TREATMENT OF ATRIAL FIBRILLATION AFTER SURGICAL REPAIR OF THE MITRAL VALVE.
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Biomedical subjects
Publications and source records attributed to A SELZER.
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In the past few years medical education in Poland has undergone considerable change, particularly at the graduate and postgraduate levels, and has shown increasing Western influences. On the negative side, a physician who was trained in pre-war Poland and is now in the United States, noted mass production of physicians with modest clinical facilities and the preponderance of didactic lecturing over semi-individual instruction-conditions rather characteristic of most European medical schools. On the positive side were well-informed, up-to-date faculties and the thoughtful planning and organization of graduate and postgraduate medical education. The overall impression was a favorable one, but the system of schooling and of evaluation of students' work made it possible for indifferent students to progress to licensure.
PULMONARY EMBOLISM OCCURS IN THREE FORMS: (1) Asymptomatic "silent" embolization of lungs; (2) pulmonary infarction; and (3) massive pulmonary embolization leading to acute cor pulmonale. The commonest source of emboli are veins of the lower extremities and of the pelvic organs. The prevention and the treatment of pulmonary embolism overlap, for except for the heroic procedure of pulmonary embolectomy, treatment is equivalent to the prevention of further emboli. The diagnosis may be easy in typical cases and very difficult in others.
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TREATMENT OF CARDIAC FAILURE CONSISTS OF THREE PRINCIPAL METHODS OR A COMBINATION OF THEM: (a) rest, or reduction of overload; (b) diuretic therapy and sodium restriction, and (c) administration of digitalis. In a series of patients treatment with the aid of the first two methods was compared with the effect of adding digitalis to this regimen.Clinically, most patients can be brought back to a state of compensation without the use of digitalis. Hemodynamically, digitalis exerts a further favorable action by improving cardiac performance. The discrepancy between clinical and hemodynamic cardiac state is emphasized, for patients may have no clinical evidence of cardiac failure and yet show hemodynamic abnormalities characteristic of serious impairment of cardiac performance. Thus digitalis has been shown to exert a favorable effect in cardiac failure even if such an effect cannot be clinically assessed.
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