Cardiac arrest in acute myocardial infarction: its signs, the effect of resuscitation and outcome

A study of 585 patients with acute myocardial infarction (285 with and 300 without cardiac arrest) showed the two groups to differ significantly in terms of clinical, laboratory and electrocardiographic findings. Resuscitation effectiveness depended upon the form of cardiac arrest (chi 2 = 209.25; p less than 0.001). A stable resuscitation effect (survival within and beyond 28 days after the onset of acute myocardial infarction) was achieved in 78.4% of cases of primary ventricular fibrillation, 24.0% of cases of secondary ventricular fibrillation, and 4.9% of asystolia cases. All cases of electromechanical dissociation were fatal. Long-term follow-up showed that 17.3% of patients with cardiac arrest and 21.9% of patients without cardiac arrest died over 4 years (p greater than 0.05).     

The influence of piracetam on the effects of narcotic analgesics

In experiments on white male mice there was studied the influence of piracetam (250-300 mg/kg) on the analgesic effect of ligands of different types of opioid receptors (morphine, 7.5 mg/kg, DADLE, 7.5 mg/kg, pentazocine, 15 mg/kg) and also on the action of morphine concerning the cardiovascular system and respiration. Piracetam was shown to possess the antagonistic properties with respect to some effects of morphine, however they are not of the universal character and do not depend on the interaction with a certain type of opioid receptors.     

Status of the blood coagulation system in traumatic disease

Under examination there were 198 patients with severe mechanical traumas at their admission to the clinic and on the 1st, 3d, 7th, 14th and 21st days by 25 hemocoagulation parameters determined by common present-day methods. The direction and degree of hemocoagulation alterations were found to be related with the severity of trauma, blood loss volume and severity of shock. It was shown that disseminated intravascular coagulation (DIC) of the II and III degree was developing in critical associated traumas, massive blood loss and severe shock in acute period of the disease. The acute form of DIC with reactive fibrinolysis was established in the lethal outcome during the shock period, latent (slow) DIC with local fibrinolysis took place in lethal outcomes in later periods.     

Microbiology of adult cellulitis

Needle aspiration of cellulitis sites is commonly advocated to assist in the identification of causative organisms. Twenty-five nondiabetic, adult patients with a clinical diagnosis of cellulitis had site aspirations and blood cultures obtained before antibiotic therapy was initiated. Site cultures were positive in 6 of 25 patients. Blood cultures were positive in 4 of 25 patients. All organisms except one (Enterobacter agglomerans) were staphylococci or streptococci. The gram-negative bacilli were not believed to be a pathogen based on the patient's prompt response to nafcillin. In adult patients who do not have complications, the use of needle aspiration was not supported. Empiric treatment of cellulitis aimed at gram-positive cocci appears to be sufficient.     

An unusual neck lump: intramuscular haemangioma of the sternocleidomastoid muscle

Neck lumps can often present a diagnostic dilemma, with a wide pre-operative differential diagnosis. We present an unusual case of an intramuscular haemangioma arising in the sternocleidomastoid muscle. Pre operative diagnosis is often difficult, as these lesions are extremely rare in the head and neck region and only few sporadic cases have been reported in the literature. We report the presentation diagnosis and management of intramuscular haemangiomas of the sternocleidomastoid muscle.