ABSTRACT
AIM: To identify the meteorological factors or their combinations, which are most significant for the development of acute coronary syndrome (ACS) in different seasons. SUBJECTS AND METHODS: A Statistica package was used to make an exploration analysis of the data of the A.S. Puchkov Central Emergency Medical Care Station on 63,412 admissions of patients diagnosed with acute myocardial infarction (AMI) to Moscow hospitals in 2009-2012 and those of the Hydrometeorology Center of Russia on weather conditions in the period under study. RESULTS: Among the 63,412 patients, there were more men than women (p < 0.000005). Two long frost periods and three long abnormal heat periods were recorded in 2009-2012. In summer, the number of patients with a prehospital diagnosis of AMI was an average 19-22% less than in the other seasons. There was no peak in the number of hospitalizations during the abnormally hot summer of 2010. Air temperature proved to be a factor that was most strongly associated with the trend in AMI hospitalizations in men (MS = 1011.52, MSor = 27.27; p < 0.00005) and women (MS = 895.36, MSor = 25.37; p < 0.00005). The number of hospitalizations was negatively associated with daily average temperature in its positive range. In summer, the interdaily temperature difference turned out to be statistically significant; the highest number of hospitalizations was noted when it grew 6 °C colder. On days off, the number of admitted patients was 25% less than that on weekdays. CONCLUSION: The trend in hospitalizations for a referral diagnosis of AMI has a significant seasonal component. Their number was minimal in summer, including in the abnormally hot summer of 2010. Air temperature is the most important factor. Positive temperature was found to be strongly negatively correlated with diagnosed AMI hospitalizations.
Subject(s)
Acute Coronary Syndrome/epidemiology , Hospitalization/statistics & numerical data , Myocardial Infarction/epidemiology , Seasons , Weather , Acute Coronary Syndrome/therapy , Adult , Aged , Female , Hospitalization/trends , Humans , Male , Middle Aged , Moscow/epidemiology , Myocardial Infarction/therapyABSTRACT
Aim of the study was to analyze causes of pulmonary artery thromboembolism (PATE) hypodiagnostics at prehospital stage. We compared clinical and electrocardiographic picture of acute period of the disease in groups of patients with diagnosed (n=61) and undiagnosed (n=22) PATE at prehospital stage. We also assessed retrospectively probability of PATE according to Revised Geneva Score. In 49 cases we analyzed dynamics of the acute period of PATE. The analysis showed that in more than 50% of cases hypodiagnostics of PATE was caused by similarity of observed clinical and electrocardiographical picture and that of acute coronary syndrome. There were no differences between groups in Revised Geneva Score.
Subject(s)
Diagnostic Errors , Electrocardiography/methods , Emergency Medical Services/methods , Physical Examination/methods , Pulmonary Embolism , Aged , Aged, 80 and over , Analysis of Variance , Causality , Comorbidity , Diagnostic Errors/prevention & control , Diagnostic Errors/statistics & numerical data , Emergency Medical Services/standards , Emergency Medical Services/statistics & numerical data , Female , Humans , Male , Middle Aged , Moscow/epidemiology , Propensity Score , Pulmonary Artery/pathology , Pulmonary Artery/physiopathology , Pulmonary Embolism/diagnosis , Pulmonary Embolism/epidemiology , Pulmonary Embolism/physiopathology , Risk FactorsABSTRACT
In the review we present detailed analysis of antihypertensive action of 3-nd generation sympatholytic moxonidine. Due to selective interaction with imidazoline I1-receptors moxonidine diminishes sympathetic activity causing lowering of peripheral vascular resistance. This leads to significant lowering of systolic and diastolic arterial pressure. Efficacy and safety of the drug has been shown both for the management of uncomplicated hypertensive crises and long term treatment of arterial hypertension (AH). Appropriateness of the use of moxonidine in patients with AH combined with diabetes mellitus, metabolic syndrome, chronic obstructive pulmonary disease has been confirmed. Moxonidine is well tolerated; its bioavailability after oral intake reaches 90%. The drug produces neither hypotensive "first dose" nor rebound effects.
Subject(s)
Blood Pressure/drug effects , Hypertension, Malignant/drug therapy , Imidazoles , Imidazoline Receptors/metabolism , Sympathetic Nervous System/drug effects , Vascular Resistance/drug effects , Administration, Oral , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/adverse effects , Biological Availability , Humans , Hypertension, Malignant/metabolism , Hypertension, Malignant/physiopathology , Imidazoles/administration & dosage , Imidazoles/adverse effects , Imidazoles/pharmacokinetics , Severity of Illness Index , Treatment OutcomeABSTRACT
Clinicostatistical analysis of arterial hypertension complicated with hypertensive crisis using data of Moscow A.S.Puchkov Station of Urgent and Emergent Medical Aid revealed 14% rise in number of hypertensive crises during the period from 2005 to 2009. Number of hypertensive crises increased among persons of young age (18-35 years). Frequency of cerebrovascular complications of hypertensive crises was age dependent with maximal values among men aged 36-74 years and women older than 75 years.
