[Study of human papillomavirus via chemiluminescence technic and polymerase chain reaction in transitional cell carcinoma of the bladder]. / Ricerca del papillomavirus umano mediante tecniche di chemiluminescenza e di polymerase chain reaction nel carcinoma a cellule transizionali della vescica.

INTRODUCTION: The exact ethiology of bladder carcinoma isn't yet known; an implication of human papillomavirus (HPV) has been recently hypothesized. MATERIALS AND METHODS: In this study HPV-DNA was investigated in urethral secretion and in bladder carcinoma of 37 patients. The analysis was performed by in vitro hybridization (chemiluminescent assay) and Polymerase Chain Reaction in order to detect HPV 6, 11, 16, 18, 31, 33 through specific primers. RESULTS: On 3 out of 37 patients (8.1%) we found the presence of HPV-DNA, only in bladder T.U.R. and not in the corresponding urethral swab. CONCLUSIONS: Our data suggest that human papillomavirus is unlikely to be involved in the pathogenesis of transitional cell carcinoma, in agreement with most European and American research groups.

Regular ventricular rhythms before conversion of recent onset atrial fibrillation to sinus rhythm.

The incidence of fast atrial tachycardias with regular ventricular rhythm was assessed in a population of 243 patients with recent onset (< 72 hours) atrial fibrillation (AF), without heart failure, randomly treated with single loading oral dose of propafenone (600 mg), flecainide (300 mg), digoxin (1 mg), or placebo for acute conversion to sinus rhythm (SR). Fast atrial arrhythmias developed in 14 (6%) patients: 6/92 treated with propafenone, 3/34 treated with flecainide, 1/25 treated with digoxin, and 4/92 who received placebo (P = NS). Heart rate > 175 beats/min with 1:1 AV conduction ensued in 4 cases: 2 treated with flecainide and 2 treated with placebo; in the other cases 2:1 AV conduction was observed. Widening of QRS during regular tachycardia was observed in 4 patients; 3 who received propafenone and 1 who received flecainide. Conversion to SR within 4 hours was achieved in 55/92 (60%) patients treated with propafenone, 20/34 (59%) patients treated with flecainide, 7/25 (28%) patients treated with digoxin, and 19/92 (20%) treated with placebo (P < 0.001 propafenone vs placebo and flecainide vs placebo; P < 0.05 propafenone vs digoxin and flecainide vs digoxin). Periods of regular tachycardia are expected in recent onset AF and may not necessarily represent a proarrhythmic effect of Class 1C drugs, rather than mark the transition from AF to SR. Class 1C agents are probably responsible for widening of the QRS complex seen during these tachycardias. Propafenone and flecainide appear equally effective in converting recent onset AF.