative results (AUC: 0.764; CI 95%: 0.674-0.855; p<0.001). Conclusion: D-dimer testing is helpful for emergency physicians in detection of patients with suspected acute aortic dissection in the emergency department. (Anadolu Kardiyol Derg 2010; 10: 434-9) Key words: Acute aortic dissection, D-dimer, fibrin degradation products, emergency department, diagnostic value of tests ÖZET Amaç: D-dimer testinin akut aort disseksiyonunu belirlemede tanısal değerini saptamak. Yöntemler: Bu çalışma retrospektif bir çalışmadır. Acil serviste akut aort disseksiyonu şüphesi mevcut olan ve ileri tetkik öncesi D-dimer testi istenen hastalar çalışmaya dâhil edilmiştir. 3. basamak bir sağlık kuruluşunda gerçekleştirilen çalışmada, Şubat 2006-Ağustos 2008 tarihleri arasındaki kayıtlar incelenmiştir. Kullanılan D-dimer ölçüm yöntemi immunoturbidimetrik yöntemdir ve 0.246 μg/ml'ye kadar olan sonuçlar normal olarak kabul edilmiştir. İstatistiksel analizde Ki-kare testi, Student's t-testi kullanılmış, ayrıca ROC eğrisi analizi yapılmıştır. Bulgular: Çalışmaya 30 akut aort disseksiyonu mevcut, 69 akut aort disseksiyonu mevcut olmayan kontrol grubu olmak üzere 99 hasta dâhil edilmiştir. Bu iki gruba ait D-dimer ölçümlerinin karşılaştırılmasında akut aort disseksiyonu olan hastaların olmayanlara göre istatistiksel anlamlı olarak daha fazla pozitif sonucunun olduğu görülmüştür (p<0.001). Akut aort disseksiyonunu saptamada D-dimer testinin duyarlılığı %96.6 özgünlüğü %52.2 negatif prediktif değeri %97.3 pozitif prediktif değeri ise %46.8 olarak bulunmuştur. ROC analizi sonucunda eğri altında kalan (AUC) değeri 0.764 (CI %95: 0.674-0.855) ve p<0.001) olarak saptanmı...

intraaortic infusion of a hypothermic blended solution containing methylprednisolone, vitamins C and E provided best protection against postischaemic spinal cord dysfunction.