• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 4
  • 2
  • 1
  • 1
  • Tagged with
  • 8
  • 8
  • 5
  • 4
  • 3
  • 3
  • 3
  • 3
  • 3
  • 3
  • 2
  • 2
  • 2
  • 2
  • 2
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Průchodnost dialyzačních zkratů u pacientů podstupujících vaskulární intervenční výkony. / Patency of dialysis fistulas in patients undergoing vascular interventional procedures.

Kaván, Jan January 2020 (has links)
Purpose. The primary objective was to compare primary and secondary patency, number of percutaneous transluminal angioplasty (PTA) interventions and cost-effectiveness among PTA, deployment of a stent, or a stent graft in the treatment of failing arteriovenous dialysis grafts. The secondary objective was to compare the residual diameter at the site of dialysis shunt stenosis using sonography and digital subtraction angiography (DSA). Methods. Sixty patients were randomly assigned to either PTA, placement of a stent or stent graft. Follow-up angiography was scheduled at 3, 6, and 12 months or when requested by the physician. Residual diameter of a dialysis shunt stenosis was measured in 20 patients with significant stenosis by ultrasonography and on an angiogram from DSA. Results. During a median follow-up of 22.4 months patients with PTA, stent, or stent graft required 3.1±1.7, 2.5±1.7, or 1.7±2.1 (P=0.031) secondary PTA interventions. The primary patency rates were 0%, 18%, and 65% at 12 months and 0%, 18%, and 37% at 24 months in the PTA, stent, and stent graft group respectively (P<0.0001). The cost of the procedures was €7,900±€3,300 in PTA group, €8,500±€4,500 in stent group, and €7,500±€6,200 in stent graft group (P=0.45). The mean residual diameter measured by ultrasonography and DSA was...
2

Lėtinio paviršinės šlaunies arterijos užakimo gydymo subintimine angioplastika rezultatų įvertinimas / Evaluation of subintimal angioplasty treatment of superficial femoral artery chronical occlusion

Aleksynas, Nerijus 29 January 2008 (has links)
Aterosklerozė, kaip arterijas pažeidžianti liga, žinoma jau daugelį metų. Periferinių arterijų okliuzinės ligos (PAOL) simptomus jaučia apie 27 milijonai žmonių Šiaurės Amerikoje ir Europoje. Nežiūrint gerėjančios PAOL diagnostikos, chirurginio, endovaskulinio ir medikamentinio gydymo, jos paplitimas toliau didėja. Ši liga ypač neigiamai veikia gyvenimo kokybę ir išgyvenamumą. Populiacijai senstant, 2040 metais žmonių, sergančių PAOL, skaičius padidės iki 22 proc.. Taigi, akivaizdžiai galime pastebėti, kad žmonėms senstant, daugėja PAOL sergančiųjų ir ši liga progresuoja, blogina žmonių gyvenimo kokybę bei didina mirštamumą ar sunkina gretutinių susirgimų eigą. Ilgėjant žmonių amžiui, jie turi daug gretutinių susirgimų. Todėl PAOL operacinis gydymas gali būti gyvybei pavojingas, nes sukelia gretutinių ligų pasunkėjimą. Šiuo metu šią problemą bandoma spręsti pritaikant endovaskulinius arterijų užakimo koregavimo metodus, kurie yra mažai invazyvūs, atliekami vietinėje nejautroje ir sąlyginai pigūs. Darbo tikslas: palyginti subintiminės angioplastikos (SA), arterijų šuntavimo operacijų ir perkutaninės transliuminalinės angioplastikos (PTA) gydymo rezultatus, esant paviršinės šlaunies arterijos lėtiniam užakimui bei įvertinti subintiminės angioplastikos rizikos veiksnius. Darbo uždaviniai: 1. Įvertinti subintiminės ir perkutaninės transliuminalinės angioplastikų bei arterijų šuntavimo operacijos ypatumus, gydant lėtinį paviršinės šlaunies arterijos užakimą. 2. Įvertinti... [toliau žr. visą tekstą] / The Aim The aim of this study is to compare the results of subintimal angioplasty (SA), the bypass surgery and percutaneus transluminal angioplasty (PTA) in treatment of the chronic occlusion of superficial femoral artery (SFA) and determine risk factors of subintimal angioplasty. The objectives: 1. To evaluate peculiarity of subintimal and percutaneus transluminal angioplasty and arterial bypass surgery in treatment the chronic occlusion of superficial femoral artery. 2. To evaluate the primary results of subintimal and percutaneus transluminal angioplasty and arterial bypass surgery in treatment the chronic occlusion of superficial femoral artery. 3. To evaluate the early results of subintimal and percutaneus transluminal angioplasty and arterial bypass surgery in treatment the chronic occlusion of superficial femoral artery. 4. To determine risk factors predicting the primary and the early results of chronic superficial femoral artery occlusion treatment by means of subintimal and percutaneus transluminal angioplasty and the arterial bypass surgery. 2.1. Patients The prospective clinical study is being performed at the Department of Vascular Surgery of the Clinic of Cardiac, Thoracic and Vascular Surgery of Kaunas University of Medicine. The study was started in November 2002 and ended on December 2006. We had 255 patients admitted to the clinic during this period of time due to the occlusion of SFA, which matched the criteria of the study. The patients were... [to full text]
3

Methods of interventional pediatric cardiology in treatment of congenital heart diseases: immediate and long-term results / Intervencinės pediatrinės kardiologijos metodai įgimtų širdies ydų gydymui: ankstyvieji ir vėlyvieji rezultatai

Čibiras, Sigitas Vladas 04 February 2010 (has links)
Objective - to assess possibilities and specific characteristics of pediatric cardiology in treatment of congenital heart diseases (CHD), to evaluate efficacy of curative per-catheter procedures by means of analysis of immediate and long-term results. Retrospective study. The data of 422 patients who underwent 467 CHD palliative-curative procedures during the period since 1971 till 2007 were analyzed. It was postulated that balloon atrial septostomy resulted in statistically significant increase of atrial septal defect, increase of arterial blood oxygen saturation and decrease of interatrial preasure gradient (PG). Balloon pulmonary valvulotomy (BPV) is one of the most common curative procedures; this procedure has an effect of marked decrease of pressure gradient between the right ventricle and right atrium; development of pulmonary artery valve insufficiency is the most common complication of this procedure. The long - term results of BPV are less positive when higher PG prior the procedure is present and residual PG after the procedure is 36mmHg and higher. It was postulated, that closure of small (less than 3 mm) persistent ductus arteriosus using Cook coils may compete with surgical treatment successfully. It was stated, that the efficacy of balloon angioplasties of aorta, caval veins and pulmonary artery branches is transient; treatment using stents is more effective. It was postulated, that closure of congenital and postsurgical anomalies connections using coils is... [to full text] / Disertacijos objektas yra nustatyti intervencinės pediatrinės kardiologijos galimybes ir ypatumus, gydant įgimtas širdies ydas (ĮŠY), įvertinti gydomųjų perkateterinių procedūrų efektingumą, remiantis ankstyvųjų ir vėlyvųjų rezultatų analize. Tai retrospektyvus tyrimas. Analizuoti 422 ligonių duomenys, kuriems 1971 - 2007 m. buvo atliekamos 467 įgimtų širdies ydų paliatyvinės - gydomosios procedūros. Nustatyta, kad po balioninės tarpprieširdinės pertvaros septostomijos, statistiškai reikšmingai padidėja prieširdžių pertvaros defektas, didėja arterinio kraujo įsotinimas deguonimi ir mažėja spaudimų skirtumas (SS) tarp prieširdžių. Balioninė plaučių arterijos valvuloplastika (BPV) yra viena iš dažniausiai taikomų gydomųjų procedūrų, jos efektas – ryškus SS tarp dešiniojo skilvelio ir plaučių arterijos (PA) sumažėjimas, o pagrindinė komplikacija – PA vožtuvo nesandarumo vystymasis. BPV vėlyvieji rezultatai blogesni, kai yra didelis SS prieš procedūrą, o po procedūros liekamasis SS ≥ 36mmHg. Nustatyta, kad mažų iki 3mm AAL kimšimas Cook spiralėmis gali sėkmingai konkuruoti su operaciniu gydymu. Rasta, kad aortos, tuščiųjų venų ir plaučių arterijos šakų balioninės plastikos efektas trumpalaikis, o gydymas stentais daug sėkmingesnis. Nustatyta, kad anomalinių įgimtų ir pooperacinių kraujagyslinių jungčių užkimšimas spiralėmis yra saugus ir efektyvus gydymo metodas.
4

Arterioveninių jungčių dializuojamiems pacientams funkcionavimo pailginimo galimybių tyrimas / Investigation of possibilities to extend functioning time of arteriovenous fistulas for hemodialysis patients

Kybartienė, Sondra 02 July 2012 (has links)
Darbo tikslas: nustatyti veiksnius, susijusius su arterioveninių jung¬čių (AVJ) dializuojamiems pacientams funkcionavimo trukme bei įvertinti jungčių funkcijos monitoravimo naudą jų funkcionavimo trukmei prail-ginti. Darbo uždaviniai: 1. Įvertinti AVJ funkcijos monitoravimo naudą jos funkcionavimo trukmei prailginti. 2. Nustatyti pirmosios hemodializės procedūros atlikimo būdo ryšį su paciento stacionarizavimo trukme. 3. Nustatyti veiksnius, susijusius su AVJ funkcionavimo trukme. 4. Nustatyti centrinės venos kateterio buvimo ir lokalizacijos reikšmę AVJ funkcionavimo trukmei. 5. Įvertinti AVJ „brandinimo“ trukmės ryšį su AVJ funkcionavimo trukme. 6. Įvertinti priešoperacinio kraujagyslių ultragarsinio ištyrimo reikšmę pirminių jungties disfunkcijų išsivystymui bei AVJ funkcionavimo trukmei. DARBO METODIKA Tyrimas atliktas Lietuvos sveikatos mokslų universiteto Nefrologijos klinikoje, gavus Kauno regioninio tyrimų etikos komiteto leidimą Nr. BE 2-20. Dalis duomenų buvo renkama retrospektyviai, naudojant medicinos dokumentaciją, kita dalis informacijos apie pacientų laboratorinių tyrimų duomenis bei HD procedūros parametrus buvo renkama viso tyrimo ei¬goje. Visos AVJ pagal buvo suskirstytos į tris grupes: 1. Istorinė grupė – monitoravimas taikytas nebuvo (187 pacientai, 260 AVJ); 2. Monitoruota grupė – AVJ buvo monitoruojamos nuo pirmosios per ją atliktos HD (29 pacientai, 31 AVJ); 3. Dalinai monitoruota grupė – AVJ naudojamos HD iki 2008 m. gruo-džio 31 d., o vėliau... [toliau žr. visą tekstą] / Patients to be treated with chronic hemodialysis (HD) must have blood vessel connection. There are three types of blood vessel connections: native arteriovenous fistula (AVF), synthetic prosthesis and permanent central venous catheter. Each connection has its strengths and weaknesses. Primary AVF dysfunction occurs in 7.5% of the whole population of patients receiving HD, and in up to 80% of high risk patients (those with diabetes, elderly patients, and women) [Mann et al 2005]. Compared to other blood vessel connections (permanent central venous catheter or synthetic prosthesis) function of properly formed AVF is the longest, and incurs the lowest incidence of infectious and thrombotic complications. All international guidelines on HD procedures recommend native AVF as the method of choice. Formation of blood vessel junctions and treatment of their complications account for up to 20% of all hospitalizations of patients with end stage renal failure in USA [Allon et al 2002], up to 30% in Canada [Mann et al 2005], and up to 25% in Europe [Pissoni et al 2002]. It should be stated that formation of AVF and treatment of their complications are very expensive, and therefore determining the causes of the development of AVF complications and their timely diagnosis and correction are extremely important. Various methods of monitoring of AVF function are used in many European and USA HD centers; however, the most important criterion of early diagnosis of AVF complications has not... [to full text]
5

Ehokardiografski i angiološki prediktori remodelovanja leve komore nakon akutnog infarkta miokarda prednjeg zida / Echocardiographic and angiographic predictors of left ventricular remodeling after the acute anterior myocardial infarction

Tadić Snežana 23 June 2016 (has links)
<p>Cilj: Kod trećine bolesnika sa akutnim ST-eleviranim infarktom (STEMI) nakon primarne angioplastike (pPCI) razvije se postinfarktno remodelovanje leve komore (LK). Cilj istraživanja je nalaženje ranih prediktora post-infarktnog remodelovanja leve komore nakon akutnog STEMI i pPCI. Metodologija: Uključeno je 210 ispitanika sa prvim akutnim STEMI prednjeg zida, lečenih pPCI. Urađena je ehokardiografija u prva 24h, a zatim nakon 6 meseci, kada su ispitanici podeljeni u 2 grupe: ispitivanu sa remodelovanjem (n=55; 26%) i kontrolnu bez remodelovanja (n=155; 74%). Ispitanici su klinički praćeni godinu dana. Rezultati i dikusija: Multivarijantnom regresionom analizom, kao najsnažniji rani prediktori post-infarktnog remodelovanja izdvojili su se: postojanje &quot;no reflow&quot; fenomena nakon pPCI (OR=30.0 95% CI, p&lt;0.0001), pojava dijastolne disfunkcije u prva 24h (OR=27.7 95% CI, p&lt;0.0001), povećan dijametar leve pretkomore - LA (OR=5.0 95% CI, p=0,044) i srčana slabost na prijemu - Killip klasa 2-4 (OR=3.4 95% CI, p=0.003.). Univarijantnom regresionom analizom, snažni prediktori su neadekvatna rezolucija ST segmenta - STR (OR 2.0 95% CI, p=0.024) i zbirni indeks zidne pokretljivosti &ndash; WMSI &gt;2 (OR 21.6 95% CI, p&lt;0.0001). Totalno ishemijsko vreme nije imalo uticaja na post-infarktno remodelovanje (p=0.546). Tokom jednogodi&scaron;njeg praćenja ispitanici sa post-infarktnim remodelovanjem su imali značajno veću incidencu glavnih neželjenih kardiolo&scaron;kih događaja: rehospitalizacija (61.8% vs 22.6%; p&lt;0.0001) / najvi&scaron;e rehospitalizacija zbog srčane slabosti (40% vs 2.6%; p&lt;0.0001), sa mortalitetom 5.5%/; reinfarkta (20% vs 7.1%; p=0.007); rekoronarografija (45.5% vs 18.1%; p&lt;0.0001); revaskularizacija (30.9% vs 11%; p=0.001). Zaključak: Kod pacijenata sa akutnim STEMI prednjeg zida lečenih pPCI, pojava &quot;no reflow&quot; fenomena, dijastolne disfunkcije, povećana LA i srčana slabosti na prijemu su najjači rani nezavisni prediktivni faktori za nastanak post-infarktnog remodelovanja. Značajni prediktori su i neadekvatna STR i WMSI&gt;2. Pacijenti sa post-infarktnim remodelovanjem imaju veću incidencu glavnih neželjenih kardiolo&scaron;kih događaja i mortaliteta.</p> / <p>Objective: Patients with ST-elevated myocardial infarction (STEMI) treated by primary angioplasty (pPCI) will develop left ventricular (LV) remodeling in one third of the cases. The purpose of this study is to determine early predictors of LV remodeling after acute STEMI and pPCI. Methods: 210 patients with a first acute anterior STEMI treated by pPCI were included. All participants underwent echocardiography in the first 24hrs and again after 6 months, after which they were divided into two groups: remodeling (n=55; 26%) and nonremodeling (n=155; 74%). Results and discussion: The most powerful independent early predictors were: &quot;no reflow&quot; after pPCI (OR=30.0 95% CI, p&lt;0.0001), diastolic dysfunction in the first 24hrs (OR=27.7 95% CI, p&lt;0.0001), increased diameter of the left atrium - LA (OR=5.0 95% CI, p=0.044) and at admission Killip class 2-4 (OR=3.4 95% CI, p=0.003), by multivariant regression analysis. Also, strong predictors were incomplete ST-resolution - STR (OR 2.0 95% CI, p=0.024) and Wall motion score index - WMSI &gt;2 (OR 21.6 95% CI, p&lt;0.0001), by univariant regression analysis. Total ischaemic time had no influence on LV remodeling. The group with remodeling had more frequent major adverse cardiac events (MACE) during one year follow-up: re-hospitalisation (61.8% vs 22.6%; p&lt;0.0001) / mostly re-hospitalisation due to heart failure (40% vs 2.6%; p&lt;0.0001) and mortality 5.5%; reinfarction (20% vs 7.1%; p=0.007); recoronagraphy (45.5% vs 18.1%; p&lt;0.0001); revascularisation (30.9% vs 11%; p=0.001). Conclusion: For the patients with a first acute anterior STEMI, treated by pPCI, development of &quot;no reflow&quot; after pPCI, diastolic dysfunction, increased LA and heart failure on admission are the most powerful early independent predictors for LV remodeling. Incomplete STR and WMSI&gt;2 are strong predictors too. Remodeling patients will have a more frequent incidence of MACE and mortality.</p>
6

Specifika ošetřovatelské péče u klientů/pacientů s komplikacemi po selektivní koronarografii/PTCA / Specifications of nursering care of patiens with complications after direct SKG/PTCA

BLÁHOVÁ, Ilona January 2010 (has links)
Abstract In the Czech Republic there is no doubt about the tendency of gradual increase in median life expectancy, which is significantly affected by the fact that mortality from cardiovascular diseases, especially from acute coronary syndromes, has been decreasing. Besides the provable effect of a healthy lifestyle, diet and, by all means, a quality and effective pharmacotherapy, a significant development in the field of interventional cardiology contributes to this accomplishment. The number of coronographies, coronary angioplasties and implanted stents have multiplied, and today the invasive coronarographic diagnostics and percutaneous myocardial revascularization belong to the the most common diagnostic and therapeutic methods in treatment of acute forms of ischemic heart diseases. An obvious prerequisite for such a rapid development in the field of intervention coronary angiography was the establishment of a sufficiently dense network of catheter laboratories and specialized facilities, which provide a highly professional and intensive care for patients. This thesis is focused on three basic objectives: ? To survey and characterize differences in nursing care concerning various complications in patients after SKG / PCI ? To survey bio / psycho / social impacts of complications after SKG / PCI on a patient ? To identify and summarize personal and material prerequisites and requirements to ensure quality nursing care for these complicated conditions The research was conducted by using a qualitative methodology. The methods used were observation, non-standardized interviews and medical and nursing records analyses. The research survey samples on which the investigation was focused were patients with the acute coronary syndrome hospitalized in the coronary care unit in the Cardio Center in České Budějovice, their family members and also the nursing staff providing the comprehensive nursing care. The outcomes of this survey were eleven descriptive case reports characterizing the occurrence of the most frequent complications in patients with ACS after SKG / PCI. To ensure clarity, each case study is complemented by a thought map with an account of the most important nursing interventions in the management of specific acute conditions. The paper also contains a framework analysis of bio / psycho / social impacts of complicated situations on patients. It is interesting to compare this matter from the perspective of nurses and patients, which is seen in correlation graphs. The section describing the organizational and personnel provision is introduced with the characteristics of the medical process and it also contains the list of medical personnel with their qualifications and the length of experience in the Coronary care unit in České Budějovice. Summarization of the instrumental medical equipment is also based on the analysis of previous cases and is accompanied by photographs of the equipment typical and indispensable for the care of patients in the Coronary care unit, which primarily has an informative and complementary character to get an integrated view of the Coronary care unit running and the nursing staff work.
7

Syndrom karotického pahýlu / The Carotid Stump Syndrome

Hrbáč, Tomáš January 2012 (has links)
Introduction: Internal Carotid Stump Syndrome may be one of the possible causes of ischemic stroke (iCMP), as well as retinal infarction (RI). Syndrome of the occluded internal carotid (ACI) (stump syndrome) is a nosological unit, which is characterized by an onset of ipsilateral iCMP or RI of thromboembolic ethiology in patients with occlusion of ACI via the externa carotid or arteria ophthalmica. In my thesis, I have concentrated upon the specification of the stump syndrome, its diagnostics and treatment; furthermore I have assessed the appropriateness of surgical approach in comparison with conservative approach. Material and methods: A total of 621 patients with occlusion were treated in two centres in the course of five years. In a group of 40 patients, the ACI occlusion was detected sonographically, the length of the occluded ACI being >5 mm, with normal vasoreactivity based upon SPECT CO2 and excluded cardiogenic cause of iCMP. The patients were divided in two groups - surgical and conservative. Patients were monitored in 6-month intervals for the total period of four years. Results: No RI or iCMP were detected in the surgical group; one patient died six months after surgery. We observed one case of amaurosis fugax in the conservative group. Conclusion: Ultrasound examination is a fully sufficient...
8

Syndrom karotického pahýlu / The Carotid Stump Syndrome

Hrbáč, Tomáš January 2012 (has links)
Introduction: Internal Carotid Stump Syndrome may be one of the possible causes of ischemic stroke (iCMP), as well as retinal infarction (RI). Syndrome of the occluded internal carotid (ACI) (stump syndrome) is a nosological unit, which is characterized by an onset of ipsilateral iCMP or RI of thromboembolic ethiology in patients with occlusion of ACI via the externa carotid or arteria ophthalmica. In my thesis, I have concentrated upon the specification of the stump syndrome, its diagnostics and treatment; furthermore I have assessed the appropriateness of surgical approach in comparison with conservative approach. Material and methods: A total of 621 patients with occlusion were treated in two centres in the course of five years. In a group of 40 patients, the ACI occlusion was detected sonographically, the length of the occluded ACI being >5 mm, with normal vasoreactivity based upon SPECT CO2 and excluded cardiogenic cause of iCMP. The patients were divided in two groups - surgical and conservative. Patients were monitored in 6-month intervals for the total period of four years. Results: No RI or iCMP were detected in the surgical group; one patient died six months after surgery. We observed one case of amaurosis fugax in the conservative group. Conclusion: Ultrasound examination is a fully sufficient...

Page generated in 0.0642 seconds