The term nontuberculous mycobacteria (NTM) includes different species of mycobacteria, other than Mycobacterium tuberculosis complex (M. bovis, M. africanum, M. microti, M. canetti, M. caprae, M. pinnipedii, M. suricatta, M. mungi) and other than those that cause leprosy (M. leprae, M. lepromatosis). The rate of lung infection with NTM increases with age and varies considerably in different countries. NTM are opportunistic pathogens that can cause the disease, especially in immunocompromised patients or in those with preexisting lung disease. The decision to initiate the treatment is based on an assessment of the potential risks and benefits, individually for each patient. The aim of the treatment is to liquidate/ improve the clinical and functional manifestations, to reduce the lung lesions and to restore work capacity. The treatment of patients with mycobacteriosis is a complex one (polychemotherapy, if necessary — surgical treatment etc.), long-term, under direct observation, administered in the hospital and/or at home. The treatment regimen is chosen depending on the species involved, radiological picture, comorbidities, drug sensitivity etc.
QT interval prolongation is a predictor of the life-threatening cardiac arrhythmias — polymorphic ventricular tachycardia (torsade de pointes). Long QT syndrome may be congenital or acquired. It is known that a wide range of both antiarrhythmic and non-cardiac medications might lead to QT interval prolongation. List of drugs that cause QT prolongation is constantly growing and being updated. The review contains current data on the clinical significance of the control of QT interval duration within drug therapy. Clinical conditions associated with an increased risk of QT interval prolongation are described. Drugs that can induce QT prolongation are also discussed.
146 Understanding the pulmonary circulation stable on calcium channel blocker therapy for at least 1 year. The following cardiovascular (CV) risk factors were assessed: lipid profile, serum glucose level, presence of diabetes, hypertension and smoking status. The association between level of HDL-C and results of the VR testing were adjusted for CV risk factors and established markers of IPAH severity: World Health Organization functional class (WHO-FC), 6-minute walk distance (6-MWD), N-terminal pro-brain natriuretic peptide (NT-proBNP) serum level, cardiac index (CI), right atrial pressure (RAP) and pulmonary vascular resistance (PVR). Results: We enrolled 66 IPAH patients, treatment-naive at baseline, aged 49.4±17 years (43 females): 9 long-term responders and 57 non-responders in WHO-FC II-IV. HDL-C level was correlated with greater drop of mPAP during VR testing (r=0.32; p=0.009) and this association remained significant after adjustment for IPAH severity markers and CV risk factors (R2=0.23; p=0.002). Patients classified as long-term responders were characterized by higher baseline HDL-C concentration than non-responders (1.75±0.27 vs. 1.14±0.34mmol/l; p<0.001). Non-responders presented with more severe disease defined by higher WHO-FC (3.0±0.5 vs. 2.5±0.5; p=0.009), NT-proBNP level (2266±3726 vs. 547±1035pg/mL; p=0.004), RAP (8.5±5.5 vs. 4 Research Institute of Phthysiopulmonology, Chisinau, Moldova Republic ofThe aim of this study was to investigate the relationship between polymorphism of angiotensin-converting enzyme (ACE), pulmonary hypertension and the right ventricle parameters in patients with chronic obstructive pulmonary disease (COPD). Materials and methods:The study was performed on 127 patients (124 males and 3 females) with different severity grades of COPD, aged between 22 and 60 years (mean age 55,7±0,74 years). All patients satisfied the GOLD criteria for COPD. Pulmonary function tests, blood gases, bodyplethysmography, diffusing capacity for CO, ECG, Doppler EcoCG had been performed in all patients. This data was analysed depending on the revealed genotype. Genomic DNA was extracted from peripheral blood leucocytes by standard methods while the ACE genotypes of all subjects were determined by polymerase chain reaction. Concomitant left ventricular dysfunction was excluded in all patients by echocardiography. Results: The obtained data revealed prevalence of patients with ID genotype (44,1%) in comparison with DD and II genotypes (28,3% and 27,6%, respectively). The highest values of mean pulmonary artery pressure (mPAP) were observed in patients with ID genotype (32,4±2,75 mmHg, p<0,05) vs. 26,8±3,63 mmHg and 25,7±2,72 mmHg in II and DD genotypes, respectively). The right ventricle (RV) end-diastolic diameter was significantly increased in patients with DD genotype (30,4±2,75 mm, p<0,05) vs. patients with II and ID genotypes (25,7±2,42 mmHg and 24,3±3,15 mmHg, respectively). There was no observed relationship between ACE gene genotypes and right and left ventricle hypertrophy, left ventri...
Purpose. Highlighting the medical and legal aspects of patient identification in a specialized medical institution. Materials and methods. The materials of the expert assessment of the patient identification process in a medical organization have been studied: regulatory and methodological acts; medical records; data of direct observation of the processes of medical activity, interviews of medical personnel and patients; special literature selected from medical information databases. Results. It has been established that patient identification is carried out in accordance with international recommendations; within the framework of the current national regulations. The patient identification algorithm is performed by all medical professionals at all stages of medical care. At the same time, omissions were noted in the actions of medical personnel, which in an emergency situation could cause a real mistake — unintentional harm to the patient. Conclusions. Developing a patient safety culture in a medical organization and implementing a system that ensures correct patient identification helps to reduce the number of errors associated with it and the associated medical and legal consequences.
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