Deep vein thrombosis (DVT) is a medical condition, occurs when a blood clot forms in a deep vein and pulmonary embolism (PE) occurs when a blood clot gets lodged in an artery in the lung, affecting blood flow to part of the lung.The frequencies of using computed tomography (CT) and magnetic resonance imaging (MRI) to diagnose deep venous thrombosis and pulmonary embolism is increasing day by day.Both the technics are noninvasive and provide prompt results. But there are a good number of alternative technics for the same purposes. That is why, till now scholars and respective professionals are interested to know more about the justification and comparative effectiveness of CT and MRI in detecting DVT and PE.This review aimed to analyze the history of several detecting methods for DVT and PE and to dig out the clear concepts about the effectiveness and patient compliances of CT and MRI in detecting deep venous thrombosis and pulmonary embolism. For proper analysis a lot of research as well as meta-analysis had been studied.From this article besides scholars and professionals, general readers will get a clear concept about the features, effectiveness and justifications of CT and MRI in treating DVT and PE.
Thrombosis is a common complication in cancer patients. In all cancer patients, changes occur that lead to arterial and venous thrombosis. It is not known for certain what exactly provokes the appearance of blood clots and causes disseminated intravascular coagulation (DIC). A morpho-histological study of the muscles of the lower extremities was carried out in two groups of people who suffered from cancer and had deep vein thrombosis of the lower extremities with subsequent migration of blood clots. In two groups of people who died due to the migration of blood clots from the veins of the lower extremities in the pulmonary artery, clear dystrophic changes in muscle fibers were found with narrowing of all arterioles and a strong expansion of the venous vessels. In all the venous vessels of the preparation, damage to the endothelium was found, which may indicate the presence of thrombosis of the venous vessels carrying blood from the muscles. People with cancer of the pancreas and/or colon have significant hemodynamic, hypertrophic, dystrophic, and atrophic changes in muscle fibers. There are signs of a systemic effect of the tumor on the vessels and hemodynamics in the lower extremities.
Annotation. The goal of this study was to investigate the characteristic histological and morphological signs of changes in the venous wall as one of the main pathogenetic links of thrombosis in oncological pathology. Assessment of these changes is necessary to understand the process of occurrence and prevention of thromboembolic and thrombotic complications in patients with oncological diseases. Histological, submicroscopic and polarizing materials of hind limb veins of 11 mature nonlinear male rats weighing 170-180 g on day 30 of chronic neoplastic intoxication complicated by deep limb vein thrombosis were studied. It is established that experimental neoplastic intoxication in rats on histological examination was accompanied by the development of submicroscopic reorganization of endotheliocytes and their desquamation, platelet ligation as one of the causes of future thrombotic complications. Thus installed the negative effect of long-term neoplastic intoxication on the cells and all layers of the venous vascular wall as well as on the blood forming elements was studied. A close connection between the presence of the obtained changes against the background of oncological diseases and the development of such thrombotic complications as phlebothrombosis, pulmonary embolism and thrombophlebitis has been established. The development of complications shows that the prevention of thrombosis is an important component of conservative therapy of cancer patients, to prevent the development of lethal outcomes. High incidence of PE, deep vein thrombosis and thrombophlebitis in the superficial venous system emphasizes the use of preventive means of conservative treatment of cancer patients to prevent these complications, resulting in a high mortality rate. The study of morphological changes of the venous wall under the influence of chronic neoplastic intoxication in experimental conditions allows to carry out a detailed analysis of possible complications.
The study of the risk factors of occupational diseases is a medical and social issue from a view point of practice and sociology, it is a theoretical basis for the development of methods for their prevention. The official statistical reports prove that in Ukraine, more than 60 % of 1.1 million health workers undergo harmful exposure and danger, and occupational disease occurrence among them is recorded at the level of 0.71 per 100 thousand working population. In the structure of occupational diseases, tuberculosis is first (80–100 %, on average – 87.7 %), diseases of musculoskeletal system are second (1.3–6.7 %, on average – 3.1 %), allergic diseases are third – 1.0–5.1 % (on average – 2.3 %).The aim of the study – to learn and summarize the causes of professional diseases of medical workers in Ukraine.Materials and Methods. Occupational morbidity of medical staff is caused by the influence of risk factors: mechanical, physical, chemical, biological, nervous-emotional. Medical workers under static work conditions are exposed to negative mechanical influences. The harmful effects of physical factor are considerably increased at present due to a widespread implementation of equipment with light, electromagnetic and radioactive radiation into medical and diagnostic processes. Due to the rapid development of chemical and pharmaceutical industries, the number of chemicals that cause not only the therapeutic effect on a patient but also have a negative impact on healthcare workers in cases of their systematic use has increased significantly.Results and Discussion. A group of occupational diseases caused by pathogens of tuberculosis, toxoplasmosis, viral hepatitis, skin mycoses, syphilis, and HIV infection is an urgent matter of health care in Ukraine. The risk of HIV infection is about 0.3 % and reaches 10 % in cases of hepatitis C virus, and 30 % in hepatitis B virus. In Ukraine, according to the Ministry of Health, every year 30.0–50.0 thousand patients are diagnosed with this illness (84.1 per 100 thousand population). Manifestations of the emotional affection as a symptom complex of “professional burnout” have been revealed in almost 80 % of psychiatrists, psychotherapists, narcologists, in 61.8 % of dentists, and 60.6 % of medical nurses of oncology departments.Conclusion. The analyses of occupational diseases cases among healthcare workers of various medical facilities of Ukraine in 2011–2017 has proved that the highest number of occupational diseases is registered in TB facilities – 70.1–95.5 %. 3.0–6.4 % of all occupational diseases in the healthcare have been registered in community hospitals, 1.5–10.2 – in psychoneurological hospitals, 1.9–3.0 % – in the Bureau of Forensic Medicine and 2.6–3.0 % – in research institutions.
The article explores the category of «property management», its concepts and content, as well as its relation with the categories, «management of objects of state (municipal) property», «right of operational management», «sphere of management», «transfer of property» to the sphere of management. According to the results of the research, the definition of the concept of communal property as the right of a territorial community to formulate, use and dispose of property belonging to it, both directly and through local authorities, at its discretion and in its own interests on the basis of expediency, economy and efficiency is formulated. It is proposed to administer communal property to understand the exercise of powers of local self-government and their authorized bodies to exercise the rights of the territorial community of a village, settlement, city as the owner of such objects related to the possession, use and disposal of them, within the limits defined by the legislation of Ukraine, to meet the needs of the local community, state and public. The characteristic features of property management based on the contract of property management (Article 1029 of the Civil Code of Ukraine) and the management of state and communal property, which is carried out, in particular, in accordance with the Laws of Ukraine «On State Property Management» and «On Local Self-Government in Ukraine», indicating a significant difference between these types of government. It is proposed to amend: a) the Constitution of Ukraine, which establish that: 1) the subject of state ownership is the state represented by the Verkhovna Rada of Ukraine; 2) the property belonging to the Autonomous Republic of Crimea (the Crimean Tatar Autonomous Republic, if any) is state property; b) to the Law of Ukraine «On Local Self-Government in Ukraine» by defining the concept of management of communal property objects and clarifying the definition of the term «communal property right». Keywords: communal property right, management of communal property, sphere of management, transfer of property to the sphere of management.
Реферат. Метою дослідження є показати доцільність застосування електрохірургічних методів коагуляції в хірургії щитоподібної залози. Експериментальне дослідження було проведене на 80 лабораторних щурах, для розсікання тканин використовувався хірургі-чний скальпель, для гемостазу виконували лігування судин атравматичною ниткою, застосовували моно-та біполярну коагуляцію та апарат LigaSure. Результати дослі-дження: встановлено зональність впливу високочастотного струму на структуру щито-подібної залози. Висновок. Встановлено переваги використання термічного фактору в тиреоїдній хірургії над класичним розсіканням тканин і лігуванням судин атравматич-ною ниткою. Methods. The study was conducted on 80 laboratory rats. Studied animals were divided into groups according to the surgical intervention methods. Results were analyzed with histological methods on the 3 rd , 7 th and 14 th days. Results. Histological examination of soft tissues in the area of wound on the third postoperative day showed pronounced inflammatory reaction against the foreign body. The inflammatory infiltrate had spread to the thyroid tissue. In general morphological changes were characterized by non-specific aseptic necrosis and development of granulation tissue at the site of coagulation. Conclusion. This analysis of wounds healing shows the benefits of using thermal factor in thyroid surgery over classic dissection with scalpel and vascular ligation with atraumatic thread.
Вступ. Онкопатологія – одна з основних причин смертності населення, що спричиняє економічні втрати, пов’язані не тільки з вартістю лікування, але і з втратою здоров’я і інвалідністю населення працездатного віку. Рак шийки матки в даний час – одна з найбільш частих злоякісних пухлин жіночих статевих органів. Наявність флеботромбозів в онкологічних хворих достовірно впливає на тривалість життя, викликає триразове збільшення смертності у порівнянні з пацієнтами з поєднанням тромбозу з доброякісними захворюваннями. Найбільш поширеною причиною смерті госпіталізованих у стаціонар хворих є тромбоз. Дослідження гемостазіологічних показників повинно враховуватися при визначенні тактики лікування онкологічних хворих. Мета дослідження. Визначити закономірності зміни гемостазіологічних показників крові у хворих на рак шийки матки в залежності від гістологічного варіанту пухлини. Матеріали та методи. Обстежено 28 жінок, які були розподілені на контрольну групу: 7 жінок соматично здорових та 12 пацієнток з аденокарциномою шийки матки та 9 пацієнток з плоскоклітинним раком шийки матки для вивчення показників системи гемостазу, що знаходилися на стаціонарному лікуванні у гінекологічному відділенні Тернопільського обласного клінічного онкологічного диспансеру. У всіх пацієнток діагностовано гострий флеботромбоз підколінно-гомілкового сегмента. Результати досліджень та їх обговорення. З представлених даних при порівнянні груп пацієнток з аденокарциномою шийки матки і плоскоклітинним раком шийки матки статистично достовірним виявилося зменшення тромбінового часу (p<0,01), активованого часткового тромбопластинового часу (p<0,005) і протромбінового часу(p<0,005) що свідчить про гіперкоагуляцію. При аналізі фібриногену виявлено статистичне збільшення показників(p<0,01), що свідчить про схильность до тромбоутворення з ризиком тромбоембологенних ускладень. Підвищені значення розчинних фібрин-мономерих комплексів (РФМК) (p<0,01), які є маркерами тромбінемії при внутрішньосудинному згортанні крові, свідчать про активацію згортальної системи крові. Також нами відзначено статистич-ний вплив морфологічної структури пухлини на показники згортальної ситеми. Так, рівень фібриногену (p<0,005),РФМК (p<0,005) більший у пацієнтів з аденокарциномою шийки матки порівняно з пацієнтами з плоскоклітинним раком шийки матки, також відзначено зменшення протромбінового та тромбінового часу, що свідчить про активацію згортальної системи крові. Висновки. Встановлено достовірний вплив раку шийки матки на активацію згортальної системи крові. Виявлено залежність морфологічної структури раку шийки матки на розвиток тромбозу. Так, встановлено статистично біль-ший прояв гіперкоагуляції у пацієнтів з аденокарциномою шийки матки в порівнянні з пацієнтами із плоскоклітинним раком шийки матки. Хворі з раком шийки матки відносяться до групи високого ризику розвитку тромбоемболічних ускладнень і потребують профілактики тромботичних ускладнень. Ключові слова: рак шийки матки, тромбоз глибоких вен, згортальна система.
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