The Netherlands journal of medicine
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Admission hyperglycaemia is associated with an increased risk of mortality after myocardial infarction. Whether long-term glucose dysregulation (assessed by HbA1c) is more important than acute hyperglycaemia is unknown. We evaluated the prognostic value of admission glucose and HbA1c levels in nondiabetic patients with ST-segment elevation acute myocardial infarction (STEMI). ⋯ Elevated admission glucose is an important predictor of 30-day outcome after STEMI, while prior long-term glucose dysregulation is a covariate of other high-risk clinical characteristics. Among 30-day survivors, neither admission blood glucose nor HbA1c were predictors of long-term outcome.
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Case Reports
Therapeutic hypothermia after prolonged cardiopulmonary resuscitation for pulseless electrical activity.
We report an 18-year-old female patient with cardiac arrest due to pulseless electrical activity caused by a massive pulmonary embolism. Cardiopulmonary resuscitation was continued for more than one hour. ⋯ She recovered uneventfully without neurological deficit. Therapeutic hypothermia may be effective for neuroprotection in non-VFcardiac arrest.
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Phaeochromocytoma is a rare catecholamine-secreting neuroendocrine tumour with a high cardiovascular morbidity and mortality if left untreated. Surgical resection is the only curative therapy. During surgery there is a high risk of massive release of catecholamines, which can result in potentially fatal hypertensive crises and cardiac arrhythmias. ⋯ Guidelines for the preoperative medical management of the patient with a phaeochromocytoma are mainly based on retrospective studies and case reports. We reviewed the relevant literature on this subject. In addition, we compared the several preoperative treatment protocols of the eight university medical centres in the Netherlands.