RESUMO
The degree of left main coronary artery (LM) lesions is one of the main factors that predetermine the survival rate of patients with coronary heart disease. Below is a description of a clinical case of a successful stenting in a young 35 year old patient with a severe LM obstruction and an underlying acute coronary syndrome (ACS). Urgent stenting in such clinical situations have been found to be very effective and safe as demonstrated below in the following case study.
Assuntos
Síndrome Coronariana Aguda/diagnóstico , Vasos Coronários/fisiopatologia , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Síndrome Coronariana Aguda/fisiopatologia , Síndrome Coronariana Aguda/terapia , Adulto , Angioplastia Coronária com Balão , Humanos , Masculino , Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Choque Cardiogênico/diagnóstico , Choque Cardiogênico/fisiopatologia , Choque Cardiogênico/terapia , StentsRESUMO
The purpose of our work was to determine a prevalence of depression and its distribution by grades in patients with a coronary heart disease, namely - with the myocardial infarction. The study involved 125 patients of average age 64.2±4.7 years, treated at cardiology department for myocardial infarction. The first stage was a depression screening using PHQ - 2 questionnaire. In case of positive answer to at least one question, we assessed the severity of depression using a PHQ-9 tool. We established, that PHQ-2 questionnaire questions for screening depressive disorders were positively answered by 80 patients (64.3%). Total signs of depression of various severity grades was diagnosed in 68 patients (54.4%). Minimal depression was diagnosed in 25 (36.8%) patients, mild depression - in 20 (29.4%) patients, moderately severe disease - in 16 (23.6%) patients, and severe depression - in 7 (10.2%) patients. The severity of depression was clearly related to age, gender of patients, comorbid diseases, and a history of MI and revascularization.
Assuntos
Doença das Coronárias/psicologia , Depressão/epidemiologia , Fatores Etários , Idoso , Doença das Coronárias/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/psicologia , Infarto do Miocárdio/terapia , Revascularização Miocárdica , Prevalência , Índice de Gravidade de Doença , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
The main methods of surgical treatment of 122 patients, suffering achalasia of cardia, in 1996-2007 yrs are depicted. The authors propose to improve the performance of cardiodilatation and esophagocardiomyotomy.
Assuntos
Cárdia/cirurgia , Acalasia Esofágica/cirurgia , Esofagectomia/métodos , Adolescente , Adulto , Idoso , Criança , Acalasia Esofágica/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto JovemRESUMO
The results of treatment of 334 patients, operated on for cholelithic disease, were analyzed. In 164 of them intraoperative transillumination (IT) was applied and in 170--the generally accepted methods of the hepatoduodenal ligament content exposure. There was established the expedience of the IT application for the extrahepatic biliary ducts (EBD) and vessels verification as well as for the choledocholithiasis diagnosis during performance of laparoscopic and open cholecystectomy. Application of IT and the laparoscopic cholecystectomy method proposed have ad permitted to reduce trustworthy the frequency of the EBD and the vessels iatrogenic injury.
