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Relevance. Acute urinary retention (AUR) and associated arrhythmias negatively affect the prognosis of myocardial infarction (MI). Aim. To evaluate the features of heart rhythm and conduction disturbances and electrocardio-graphic changes in men under 60 years old (y.o.) with AUR in MI to improve understanding of the mechanisms of development and prevention. Material and methods. The study included men aged 19-60 years old with MI and AUR were studied. The patients were divided into two age comparable groups: I - study group, with AUR - 22 patients; II - control, without it - 644 patients. A comparative analysis of the fre-quency of observation of arrhythmias and ECG changes in the selected groups, analysis of the influence of various factors (Pearson's Chi-square) on the risk of arrhythmia in the study group were performed. Results. The study group was dominated by: ECG signs of enlargement of the left (I: 90.9 and II: 65.0%; p=0.03) and right ventricle (9.1 and 2.0%, respectively; p=0.03 ), sinus brady- (50.0 and 13.1%; р˂0.0001) and tachycardia (36.4 and 15.8%; р=0.01), asystole (36.4 and 1.9% ; p˂0.0001), atrial fibrillation and flutter (AF and AFl) (31.8 and 7.2%; p˂0.0001), complete atrioventricular (AV) blocks (27.3 and 2.5%; p˂0.0001), ventricular fibrillation (18.2 and 4.2%; p˂0.0001) and ventricular tachycardia (18.2 and 3.9%; p=0.001). For the de-velopment of arrhythmias in the study group, the most important were: smoking (absolute risk (AR): 85.7%; p=0.03); non-anginal variants of the disease course (AR: 89.5%; relative (RR) - 2.68; p=0.02); lower IM localization (100.0%; 1.57; p=0.03); overweight without obesity (100.0%; 2.0; p=0.01), duration ≥10 years (100.0%; 1.67; p=0.02); non-ulcerative digestive diseases (94.1%; 2.35; p=0.006). For the development of life-threatening arrhythmias (ven-tricular fibrillation and asystole) in the study group, arterial hypertension (AH) with a crisis course (66.7%; 6.3; p=0.02), penetrating lesions (33.3%; p=0.04) and body weight ≥110 kg or more (100.0%; p=0.0001). Conclusions. The men under 60 y.o. with AUR, MI are characterized by both life-threatening arrhythmias (ventricular fibrillation and tachycardia, complete AV block and asystole) and less dangerous its (AF and AFl). For the development of arrhythmias in MI and AUR, the fol-lowing causes were: smoking; nonanginal variants of MI; lower localization of the lesion; overweight without obesity for ≥10 years; non-ulcer digestive diseases. For the occurrence of life-threatening arrhythmias in MI and AUR, an additional role was played by: AH, obesity and penetrating lesions.
Relevance. Acute urinary retention (AUR) and associated arrhythmias negatively affect the prognosis of myocardial infarction (MI). Aim. To evaluate the features of heart rhythm and conduction disturbances and electrocardio-graphic changes in men under 60 years old (y.o.) with AUR in MI to improve understanding of the mechanisms of development and prevention. Material and methods. The study included men aged 19-60 years old with MI and AUR were studied. The patients were divided into two age comparable groups: I - study group, with AUR - 22 patients; II - control, without it - 644 patients. A comparative analysis of the fre-quency of observation of arrhythmias and ECG changes in the selected groups, analysis of the influence of various factors (Pearson's Chi-square) on the risk of arrhythmia in the study group were performed. Results. The study group was dominated by: ECG signs of enlargement of the left (I: 90.9 and II: 65.0%; p=0.03) and right ventricle (9.1 and 2.0%, respectively; p=0.03 ), sinus brady- (50.0 and 13.1%; р˂0.0001) and tachycardia (36.4 and 15.8%; р=0.01), asystole (36.4 and 1.9% ; p˂0.0001), atrial fibrillation and flutter (AF and AFl) (31.8 and 7.2%; p˂0.0001), complete atrioventricular (AV) blocks (27.3 and 2.5%; p˂0.0001), ventricular fibrillation (18.2 and 4.2%; p˂0.0001) and ventricular tachycardia (18.2 and 3.9%; p=0.001). For the de-velopment of arrhythmias in the study group, the most important were: smoking (absolute risk (AR): 85.7%; p=0.03); non-anginal variants of the disease course (AR: 89.5%; relative (RR) - 2.68; p=0.02); lower IM localization (100.0%; 1.57; p=0.03); overweight without obesity (100.0%; 2.0; p=0.01), duration ≥10 years (100.0%; 1.67; p=0.02); non-ulcerative digestive diseases (94.1%; 2.35; p=0.006). For the development of life-threatening arrhythmias (ven-tricular fibrillation and asystole) in the study group, arterial hypertension (AH) with a crisis course (66.7%; 6.3; p=0.02), penetrating lesions (33.3%; p=0.04) and body weight ≥110 kg or more (100.0%; p=0.0001). Conclusions. The men under 60 y.o. with AUR, MI are characterized by both life-threatening arrhythmias (ventricular fibrillation and tachycardia, complete AV block and asystole) and less dangerous its (AF and AFl). For the development of arrhythmias in MI and AUR, the fol-lowing causes were: smoking; nonanginal variants of MI; lower localization of the lesion; overweight without obesity for ≥10 years; non-ulcer digestive diseases. For the occurrence of life-threatening arrhythmias in MI and AUR, an additional role was played by: AH, obesity and penetrating lesions.
Relevance. Changes in the quality of life associated with heart failure (HF) in young and mid-dle-aged men with urological pathology and myocardial infarction (MI) are not well under-stood. Aim. To evaluate changes in the quality of life (QL) indicator associated with heart failure (HF) in men under 60 years old with MI and acute urinary retention (AUR) to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I MI. Patients are divided into two age-comparable groups: I - the study group, with AUR - 22 patients; II - control, without it - 633 patients. A comparative analysis of the QL indicator associated with HF (HFQL) (V. Ironosov) was performed in the selected groups in the first 48 hours (I) and at the end of the third week (II) of MI. The changes and correlations (C. Spearmen) of HFQL with clinical features, metabolic parameters, central and peripheral hemodynamics were studied. Results. HFQL in patients with AUR (85.7±15.6%) was worse than in the control group (59.4±20.1%; р˂0.0001) in the first hours of MI. At the end of the third week of the disease, no differences between the groups were observed (24.3±11.9 and 18.6±11.9%, respectively; p = 0.06). A positive (72 and 69%) dynamics of HFQL were obtained from the first hours to the end of the subacute MI period in both patient groups (р˂0.0001). In the study group, signifi-cant correlations of HFQL with the size of the left heart chambers, parameters of left ventricle systolic and diastolic function, peripheral hemodynamic, and lipid metabolism parameters were revealed. In the control group, more correlations were found, but their strength was less. Conclusions. The quality of life associated with HF is worse in patients with AUR during the first hours of MI. Dilatation of the left heart chambers, left ventricle systolic and diastolic dys-function, no history of arterial hypertension, and hypocholesterolemia were the most associat-ed with quality of life in the study group. The assessment of HF-related quality of life is use-ful as an adjunct to the examination of patients with MI, starting from the first hours of the disease, for early identification of risk groups for adverse events and chronic HF formation.
When taking blood from a vein for laboratory tests, nurses may have situations related to the use of vacuum systems (VS) from different manufacturers. Most often this is due to the requirements of tender purchases, when vacuum containers (VC) and double-sided needles are placed in different LOTs. To understand the depth of the problem, we developed a questionnaire and conducted an online survey of 188 nurses of hospitals in Moscow, which showed that almost half of the respondents (42.2%) experienced difficulties related to the compatibility of components from different manufacturers, which negatively affected the test results, increased direct and hidden costs of the medical organization. The authors analyze the results of the survey and give recommendations on how to avoid such problems: use components of vacuum blood collection system from one manufacturer or, if this is not possible, conduct compatibility testing of the components before use. The authors suggest ways to check for compatibility, referring to domestic and international recommendations. These measures will ensure safer and more effective venipuncture
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