[META-ANALYSIS OF CLINICAL STUDIES ON THE USE OF STATINS FOR PREVENTION OF ATRIAL FIBRILLATION SOON AFTER CORONARY BYPASS SURGERY].

BACKGROUND: Atrial fibrillation (AF) develops in the early postoperative period in each third patient undergoing coronary bypass surgery (CBPS). Multifactorial pathogenesis of postoperative AF is unclear. The concept of postoperative inflammation as a potential basic mechanism of this condition has been implied in many studies. Pre- and postoperative treatment with antiinflammatory statins proved beneficial as a means for reducing the frequency of AF. MATERIALS AND METHODS: The meta-analysis is based on the results of 15 clinical studies carried out in the last 15 years. They included 9369 patients of whom 5598 (59.75%) used statins and 3771 (49.25%) did not receive them. The following endpoints were evaluated in the early postoperative periods: fiequency of AF, overall lethality, frequency of cerebral circulation disorders and myocardial infarction. Odds ratio (OR) and 95% CI were calculated, levels of inflammation markers before and after surgery and duration of hospitalization were determined. RESULTS: Statins decreased the frequency of AF soon after CBPS (OR 0,481 at 95% CI 0,345-0,672; p = 0,000), they did not influence overall lethality (OR 0,837 at 95% CI 0,501-1,399: p = 0,497) and frequency of myocardial infarction (OR 1,001 at 95% CI 0,702-1,426; p = 0,997), but decreased frequency of cerebral circulation disorders (OR 0,067 at 95% Cl 0,037- 0,121; p = 0,000). Also, they reduced duration of hospitalization and serum levels of inflammation markers. CONCLUSION: Results of clinical studies available to date leave no doubt that statins produce anti-inflammatory and anti-arrhythmic effects. Meta-analysis of relevant studies confirmed on the whole the positive role of statin therapy prior to CBPS.

Non-invasive evaluation of the kinematic activity of the intact left ventricle of the heart.

Vector analysis of the movement of the epicardium has been used to calculate the energy efficiency of different parts of the left cardiac ventricle. The protocol based on the results of these calculations would allow the calculation of the potential power of myocardial contraction.

[The history of Wolf-Parkinson-White syndrome and evolution of surgical methods for its management].

Wolf-Parkinson-White syndrome (WPW syndrome) affects roughly 1% of the population. It usually occurs in subjects with normal heart function but may combine with congenital cardiac failure and cardiomyopathy. Paroxysmal tachycardia is recorded in 40-80% of he WPW patients, largely in the form of reciprocal tachycardia related to circulation of excitation in the atrioventricular junction and Kent's bundle. Development and improvement of surgical methods for the management of supraventricular tachycardia became possible with the advent of transcatheter registration of electrical activity in different heart regions and programmed heart stimulation techniques. Catheter-assisted methods for the treatment of cardiovascular disorders including arrhythmia have been extensively used in recent decades. Transvenous fulguration is one of them replaced at present by radiofrequency ablation (RFA). The discovery of WPW syndrome made possible a new approach to the the problem of sudden death in young age. Treatment of this syndrome by RFA of additional atrioventricular junction in the last 20 years permitted not only to manage the syndrome itself but also to ensure practically complete recovery of the patients.

[Satisfaction of patients hospitalized in Ho Chi Minh City, Vietnam]. / Satisfaction des patients hospitalisés à Hô Chi Minh-Ville, Viet Nam.

This study aims to describe the level of satisfaction of patients and their families, according to the type of hospital and the sociodemographic characteristics of patients hospitalised within Ho Chi Minh City (HCMC), Vietnam. The study is supported by a sample of 538 patients and their families from all of the hospitals in HCMC to whom an evaluation questionnaire was given to be filled out on the day of their release. The average age is 39, and 64.4% are women. The scores measuring the level of satisfaction vary from 57.7 to 90.7 points (on a scale of 0 to 100). The section under the heading "treatment provided by the doctors" received the highest scores (90.7/100). Dissatisfaction was primarily associated with factors such as the amount of time spent waiting, the behaviour of the hospital staff, cleanliness, the cafeteria and parking for motorbikes. Almost 100% of the patients spoke about their experiences during their stay in the hospital, and 50.2% had some negative opinions (1.042 complaints registered). The older patients, having a lower level of education and living either in other cities or in the rural region of HCMC, tented to be more satisfied than the younger patients, possessing higher levels of education and generally residing in the sub-urban or urban regions of HCMC. The patients who judged their condition to be very serious and their problems bad enough to justify hospitalisation, and who also felt that their health and condition had improved at the time of release compared to the time of admission were more satisfied than the other patients. Patients hospitalised who had an individual private room in a specialised hospital tended to be more satisfied that those who had a room sharing many beds for several patients in either a general hospital or in the emergency area of a specialised hospital. The authors observed no correlation between the level of satisfaction and the patient's gender. The results of this study have highlighed that certain domains, notably hat of the hospital's environment, should be reviewed and examined by health care administrators and managers in order to ensure the quality of the patient's care and coverage.