Arrhythmias following cardiac valve replacement

A prospective study of 50 consecutive patients undergoing cardiac valve replacement was designed to determine the incidence, types, and predisposing factors to postoperative arrhythmias. Patients were monitored continuously for the first 7 days following surgery.

Thirty-seven patients (74%) experienced a total of 66 episodes of arrhythmia. Supra-ventricualr arrhythmias were the most common (43 of 66; 65%). The most frequent specific arrhythmia was atrial fibrillation (21 of 66; 32%). Arrhythmias occurred 77% of the time within the first 48 hours of surgery.

Of 25 factors evaluated preoperatively in each patient, only two were found to predispose to postoperative arrhythmias. These were: (1) previous cardiac surgery; and (2) elevated blood urea nitrogen.

There were four hospital deaths, representinig a hospital mortality of 8%. No deaths were due to a primary arrhythmia.

It is concluded that whereas arrhythmias are a very common complication of cardiac valve replacement, early detection and treatment has lessened their significance as a cause of postoperative mortality and morbidity.

Neurosis and marital interaction. 3. Family roles and functions

In this paper we consider another aspect of the marriages of male neurotic patients and their wives, namely the pattern of role-playing within the marriage and the family. Though no formal predictions were made regarding the differences that might be found between the marriages of the patient and control groups, it was hoped that examination of the role-activity patterns would illuminate the data already reported in Part I and II on health, personality, time-sharing and social activity.

Neurosis and marital interaction. IV. Manifest psychological interaction

One of the many possible ways of obtaining information about the marital relationship is by observing the marital partners together, a procedure being increasingly used in clinical practice. Little is established, however, for either clinical or research purposes, about how such observations may be ordered, with what reliability they can be made, or how they relate to other aspects of marital function and to the psychological health of the partners. This paper is concerned with just such issues.

A case of self-poisoning with Carbrital

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