In a retrospective analysis, the efficacy of lysis, the degree of systemic thrombolytic effect, and the rate of complications during local thrombolytic therapy with either streptokinase (SK) or urokinase (UK) were compared in 47 patients. There were 24 infusions of each agent; one patient in the UK group received two infusions. The overall efficacy of lysis was better in the UK-treated group (80% vs. 63%). The UK group had a lower frequency of systemic thrombolytic effect and of bleeding complications. SK antibody titers were measured in all patients who received infusions. Patients with high titers who were treated with SK responded poorly (20% lysis); patients with low titers responded at a rate equal to that of UK-treated patients. Three patients with high titers of SK antibodies did not respond to SK, but subsequent successful lysis did occur with UK. In conclusion, UK is believed to be preferable to SK for local thrombolytic therapy due to increased efficacy of lysis and decreased rate of systemic fibrinolytic effect and bleeding complications.
Objective:
Due to recent publications a magnesium deficiency in elderly is up to 50%, depending on co - morbidity, drugs and nutritional status. On the other hand it is well known that a magnesium insufficiency is a pathogenetic factor in the development of hypertension. In this context calcium magnesium antagonism, sodium magnesium antiport, disturbed vitamin D metabolism or disturbed magnesium channels are of special interest.
In this context magnesium metabolism was of interest in elderly hypertensives. Ionized magnesium is the active form and was measured additionally.
Design and method:
We studied 45 essential hypertensive patients with normal renal function. None of the patients received diuretics or magnesium. No diabetics were included. The age of patients was beyond 65 years, 23 persons were male, 22 female.
Measurements of magnesium were performed either in serum (Cobass, Roche, Germany) or ionized in blood (NOVA, Rödermark, Germany).
Results:
In serum magnesium concentrations only 1 person had values below 1.5 mg/dl, all other elderly hypertensives had a normal serum magnesium concentration.
In contrast ionized magnesium concentrations was significantly decreased in 12 of 45 patients, showing values below 0.5 mmo/l (p < 0.0)1, that is about 27%.
In addition, no correlation between total serum and ionized blood magnesium exists (ns, Pearson or Spearmann rank test, p value 0.91 and 0.41).
Blood pressure was controlled and below 150/90 mmHg.
Conclusions:
There is no correlation between serum and ionized blood magnesium content. This is of special importance as a normal serum magnesium content doesn‘t exclude a deficiency of ionized magnesium. As ionized magnesium is the vasoactive form of magnesium in the body and acts on vessels, it is mor useful to determine ionized magnesium concentrations in assessing body magnesium stores.
In elderly hypertensives under blood pressure control nearly 27% showed an ionized magnesium deficieny despite normal serum magnesium values.
The European Cardiac Resynchronization Therapy Survey II is the second CRT survey of the Heart Failure Association and European Heart Rhythm Association designed to observe implantation and follow-up practices across European countries. These data allow, for the fi rst time, a valuable insight on CRT implantation strategies for Romanian patients.
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