ABSTRACT
The aim of the study was to assess the effectiveness of infrared spectroscopy for verification of pulmonary embolism (PE) and a number of similar diseases. MATERIALS AND METHODS: Infrared spectroscopy was used to investigate blood serum of 19 healthy volunteers and 30 patients with intraoperatively confirmed PE as well as with chronic obstructive pulmonary disease (COPD) (n=10), pneumonia (n=10), tuberculosis (n=10), lung abscess (n=10) and lung cancer (n=10), acute disorder of cerebral circulation (ADCC) (n=10), ischemic heart disease (IHD) (n=10). Peak height ratios of absorption band were taken as diagnostic parameters (cm-1/Ñm-1): P1 - 1160/1165; P2 - 1165/1070; P3 - 1165/1150; P4 - 1165/1050; P5 - 1100/1050; P6 - 1025/1165. These parameters of IR spectrum are significant for the given nosology. RESULTS: The calculated indicators have demonstrated statistically significant difference of IR spectra parameters for the studied nosologies (p<0.001) even on the small samples supplementing each other and enabling step-by-step exclusion of lung abscess and pulmonary tuberculosis, COPD and pneumonia, cancer, IHD, ADCC, and PE.The presented radar charts, built with consideration of the values of all peak height ratios of the absorption bands with diagnostically significant maxima, provided the possibility to visualize the IR profiles making the differentiation of PE and its clinical analogs not only more objective and reliable but also more explicit and compelling. CONCLUSION: Infrared spectroscopy is a potentially effective method of PE differential diagnosis. Sample expansion will allow researchers to evaluate the sensitivity and specificity of this technique compared to the existing standard schemes of PE verification.
Subject(s)
Pneumonia , Pulmonary Disease, Chronic Obstructive , Pulmonary Embolism , Diagnosis, Differential , Humans , Pneumonia/diagnosis , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Embolism/diagnosis , Spectrophotometry, InfraredABSTRACT
We compared the efficiency of treatment of 99 patientswith pulmonary thromboembolism using thrombolytic agents, surgical intervention, and anticoagulation therapy with heparin and vitamins K. The surgical treatment proved more efficient than the two other options.
Subject(s)
Anticoagulants/therapeutic use , Pulmonary Embolism , Thrombolytic Therapy/methods , Vascular Surgical Procedures/methods , Aged , Algorithms , Clinical Decision-Making , Comparative Effectiveness Research , Female , Humans , Male , Middle Aged , Patient Care Management/methods , Pulmonary Embolism/drug therapy , Pulmonary Embolism/mortality , Pulmonary Embolism/surgery , Survival AnalysisABSTRACT
We operated on a total of twenty-seven patients presenting with acute massive thromboembolism of pulmonary arteries. The patients' mean age amounted to 38.6 ± 9.17 years. The estimated pressure in the pulmonary artery averaged 54.2 ± 7.15 mm Hg. A total of twenty- two thromboembolectomic procedures were performed in the setting of assisted circulation. In five patients embolectomy was carried out from a thoracotomic approach without artificial circulation. The remote period was marked by a relapse of thromboembolism, with the female patient having completely refused to undergo treatment. All the patients remain in a satisfactory condition, with the estimated pressure in the pulmonary artery maintaining at an average level of 27.05 ± 3.11 mm Hg.
Subject(s)
Embolectomy , Pulmonary Artery , Pulmonary Embolism , Risk Adjustment , Secondary Prevention , Acute Disease , Adult , Anticoagulants/therapeutic use , Blood Pressure , Early Diagnosis , Embolectomy/methods , Embolectomy/mortality , Embolectomy/rehabilitation , Embolectomy/standards , Extracorporeal Circulation , Female , Humans , Long-Term Care/methods , Long-Term Care/standards , Male , Middle Aged , Monitoring, Physiologic/methods , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/physiopathology , Pulmonary Circulation/drug effects , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/mortality , Pulmonary Embolism/physiopathology , Pulmonary Embolism/surgery , Radiography , Risk Factors , Thoracotomy , Treatment Outcome , Ultrasonography , Vena Cava FiltersABSTRACT
Operations were fulfilled on 42 patients with embolism threatening formations of the right parts of the heart. An episode of pulmonary arteries was in the anamnesis of 11 patients. In all cases the operations were fulfilled under conditions of extracorporeal circulation and cardioplegia. One patient died at the hospital. Lethality was 2.33%.
Subject(s)
Cardiovascular Surgical Procedures/methods , Heart Atria , Heart Diseases/surgery , Heart Ventricles , Pulmonary Artery , Pulmonary Embolism/etiology , Pulmonary Embolism/prevention & control , Adult , Cardiovascular Surgical Procedures/mortality , Extracorporeal Circulation/methods , Female , Heart Arrest, Induced/methods , Heart Atria/pathology , Heart Atria/physiopathology , Heart Diseases/complications , Heart Diseases/mortality , Heart Diseases/pathology , Heart Diseases/physiopathology , Heart Ventricles/pathology , Heart Ventricles/physiopathology , Hemodynamics , Humans , Male , Middle Aged , Pulmonary Artery/pathology , Pulmonary Artery/physiopathology , Pulmonary Embolism/pathology , Pulmonary Embolism/physiopathology , Risk Assessment , Severity of Illness Index , Treatment OutcomeABSTRACT
Presented herein is a clinical case report regarding a patient who was found to have embolism of the right renal artery with accompanying atrial fibrillation. Open surgery is viewed as a method of choice amongst a variety of the available treatment modalities aimed at re-establishing renal blood supply impaired due to embolism of the renal artery trunk. This clinical example demonstrates a possibility of successful renal revascularization undertaken 72 hours after renal artery embolism. The decision to simultaneously perform a combined surgical intervention consisting of embolectomy from the bifurcation of the renal artery, thrombectomy from it branches, and finally followed by radiofrequency ablation of the cava-tricuspidal isthmus, turned out an appropriate therapeutic policy which yielded a patient-friendly immediate outcome as well as favourable remote results persisting over time.
