Effectiveness of antazoline versus amiodarone, flecainide and propafenone in restoring sinus rhythm at the emergency department.

PURPOSE: Little is known about the effectiveness of pharmacological cardioversion (PCV) with antazoline in comparison to flecainide. The aim of this study was to compare the effectiveness of antazoline in restoring sinus rhythm (SR) versus amiodarone, flecainide and propafenone in a group of emergency department (ED) patients. MATERIALS/METHODS: This was a single-centre retrospective analysis of patient records from an ED in a large hospital in Poland. We analysed a total of 1878 patient records, divided based on the anti-arrhythmic drug (AAD) administered during PCV: antazoline (n â€‹= â€‹1080), antazoline â€‹+ â€‹ß-blocker (n â€‹= â€‹479), amiodarone (n â€‹= â€‹129), flecainide (n â€‹= â€‹102), propafenone (n â€‹= â€‹88). Of the patients, 63.5 â€‹% were female (median 65 years, [19-100]). RESULTS: The percentage of successful PCV was significantly higher in the antazoline group (84.3 â€‹%) than in the antazoline â€‹+ â€‹ß-blocker (75.8 â€‹%, p â€‹= â€‹0.0001), propafenone (75.6 â€‹%, p â€‹= â€‹0.0364) and amiodarone (68.8 â€‹%, p â€‹< â€‹0.0001) groups. Post-hoc analysis revealed that patients who received PCV with antazoline, antazoline â€‹+ â€‹ß-blocker, flecainide and propafenone had significantly shorter time to SR than those who received amiodarone (p â€‹< â€‹0.0001). Univariate regression analysis revealed that patients who underwent PCV with antazoline were almost twice as likely to return to SR compared to the other groups (p â€‹< â€‹0.0001, OR 1.81, 95 â€‹% CI 1.44-2.27). CONCLUSIONS: This is the first study comparing the effectiveness of antazoline in PCV versus flecainide in addition to the previously studied amiodarone and propafenone. Our results indicate that antazoline is more effective in restoring SR than amiodarone, flecainide and propafenone. In addition, antazoline restored SR significantly faster than amiodarone or propafenone.

[Thrombotic thrombocytopenic purpura in a patient with systemic lupus erythematosus--complication of connective tissue disease or overlap syndrome?]. / Zakrzepowa plamica maloplytkowa u chorej na toczen rumieniowaty ukladowy--powiklanie ukladowej choroby tkanki lacznej czy zespól nakladania?

Thrombotic thrombocytopenic purpura (TTP) and systemic lupus erythematosus (SLE) are two separate diseases, whose clinical symptoms maybe similar. The coexistence of these two diseases is very rare. We present the case report of a 29-year-old female patient with simultaneous diagnosis of TTP and SLE. The purpose of this article is to draw attention to the diagnostic difficulties which may result from the co-existence of both diseases.

[A case report of idiopathic thrombocytosis in 27-year-old man treated for myocardial infarction]. / Przypadek nadplytkowosci samoistnej u 27-letniego mezczyzny leczonego z powodu zawalu miessnia sercowego.

We present the case of 27-year-old male, physical training teacher in whom the first clinical sign of idiopathic thrombocytosis was myocardial infarction. The infarct was complicated by heart arrest caused by ventricular fibrillation. Streptolysis (streptokinase) was used in treatment. Thrombocytosis 842 G/l was observed in blood tests at admission. To estimate its cause the bone marrow biopsy and trepanobiopsy of hip bone were performed. Tests were performed to exclude the secondary cause of thrombocytosis. The coronarography did not show relevant stenoses of coronary arteries. The results let diagnose myocardial infarction in a patient with essential thrombocytosis.

[Myelodysplastic syndromes--pathogenesis and treatment]. / Zespoly mielodysplastyczne--patogeneza i leczenie.

The essence of myelodysplastic syndromes is damage of CFU. We can also observe different chromosomes' defects which in consequence cause disorder of differentiation and maturation of hematopoietic cells. The aim of therapy is elimination of damaged CFU, possible only by bone marrow transplant. Patients who can not qualify for a transplant are treated by pharmacologic means. Pharmacological treatment aims to induce differentiation of hematopoietic cells and also to inhibit apoptosis. Since in this disease multiple genetics anomalies are affirmed, in the future gene therapy will play a big role in the treatment.