Adv Clin Exp Med
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Chronic atrial fibrillation may temporarily resolve after cardiac surgery. Prolongation of the ventricular repolarization period may be the electrophysiological background for this phenomenon. ⋯ Spontaneous temporary resolution of atrial fibrillation is a common finding after cardiac surgery in patients with chronic atrial fibrillation. This phenomenon is related to a prolonged QT interval, therefore it may have an electrophysiological basis rather than a hemodynamic background. Further studies are required to assess the clinical importance of the prolongation of the QT interval after cardiac surgery.
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The treatment of cerebral aneurysms has undergone significant evolution since the 1990s when the endovascular methods were introduced. After the results of ISAT were published in 2002, a change in practice occurred which resulted in more ruptured aneurysms treated endovascularly rather than by surgical clipping. This change in practice was referred to as a paradigm shift. ⋯ The introduction of endovascular methods in the treatment of patients with aneurismal SAH resulted in an almost halving of the number of patients treated surgically. The outcomes of patients with cerebral aneurysms depend mainly on non-modifiable factors (the neurological state of the patients on admission and age). GCS has a better predictive value for outcomes in patients with aneurysmal SAH than the commonly-used WFNS and Hunt-Hess scales. Due to the fact that the majority of aneurysms are small or medium sized, the authors recommend the treatment of unruptured aneurysms less than 10 millimeters as a prevention of SAH.
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Potential drug-drug interactions (DDIs) are known to be a risk factor for the development of adverse drug reactions (ADRs). Data on the occurrence of ADRs related to DDIs is scarce and comes from different groups of patients. ⋯ Potential DDIs were frequent in hospitalized dermatology patients. The drug groups most commonly involved were cardiovascular drugs. The proportion of DDIs associated with the occurrence of ADRs was relatively low, but close monitoring of patients on multiple drug regimens is essential because these reactions may be severe.
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Cardiosurgical operations in cardiopulmonary bypass (CPB) constitute a risk of acute kidney injury (AKI). ⋯ Determining sIL6 in children after cardiosurgical operations at 2 hrs after the procedure constitutes a good, yet not a perfect marker of AKI risk development. Nomograms of the constant risk values of AKI were worked out presenting the ranges of values in relation to serum IL6 concentrations and the child's body mass, age and the time of circulatory arrest.
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An aneurysmal subarachnoid hemorrhage could be complicated with cerebral vasospasm and resultant ischemia, causing neurological deficit. ⋯ When a patient with SAH is treated with the endovascular clipping procedure, prophylactic administration of nimodipine is mandatory due to the reduced rate of cerebral vasospasm and delayed cerebral ischemia.