comparison of jurkat cell-reactive anti-T lymphocyte globulin and fetal andti-thymocyte globulin preparations in the treatment of aplastic anemia

The aim of this study was to investigate the success rate and effects on survival of different anti-thymocyte globulin [ATG] preparations in patients diagnosed with aplastic anemia. Of the total 24 patients included in the study, 12 were male and 12 female with a median age of 44 years [range 16-72]. Nine patients received Lymphoglobulin [registered sign], 7 Thymoglobulin [registered sign] and ATG-Fresenius [registered sign] [ATG-F]. There was no significant difference between the three treatment groups in terms in severity of aplastic anemia. The estimated 6-month survival rates for ATG-F, Lymphoglobulin and Thymoglobulin groups were 42.9, 77.8 and 71.4%, respectively. The difference in overall survival rates between groups was not significant, most likely due to the low number of patients. The most striking result was that none of the patients in the ATG-F preparation group showed any response to treatment. The ATG-F group was found to have a significantly inferior response rate [p=0.07]. Our data showed that none of the patients responded to ATG-F treatment. Hence, despite the small number of the patients, we recommend that ATG-F should not be used for treatment of severe aplastic anemia

new candidate as a hemostatic agent for difficult situations during variceal bleeding: ankaferd blood stopper

Variceal bleeding is the most challenging emergent situation among the causes of upper gastrointestinal bleeding. Despite substantial improvement, a need remains for therapeutic armamentarium of such cases, which is easy, effective and without side-effect. Ankaferd blood stopper [ABS] is a standardized herbal extract acting as a hemostatic agent on the bleeding or injured areas. In this observational study, a total of four patients with variceal bleeding were treated with endoscopic ABS application. The lesions were bleeding gastric varices [n:3] and bleeding duodenal varix [n:l]. ABS was selected as a bridge to definitive therapies due to unavailability or inappropriateness of bleeding lesions to conventional measures. ABS was instilled or flushed onto the bleeding areas by sclerotherotherapy needle or heater probe catheter. Periprocedural control of the bleeding was achieved in all instances. Thereafter, on an elective basis, two patients with gastric varices underwent cyanoacrylate injection, while third underwent Transjugular intrahepatic portosystemic shunt and embolization. The patient with duodenal varix refused further therapy, after a few hours after admission and was discharged. He again presented the same day with rebleeding, but died before any attempt could be made to control his bleeding. ABS seems to be effective in cases of variceal bleeding as a bridge to therapy. Its major advantages are the ease of use and lack of side-effects