Отдаленные результаты хирургического лечения тромбоэмболии легочной артерии (ТЭЛА) методом баллонной ангиопластики (БАП) в сочетании с тромболитической терапией

Introduction. Pulmonary Arterial Thromboembolism (PATE), which is characterised by low prognosis probability and potentially high danger, ranks third in the mortality structure of cardiovascular diseases. The primary method for treating PATE is recanalisation of the pulmonary arteries affected by embolism. Although the destruction of thromboemboli with thrombolytic drugs has proven effective, the right ventricular failure progresses faster in a majority of patients with massive pulmonary embolism. The aim of the present study is to evaluate the long-term results of surgical treatment of PATE by balloon angioplasty in combination with thrombolytic therapy in comparison with isolated systemic thrombolysis.Materials and methods. The treatment of 80 patients with pulmonary embolism was analysed. Depending on the selected treatment approaches, the patients were divided into 2 groups as follows: group 1 — 39 patients, conducted by the BAP LA, in combination with thrombolysis; group 2 — 41 patients who underwent conservative treatment (thrombolysis and subsequent anticoagulation therapy).Results. Despite the small sample and short period of observation, we may note the significantly better results of treatment in group 1 of the study. Positive dynamics of ECG indicators — in particular, pulmonary hypertension, RV KDR, functional class of heart failure NYHA as well as the reduction of right ventricular overload according to the ECG — indicates that the BAP LA method for the surgical treatment of pulmonary embolism, in combination with thrombolytic therapy, is effective and safe.Conclusions. Balloon angioplasty of pulmonary arteries in combination with thrombolytic therapy can significantly reduce the degree of pulmonary hypertension (рχ2 = 0.034), as well as helping to normalise the size of the right ventricle (рχ2 < 0.001) and improvement in functional class of heart failure NYHA (рχ2 = 0.026) in patients with pulmonary embolism compared with patients with isolated thrombolytic therapy.Введение. ТЭЛА характеризуется низкой вероятностью прогноза и потенциально высокой опасностью, занимает третье место в структуре смертности от сердечно-сосудистых заболеваний. Основным методом лечения ТЭЛА является реканализация пораженных эмболией легочных артерий. Несмотря на доказанную эффективность разрушения тромбоэмболов тромболитическими препаратами, у значительной части пациентов с массивной легочной эмболией правожелудочковая недостаточность прогрессирует быстрее. Настоящее исследование посвящено оценке отдаленных результатов хирургического лечения ТЭЛА методом баллонной ангиопластики в сочетании с тромболитической терапией в сравнении с изолированным системным тромболизисом.Материалы и методы. Проведен анализ отдаленных результатов лечения у 80 пациентов с ТЭЛА высокого и промежуточно-высокого риска с 2015 по 2018 г. Пациенты разделены на 2 группы в зависимости от выбранной тактики лечения: 1 группа — 39 пациентов, которым было проведено БАП легочной артерии в сочетании с тромболизисом, 2 группа — 41 пациент, которым проводилось консервативное лечение (тромболизис с последующей антикоагулянтной терапией).Результаты. Несмотря на малую выборку и небольшой срок наблюдения, можно говорить о получении достоверно лучших результатов лечения в 1 группе исследования. Положительная динамика ЭхоКГ показателей, в частности легочной гипертензии, КДР ПЖ, функционального класса сердечной недостаточности по NYHA, а также уменьшение перегрузки правых отделов сердца по данным ЭКГ, указывает на то, что метод хирургического лечения ТЭЛА — БАП ЛА в сочетании с тромболитической терапией — является эффективным и безопасным.Заключение. Баллонная ангиопластика легочных артерий в сочетании с тромболитической терапией является безопасным и эффективным методом лечения пациентов с ТЭЛА, позволяющим значительно снизить степень легочной гипертензии (рχ2 = 0,027), ускорить ремоделирование правого желудочка (рχ2 < 0,001) и улучшить функциональный класс сердечной недостаточности по NYHA (рχ2 = 0,026) по сравнению с группой пациентов с изолированной тромболитической терапией

Radioactive elements in the environment

Indicated role of natural radioactive elements (U, Th) in geospherical layers and various environmental components is discussed. Induced radionuclide problems are examine

The Calabrian in the Western Transcaucasian basin (Georgia): Paleomagnetic constraints from the Gurian regional stage

© 2017 Elsevier Ltd The precise Eurasian chronostratigraphy of the Neogene-Quaternary period is still hampered by the existence of numerous regional stages often lacking independent and absolute age constraints. Therefore, detailed paleoclimatic reconstructions of areas like the Caucasus are still poorly constrained and the influence of climate variability on faunal interchange between Africa and Eurasia in the late Neogene-Quaternary is still difficult to address. During the last decades, Quaternary sections from western Georgia have produced a wealth of paleoclimatic proxy data. Unfortunately, these sections do not have a robust age control. This is especially true for the Gurian stage which has been vaguely defined as being coeval with the lower Pleistocene on the basis of poorly documented bio- and magnetostratigraphic data. In order to constrain the age of the Gurian stage, a detailed magnetostratigraphic study has been carried out. All major sections with known Gurian sediments in the former Rioni bay (a marine restricted area to the southeast of the Major Caucasus) have been studied. Our results confirm for the first time the strict correlation between the Gurian succession and the Calabrian stage. In addition, our data provides further information on the tectonic setting of the Rioni bay during the Calabrian in this region: (1) in the north, Gurian sediments were unconformably deposited on older Meotian sediments in a piggy back basin, (2) in the south, Gurian sediments are conformably overlying Kujalnician (Plio-Pleistocene) strata, (3) magnetostratigraphic correlation among sections indicate drastic changes in sediment accumulation rates within the basin, (4) rock magnetic experiments reveal significant magnetomineralogical differences between Gurian and the underlying Miocene sediments likely documenting a transition related to changes in oxic conditions, supply of terrigenous material and sedimentation rate close to the Miocene-Pliocene boundary. These results provide a robust basis for further tectonic and paleoclimatic investigations of this region

Long-Term Results of Surgical Treatment of Pulmonary Embolism (PE) by Balloon Angioplasty (BAP) in Combination with Thrombolytic Therapy

Introduction. Pulmonary Arterial Thromboembolism (PATE), which is characterised by low prognosis probability and potentially high danger, ranks third in the mortality structure of cardiovascular diseases. The primary method for treating PATE is recanalisation of the pulmonary arteries affected by embolism. Although the destruction of thromboemboli with thrombolytic drugs has proven effective, the right ventricular failure progresses faster in a majority of patients with massive pulmonary embolism. The aim of the present study is to evaluate the long-term results of surgical treatment of PATE by balloon angioplasty in combination with thrombolytic therapy in comparison with isolated systemic thrombolysis.Materials and methods. The treatment of 80 patients with pulmonary embolism was analysed. Depending on the selected treatment approaches, the patients were divided into 2 groups as follows: group 1 — 39 patients, conducted by the BAP LA, in combination with thrombolysis; group 2 — 41 patients who underwent conservative treatment (thrombolysis and subsequent anticoagulation therapy).Results. Despite the small sample and short period of observation, we may note the significantly better results of treatment in group 1 of the study. Positive dynamics of ECG indicators — in particular, pulmonary hypertension, RV KDR, functional class of heart failure NYHA as well as the reduction of right ventricular overload according to the ECG — indicates that the BAP LA method for the surgical treatment of pulmonary embolism, in combination with thrombolytic therapy, is effective and safe.Conclusions. Balloon angioplasty of pulmonary arteries in combination with thrombolytic therapy can significantly reduce the degree of pulmonary hypertension (рχ2 = 0.034), as well as helping to normalise the size of the right ventricle (рχ2 < 0.001) and improvement in functional class of heart failure NYHA (рχ2 = 0.026) in patients with pulmonary embolism compared with patients with isolated thrombolytic therapy

Crystallization Pathways of FABr-PbBr₂-DMF and FABr-PbBr₂-DMSO Systems: The Comprehensive Picture of Formamidinium-Based Low-Dimensional Perovskite-Related Phases and Intermediate Solvates

In this study, we systematically investigated the phase diversity and crystallization pathways of the FABr excessive regions of two ternary systems of FABr-PbBr2-DMF and FABr-PbBr2-DMSO (where FA+—formamidinium cations, DMF—dimethylformamide and DMSO—dimethyl sulfoxide solvents). In these systems, a new FA3PbBr5 phase with a structure containing chains of vertex-connected PbBr6 octahedra is discovered, and its crystal structure is refined. We experimentally assess fundamental information on differences in the mechanisms of crystallization process in FABr-PbBr2-DMF and FABr-PbBr2-DMSO systems and determine possible pathways of crystallization of hybrid perovskites. We show that intermediate solvate phases are not observed in the system with DMF solvent, while a number of crystalline solvates tend to form in the system with DMSO at various amounts of FABr excess

Anti-inflammatory effect of siRNAs targeted il-4 and il-13 in a mouse model of allergic rhinitis

[No abstract available