Romanian journal of internal medicine = Revue roumaine de médecine interne
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The aim of our study was to assess the clinical effectiveness of a simplified algorithm using the Wells clinical decision rule, D-dimer testing, and computed tomography (CT) in patients with suspected pulmonary embolism (PE) in an Emergency Department (ED). ⋯ In this study we have confirmed the effectiveness of a diagnostic management strategy using a simple clinical decision rule, D-dimer testing, and CT in the evaluation and management of patients with clinically suspected pulmonary embolism.
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The use of lead aVR for predicting appearance of left main coronary artery (LMCA) lesion has been recently a subject of great interest. This study evaluates the predictive value of ST-segment elevation in lead aVR on electrocardiogram in the diagnosis of significant LMCA lesions. ⋯ ST-elevation of lead aVR is a valuable indicator for predicting LMCA lesion with acceptable accuracy and predictive value.
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Review
Diagnostic value of calprotectin in irritable bowel syndrome and in inflammatory bowel disease.
The inflammation is an important component of the bowel wall structure. The amount of inflammation is gradually increased from normal state, to functional bowel disorders and to inflammatory bowel disease. ⋯ We also show on a sample of patients that inflammation as tested with fecal calprotectin test may also be found, in lower degree, in irritable bowel syndrome. In inflammatory bowel disease, the calprotectin fecal test shows higher intensity values.
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Pulmonary arterial hypertension is defined as a group of diseases characterised by a progressive increase in pulmonary vascular load, leading to marked increase in pulmonary artery pressure, right ventricular failure and premature death. Given the nonspecific nature of its early symptoms and signs, pulmonary arterial hypertension (PAH) is often diagnosed in its advanced stages. Although clinical assessment is essential when initially evaluating patients with suspected PAH, echocardiography is a key screening tool in the diagnostic algorithm, because, in comparison with invasive measurements, it has the advantages of being safe, portable, and repeatable. ⋯ Several echocardiographic techniques centered on the Doppler principle (both conventional Doppler parameters and tissue Doppler imaging) used in the assessment of PAH magnitude and its cardiac effects are presented in this paper. They provide important data on the severity, possible causes and consequences of pulmonary hypertension, both initially and during follow-up, therefore having the ability to estimate disease progression, prognosis, or to monitor therapeutic response. Doppler echocardiography allows to noninvasively estimate systolic pulmonary arterial pressure (SPAP), mean and end-diastolic pulmonary arterial pressure, as well as the quantification of right ventricular (RV) function and the evaluation of pulmonary vascular resistance (PVR).
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Arterial hypertension is associated with accelerated atherosclerosis resulting in increased arterial stiffness. It is well known that left ventricular diastolic function declines in patients with hypertension. The study aims to determine the relationship between arterial stiffness and left ventricular diastolic dysfunction in patients with hypertension with preserved left ventricular ejection fraction using newly developed ultrasonic imaging. ⋯ Our data confirm the positive correlation between diastolic dysfunction and arterial stiffness, and suggest that non-invasive assessment of the 13 index might be useful for studying the effects on arterial stiffness of treatment designed to optimize cardiac performance in patients with hypertension. Arterial stiffness is an independent predictor of diastolic dysfunction in hypertensive patients and should be considered a potential target for intervention in diastolic heart failure. TDI-detected left ventricular diastolic dysfunction is accompanied by increased arterial stiffness in newly diagnosed essential hypertension.