ABSTRACT
Patients with acute coronary syndrome and elevated ST segment in the pre-hospital phase were treated with metoprolol succinate (MS) and thrombolytic therapy. Severe and moderate pain decreased by 54.1 and 16.1% respectively within 60 min after MS intake. Systolic (SAP) and diastolic (DAP) arterial pressure dropped by 35.7 and 16.8 mmHg during the same period. The heart rate (HR) decreased by 25.1 beats/min. 21.8 and 25.3% of the patients showed positive dynamics of ST segment 90 and 180 min after intake of MS. The height of the ST segment was normal in 18.4 and 31.0% of the patients respectively. No cases of external heart rupture were documented at autopsy whereas it was a cause of death in 39.1% of the patients given standard thrombolytic therapy. It is concluded that the use of MS starting from the pre-hospital stage in patients with acute coronary syndrome decreases pain intensity. HR, DAP and SAP and helps to prevent heart rupture.
Subject(s)
Acute Coronary Syndrome/drug therapy , Adrenergic beta-Antagonists/pharmacology , Metoprolol/analogs & derivatives , Thrombolytic Therapy/adverse effects , Adrenergic beta-Antagonists/administration & dosage , Adrenergic beta-Antagonists/adverse effects , Aged , Drug Therapy, Combination , Emergency Medical Services/methods , Female , Humans , Male , Metoprolol/administration & dosage , Metoprolol/adverse effects , Metoprolol/pharmacology , Middle Aged , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
We studied effect of time on the outcome of acute coronary syndrome and elevated ST segment at the prehospital stage. Logistic regression analysis revealed two time-dependent predictors: "symptom-needle" time and total call service time. In patients undergoing prehospital thrombolysis, these indices (88 and 85 min respectively) reliably predicted the probability of fatal outcome. Their values of 71 and 77 min respectively predicted the risk of unfavourable outcome. The total call service time may serve as an indicator of the quality of work of an ambulance crew at the prehospital stage of management of acute coronary syndrome with elevated ST segment.
Subject(s)
Acute Coronary Syndrome/therapy , Outcome Assessment, Health Care , Thrombolytic Therapy/standards , Acute Coronary Syndrome/drug therapy , Aged , Female , Humans , Male , Middle Aged , PrognosisABSTRACT
The case records of 259 patients with purulent surgical diseases are analysed. The following social groups of patients were distinguished; students--10.4%, office workers--20.5%, factory and agricultural workers--35.9%, lonely pensioners, invalids, and homeless persons--33.2%. The last named group is least socially protected, and the diseases in these cases have a characteristic course and outcomes. In the groups of students and office workers the disease is predominantly marked by the formation of abscesses with rapid resolution after an operative intervention. In the socially unprotected group with somatic diseases, poor nutrition, and absence of care, the purulent process takes a phlegmanous course calling for the use of antibiotics and immunostimulators. The percentage of rehospitalization among these patients is high (up to 20%) due, in many respects, to social factors.
Subject(s)
Abscess/epidemiology , Bursitis/epidemiology , Cellulitis/epidemiology , Social Class , Staphylococcal Infections , Abscess/drug therapy , Abscess/microbiology , Abscess/surgery , Adjuvants, Immunologic/therapeutic use , Adolescent , Adult , Age Factors , Anti-Bacterial Agents/therapeutic use , Bursitis/drug therapy , Bursitis/microbiology , Bursitis/surgery , Cellulitis/drug therapy , Cellulitis/microbiology , Cellulitis/surgery , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Social Environment , SuppurationABSTRACT
Based upon their experience with treatment of 259 patients the authors have shown that purulent diseases are caused mainly by Staphylococcus aureus in combination with other microbes. The microflora of purulent wounds often was antibiotic-resistant. The duration of treatment is dependent on the character of the microflora.
