Articles: ninos.
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In addition to ventricular arrhythmias, various forms of supraventricular arrhythmias (SVA) and atrioventricular (AV) and intraventricular (IV) conduction disturbances occur also in acute myocardial infarction (AMI). In the setting of AMI, SVA may be caused by relevant atrial ischemia or infarction. SVA complicate the course especially that of inferior, posterior and lateral AMI, SVA occur frequently also in the right ventricular myocardial infarction and in pericarditis. ⋯ The major cause of death in these patients are heart failure cardiogenic shock and malignant ventricular arrthythmias due to larger AMI, significant reduction of left ventricular function and advanced coronary heart disease. Complex SVA as well as serious AV and IV conduction disturbances are usually considered as markers, but not as independent predictors for both increased hospital mortality and in some cases also for that of posthospital mortality. Their occurrence in AMI may help to identify the patients at great risk who require a very intensive treatment including aggressive management of extensive coronary heart disease. (Ref. 62.).
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Third degree atrioventricular block is considered present when none of the atrial impulses are conducted to the ventricles because of a disruption in the conducting system. Third degree atrioventricular block is usually considered a serious sign but most studies have been performed on hospitalized patients or certain professional groups. The objective of this study was to find the prevalence of third degree atrioventricular block in a representative population sample and estimate its prognostic significance. ⋯ The prevalence of third degree atrioventricular block in this general population was low but nevertheless considerably higher than previously reported. The block was temporary in the majority of subjects. All had some underlying heart disease which seemed to affect the prognosis more than the heart block. In this survey fewer subjects than expected were found to need a pacemaker.
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The Health Centre at Kirkjubaejarklaustur serves a large rural district with a population a little over 600. Agriculture and various services including tourism are the main occupations. Almost 20% of the population are over 65 years of age, which is an unusually high figure compared to the rest of the country. Ambulance transports are one of the health centre's responsibilities. Most of these are surface transports to hospitals, 200-250 kilometres away. ⋯ Ambulance transport including the preparation of the sick or injured person is an important part of health care in this region. General practitioners need to be well versed in emergency medicine and ambulance attendants in preparing the patient for transport. Therefore continuing education is an important factor in this discussion. Tourism in the summertime may prompt the need for increased staffing in the health care sector. There is no indication that helicopter transport will replace surface transport in the near future except in special cases as it has been. Good primary health care and regular access to physicians in the nursing home setting decrease the need for ambulance transport. Further studies in the area of ambulance transport especially concerning tourists and the elderly are needed in the Icelandic context. Both groups are on increase and will probably be more in demand of emergency medical services such as ambulance transports.
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Annals of Saudi medicine · Mar 1995
Ultrasonography detection of radiolucent foreign bodies in soft tissue compared to computed tomography scan.
Thirty-one patients with suspected radiolucent foreign bodies (wooden splinters) in soft tissues of extremities were investigated by plain radiography, computed tomography (CT) scan and ultrasonography to the area suspected clinically. Ultrasonography detected and localized radiolucent foreign bodies in 18 of the 31 patients, while only 14 were seen on CT scan. ⋯ The size of foreign body, the presence of infection or the delay in diagnosis had no effect on results. Ultrasonography is clearly a reliable method of detecting radiolucent foreign bodies in soft tissues of extremities.