RESUMO
This clinical study revealed peculiarities of early and late infectious endocarditis (IE) of artificial aortic valves. Possible sources of bacteremia, pathogenic agents and clinical picture of this pathology, methods of its early and differential diagnostics are described. High efficacy of combined antibiotic therapy is demonstrated in case of impracticability of surgical treatment.
Assuntos
Antibacterianos/uso terapêutico , Insuficiência da Valva Aórtica/cirurgia , Endocardite Bacteriana/tratamento farmacológico , Próteses Valvulares Cardíacas/efeitos adversos , Infecções Relacionadas à Prótese/tratamento farmacológico , Idoso , Ecocardiografia , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/etiologia , Seguimentos , Humanos , Masculino , Complicações Pós-Operatórias , Infecções Relacionadas à Prótese/etiologia , Fatores de TempoRESUMO
The clinical course of infectious endocardities (IE) was followed in 112 patients admitted to the Botkin City Hospital in 2000-2007 with reference to the age and social structure of the pathology, its clinical symptoms, results of laboratory and instrumental analysis, strategy of antibacterial therapy, and outcome of the disease. The data were compared with those obtained in the previous period (1987-1955). He study demonstrated an increased number of men with IE (up to 65%) in the recent years and an almost two-fold rise in the incidence of primary endocardities. The frequency of thromboembolic complications also increased (from 34 to 69%) involving the pulmonary artery system (24%). The same refers to the number of patients with multivalvular lesions (2, 3 or 4 heart valves) and affected right cardiac chambers (28.4%). Shortcomings at various stages of the treatment of patients with endocarditis have been revealed.
Assuntos
Endocardite Bacteriana/terapia , Hospitais Gerais/métodos , Avaliação de Resultados em Cuidados de Saúde , Tromboembolia/prevenção & controle , Endocardite Bacteriana/complicações , Humanos , Federação Russa , Tromboembolia/etiologiaAssuntos
Hipertensão Renal/diagnóstico , Hipertensão/diagnóstico , Determinação da Pressão Arterial/métodos , Diagnóstico Diferencial , Glomerulonefrite/complicações , Glomerulonefrite/diagnóstico , Humanos , Hipertensão/etiologia , Hipertensão Renal/diagnóstico por imagem , Hipertensão Renal/etiologia , Radioisótopos do Iodo , Ácido Iodoipúrico , Compostos de Organotecnécio , Ácido Pentético , Renografia por Radioisótopo/métodos , Pentetato de Tecnécio Tc 99mAssuntos
Doença das Coronárias/etiologia , Doenças Profissionais/etiologia , Humanos , Risco , Navios , UcrâniaRESUMO
A study of the causes of mortality among myocardial infarction patients and of the peculiarities of the manifestations of cardiac decompensation was conducted by way of mathematical prognosing and with the aid of the "Mmirp-1" computer, and permitted to conclude on the necessity of distinguishing between the primary circulatory insufficiency in the acute period, and relapsing circulatory disorders. The prognosis in myocardial infarction permits indirect appraisal of the reserve capacities of the diseased heart. The results of the conducted study indicate that the primary circulatory disorders are 6 times as frequent as the relapsing ones and that half of the patients with signs of circulatory failure dies within the first day of the disease. The long-term prognosis is equally unfavourable for the patients with circulatory insufficiency signs in the acute period: by the end of the 2nd year only 4 of every 10 patients with primary circulatory disorders survive, and 1--2 of every 10 patients with signs of relapsing circulatory disorders, which should be taken into consideration when developing the methods of complex therapy.
