Medical transcriptions provide their services in clinics, hospitals, physician offices, insurance companies, transcription services, home healthcare agencies and other places where medical documentation requires transcription.

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Vitamin C can eliminate all violations of circulation associated with prolonged smoking. At least, as demonstrated by American scientists, its daily admission restores normal blood flow characteristics in the heart muscle.

According to their results to eliminate the consequences of smoking, smokers should take about 2 grams of vitamin C per day. Only such a dose is able not only to restore normal physiological indicators of blood circulation is normal, but also improve the ability of the heart and vessels to carry the physical loads.

However, it should be noted that the results of this study are contrary to data obtained in the course of other works. Thus, only in the last 2 years in the medical literature has published several articles whose authors argued that in similar cases, not enough vitamin C is effective. Therefore, do unambiguous conclusions still too early…

Not only red wine, which is known benefits, but also other types of alcoholic drinks are very useful for the heart. In moderate quantities, they reduce the likelihood for cardiovascular disease, as well as accelerate the restoration of the cardiovascular system after heart attacks and strokes. That is the conclusion reached scientists from the University of Missouri.

By studying the effects on laboratory animals ethanol at blood vessels, scientists drew attention to the fact that it reduces the cells in the walls of their protein R-selektina. This protein has been actively involved in the development of inflammatory reactions, developing, for example, when atherosclerotic vascular injuries or heart failure caused by myocardial infarction.

According to researchers, this effect will manifest itself and at the level of the whole organism, that is, alcoholic beverages theoretically can be used for prevention of cardiovascular diseases and their complications. But scientists warn that ethanol has and other effects, including unfavourable to the body (such as liver damage and loss of nerve cells), so it is unlikely to put one of the drugs.

Love - and be healthy!

Everyone wants to avoid such cardiovascular diseases like heart attacks and angina. A fallacy to think that only sick heart requires attention and care. Of course, if the heart sick, the person must treat it carefully and comply with doctor's advice. It does not need to overload, it should seriously worry. But a healthy heart requires care and attention, only a few other nature. Cautious attitude to the cardiovascular system does not mean that everyone should be afraid of excess traffic and at every level staircase. On the contrary, the heart must be trained, particularly smolodu, and this is achieved through physical exertion. However, British doctors made the pleasant discovery. In order not to fall into the hands eskulapov need to love and be loved.

Such interesting conclusions were made by scientists based on the results of their research and surveys of 600 people who have experienced myocardial infarction. By studying people's lives (re-registration of cases of heart attacks, the attitude with other people) throughout the year, after hospitalization. Excluding such factors as "unhealthy lifestyle", low mobility, smoking, the possibility of recurrence of illness linked to how people are around, and how they relate to it. The strength of attachment greatly affects the possibility of re-entering the hospital, reducing the possibility of doing so by 50 per cent, "sudden heart death by 70 percent.

Psychologists who processed the results of this study are not surprised such results. A stable psyche, in their view, this is an obstacle to cardiovascular disease. People who do not feel alone and not prone to depression are much less suffering from heart pains, unlike the single and overly emotional people.

MAGNITNO - REZONANSNAYA (MR) TOMOGRAFIYA. The basis of the method is the ability of atomic nuclei, placed in a magnetic field, radiate energy with a certain characteristic only this element, frequency. In research for medical purposes increasingly using hydrogen nuclei resonance radiation. In doing so, the signal intensity to a large extent depends on the water content in the examined tissue. Resonance radiation through a computer translates into high tomographic image. Perhaps study the entire body. Bone tissue is not delaying the signal. Resolution of about 1 cm

Unlike other existing methods of MRI, especially in modulating the nuclei of different elements, allows judged not only on structural change, but also the local chemical features (acidosis, the lack of certain enzymes, edema, ischemia, etc.). The study is noninvasive and is not associated with ionizing radiation.

The real diagnostic value method when examining patients with heart requires clarification. It provides information on anatomical, physiological and biochemical features of the heart, helps in recognition of vascular aneurysms, make for a picture of blood flow in large vessels and even the movement of drugs in them.

The disadvantages method, in addition to the extremely high cost of equipment include the inability to examine patients with metal implants and postoperative clip (which are heated in a magnetic field), in particular, patients with pacemakers, which function in a magnetic field can be violated.

KATETERIZATSIYA HEART AND ANGIOKARDIOGRAFIYA. Introduction rentgenokontrastnogo substance in the heart or blood vessels, followed by x-ray (perhaps with obtaining series rentgenogramm at short intervals) makes it possible to obtain quantitative information about important anatomical and physiological characteristics of heart and is widely used in the selection of patients for surgical treatment. To conduct the study requires special equipment and highly qualified staff, his serve in some specialized cardiological surgery and institutions.

Angiokardiografiyu always conducted simultaneously with cardiac catheterization, which in itself provides important diagnostic information. It helps determine the pressure in the cavities, to obtain blood for analysis directly from the heart chambers, and if there is special equipment - to determine Cardiac Output, for example termodilyutsii method, to comply vnutriserdechnoe elektrofiziologicheskoe study endomiokardialnuyu biopsy.

Below are some upper limits rules indicators obtained from cardiac catheterization: pressure in the right predserdii 6 mm Art. Art. (average), in the right ventricle 30 / 7 mm Art. Art., in the left 145/12 mm Art. Art. in the pulmonary artery 30/14 mm Art. Art., Shim pressure in the pulmonary artery branches 12 mm Art. Art. (average), Cardiac index 2,4-3,8 l min-1 m-2, arteriovenous difference in oxygen 3,5-5 ml / dl, pulmonary vascular resistance din with 250 cm-5.

Right-heart catheterization divisions technically easier, it is usually carried out through the subclavian vein. Under the supervision of X-ray catheter can be predserdie move to the right, the right ventricle, lung artery to branched 3-4 - th order (which is defined Shim pressure). Introduction contrast substance at various levels (that is, selectively) helps to understand birth defects defeat trikuspidalnogo heart valves and valve pulmonary artery, a blood clot in the pulmonary artery, constrictive pericarditis.

Left cardiac catheterization departments often carry out through the femoral artery with a catheter advance against the current blood on the left ventricle to the aorta. Angiokardiografiya reveals flaws and anomalies aorta (including the aorta aneurysm and sinus Valsalvy, to delaminate aneurysm, sub-and supravalvulyarny stenosis) and left-wing divisions of the heart, left ventricular aneurysm, of a blood clot, and a blood clot in the left predserdii mix. Suffice detail can be determined hemodynamic performance left ventricle, in particular faction release, end systolic and diastolic volumes, the shunt, the expression regurgitatsy etc.

Koronarografiya is widespread. Currently in our country carry out its increasingly patients with IBS set for a decision regarding the need and possibility of surgical treatment (aortokoronarnoe bypass or coronary artery dilatation cylinders). Through the catheter, introduced in femoral artery and advanced proximal directly in the mouth of each coronary artery impose 5-10 ml contrast substance. Multiple rentgenogrammy on film will give quite a complete picture of the anatomical features and patency of the coronary bed, the status of the collaterals. Introduction ergonovina during the study provides an opportunity to register a local koronarospazm vazospasticheskoy in patients with angina.

Koronarografiya - invasive procedures associated with some risk. During the procedure, and in the next 48 hours are possible embolism receptacles great circle, myocardial infarction and death of a patient. In imposing ergonovina risk increases. Introduction contrast substance may complicate anafilakticheskoy reaction worsen renal function. Radiation pressure higher than ordinary X-ray study. The frequency of severe complications in laboratories with strong experience in koronarografii amounts per share.

MEASURING SERDECHNOGO VYBROSA. Under cardiac output understand amount of blood, throws one of the ventricles in the heart unit of time (in emission standards from both ventricles same). This figure is expressed as a minute amount (MO - The volume of blood, heart ventricle emitted within 1 min), cardiac index (MO, calculated at 1 m2 of body surface) and systolic volume (volume of blood, emitted during sistoly ventricle). Cardiac release of a person calculated on the basis of indirect data. A study conducted in a substantive exchange and, if necessary - after functional loads.

Cardiac release along with other important parameters are now increasingly determined using echocardiography (more accurately - dopplerehokardiografii), as well as angiokardiografii, radioisotope techniques of cultivating an indicator.

Definition of cardiac output should be mainly in intensive care units for some hard myocardial infarction patients with unstable hemodynamics, as well as before surgery intervention.

FONOKARDIOGRAFIYA - graphic method of registration of heart tones and noise. Modern fonokardiograf registers sound symptoms in the range of 15-1000 Hz. Using filters emit high and low-frequency components of sounds, as well as provide them with such a characteristic frequency, which is most consistent with the perception of sound man, that is comparable to auskultativnym impressed.

Fonokardiograf usually a multi-device electrocardiographs. Use of piezoelectric microphone, recording on moving paper. Mandatory synchronous record ECG. A study conducted in the usual position of a patient lying on his back with a delay of breath. The microphone recorded in the standard locations auskultatsii hearts or in the space referred to the doctor.

Fonokardiografiya allows clarify and sound obektivizirovat symptoms, correct noises and tones correlate with the phases of cardiac cycle (even against the backdrop of tachycardia), to determine the shape and duration of noise, some important time intervals: the interval Q - I tone, II tone - the tone for the opening of mitral valve, the expression and stability of splitting II tone, etc.

The amplitude (volume) sound - poorly reproduced fonokardiograficheskaya characteristic, depends in part on the vneserdechnyh conditions, regulations and forces pressed the microphone, that is Registration of conditions that are difficult to standardize. Sometimes amplitude noise estimate comparing with the amplitude I tone. But actually compare the volume of noise, recorded from different points or fonokardiogrammah different, insecure.

With regard to the identification of pathological noises, then, based on experience, it can be assumed that the sensitivity fonokardiograficheskogo method is not higher than medical auskultatsii. The latest in this respect more informative, as an experienced doctor listens to a greater number of points, changing the position of the patient, takes into account individual topographical features, the possible spread of noise and other factors.

EHOKARDIOGRAFIYA - method study of heart and major vessels, based on the reflection of ultrasonic signal. Used probe containing crystal capable of creating piezoelectric effect. Alternating current produce in a crystal ultrasonic radiation with a frequency of 2-5 MHz. The same crystal perceives reflected signal. Thus, the crystal works alternately as a source and receiver, altering its function once in 1000 to 1. Surveyed lies on his back. The sensor is placed on the chest, over the intercostal interval, press tightly to the skin. Ultrasound beam sent to the heart. The depth of its penetration reaches 21 cm partial reflection of the beam happens to the surface, separating environment with different densities (these surfaces should be roughly perpendicular to the direction of the beam). Reflected signal, transformed the computer, gives a calibrated screen or paper picture of moving cardiac structures. Resolution of about 2-3 mm.

Modern echocardiography allows the use of 3 mutually complementing each other modifications ehokardiograficheskogo study.

One-dimensional echocardiography (M-scanning) gives a detailed picture over time, created by ultrasonic waves reflected along the same lines, one beam. When changing tilt sensor or its provisions can be adequately investigate the structure of the heart during diastole sistoly and, to measure wall thickness, to assess the state of the valves, to determine the heart chambers (and on this basis to calculate the Cardiac Output) , Speed reduction and relaxation. Modifying characterized by high temporal resolution.

Two echocardiography (V-scanning) gives dvuhmernoe clear how tomographic image of moving structures at varying depths, in the sector with the angle of 60-90 °. Modifying permit a broad morphological and physiological description of the working heart, has a particularly high spatial resolution. When most of heart disease it is more informative.

Dopplerehokardiografiya - the study of blood flow, based on the fact that the frequency of continuous (not pulsed) ultrasonic waves reflected from erythrocytes, respectively, changing direction and speed of blood. This modification gives an impression of uniformity, direction and strength vnutriserdechnyh blood flow, which is important to diagnose ills and shunt, evaluation vnutriserdechnoy hemodynamics, the definition of cardiac output.

Has the standard position sensors ( "ehokardiograficheskie window") to systematically, consistently explored all the structures of heart. The study can be documented photographer, is usually stored in parallel with the EKG.

Echocardiography extremely useful in any of heart disease and large vessels. Method vysokoinformativen, neobremenitelen and relatively safe for the patient, has no contraindications, gives a good play, quantify the results, it is completely characterize the anatomical and functional features of the working heart. With the availability of its need to use at different stages of the survey, including the earliest.

Lung emphysema, as well as narrow intercostal intervals may impede ehokardiograficheskoe study.

RENTGENOLOGICHESKIE METHODS. Kilns study of the thorax (X-ray, x-ray) at the heart of patients to determine the size and shape of heart as a whole, its departments, large vessels, the presence of fluid in the pericardial, the state of pulmonary circulation , Some typical changes in skeletal (uzuratsiya ribs, deformed sternum). When X-rays can be seen moving kaltsifikaty (in valves, pericardial, sometimes in the coronary arteries), especially to evaluate the pulsation of heart and large vessels. In patients with pacemakers can see the situation and condition electrode. With regard to estimate the size of heart cells x-ray study concedes echocardiography (but surpasses percussion). Identification of changes in the lungs and skeletal remains the prerogative ray method.

The size of the heart chambers define standard projections - direct, skew, sometimes in the left side, contrasting with the esophagus sulfatom barium. Better cameras detected dilation, worse - concentric hypertrophy.

If you raise the left ventricle of his shadow extends down, back and left. In a study in the left oblique projection shows narrowing or filling retrokardialnogo space. The increase in the right ventricle can be found in the same projection, it leads to filling retrosternalnogo space. With a substantial increase in the right ventricle other divisions may be removed passively, while their size was difficult to assess accurately. The increase left predserdiya better seen in the right oblique projection, contrasting with the esophagus. In contrast norm esophagus at the level predserdiya not rejected. If you raise the left predserdiya he may deviate through the arc of a small radius, that is 3-6 cm (which is more characteristic of mitral stenosis) or through the arc of a large radius, that is 7-11 cm (which is more characteristic of mitral insufficiency). Increased right predserdiya better detected in the left oblique projection. To estimate the size of the heart often use cardio-thoracic index - the ratio of maximum width silhouette hearts to the maximum widths of Inland chest (in direct projection). In less than normal, he is 1:2.

In the study, lung X-ray method allows fields, in addition to actual pulmonary pathology, to identify changes in pulmonary circulation, the state of venous network, signs of edema, first interstitial, then alveolar. In the small circle of hypertension seen expansion pulmonary artery and its major branches. In the case of high peripheral resistance peripheral fields increase transparency.

Kilns study may be informative in any of heart disease. However, it is linked to radiation exposure, so this study should be conducted on specific indications, when expectancy information can not be obtained by other available methods. Preferred X-ray. All diagnostic X-ray techniques combination of pregnancy.

Computer tomography - a kind of ray method. In doing so, X-rays taken special detectors and computer reconstructed in a clear picture of horizontal sections tomographic body with spatial resolution of about 0,5-0,7 see All structures accessible to inspection, no hidden zones. Introduction contrast substance expands the diagnostic capabilities of the method. To implement this method requires expensive equipment.

Accumulate experience, indicating that this method may be useful when examining patients with heart, as well as helping to recognize aorta aneurysm, to delaminate aorta aneurysm, the voluminous formations in the heart and pericardial, defining cross aortokoronarnogo vascular transplant. With it, trying to determine the extent of myocardial infarction.

Radiation pressure higher than ordinary X-ray study.

Kilns method is also used in angiokardiografii and cardiac catheterization.

RADIONUKLIDNYE METHODS. Typed into the body radioisotopes, including in metabolism, along with neizluchayuschimi isotopes, are distributed in a certain way of blood and tissues. Lysbuedræbere (gamma camera, scanners) allows local measure radioactivity and thus to identify particular distribution of radioisotopes. Sometimes identified "hot" pockets of excessive accumulation of radioisotopes or vice versa, "cold" pockets of his nenakopleniya. For diagnostic purposes using radioisotopes with relatively short half (several hours or days).

In general, radionuclide techniques, as neobremenitelnymi for the patient, can provide a variety of useful information when examining heart patients.

Introduction 131I-albumin helps determine the minute amount of blood circulation and other hemodynamic performance left and right ventricles. Introduction of erythrocytes, tagging 99mTc; provides an opportunity to comply with radionuclide angiokardiografiyu and radionuclide ventrikulografiyu with visualization of cavities and major heart vessels, with the possible calculation of hemodynamic parameters, and even identifying sites hypokinesia.

99mTc B comprising pirofosfata concentrated in nekrotizirovannoy (not normal) myocardial tissue, forming in acute heart attack "hot" hotbed. The maximum accumulation of technetium occurs through transmuralnogo 2-4 days after a heart attack. Later, the picture becomes unclear. Identifying the epicenter at a later date showed on education aneurysm. The intensity reflects the amount of isotope accumulation of a heart attack. Melkoochagovye infarctions diagnosed bad. Resolution of about 1-2 see severe angina and some cardiomyopathy may diffuse increasing accumulation of isotope. The method has a real diagnostic value in special cases - when suspected heart attack patient with the blockade left legs, with atypical picture infarction (with unclear EKG changes and fluctuations in activity of enzymes), with suspected heart attack patient, which made the operation on the heart.

201T l after intravenous distributed in proportion to the heart miokardialnomu bloodstream. In hotbeds of ischemia, heart attack, scar thallium accumulates less ( "cold" pockets), while you can roughly determine their prevalence. Assessing veloergometricheskogo test using this method more informative in the diagnosis of ischemic heart disease than the estimate only on ECG. In unstable angina, koronarospazme "cold" pockets can sometimes be identified and at rest. The method also raises some medicinal informative samples. However, he does not reliably identify the localization artery stenosis.

Radionuclides studies performed in a specially equipped laboratories. Some radioisotopes malodostupny. Studies have linked to radiation load, which in the use of radioisotopes in the overall short-less than under normal rentgenodiagnosticheskih research. Radionuclides combination study of pregnancy.

ELEKTROKARDIOGRAFIYA. At the core of electrical processes lies in the heart of the movement of ions through the cell membrane miokardialnoy. This makes changing transmembrane capacity over the cardiac cycle, which repeats the depolarization (stir with consequent reduction) and repolyarizatsiya (return to the starting point) cells. All myocardial cells electrically active, but only in the cells conducting the system slow depolarization occurs spontaneously, and that determines their ability to automaticity.

Under normal circumstances, arousal is distributed on conductive system and divisions hearts consistently, from sinusno-predserdnogo (sinusovogo) hub, located in the wall right predserdiya and characterized most of automaticity, through myocardial predserdy, predserdno-ventricular (atrioventrikulyarny) node, predserdno-ventricular bundle (bundle Guisa) and of divergence, to the ventricle. In doing so, departments conducting system located distally sinusovogo hub, covered excitation before manifest their own automaticity.

The outer surface of the myocardium instituted on elektronegativna not yet excitations. Thanks to these body tissues of electrical power partly processes can be registered with the placement of electrodes on the surface of the body, where fluctuations in the difference between excitation and potentials nevozbuzhdnnoy parts reach the surface of heart mV 1-3. When recording these fluctuations on the moving paper produced curve - electrocardiogram (EKG), consisting of teeth, repetitive during each reduce heart.

Teeth EKG taken to signify large Latin letters P, Q, R, S, T, U. Zubets R reflects depolarization predserdy, teeth (complex) QRS - ventricular depolarization, zubets T - repolyarizatsiyu ventricles, zubets U, usually malovyrazhenny - presumably repolyarizatsiyu distal segments conductive system ventricles. Teeth, directed upward, considered positive, down - negative. Teeth R, T and U may be positive or negative, always positive zubets R, Q and S teeth always negative, and if they are expressed, located directly in front (Q) or after (S) points R.

To register ECG using special devices - electrocardiographs, with amplifier, DSC galvanometer, recorder.

Comparability EKG achieved through standard conditions of registration. Calmly surveyed lies on his back. Typically, apparatus govern in a manner that tension 1 mV declined arrow to the top 1 cm rectangular shape That label - "calibration" Millivolt - should be at each ECG. With the speed of paper 50 mm / s 1 mm horizontally corresponds to 0.02 (in this case points R width of about 5 mm), at a speed of 25 mm / s 1 mm - with 0.04 (width R points about 2-3 mm ).

Placing electrodes on the surface of the body, their polarity and some technical conditions for registration capability also standardized. In principle for the registration of ECG electrode needed 2, that is Each is like allocating a 2 pole. Using techniques developed "single" of abstraction in which virtually defines the form of ECG fluctuations capacity, with one of the electrodes, called active. Potential from another electrode remains close to zero. Under such a system of registration form EKG increasingly depend on the myocardium, addressed to the active electrode, and thus few opportunities topical diagnosis. Expression of teeth and the ratio of their values vary from aside.

There are currently used, typically 12 ECG: standard - I, II, III; so-called enhanced single from the limbs of abstraction - aVR, aVL, aVF; so-called single-thoracic - V1, V2, V3, V4, V5, V6; on more narrow grounds - other single chest of abstraction, of abstraction for bipolar Nebu (D, A, I). Occasionally apply esophageal (active electrode is placed in the esophagus at the level predserdiya left) and other complementary of abstraction.

When analyzing ECG measures the interval between its elements, are counting the frequency of rhythm, assess the availability, size and shape of teeth in different aside and for that reason be judged on the nature of rhythm, features electrical processes in the heart in general and to some extent - on the electrical activity limited plots the heart muscle. A more rigorous quantitative analysis is possible using a vector theory. Applying this theory in electrocardiography linked with certain assumptions. The difference is the vector potentials, the direction and magnitude of which are constantly changing throughout the cardiac cycle. The spatial representation of the nature of the electrical processes in the heart may be obtained by approximately analysis (with a space teeth) 12 conventional ECG. However, easier and more accurate this is achieved by using specially allocated. In practical work are often limited indication of the position of the electric axis of heart - the vector of the total area of QRS in projection on frontal plane, which, in particular, depends on the situation of anatomical heart in the chest, state intraventricular conduction, the ratio of masses ventricles.

In clinical medicine electrocardiography is the most important in diagnosing cardiac rhythm irregularities. It is important to identify IBS, particularly myocardial infarction, heart attack localization. At the EKG can detect shifts with an increase in heart cells, miokarditah, electrolyte and other metabolic irregularities. The changes reflect a violation of ECG electrical processes in the heart, and they usually are not specific nozologicheski not characterize retractive heart function, may arise not only because of the disease, but also with a substantial violation frequency rate, under the influence of normal daily activity, eating, alcohol, drugs and other causes. Many factors vneserdechnye (emphysema lung fluid in the pleura perikardialnoy and cavities, obesity) contribute to reducing the size of teeth. The structural and metabolic changes in the heart necessary to diagnose not only on ECG, but collectively signs. It facilitates the establishment of a number of ECG diagnosis comparison, has consistently taken at intervals of several days or weeks. Registration is a normal component of ECG BRUY healthy persons.

Informative method significantly increases in long-term continuous monitoring of ECG (even at 1-2 reserved) and conduct functional samples.

For seriously ill (for example, in intensive care units) were observed using bednets kardiomonitorov that permit, in particular, the continual monitoring of ECG. Portable system daily (Holter) monitoring provide continuous recording of ECG on tape during the day in ambulatory conditions, with normal activity of the patient. These systems help detect rare fast emerging and ongoing arrhythmia, provokes clarify the role of external factors, appreciated the aritmicheskogo syndrome and results of treatment. Maybe monitor the shift in ST segment, and thus bezbolevoy identifying ischemia. As vysokoinformativnym, technically relatively simple and neobremenitelnym method for the patient, electrocardiography has found wide application in telemetric control of the state of the working man in professional sports, space medicine. To this end, use special means of imposing electrodes (only on the thorax) and radio communications between galvanometers and recorders.

Of the functional samples from elektrokardiograficheskim control samples from the most common dose of physical stress, especially veloergometriya, which helps determine individual tolerance to stress and substantially increases the sensitivity and specificity of electrocardiography in the diagnosis of IBS. When satisfactory portability initial load the total load of step increases until submaksimalnogo level, which usually corresponds to the frequency pulse 200 minus age (this figure could more accurately define the special tables). Conversion tracking EKG during exercise and during the 6-12 min after loading. Other forms of loads - tredmil, two-stage sample Masters, isometric load - for various reasons, particularly because of the difficulties of dispensing, use less. Contraindications to the use of load tests: acute myocardial infarction, heart failure, expressed violations of rhythm, myocarditis, pulmonary heart, aorta stenosis of the mouth, heart or aorta aneurysm, blood pressure above 200/110 mm Art. Art. Glycosides and beta-blocker cancel a few days before the performance of samples. Among other provocative mention test samples from ergonovinom, which helps in the diagnosis vazospasticheskoy angina. All the samples relate to the character provokes some risk, therefore, should fulfil their experienced staff, with caution, given the contraindications, in the context of preparedness for resuscitation.

Less important are drug samples. For example, in the form of nitroglycerine tablets, the provisions under the tongue, may, through 2-10 min partially remove the EKG changes associated with ischemia, propranolol through 30-60 min after taking 40 mg will eliminate or reduce rather violations arising from the vegetative disregulyatsiey; prednisolone can reduce changes Associated with miokarditom. The specificity and reliability of those samples generally small. Sometimes they can be useful, but not so much to clarify the nature of ECG changes, but rather for the treatment of choice.

Vnutriserdechnaya electrocardiography also applies to elektrofiziologicheskim methods. This invazivnyi method used for specifying the diagnosis arrhythmia and blockades. To this end, the right ventricle heart transvenozno impose catheter with electrodes, which must be pressed to mezhpredserdnoy mezhzheludochkovoy and bulkheads near trikuspidalnogo valve. With such a bipolar allocated separately managed to register signals corresponding to depolarization predserdy, Gisa beam and ventricles. These signals are normally written in such a sequence, time-bound relations among themselves and with elements outside ECG, which always register at the same time. Short-term (for example, for 1 min) frequent (about 150 pulses in 1 min) stimulation programming segments conductive system through electrodes and imposed an additional dimension to follow predavtomaticheskoy allow pause to assess the basic properties of local elektrofiziologicheskie. Vnutriserdechnuyu electrocardiography performed on narrow grounds in the heart of some institutions. In particular, it helps more reliable than a standard ECG, to differentiate levels ektopicheskih arrhythmia and blockades, which is important for the treatment of choice, and detail elektrofiziologicheskie effects of drugs.

An unusual way to care for the health of their employees used the owner of an American insurance company "Weyco Inc.". In order to force subordinates to quit, he simply put them… ultimatum. Employees are invited to choose between the abandonment of smoking and loss of work.

71-year Veyers Howard, the founder and sole owner "Weyco Inc.", Are fighting for the health of their subordinates are already quite a long time. Last year he first imposed the ban on smoking in buildings owned by the company, then demanded that its employees regularly pass tests on nicotine content in urine, and eventually imposed a system of periodic medical examinations subordinates. As a result of cigarettes declined at least 20 out of 200 employees. But he seemed little, and he ordered his subordinates banned smoking not only in the office but also at home. Monitoring implementation of the orders will be processed through the same tests, but now, if they prove positive, a staff member, is waiting for his immediate dismissal.

"I do not intend to violate whose then-law - told Howard Veyers correspondent in an interview with" Reuters ". - If an employee does not agree with the requirements of the company, he may change the place of work. And I do not think that the demand for something unusual -- I just want my employees care about their health. "

By the way, smoking - not only harmful habit, declared "non grata" in the walls "Weyco Inc.". Veyers now developing a programme of activities to protect its employees from over-and being overweight. In his plans - Diet consultations, establishment of the office of special "food item, which will be sold exclusively healthy food, special financial rewards for those who maintain healthy lifestyles, and much more.

It should be noted that, according to estimates, the initiative "Weyco Inc." can be supported and other companies. And the reason typing similar restrictions in their case could become even health care staff and banal pursuit of profit. The point is that because of the constant growth of prices for medical services loss of profits associated with a temporary disability and people need to pay for their treatment, in many companies is becoming quite visible. And the sake of eliminating this "object of expenditure" dealers may even go to the dismissal of specialists, not willing to part with their own bad habits.

Do you think that going to work with "current" nose, you increase the likelihood that in the future to treat his heart.
According to research conducted by scientists from University College London middle class (workers incumbents in commercial firms low post) most prone to cardiovascular disease. Why them? After 10 - years of observation revealed what most of these marginalized people their health at the latest plan (the refusal to take the hospital, excessive stress in unhealthy condition, etc.). With this in mind, do not be surprised that the possibility of the disease rises twice. After all, at reduced immunity of the human body particularly sensitive to different types of diseases.

Such fanatic attitude brings not only harm the body, but does not give a qualitatively carry out their work. These conclusions came leader of the study, Professor Michael Marmot. Also, he noticed that during the cold (cold, high temperature) people going through a particularly hard all their failures, resulting in the aggravation of his condition. And this in turn affects the quality of work and attitude on the part of leadership.