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#182
13.10.2008, 18:26
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Óâàæàåìàÿ Êèðà!
Ïîìèìî ïóáëèêàöèè â æóðíàëàõ âñå ãàéäû ðàçìåùàþò íà ñàéòàõ îðãàíèçàöèé: åâðîïåéñêèå íà [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ], àìåðèêàíñêèå - íà [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] 2 dmblock Äàëåå âàðôàðèí, ìèíèìóì 3 ìåñÿöà. À íà ôîíå ÷åãî îí ïîëó÷èë òðîìáîç â íîãå? Êàêèå ôàêòîðû ðèñêà? 
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#183
13.10.2008, 19:11
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Öèòàòà:
 Õîòÿ íà [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] çàãëÿäûâàþ ðåãóëÿðíî. Öèòàòà:
 "The 60/60 sign required RV acceleration time of ≤60 ms in presence of tricuspid insufficiency pressure gradient ≤60 mm Hg." Âðåìÿ óñêîðåíèÿ ÂÒÏÆ íàì íåèçâåñòíî, íî ãðàäèåíò ÒÐ áîëüøå 60 ìì. ðò. ñò. Ñïðàâåäëèâîñòè ðàäè íóæíî ñêàçàòü, ÷òî ñïåöèôè÷íîñòü ïðèçíàêà 60/60, â îòëè÷èå îò ïðèçíàêà ÌàêÊîííåëëà, ðàâíà 100% òîëüêî ó ïàöèåíòîâ áåç ñåðäå÷íî-ëåãî÷íîé ïàòîëîãèè â àíàìíåçå. "APE was ultimately confirmed in 67 of 100 patients. In 17 of 67 patients, 60/60 sign correctly suggested APE, whereas 2 false-positive results were noted: in pulmonary fibrosis and in acute respiratory distress syndrome following lung resection. McConnell sign was fully specific but was noted in only 13 of 67 patients." [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Ñ óâàæåíèåì, Êèðà.
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#185
13.10.2008, 21:32
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Öèòàòà:
Âîñïðîñ: íàñêîëüêî íåîáõîäèìî èíâàçèâíîå èññëåäîâàíèå ãåìîäèíàìèêè? Ýòî âñå-òàêè âðåìÿ, ðèñê êðîâîòå÷åíèÿ íà ôîíå ïîñëåäóþùåé ÒËÒ, äà è íåïîíÿòíî êàê òàì êàòåòåð ñ òðîìáîì âçàèìîäåéñòâóåò...
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#186
15.10.2008, 17:36
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Öèòàòà:
Âîîáùå ìû ðóòèííî ñòàâèì ïëàâàþùèé êàòåòåð áîëüíûì ñ ÈÌ ñ ëåâîæåëóäî÷êîâîé íåäîñòàòî÷íîñòüþ è ïðè ÈÌ ÏÆ íà ôîíå ìîùíîé àíòèòðîìáîòè÷åñêîé òåðàïèè. Äëÿ ýòîãî ìû èñïîëüçóåì èñêëþ÷èòåëüíî âíóòðåííþþ ÿðåìíóþ âåíó. Ñóùåñòâóþò äîïîëíèòåëüíûå òåõíè÷åñêèå õèòðîñòè, êîòîðûå ïîçâîëÿþò óìåíüøèòü ðèñê îñëîæíåíèé. Øèðîêî èçâåñòíû ñòàòüè, â êîòîðûõ îáñóæäàåòñÿ âîïðîñ íóæíî ëè âîîáùå ïðèìåíÿòü Swan-Ganz êàòåòåð. Ìíåíèÿ ó÷åíûõ ðàçîøëèñü. Åñëè ó êîìó-òî ýòà òåìà ïîêàæåòñÿ èíòåðåñíîé è åñòü ñîáñòâåííîå ìíåíèå íà ýòîò ñ÷åò áóäåò î÷åíü ëþáîïûòíî îáñóäèòü. Öèòàòà:
PS Íåìíîãî ÝÕÎ äèíàìèêè. Ïîòîì âûëîæó åùå. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#187
16.10.2008, 04:57
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Öèòàòà:
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#188
24.10.2008, 17:40
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Öèòàòà:
Association between long travel and venous thromboembolic disease: a systematic review and meta-analysis of case-control studies // [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#189
16.03.2009, 12:58
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Óâàæàåìûå êàðäèîëîãè! Íå íàøëà òåìó "ÝÊà äëÿ ÷àéíèêîâ", ïîýòîìó ñïðîøó çäåñü.ß íå ñìîãëà ðàçîáðàòüñÿ â ëåíòå, êîòîðàÿ äëÿ âàñ ñêîðåå âñåãî ""íåçàíÿòíàÿ". Âðîäå ïîëíàÿ à-â áëîêàäà, à çóáöû Ð âñå æå åñòü. Äëÿ à-â áëîêàäû 1-é ñòåïåíè çóáöû Ð íå âåçäå. Ïðèøëîñü èç-çà ýòîãî ïàöèåíòà îòïðàâèòü ê êàðäèîëîãó.
Ïàöèåíò 70 ëåò, ÑÄ èíñóëèíîçàâèñèìûé, äèàáåòè÷åñêàÿ ðåòèíîïàòèÿ, îäûøêà ïðè ìàëåéøåé ôèç. íàãðóçêå, îòåêè íà íîãàõ, ðåçêî óõóäøèëñÿ ãîä íàçàä. Íà ðåíòãåíå (âîçìîæíî, ñ ïðîøëîãî ãîäà) 80-100 ìë æèäêîñòè â ïðàâîé ïëåâðàëüíîé ïîëîñòè, óòîëùåíèå áàçàëüíîé ïëåâðû, äèàôðàãìà ïîäòÿíóòà ââåðõ. Ãîâîðèò, ÷òî ïóëüñ ó íåãî ÷àñòî áûâàåò 35-36 â ìèíóòó, ïðè íåñêîëüêèõ îñìîòðàõ ïóëüñ áûë 47 â ìèí. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#190
16.03.2009, 13:05
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Ïîëíîé áëîêàäû íåò. Äóìàþ, ÷òî äàæå À 1-é ñò íåò (êàëèáðîâêè íå âèæó). Ïóëüñ ìîæåò áûòü ðåäêèé çà ñ÷åò ýêñòðàñèñòîë.
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#192
16.03.2009, 14:30
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Öèòàòà:
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#193
16.03.2009, 15:14
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Çóáöû Ð ïðîñëåæèâàþñÿ âåçäå íà êàðòèíêå óâàæàåìîãî dmblok~a. Òàê æå êàê çóáåö U (÷òî âïðî÷åì íåâàæíî), èç ÷åãî ÿ äåëàþ âûâîä, ÷òî ðèòì ñèíóñîâûé.
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#194
16.03.2009, 15:29
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ß çâîíèëà êàðäèîëîãó íà ñëåäóþùèé äåíü âèçèòà ê íåìó áîëüíîãî (äëÿ îáðàçîâàíèÿ). Îí ñêàçàë, ÷òî ýòî à-â áëîêàäà 1-é ñòåïåíè, âðîäå âñïîìíèë áîëüíîãî. Ñàìà ÿ â äåíü îñìîòðà äóìàëà ìåæäó 2-é è 3-é ñòåïåíÿìè àâ-áëîêàäû. Ñìóòèë ðåäêèé ðèòì.
À çäåñü ìîæíî äóìàòü î ÑÑÑÓ?
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#195
16.03.2009, 19:33
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Ýòî À áëîêàäà 1 ñò. Î ÑÑÑÓ, ó÷èòûâàÿ ñèíóñîâóþ áðàäèêàðäèþ ìîæíî äóìàòü â òîì ñëó÷àå, åñëè ïàöèåíò íå ïðèíèìàåò ïðåïàðàòû, âëèÿþùèå íà ×ÑÑ (áåòà-áëîêàòîðû, âåðàïàìèë è ò.ï.). Êñòàòè, çóáöû Ð ëó÷øå âñåãî èñêàòü â îòâåäåíèè II, III, aVF èëè V1.
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Ëèíåéíûé âèä
