[Analysis of cardiovascular complications occurring during inter-hospital transfers of patients with non-ST elevation myocardial infarction]. / Étude des complications per-transfert interhospitalier des patients présentant un syndrome coronarien aigu sans élévation du segment ST.

AIM OF THE STUDY: Patients with non ST-segment elevated acute coronary syndrome justify specific management in a hospital with an Intensive Cardiac Care Unit. In our area, these transfers are often provided by the Emergency Medical Service. Nevertheless we wonder whether a quasi-systematic medicalization of these patients is rational. PATIENTS AND METHOD: We tried to authenticate the need for medicalization of these patients through a prospective study including any patient with acute non-ST elevation Coronary Syndrome managed in one of the peripheral hospitals of the area and transferred to the major hospital center in La Roche-sur-Yon. We noted all the complications that occurred during the transfer and, if need be, when these complications required medical intervention. RESULTS: Out of 226 patients included, 19 had a complicated form of acute non-ST elevation Coronary Syndrome. Out of the remaining 207 patients, 16 (7.7 %) showed a complication during their transfer, 5 of which underwent a medical intervention, none of which was immediately vital. Nevertheless, the statistical analysis did not highlight any significant worsening factors. CONCLUSION: The low rate of complications occurring during the transfer of initially stable patients encourages us to limit our indications of medicalization in favour of only the unstable patients or having a complication of their non-ST elevation acute coronary syndrome.

Virtual Resonant Emission and Oscillatory Long-Range Tails in van der Waals Interactions of Excited States: QED Treatment and Applications.

We report on a quantum electrodynamic (QED) investigation of the interaction between a ground state atom with another atom in an excited state. General expressions, applicable to any atom, are indicated for the long-range tails that are due to virtual resonant emission and absorption into and from vacuum modes whose frequency equals the transition frequency to available lower-lying atomic states. For identical atoms, one of which is in an excited state, we also discuss the mixing term that depends on the symmetry of the two-atom wave function (these evolve into either the gerade or the ungerade state for close approach), and we include all nonresonant states in our rigorous QED treatment. In order to illustrate the findings, we analyze the fine-structure resolved van der Waals interaction for nD-1S hydrogen interactions with n=8, 10, 12 and find surprisingly large numerical coefficients.