Kardiologiya
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Multicenter Study
[Adherence to guidelines on management of acute coronary syndrome in Russian hospitals and outcomes of hospitalization (data from the RECORD-2 Registry)].
Complete following existing guidelines for management of acute coronary syndrome (ACS) is known to be associated with better outcomes. Partly this is explained by lesser adherence to recommendations in high risk patients. Aim of our study was to assess relationship between degree of following current guidelines and in hospital outcomes independently from initial assessment of risk. ⋯ In RECORD-2 ACS registry low adherence to guidelines was more frequent among high risk patients and was independent predictor of inhospital death. Association between degree of guidelines adherence and outcomes persisted after equalizing groups by some factors of risk of mortality.
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Multicenter Study
[Prehospital management of patients with acute coronary syndrome in Moscow. Data of the first Moscow "snapshot" register].
To characterize the state of prehospital management of patients with acute coronary syndromes (ACS) using data from Moscow snapshot registry of hospitalized patients with ACS. ⋯ The following characteristics of prehospital management of patients diagnosed as ACS at hospital (CCU) admission could be object of improvement: long time of contact of ambulance staff with patients; attempts to diagnose (exclude) MI associated with unjustified referral to noninvasive hospitals; preferential use of thrombolysis in younger patients; relatively rare use of guideline recommended doses of aspirin and clopidogrel. Of note is association of inhospital bleedings with prehospital administration of anticoagulants.
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Scientific (analytical) approach directs researcher to the study of nosology in isolated native view. The phenomenon under consideration- comorbidity becomes significant and to a substantial degree is able to affect all aspects of the process of medical care. This is shown in this review along such directions as frequency of overt or concealed comorbidity or real state of the problem; magnitude of intracardiac and extracardiac comorbidity; difficulties of diagnostics and treatment arising with comorbidity; problems of validity of statistical (and epidemiological) side of the matter; value of social and organizational aspects of patients care in situations when comorbidity is present.
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The diagnostic efficiency of the methods of separate and combined registration of oronasal airflow and pulse oximetry in order to identify the obstructive sleep apnea/hypopnea syndrome (OSAHS) is studied in this work. Patients with cardiovascular diseases with complaints on sleep disorders were included in the study. Combined registration of oronasal airflow and pulse oximetry during sleep were performed for all examined patients (diagnostic system ApneaLink with pulse oximetry, ResMed). ⋯ The diagnostic efficiency of test methods and their criteria assessed by ROC-analysis (receiver operator characteristic, the characteristic curve analysis). The results of the study showed that combined registration of respiratory oronasal airflow and pulse oximetry during sleep was most effectively identified OSAHS and can be used as a screening method. The most accurate diagnostic criterion for identification of OSAHS is an "apnea/hypopnea combined index".