Prevalence of secondary hypertension in a population sample of Swedish women

In a comprehensive population study of 1462 women aged 38–60in Goteborg, Sweden, the prevalence of secondary hypertensionwas estimated to be 0.8% of the total population sample and4.6% of those who were hypertensive (defined as systolic bloodpressure > 160 mmHg or diastolic blood pressure > 95 mmHgor both or antihypertensive treatment irrespective of bloodpressure levels). These figures were based on thorough clinicaland laboratory investigations and a follow-up period of 12 years.Women with arterial hypertension reported a history of toxaemiaof pregnancy and a family history of hypertension more oftenthan non-hypertensive women. In comparison with non-hypertensivewomen, in both untreated and treated hypertensive women, serumuric acid, urinary methoxycatecholamine excretion, body weightand the prevalence of albuminuria were increased and serum potassiumdecreased (statistically significant differences).     

Surgery as an Effective Nonpharmacological Mode of Treatment of Atrial Fibrillation Resistant to Standard Therapy

There are two surgical methods for atrial fibrillation (AF) treatment: Maze and corridoring procedures. The first one prevents AF occurrence by performing multiple atriotomies. During the second procedure a corridor between a sino-atrial and the AV node is created together with an electrical isolation of the atria. During 1992 and 1993 seven patients, aged 27–55, mean 43-years-old, with recurrent, resistant to standard therapy AF were referred for surgical treatment to our department. Additional diagnoses include: concealed WPW syndrome in 1 patient, atrial septal defect (ASD) in 3 patients, coronary artery disease in 1 patient. Maze procedure was performed solely in 1 patient, in another together with 2 accessory pathways ablation, in 3 patients with ASD closure and in 1 patient with 2 bypass grafts. In one patient corridoring procedure was performed. Normal sinus rhythm was restored in every patient from 7 to 26 days after the procedure, No surgical complications were noted during the postoperative period. Mechanical function of the atria was documented with echo Doppler 2–6 weeks after the operation. No evidence for AF recurrence was noted within 3–14 months (mean 5 months) of follow-up. The preliminary results of Maze and corridoring procedures are encouraging.     

Does the Change of the Polarity of Electrodes Influence the Results of Transoesophageal Bidirectional DC Cardioversion?

The aim of the study was to compare the bidirectional transoesophageal DC cardioversion (BOC) with unidirectional transoesophageal DC cardioversion (UOC) and to evaluate, if the reversion of the polarity of electrodes alters the effectiveness and the amount of energy during BOC. UOC was attempted in 300 patients (pts) with atrial fibrillation (AF) and BOC in 241 pts with AF. In UOC mode shocks were delivered between the 4-ring oesophageal electrode (cathode) and the chest pad (anode) positioned in the precordial region. In BOC shocks were delivered between the same oesophageal electrode and two chest pads joined with each other, positioned on both sides of the sternum. First 147 pts were cardioverted with the oesophageal electrode as a cathode, next 94 with an anode in oesophageal position. The effectiveness of both modes (UOC and BOC) was very high, however in pts with chronic AF success rate was better in BOC approach (82% vs 100%). BOC, compared with UOC, allowed to decrease the threshold defrbrillation signifrcantly: in pts with recent onset of AF from 61,5 J to 33,3 J and in pts with chronic AF from 99,8 J to 75,2 J. In pts with long standing AF the reduction of the defrbrillation threshold was statistically not significant (from 68,6 J to 50,6 J). The effectiveness of BOC was also very high independently of the polarity of electrodes. The change of the polarity did not affect the minimal and total successful energy of shocks, too. In pts with oesophageal electrode as a cathode defibrillation threshold was 48,4 J and in pts with the anodal electrode 43,7 J. In conclusions we found BOC as a very effective method in pts with AF. Defibrillation threshold in BOC is lower than in UOC and the polarity of electrodes does not influence the success rate and successful energy.     

LACK OF EFFECT OF ACETALDEHYDE ON THE CARDIOVASCULAR SYSTEM IN RATS

The present study was destgned to evaluate the kinetics of acetaldehyde(ACT) and its action on the cardiovascular system in rats. ACT(3, 6, 12 mg/kg i.p.) causes accumulation of this metabolitein the blood, at a concentration corresponding to that obtainedfrom ethanol metabolism after its administration in doses of1, 2, 4 g/kg p.o., respectively. After intraperitoneal injectionof ACT there were no significant changes in blood pressure andheart rate in comparison to the control group. It appears that,in rats, ACT has no influence on the function of the cardiovascularsystem after the ingestion of ethanol.     

ASSESSMENT OF DIAZEPAM LOADING DOSE THERAPY OF DELIRIUM TREMENS

The efficacy of the diazepam loading dose method of treatmentof delirium tremens was assessed in comparison with the traditionaltherapy. The experimental group and the control group comprised51 and 45 patients respectively. The clinical institute withdrawalassessment for alcohol (CIWA-A) scale was applied to assessthe intensity of the symptoms. Diazepam doses in the experimentalgroup oscillated from 40 to 210 mg (mean 86.9±47.2 mg).The control group was receiving diazepam and other psychotropicdrugs in divided doses. In the experimental group deliric symptomswere present from 2 to 24 h (mean 6.9±4.8 h), and inthe control group from 2 to 123 h (mean 33.8±25.7 h).The results show a large efficacy of the loading dose methodcorresponding to substantial reduction of the psychosis duration(fivefold in comparison to the control group). The method provedto be safe, with no significant complications.