RÉSUMÉ
During a two year period, general practitioners in a local area were called to all 112 alarms (the number dialled in Denmark in emergencies) in order to improve the prognosis of patients with cardiac arrest. In 55% of the calls, the practitioners arrived within five minutes, whereas the ambulance arrived within five minutes in only 16% of the cases (p < 0.01). Three of ten patients with cardiac arrest survived without cerebral damage. In 23% of the cases final treatment was completed by the local practitioner.
Sujet(s)
Services des urgences médicales , Arrêt cardiaque/thérapie , Médecins de famille , Adolescent , Adulte , Sujet âgé , Enfant , Enfant d'âge préscolaire , Danemark , Femelle , Arrêt cardiaque/mortalité , Humains , Nourrisson , Mâle , Adulte d'âge moyen , Projets pilotes , Pronostic , Études prospectives , Population rurale , Facteurs temps , EffectifRÉSUMÉ
Eight patients with mild heart failure were treated in random order for 1 week with 2 mg bumethanide at 0800 and 1200 (treatment 1) h, 1 mg bumethanide at 0800, 1200, 1800, 2200 (treatment 2) and 5 mg bendroflumethiazide at 0800 and 1800 (treatment 3) h. The 'quality of life' did not differ significantly between the three treatment periods. At the presumed trough of the diuretic effect the circulating blood volume was largest during treatment 1; it was 6.3% smaller during treatment 2 (P < 0.02) and 6.7% lower during treatment 3 (P < 0.05). In comparison with treatment 1, the maximal increase in rate-pressure product during physical exercise was 24.6% higher in treatment 3. Compared with treatment 1 the area under the curve (AUC) for plasma lactate during physical exercise was 14% lower during treatment 2 (P < 0.05) and 18% lower during treatment 3 (P < 0.01). These findings suggest that the type of program for diuretic therapy influences the magnitude of inevitable diurnal fluctuations in body fluids, the ability of the heart to work and the ability of the body to adjust to the oxygen demand.
Sujet(s)
Diurétiques/usage thérapeutique , Défaillance cardiaque/traitement médicamenteux , Sujet âgé , Sujet âgé de 80 ans ou plus , Bendrofluméthiazide/administration et posologie , Bendrofluméthiazide/usage thérapeutique , Volume sanguin/effets des médicaments et des substances chimiques , Bumétanide/administration et posologie , Bumétanide/usage thérapeutique , Rythme circadien , Diurétiques/administration et posologie , Calendrier d'administration des médicaments , Exercice physique/physiologie , Femelle , Défaillance cardiaque/sang , Défaillance cardiaque/physiopathologie , Humains , Lactates/sang , Acide lactique , Mâle , Adulte d'âge moyenRÉSUMÉ
The blood volume can be measured after labelling of red blood cells with technetium-99m. In addition, the blood volume and its standard error of estimate can be calculated from the subject's sex, height and deviation from desired weight. By comparing the measured blood volume with the estimated normal blood volume and using a statistical test, it can be decided whether a measured blood volume is normal or not. This method was applied to a group of 36 patients with heart diseases. Four of the patients had abnormal blood volumes. In the remaining 32 patients the measured blood volumes were equally distributed around the estimated mean normal values. The method described for determination of normal/abnormal blood volumes can be considered a by-product of routine radionuclide cardiography.