PURPOSE: To demonstrate advantages of spectral dual-layer computed tomography (CT) in diagnosing pulmonary embolism (PE). To compare D-dimer values in patients with PE and concomitant COVID-19 pneumonia to those in patients without PE and COVID-19 pneumonia. To compare D-dimer values in cases of minor versus extensive PE. METHODS: A monocentric retrospective study of 1500 CT pulmonary angiographies (CTPAs). Three groups of 500 consecutive examinations: 1) using conventional multidetector CT (CTC), 2) using spectral dual-layer CT (CTS), and 3) of COVID-19 pneumonia patients using spectral dual-layer CT (COV). Only patients with known D-dimer levels were enrolled in the study. RESULTS: Prevalence of inconclusive PE findings differed significantly between CTS and CTC (0.8 % vs. 5.4 %, p < 0.001). In all groups, D-dimer levels were significantly higher in PE positive patients than in patients without PE (CTC, 8.04 vs. 3.05 mg/L; CTS, 6.92 vs. 2.57 mg/L; COV, 10.26 vs. 2.72 mg/L, p < 0.001). There were also statistically significant differences in D-dimer values between minor and extensive PE in the groups negative for COVID-19 (CTC, 5.16 vs. 8.98 mg/L; CTS 3.52 vs. 9.27 mg/L, p < 0.001). The lowest recorded D-dimer value for proven PE in patients with COVID-19 pneumonia was 1.19 mg/L. CONCLUSION: CTPAs using spectral dual-layer CT reduce the number of inconclusive PE findings. Plasma D-dimer concentration increases with extent of PE. Cut-off value of D-dimer with 100 % sensitivity for patients with COVID-19 pneumonia could be doubled to 1.0 mg/L. This threshold would have saved 110 (22 %) examinations in our cohort.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
Purpose: Quantify changes in blood flow velocity in the radial artery after local dynamic exercise and compare these results between a group of women and men. Acquire data of normal resting blood flow in the radial artery. Methods: We examined 42 healthy young volunteers (21 men and 21 women) of the age about 20. A pocket Doppler ultrasound device was used for measurements. Physical exercise was defined as one-minute-long, one-handed weightlifting. Hemodynamic parameters were registered during resting before exercise and immediately after exercise. Results: Resting baseline values: overall maximum blood flow velocity 26.49 cm/s (SD: 9.99 cm/s), mean blood flow velocity 8.46 cm/s (SD: 6.17 cm/s), and pulsatility index (PI) 5.46 (SD: 5.7) for the whole group. Mean percentage increase of maximum blood flow velocity is 36.5%, mean blood flow velocity 243%. PI was reduced by 52.8%. There was a presumed significant difference in the percentage change of PI between the group of women and men (p<0.05). There is also a typical change in velocity waveform after exercise. Conclusion: The most altered parameter is mean blood flow velocity, which corresponds to an observed change of velocity waveform probably caused by local vasodilatation lasting only for several seconds.
Aim of this study was to evaluate the possible use of infrared thermography as a supplementary method to the ankle-brachial index used in assessing the treatment effect of percutaneous transluminal angioplasty. The study included 21 patients, mean age was 60.22 years. Healthy control group included 20 persons, mean age was 55.60 years. Patients with symptomatic peripheral arterial disease (Fontaine stages I-III) were admitted for endovascular treatment by percutaneous transluminal angioplasty. Thermal images and ankle-brachial index values were obtained before and after treatment by percutaneous transluminal angioplasty. Median temperature change in the treated limb was 0.4℃, for non-treated limb was -0.5℃. The median value of ankle-brachial index in the treated limb increased by 0.17 from 0.81 after the procedure. The median value of ankle-brachial index in the non-treated limb decreased by 0.03 from the value of 1.01. Significant difference between treated limb and non-treated limb in change of ankle-brachial index was found with p value = .0035. The surface temperature obtained by the infrared thermography correlates with ankle-brachial index. We present data showing that the increase of ankle-brachial index is associated with increase of skin temperature in the case of limbs treated by percutaneous transluminal angioplasty. Our results also suggest potential of the use of infrared thermography for monitoring foot temperature as a means of early detection of onset of foot ischemic disorders.
- MeSH
- balónková angioplastika * MeSH
- dolní končetina krevní zásobení MeSH
- dospělí MeSH
- infračervené záření * MeSH
- lidé středního věku MeSH
- lidé MeSH
- onemocnění periferních arterií diagnóza patofyziologie terapie MeSH
- prediktivní hodnota testů MeSH
- prospektivní studie MeSH
- průchodnost cév MeSH
- regionální krevní průtok MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- teplota kůže * MeSH
- termografie metody MeSH
- termoregulace MeSH
- tlakový index kotník-paže MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- MeSH
- dolní končetina * krevní zásobení MeSH
- krevní oběh MeSH
- lidé MeSH
- termografie * metody MeSH
- Check Tag
- lidé MeSH
- MeSH
- biofyzika metody trendy výchova MeSH
- Evropská unie MeSH
- mezioborová komunikace MeSH
- vzdělávání odborné metody organizace a řízení trendy MeSH
- zdravotnická povolání normy trendy výchova MeSH
- zdravotnické prostředky normy MeSH
- Publikační typ
- sylabus MeSH
- Geografické názvy
- Česká republika MeSH
V rámci konference seznamujeme s e-learningovým kurzem “Management kvality ve zdravotnických organizacích”, který prošel akreditací příslušných ministerstev v několika státech EU. Současně předvedeme software “Simulační hra manažerských rolí – QM-RPS”. V současnosti jsou dostupné čtyři základní a deset volitelných modulů (různé kurzy/předměty v závislosti na individuálních požadavcích zákazníků). Kurz naplňje požadavky harmonizovaného schématu Evropské organizace pro kvalitu (EOQ) pro manažéry kvality. Ozřejmíme požadavek na potřebné zapojení laické komunity (občanů) do oblasti managementu kvality ve zdravotnickém prostředí. Kurz lze provozovat v rámci různých prostředí Webu. Předkládáme průběžné poznatky získané v rámci empirického výzkumu projektů Leonardo da Vinci SK 03/B/F/PP – 177014 “IMPROHEALTH", SK/06/3/F/PP – 177443 "IMPROHEALTH _COLLABORATIVE" and KEGA 3-4121-06 “Webové portály nástrojů, metod a případových studií managementu kvality, (“Web portal of tools, methods and case studies of the quality management".)
The aim of this paper is to present courseware "Quality Management in Healthcare Organization" supported by international projects and accredited by the respective ministries in some EU countries, and software "Quality Management Role-Play Simulation QM-RPS”. Four basic and ten optional modules (courses/subjects according to special custom requirements) have been developed. The course is in concert with the requirements of the harmonized scheme of the European Organization for Quality (EOQ) as related to quality nanagers. A claim for involvement of laypeople (citizens) in healthcare quality management will be discussed. Examples of "Quality Management in Healthcare" and application of Role-Play Simulation will be shown. The courseware and simulation can be embedded into different Web learning environments. We present ongoing and continuous knowledge acquired from theoretical and empirical research in projects Leonardo da Vinci SK 03/B/F/PP – 177014 “IMPROHEALTH", SK/06/3/F/PP – 177443 "IMPROHEALTH _COLLABORATIVE" and KEGA 3-4121-06 “Web portal of tools, methods and case studies of quality management".
