These data suggest that mortality rates could be reduced by a change in focus of the National Health Service toward an emphasis on primary rather than secondary prevention and associated clinical interventions. The greatest priority should be placed on reducing the incidence of heart disease by aggressively improving primary prevention.
Macrophages elaborate both effector and regulatory immune functions. It was hypothesised that tumours can exert a local alteration of macrophage function. Murine peritoneal macrophage‐derived cytokines were assayed in the presence and absence of cells, cytosol fractions or conditioned media (TCCM) from established murine tumour lines. Interleukin‐1β, interleukin‐6 and tumour necrosis factor‐α activities were significantly inhibited by tumour cells or their products, as were the corresponding recombinant human cytokines. Intracellular protein kinase C activation was also measured and was significantly inhibited by murine TCCM, thus suggesting one possible site of inhibitor action. Data analyses indicate that the inhibitory factor(s) is probably not an already well‐characterised macrophage inhibitor.
Postoperative atrial fibrillation is one of the most recognised complications of cardiac surgery. Although its exact pathophysiology remains unknown, evidence suggests that it is multifactorial and that it directly affects patient outcomes post cardiac surgery. It is associated with an increased risk of heart failure, renal failure, stroke and mortality. Pharmacological agents such as beta blockers and antiarrhythmic drugs are well established and extensively used for both the prevention and treatment of postoperative atrial fibrillation. This article will explore the pharmacological treatment of postoperative atrial fibrillation with specific reference to metoprolol and amiodarone, along with the pharmacokinetic and pharmacodynamic effects of both drugs. It will briefly discuss the evidence reviewed regarding the effectiveness of these drugs for postoperative atrial fibrillation and the recommendations from the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery on how postoperative atrial fibrillation should be treated.
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