Репозиторий Университета

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Purpose: to elucidate predictors of development of chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary artery thromboembolism (PTE). Material and methods. We included in this study 210 patients hospitalized with diagnosis of submassive and massive PTE from 2013 to 2017. In 1 to 3 years after initial hospitalization these patients were invited for control examination. According to results of this examination patients were divided into two groups: with (group 1, n=45) and without (group 2, n=165) signs of CTEPH. Severity of pulmonary artery vascular bed involvement was assessed by multislice computed tomography (MSCT) angiography and lung scintigraphy. For detection of thrombosis in the inferior vena cava system we used ultrasound angioscanning. Examination also included echocardiography. Results. In the process of mathematical analysis, the following risk factors for the development of CTEPH embolism were determined: duration of thrombotic history (group 1 - 13.70±2.05 days, group 2- 16.16±1.13 days, p=0.015), localization of venous thrombosis in the lower extremities (the most favorable - shin veins, popliteal, and common femoral veins, unfavorable - superficial femoral vein). The choice of the drug for thrombolytic and anticoagulant therapy: streptokinase and urokinase were significantly more effective than alteplase, rivaroxaban was superior to the combination of unfractionated or low molecular weight heparins with warfarin. Also, risk factors for the development of CTEPH were the initial degree of pulmonary hypertension and tricuspid insufficiency, as well as the positive dynamics of these indicators at the background of thrombolytic or anticoagulant therapy. Of concomitant diseases, significant risk factors for development of CTEPH were grade 3 hypertensive disease, diabetes mellitus, postinfarction cardiosclerosis. On the other hand, age, gender, degree of severity at the time of admission, presence of infarction pneumonia, surgical prevention of recurrent pulmonary embolism, number of pregnancies and deliveries, history of trauma and malignancies, cardiac arrhythmias produced no significant impact on the development of CTEPH.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Introduction. Instrumental methods of examination may alter the course of treatment and patients' management. Several studies have shown that interobserver variability in values obtained with renal scintigraphy (RS) can be as high as 10%, however, RS remains the standard investigation for the assessment of split renal function. Objective. This paper aims to present how numerical analysis of abdominal MSCT results can be used to evaluate split renal function. Materials and methods. A prospective study was launched in a Research Institute for Uronephrology and Reproductive Health from November, 2015 to May, 2017. 88 patients were enrolled into the study (2 with hydronephrosis, 10 with hypertensive kidney disease, 5 with stone kidney disease, 2 with kidney anomalies, 69 with renal tumors). Comparison made between renal scintigraphy data and 3D MSCT-based models. Results. CT-based methods for the calculation of split renal function with 3D-models showed correlation with renal scintigraphy (p<0.004). Conclusion. A new approach for split kidney function assessment based on contrast-enhanced CT with 3D-models and mathematical analysis allows for both acquiring detailed data on clinical anatomy and evaluation of renal function to promote preoperative decision-making. It showed strong correlation with no significant difference in comparison with RS in terms of glomerular filtration rate, perfusion and plasma flow.

© 2018 Stavropol State Medical University. All rights reserved. To improve the diagnostics of erectile dysfunction (ED) 138 men with the trouble of erection quality have been examined using ultrasound dopplerography of the penis and phalloscintigraphy. In 7.8 % of cases no pathology was found. In 28.1 % of patients arterial ED has been identified by phalloscintigraphy, in 23.4 % - venoocclusive ED and in 40.6 % - disruption of the microcirculation within the corpora cavernosa of the penis. Phalloscintigraphy demonstrated high sensitivity (91 %) and specificity (94 %) in identification of various forms of vasculogenic ED.