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embolism</title> <meta name="description" content="Search results for: pulmonary embolism"> <meta name="keywords" content="pulmonary embolism"> <meta name="viewport" content="width=device-width, initial-scale=1, minimum-scale=1, maximum-scale=1, user-scalable=no"> <meta charset="utf-8"> <link href="https://cdn.waset.org/favicon.ico" type="image/x-icon" rel="shortcut icon"> <link href="https://cdn.waset.org/static/plugins/bootstrap-4.2.1/css/bootstrap.min.css" rel="stylesheet"> <link href="https://cdn.waset.org/static/plugins/fontawesome/css/all.min.css" rel="stylesheet"> <link href="https://cdn.waset.org/static/css/site.css?v=150220211555" rel="stylesheet"> </head> <body> <header> <div class="container"> <nav class="navbar navbar-expand-lg navbar-light"> <a class="navbar-brand" href="https://waset.org"> <img src="https://cdn.waset.org/static/images/wasetc.png" alt="Open Science Research Excellence" title="Open Science Research Excellence" /> </a> <button class="d-block d-lg-none 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action="https://publications.waset.org/abstracts/search"> <div id="custom-search-input"> <div class="input-group"> <i class="fas fa-search"></i> <input type="text" class="search-query" name="q" placeholder="Author, Title, Abstract, Keywords" value="pulmonary embolism"> <input type="submit" class="btn_search" value="Search"> </div> </div> </form> </div> </div> <div class="row mt-3"> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Commenced</strong> in January 2007</div> </div> </div> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Frequency:</strong> Monthly</div> </div> </div> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Edition:</strong> International</div> </div> </div> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Paper Count:</strong> 295</div> </div> </div> </div> <h1 class="mt-3 mb-3 text-center" style="font-size:1.6rem;">Search results for: pulmonary embolism</h1> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">295</span> A Theoretical to Conceptual Paper: The Use of Phosphodiesterase Inhibitors, Endothelin Receptor Antagonists and/or Prostacyclin Analogs in Acute Pulmonary Embolism</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Ryan%20M.%20Monti">Ryan M. Monti</a>, <a href="https://publications.waset.org/abstracts/search?q=Bijal%20Mehta"> Bijal Mehta</a> </p> <p class="card-text"><strong>Abstract:</strong></p> In cases of massive pulmonary embolism, defined as acute pulmonary embolism presenting with systemic hypotension or right ventricular dysfunction and impending failure, there is indication that unconventional therapies, such as phosphodiesterase inhibitors, endothelin receptor antagonists, and/or prostacyclin analogs may decrease the morbidity and mortality. Based on the premise that dilating the pulmonary artery will decrease the pulmonary vascular pressure, while simultaneously decreasing the aggregation of platelets, it can be hypothesized that increased blood flow through the pulmonary artery will decrease right heart strain and subsequent morbidity and mortality. While this theory has yet to be formally studied, the recommendations for treating massive pulmonary embolism with phosphodiesterase inhibitors, endothelin receptor antagonists, and/or prostacyclin analogs in conjunction with the current standards of care in massive pulmonary embolism should be formally studied. In particular, patients with massive PE who are unable to undergo thrombolysis/surgical intervention may be the ideal population to study the use of these treatments to determine any decrease in mortality and morbidity (short term and long term). <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=acute%20pulmonary%20thromboembolism" title="acute pulmonary thromboembolism">acute pulmonary thromboembolism</a>, <a href="https://publications.waset.org/abstracts/search?q=treatment%20of%20pulmonary%20embolism" title=" treatment of pulmonary embolism"> treatment of pulmonary embolism</a>, <a href="https://publications.waset.org/abstracts/search?q=use%20of%20phosphodiesterase%20inhibitors" title=" use of phosphodiesterase inhibitors"> use of phosphodiesterase inhibitors</a>, <a href="https://publications.waset.org/abstracts/search?q=endothelin%20receptor%20antagonists" title=" endothelin receptor antagonists"> endothelin receptor antagonists</a>, <a href="https://publications.waset.org/abstracts/search?q=prostacyclin%20analogs%20in%20PE" title=" prostacyclin analogs in PE"> prostacyclin analogs in PE</a> </p> <a href="https://publications.waset.org/abstracts/49295/a-theoretical-to-conceptual-paper-the-use-of-phosphodiesterase-inhibitors-endothelin-receptor-antagonists-andor-prostacyclin-analogs-in-acute-pulmonary-embolism" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/49295.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">225</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">294</span> A Case of Postpartum Pulmonary Edema Induced by Oxytocin</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=May%20Zaw">May Zaw</a>, <a href="https://publications.waset.org/abstracts/search?q=Amber%20Latif"> Amber Latif</a>, <a href="https://publications.waset.org/abstracts/search?q=William%20Lim"> William Lim</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Postpartum dyspnea can be due to many causes, such as pulmonary embolism, amniotic fluid embolism, and peripartum cardiomyopathy, but less frequently due to acute pulmonary edema. The incidence of acute pulmonary edema during pregnancy and in the postpartum period has been estimated to be around 0.08%. About half of the cases are attributed to tocolytic therapy. Herein, we present a case of a young woman presenting with acute hypoxia after induction of labor with oxytocin and found to have acute pulmonary edema. This case aims to illustrate and add to a growing body of literature regarding oxytocin-induced acute pulmonary edema and highlights the importance of recognizing the rare complication of oxytocin and necessary interventions to avoid complications. Oxytocin-induced pulmonary edema is a relatively uncommon condition, but physicians should have a high index of suspicion to initiate timely intervention and avoid fetal complications. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=pulmonary" title="pulmonary">pulmonary</a>, <a href="https://publications.waset.org/abstracts/search?q=pregnancy" title=" pregnancy"> pregnancy</a>, <a href="https://publications.waset.org/abstracts/search?q=oxytocin" title=" oxytocin"> oxytocin</a>, <a href="https://publications.waset.org/abstracts/search?q=postpartum" title=" postpartum"> postpartum</a> </p> <a href="https://publications.waset.org/abstracts/153892/a-case-of-postpartum-pulmonary-edema-induced-by-oxytocin" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/153892.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">90</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">293</span> Validation Pulmonary Embolus Severity Index Score Early Mortality Rate at 1, 3, 7 Days in Patients with a Diagnosis of Pulmonary Embolism</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Nicholas%20Marinus%20Batt">Nicholas Marinus Batt</a>, <a href="https://publications.waset.org/abstracts/search?q=Angus%20Radford"> Angus Radford</a>, <a href="https://publications.waset.org/abstracts/search?q=Khaled%20Saraya"> Khaled Saraya</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Pulmonary Embolus Severity Index (PESI) score is a well-validated decision-making score grading mortality rates (MR) in patients with a suspected or confirmed diagnosis of pulmonary embolism (PE) into 5 classes. Thirty and 90 days MR in class I and II are lower allowing the treatment of these patients as outpatients. In a London District General Hospital (DGH) with mixed ethnicity and high disease burden, we looked at MR at 1, 3, and 7 days of all PESI score classes. Our pilot study of 112 patients showed MR of 0% in class I, II, and III. The current study includes positive Computed Tomographic Scans (CT scans) for PE over the following three years (total of 555). MR was calculated for all PESI score classes at 1, 3 & 7 days. Thirty days MR was additionally calculated to validate the study. Our initial results so far are in line with our pilot studies. Further subgroup analysis accounting for the local co-morbidities and disease burden and its impact on the MR will be undertaken. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=Pulmonary%20Embolism%20%28PE%29" title="Pulmonary Embolism (PE)">Pulmonary Embolism (PE)</a>, <a href="https://publications.waset.org/abstracts/search?q=Pulmonary%20Embolism%20Severity%20Index%20%28PESI%29%20score" title=" Pulmonary Embolism Severity Index (PESI) score"> Pulmonary Embolism Severity Index (PESI) score</a>, <a href="https://publications.waset.org/abstracts/search?q=mortality%20rate%20%28MR%29" title=" mortality rate (MR)"> mortality rate (MR)</a>, <a href="https://publications.waset.org/abstracts/search?q=CT%20pulmonary%20artery" title=" CT pulmonary artery"> CT pulmonary artery</a> </p> <a href="https://publications.waset.org/abstracts/69902/validation-pulmonary-embolus-severity-index-score-early-mortality-rate-at-1-3-7-days-in-patients-with-a-diagnosis-of-pulmonary-embolism" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/69902.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">264</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">292</span> Pulmonary Valve Papillary Fibroelastoma: A Case Report of a Fibroelastoma Presenting as a Pulmonary Embolism</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Frazer%20Kirk">Frazer Kirk</a>, <a href="https://publications.waset.org/abstracts/search?q=Matthew%20Yong"> Matthew Yong</a>, <a href="https://publications.waset.org/abstracts/search?q=Peter%20Williams"> Peter Williams</a>, <a href="https://publications.waset.org/abstracts/search?q=Andrie%20Strobel"> Andrie Strobel</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Pulmonary valve papillary fibroelastoma is an exceedingly rare pathology. The experience and literature regarding them are largely anecdotal and based on sporadic, single case reports. Throughout their known history, two features remain salient that they are classically asymptomatic and found incidentally. The demographic profile of those affected is unclear, as reports regarding those affected are mixed, and there is no clear gender or age predominance, although there is some suggestion of a predisposition to affect females. Nor has there been a well-structured epidemiological study of the entity. Interestingly they are becoming more common on peri-mortum examination. Here-after we describe our experience with a symptomatic presentation of pulmonary papillary fibroelastoma masquerading as a pulmonary embolism and its subsequent assessment and management, with intraoperative photography and echocardiography for reference. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=cardiac%20tumor" title="cardiac tumor">cardiac tumor</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20valve" title=" pulmonary valve"> pulmonary valve</a>, <a href="https://publications.waset.org/abstracts/search?q=fibroelastoma" title=" fibroelastoma"> fibroelastoma</a>, <a href="https://publications.waset.org/abstracts/search?q=cardiac%20surgery" title=" cardiac surgery"> cardiac surgery</a> </p> <a href="https://publications.waset.org/abstracts/142247/pulmonary-valve-papillary-fibroelastoma-a-case-report-of-a-fibroelastoma-presenting-as-a-pulmonary-embolism" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/142247.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">219</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">291</span> Pulmonary Embolism Indicative of Myxoma of the Right Atrium</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=A.%20Kherraf">A. Kherraf</a>, <a href="https://publications.waset.org/abstracts/search?q=M.%20Bouziane"> M. Bouziane</a>, <a href="https://publications.waset.org/abstracts/search?q=A.%20Drighil"> A. Drighil</a>, <a href="https://publications.waset.org/abstracts/search?q=L.%20Azzouzi"> L. Azzouzi</a>, <a href="https://publications.waset.org/abstracts/search?q=R.%20Habbal"> R. Habbal</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism" title="pulmonary embolism">pulmonary embolism</a>, <a href="https://publications.waset.org/abstracts/search?q=myxoma" title=" myxoma"> myxoma</a>, <a href="https://publications.waset.org/abstracts/search?q=right%20atrium" title=" right atrium"> right atrium</a>, <a href="https://publications.waset.org/abstracts/search?q=heart%20tumors" title=" heart tumors "> heart tumors </a> </p> <a href="https://publications.waset.org/abstracts/130820/pulmonary-embolism-indicative-of-myxoma-of-the-right-atrium" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/130820.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">142</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">290</span> Strategies For Management Of Massive Intraoperative Airway Haemorrhage Complicating Surgical Pulmonary Embolectomy</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Nicholas%20Bayfield">Nicholas Bayfield</a>, <a href="https://publications.waset.org/abstracts/search?q=Liam%20Bibo"> Liam Bibo</a>, <a href="https://publications.waset.org/abstracts/search?q=Kaushelandra%20Rathore"> Kaushelandra Rathore</a>, <a href="https://publications.waset.org/abstracts/search?q=Lucas%20Sanders"> Lucas Sanders</a>, <a href="https://publications.waset.org/abstracts/search?q=Mark%20Newman"> Mark Newman</a> </p> <p class="card-text"><strong>Abstract:</strong></p> INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolectomy" title="pulmonary embolectomy">pulmonary embolectomy</a>, <a href="https://publications.waset.org/abstracts/search?q=cardiopulmonary%20bypass" title=" cardiopulmonary bypass"> cardiopulmonary bypass</a>, <a href="https://publications.waset.org/abstracts/search?q=cardiac%20surgery" title=" cardiac surgery"> cardiac surgery</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism" title=" pulmonary embolism"> pulmonary embolism</a> </p> <a href="https://publications.waset.org/abstracts/142008/strategies-for-management-of-massive-intraoperative-airway-haemorrhage-complicating-surgical-pulmonary-embolectomy" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/142008.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">175</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">289</span> Ultrasonography of Low Extremities Veins Before and After Replacement of Knee Joint by Endoprosthesis </h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=A.%20V.%20Alabut">A. V. Alabut</a>, <a href="https://publications.waset.org/abstracts/search?q=V.%20D.%20Sikilinda"> V. D. Sikilinda</a>, <a href="https://publications.waset.org/abstracts/search?q=N.%20J.%20Nelasov"> N. J. Nelasov</a>, <a href="https://publications.waset.org/abstracts/search?q=O.%20L.%20Eroshenko"> O. L. Eroshenko</a>, <a href="https://publications.waset.org/abstracts/search?q=M.%20N.%20Morgunov"> M. N. Morgunov</a>, <a href="https://publications.waset.org/abstracts/search?q=I.%20V.%20Koroleva"> I. V. Koroleva </a> </p> <p class="card-text"><strong>Abstract:</strong></p> We have analyzed the results of treatment of 204 patients with knee prosthetic arthroplasty. For the purpose of active delineation of vascular pathology triplex sonography of arterial and venous vessels of low extremities was performed in all cases in the preoperative period. When it was necessary, reconstructive vascular surgery was implemented to improve peripheral circulation and reduce the hazard of thrombosis after knee replacement. The combination of specific and nonspecific methods of thromboprophylaxis was used in perioperative period. On 7-10 day and 2.5-3 month after prosthetic arthroplasty, all patients iteratively underwent triple sonography. In case of detection of floating thrombus, urgent venous ligation was performed. Active diagnostics of venous thrombosis gave the opportunity to avoid fatal pulmonary embolism. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=knee%20replacement" title="knee replacement">knee replacement</a>, <a href="https://publications.waset.org/abstracts/search?q=venous%20thrombosis" title=" venous thrombosis"> venous thrombosis</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism" title=" pulmonary embolism"> pulmonary embolism</a>, <a href="https://publications.waset.org/abstracts/search?q=vascular%20surgery" title=" vascular surgery "> vascular surgery </a> </p> <a href="https://publications.waset.org/abstracts/5218/ultrasonography-of-low-extremities-veins-before-and-after-replacement-of-knee-joint-by-endoprosthesis" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/5218.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">368</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">288</span> Diagnostic Yield of CT PA and Value of Pre Test Assessments in Predicting the Probability of Pulmonary Embolism</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Shanza%20Akram">Shanza Akram</a>, <a href="https://publications.waset.org/abstracts/search?q=Sameen%20Toor"> Sameen Toor</a>, <a href="https://publications.waset.org/abstracts/search?q=Heba%20Harb%20Abu%20Alkass"> Heba Harb Abu Alkass</a>, <a href="https://publications.waset.org/abstracts/search?q=Zainab%20Abdulsalam%20Altaha"> Zainab Abdulsalam Altaha</a>, <a href="https://publications.waset.org/abstracts/search?q=Sara%20Taha%20Abdulla"> Sara Taha Abdulla</a>, <a href="https://publications.waset.org/abstracts/search?q=Saleem%20Imran"> Saleem Imran</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=CT%20PA" title="CT PA">CT PA</a>, <a href="https://publications.waset.org/abstracts/search?q=D%20dimer" title=" D dimer"> D dimer</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism" title=" pulmonary embolism"> pulmonary embolism</a>, <a href="https://publications.waset.org/abstracts/search?q=wells%20score" title=" wells score"> wells score</a> </p> <a href="https://publications.waset.org/abstracts/41853/diagnostic-yield-of-ct-pa-and-value-of-pre-test-assessments-in-predicting-the-probability-of-pulmonary-embolism" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/41853.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">231</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">287</span> Half Dose Tissue Plasminogen Activator for Intermediate-Risk Pulmonary Embolism</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Macie%20Matta">Macie Matta</a>, <a href="https://publications.waset.org/abstracts/search?q=Ahmad%20Jabri"> Ahmad Jabri</a>, <a href="https://publications.waset.org/abstracts/search?q=Stephanie%20Jackson"> Stephanie Jackson</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism" title="pulmonary embolism">pulmonary embolism</a>, <a href="https://publications.waset.org/abstracts/search?q=half%20dose%20thrombolysis" title=" half dose thrombolysis"> half dose thrombolysis</a>, <a href="https://publications.waset.org/abstracts/search?q=tissue%20plasminogen%20activator" title=" tissue plasminogen activator"> tissue plasminogen activator</a>, <a href="https://publications.waset.org/abstracts/search?q=cardiac%20biomarkers" title=" cardiac biomarkers"> cardiac biomarkers</a>, <a href="https://publications.waset.org/abstracts/search?q=echocardiographic%20findings" title=" echocardiographic findings"> echocardiographic findings</a>, <a href="https://publications.waset.org/abstracts/search?q=major%20bleeding%20event" title=" major bleeding event"> major bleeding event</a> </p> <a href="https://publications.waset.org/abstracts/161710/half-dose-tissue-plasminogen-activator-for-intermediate-risk-pulmonary-embolism" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/161710.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">75</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">286</span> Chest Trauma and Early Pulmonary Embolism: The Risks</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Vignesh%20Ratnaraj">Vignesh Ratnaraj</a>, <a href="https://publications.waset.org/abstracts/search?q=Daniel%20Marascia"> Daniel Marascia</a>, <a href="https://publications.waset.org/abstracts/search?q=Kelly%20Ruecker"> Kelly Ruecker</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Purpose: Pulmonary embolism (PE) is a major cause of morbidity and mortality in trauma patients. Data suggests PE is occurring earlier in trauma patients, with attention being turned to possible de novo events. Here, we examine the incidence of early PE at a level 1 trauma center and examine the relationship with a chest injury. Method: A retrospective analysis was performed from a prospective trauma registry at a level 1 trauma center. All patients admitted from 1 January 2010 to 30 June 2019 diagnosed with PE following trauma were included. Early PE was considered a diagnosis within 72 hours of admission. The severity of the chest injury was determined by the Abbreviated Injury Score (AIS). Analysis of severe chest injury and incidence of early PE was performed using chi-square analysis. Sub-analysis on the timing of PE and PE location was also performed using chi-square analysis. Results: Chest injury was present in 125 of 184 patients diagnosed with PE. Early PE occurred in 28% (n=35) of patients with a chest injury, including 24.39% (n=10) with a severe chest injury. Neither chest injury nor severe chest injury determined the presence of early PE (p= > 0.05). Sub-analysis showed a trend toward central clots in early PE (37.14%, n=13) compared to late (27.78%, n=25); however, this was not found to be significant (p= > 0.05). Conclusion: PE occurs early in trauma patients, with almost one-third being diagnosed before 72 hours. This analysis does not support the paradigm that chest injury, nor severe chest injury, results in statistically significant higher rates of early PE. Interestingly, a trend toward early central PE was noted in those suffering chest trauma. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=trauma" title="trauma">trauma</a>, <a href="https://publications.waset.org/abstracts/search?q=PE" title=" PE"> PE</a>, <a href="https://publications.waset.org/abstracts/search?q=chest%20injury" title=" chest injury"> chest injury</a>, <a href="https://publications.waset.org/abstracts/search?q=anticoagulation" title=" anticoagulation"> anticoagulation</a> </p> <a href="https://publications.waset.org/abstracts/160319/chest-trauma-and-early-pulmonary-embolism-the-risks" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/160319.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">101</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">285</span> Nursing Experience in the Intensive Care of a Lung Cancer Patient with Pulmonary Embolism on Extracorporeal Membrane Oxygenation</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Huang%20Wei-Yi">Huang Wei-Yi</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Objective: This article explores the intensive care nursing experience of a lung cancer patient with pulmonary embolism who was placed on ECMO. Following a sudden change in the patient’s condition and a consensus reached during a family meeting, the decision was made to withdraw life-sustaining equipment and collaborate with the palliative care team. Methods: The nursing period was from October 20 to October 27, 2023. The author monitored physiological data, observed, provided direct care, conducted interviews, performed physical assessments, and reviewed medical records. Together with the critical care team and bypass personnel, a comprehensive assessment was conducted using Gordon's Eleven Functional Health Patterns to identify the patient’s health issues, which included pain related to lung cancer and invasive devices, fear of death due to sudden deterioration, and altered tissue perfusion related to hemodynamic instability. Results: The patient was admitted with fever, back pain, and painful urination. During hospitalization, the patient experienced sudden discomfort followed by cardiac arrest, requiring multiple CPR attempts and ECMO placement. A subsequent CT angiogram revealed a pulmonary embolism. The patient's condition was further complicated by severe pain due to compression fractures, and a diagnosis of terminal lung cancer was unexpectedly confirmed, leading to emotional distress and uncertainty about future treatment. Throughout the critical care process, ECMO was removed on October 24, stabilizing the patient’s body temperature between 36.5-37°C and maintaining a mean arterial pressure of 60-80 mmHg. Pain management, including Morphine 8mg in 0.9% N/S 100ml IV drip q6h PRN and Ultracet 37.5 mg/325 mg 1# PO q6h, kept the pain level below 3. The patient was transferred to the ward on October 27 and discharged home on October 30. Conclusion: During the care period, collaboration with the medical team and palliative care professionals was crucial. Adjustments to pain medication, symptom management, and lung cancer-targeted therapy improved the patient’s physical discomfort and pain levels. By applying the unique functions of nursing and the four principles of palliative care, positive encouragement was provided. Family members, along with social workers, clergy, psychologists, and nutritionists, participated in cross-disciplinary care, alleviating anxiety and fear. The consensus to withdraw ECMO and life-sustaining equipment enabled the patient and family to receive high-quality care and maintain autonomy in decision-making. A follow-up call on November 1 confirmed that the patient was emotionally stable, pain-free, and continuing with targeted lung cancer therapy. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=intensive%20care" title="intensive care">intensive care</a>, <a href="https://publications.waset.org/abstracts/search?q=lung%20cancer" title=" lung cancer"> lung cancer</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism" title=" pulmonary embolism"> pulmonary embolism</a>, <a href="https://publications.waset.org/abstracts/search?q=ECMO" title=" ECMO"> ECMO</a> </p> <a href="https://publications.waset.org/abstracts/190195/nursing-experience-in-the-intensive-care-of-a-lung-cancer-patient-with-pulmonary-embolism-on-extracorporeal-membrane-oxygenation" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/190195.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">27</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">284</span> A Study of NT-ProBNP and ETCO2 in Patients Presenting with Acute Dyspnoea</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Dipti%20Chand">Dipti Chand</a>, <a href="https://publications.waset.org/abstracts/search?q=Riya%20Saboo"> Riya Saboo</a> </p> <p class="card-text"><strong>Abstract:</strong></p> OBJECTIVES: Early and correct diagnosis may present a significant clinical challenge in diagnosis of patients presenting to Emergency Department with Acute Dyspnoea. The common cause of acute dyspnoea and respiratory distress in Emergency Department are Decompensated Heart Failure (HF), Chronic Obstructive Pulmonary Disease (COPD), Asthma, Pneumonia, Acute Respiratory Distress Syndrome (ARDS), Pulmonary Embolism (PE), and other causes like anaemia. The aim of the study was to measure NT-pro Brain Natriuretic Peptide (BNP) and exhaled End-Tidal Carbon dioxide (ETCO2) in patients presenting with dyspnoea. MATERIAL AND METHODS: This prospective, cross-sectional and observational study was performed at the Government Medical College and Hospital, Nagpur, between October 2019 and October 2021 in patients admitted to the Medicine Intensive Care Unit. Three groups of patients were compared: (1) HFrelated acute dyspnoea group (n = 52), (2) pulmonary (COPD/PE)-related acute dyspnoea group (n = 31) and (3) sepsis with ARDS-related dyspnoea group (n = 13). All patients underwent initial clinical examination with a recording of initial vital parameters along with on-admission ETCO2 measurement, NT-proBNP testing, arterial blood gas analysis, lung ultrasound examination, 2D echocardiography, chest X-rays, and other relevant diagnostic laboratory testing. RESULTS: 96 patients were included in the study. Median NT-proBNP was found to be high for the Heart Failure group (11,480 pg/ml), followed by the sepsis group (780 pg/ml), and pulmonary group had an Nt ProBNP of 231 pg/ml. The mean ETCO2 value was maximum in the pulmonary group (48.610 mmHg) followed by Heart Failure (31.51 mmHg) and the sepsis group (19.46 mmHg). The results were found to be statistically significant (P < 0.05). CONCLUSION: NT-proBNP has high diagnostic accuracy in differentiating acute HF-related dyspnoea from pulmonary (COPD and ARDS)-related acute dyspnoea. The higher levels of ETCO2 help in diagnosing patients with COPD. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=NT%20PRO%20BNP" title="NT PRO BNP">NT PRO BNP</a>, <a href="https://publications.waset.org/abstracts/search?q=ETCO2" title=" ETCO2"> ETCO2</a>, <a href="https://publications.waset.org/abstracts/search?q=dyspnoea" title=" dyspnoea"> dyspnoea</a>, <a href="https://publications.waset.org/abstracts/search?q=lung%20USG" title=" lung USG"> lung USG</a> </p> <a href="https://publications.waset.org/abstracts/163854/a-study-of-nt-probnp-and-etco2-in-patients-presenting-with-acute-dyspnoea" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/163854.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">76</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">283</span> Embolism: How Changes in Xylem Sap Surface Tension Affect the Resistance against Hydraulic Failure </h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Adriano%20Losso">Adriano Losso</a>, <a href="https://publications.waset.org/abstracts/search?q=Birgit%20D%C3%A4mon"> Birgit Dämon</a>, <a href="https://publications.waset.org/abstracts/search?q=Stefan%20Mayr"> Stefan Mayr</a> </p> <p class="card-text"><strong>Abstract:</strong></p> In vascular plants, water flows from roots to leaves in a metastable state, and even a small perturbation of the system can lead a sudden transition from the liquid to the vapor phase, resulting in xylem embolism (cavitation). Xylem embolism, induced by drought stress and/or freezing stress is caused by the aspiration of gaseous bubbles into xylem conduits from adjacent gas-filled compartments through pit membrane pores (‘air seeding’). At water potentials less negative than the threshold for air seeding, the surface tension (γ) stabilizes the air-water interface and thus prevents air from passing the pit pores. This hold is probably also true for conifers, where this effect occurs at the edge of the sealed torus. Accordingly, it was experimentally demonstrated that γ influences air seeding, but information on the relevance of this effect under field conditions is missing. In this study, we analyzed seasonal changes in γ of the xylem sap in two conifers growing at the alpine timberline (Picea abies and Pinus mugo). In addition, cut branches were perfused (40 min perfusion at 0.004 MPa) with different γ solutions (i.e. distilled and degassed water, 2, 5 and 15% (v/v) ethanol-water solution corresponding to a γ of 74, 65, 55 and 45 mN m-1, respectively) and their vulnerability to drought-induced embolism analyzed via the centrifuge technique (Cavitron). In both species, xylem sap γ changed considerably (ca. 53-67 and ca. 50-68 mN m-1 in P. abies and P. cembra, respectively) over the season. Branches perfused with low γ solutions showed reduced resistance against drought-induced embolism in both species. A significant linear relationship (P < 0.001) between P12, P50 and P88 (i.e. water potential at 12, 50 and 88% of the loss of conductivity) and xylem sap γ was found. Based on this correlation, a variation in P50 between -3.10 and -3.83 MPa (P. abies) and between -3.21 and -4.11 MPa (P. mugo) over the season could be estimated. Results demonstrate that changes in γ of the xylem sap can considerably influence a tree´s resistance to drought-induced embolism. They indicate that vulnerability analyses, normally conducted at a γ near that of pure water, might often underestimate vulnerabilities under field conditions. For studied timberline conifers, seasonal changes in γ might be especially relevant in winter, when frost drought and freezing stress can lead to an excessive embolism. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=conifers" title="conifers">conifers</a>, <a href="https://publications.waset.org/abstracts/search?q=Picea%20abies" title=" Picea abies"> Picea abies</a>, <a href="https://publications.waset.org/abstracts/search?q=Pinus%20mugo" title=" Pinus mugo"> Pinus mugo</a>, <a href="https://publications.waset.org/abstracts/search?q=timberline" title=" timberline"> timberline</a> </p> <a href="https://publications.waset.org/abstracts/62953/embolism-how-changes-in-xylem-sap-surface-tension-affect-the-resistance-against-hydraulic-failure" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/62953.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">294</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">282</span> Impact of Pulmonary Rehabilitation on Respiratory Parameters in Interstitial Lung Disease Patients: A Tertiary Care Hospital Study</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Vivek%20Ku">Vivek Ku</a>, <a href="https://publications.waset.org/abstracts/search?q=A.%20K.%20Janmeja"> A. K. Janmeja</a>, <a href="https://publications.waset.org/abstracts/search?q=D.%20Aggarwal"> D. Aggarwal</a>, <a href="https://publications.waset.org/abstracts/search?q=R.%20Gupta"> R. Gupta</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Purpose: Pulmonary rehabilitation plays a key role in management of chronic lung diseases. However, pulmonary rehabilitation is an underused modality in the management of interstitial lung disease (ILD). This is because limited information is available in literature and no data is available from India on this issue so far. The study was carried out to evaluate the role of pulmonary rehabilitation on respiratory parameters in ILD patients. Methods: The present study was a prospective randomized non-blind case control study. Total of 40 ILD patients were randomized into 2 groups of 20 patients each viz ‘pulmonary rehabilitation group’ and ‘control group’. Pulmonary rehabilitation group underwent 8 weeks pulmonary rehabilitation (PR) along with medical management as per guidelines and the control group was advised only medical management. Results: Mean age in case group was 59.15 ± 10.39 years and in control group was 62.10 ± 14.54 years. The case and the control groups were matched for age and sex. Mean MRC grading at the end of 8 weeks showed significant improvement in the case group as compared to control group (p= 0.011 vs p = 0.655). Similarly, mean St. George Respiratory Questionnaire (SGRQ) score also showed significant improvement in pulmonary rehabilitation group at the end of the study (p= 0.001 vs p= 0.492). However, FEV1 and FVC had no significant change in the case and control group. Similarly, blood gases also did not show any significant difference in the group. Conclusion: Pulmonary rehabilitation improves breathlessness and thereby improves quality of life in the patients suffering from ILD. However, the pulmonary function values and blood gases are unaffected by pulmonary rehabilitation. Clinical Implications: Further large scale multicentre study is needed to ascertain the association. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=ILD" title="ILD">ILD</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20rehabilitation" title=" pulmonary rehabilitation"> pulmonary rehabilitation</a>, <a href="https://publications.waset.org/abstracts/search?q=quality%20of%20life" title=" quality of life"> quality of life</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20functions" title=" pulmonary functions"> pulmonary functions</a> </p> <a href="https://publications.waset.org/abstracts/39543/impact-of-pulmonary-rehabilitation-on-respiratory-parameters-in-interstitial-lung-disease-patients-a-tertiary-care-hospital-study" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/39543.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">270</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">281</span> The Role of Pulmonary Resection in Complicated Primary Pediatric Pulmonary Tuberculosis: An Evidence-Based Case Report</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Hendra%20Wibowo">Hendra Wibowo</a>, <a href="https://publications.waset.org/abstracts/search?q=Suprayitno%20Wardoyo"> Suprayitno Wardoyo</a>, <a href="https://publications.waset.org/abstracts/search?q=Dhama%20Shinta"> Dhama Shinta</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: Pediatric pulmonary tuberculosis (TB) incidence was increasing, with many undetected cases. In complicated TB, treatment should consist of returning pulmonary function, preventing further complications, and eliminating bacteria. Complicated TB management was still controversial, and surgery was one of the treatments that should be evaluated in accordance with its role in the treatment of complicated TB. Method: This study was an evidence-based case report. The database used for the literature search were Cochrane, Medline, Proquest, and ScienceDirect. Keywords for the search were ‘primary pulmonary tuberculosis’, ‘surgery’, ‘lung resection’, and ‘children’. Inclusion criteria were studies in English or Indonesian, with children under 18 years old as subject, and full-text articles available. The assessment was done according to Oxford Centre for evidence-based medicine 2011. Results: Six cohort studies were analyzed. Surgery was indicated for patients with complicated TB that were unresponsive towards treatment. It should be noted that the experiments were done before the standard WHO antituberculosis therapy was applied; thus, the result may be different from the current application. Conclusion: Currently, there was no guideline on pulmonary resection. However, surgery yielded better mortality and morbidity in children with complicated pulmonary TB. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=pediatric" title="pediatric">pediatric</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary" title=" pulmonary"> pulmonary</a>, <a href="https://publications.waset.org/abstracts/search?q=surgery" title=" surgery"> surgery</a>, <a href="https://publications.waset.org/abstracts/search?q=therapy" title=" therapy"> therapy</a>, <a href="https://publications.waset.org/abstracts/search?q=tuberculosis" title=" tuberculosis"> tuberculosis</a> </p> <a href="https://publications.waset.org/abstracts/108284/the-role-of-pulmonary-resection-in-complicated-primary-pediatric-pulmonary-tuberculosis-an-evidence-based-case-report" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/108284.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">106</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">280</span> CT-Scan Transition of Pulmonary Edema Due to Water-Soluble Paint Inhalation</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Masashi%20Kanazawa">Masashi Kanazawa</a>, <a href="https://publications.waset.org/abstracts/search?q=Takaaki%20Nakano"> Takaaki Nakano</a>, <a href="https://publications.waset.org/abstracts/search?q=Masaaki%20Takemoto"> Masaaki Takemoto</a>, <a href="https://publications.waset.org/abstracts/search?q=Tomonori%20Imamura"> Tomonori Imamura</a>, <a href="https://publications.waset.org/abstracts/search?q=Mamiko%20Sugimura"> Mamiko Sugimura</a>, <a href="https://publications.waset.org/abstracts/search?q=Toshitaka%20Ito"> Toshitaka Ito</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: We experienced a massive disaster due to inhalation of water-soluble paint. Sixteen patients were brought to our emergency room, and pulmonary edema was revealed on the CT images of 12 cases. Purpose: Transition of chest CT-scan findings in cases with pulmonary edema was examined. Method: CT-scans were performed on the 1st, 2nd, 5th, and 19th days after the inhalation event. Patients whose pulmonary edema showed amelioration or exacerbation were classified into the improvement or the exacerbation group, respectively. Those with lung edema findings appearing at different sites after the second day were classified into the changing group. Results: Eight, one and three patients were in the improvement, exacerbation and changing groups, respectively. In all cases, the pulmonary edema had disappeared from CT images on the 19th day after the inhalation event. Conclusion: Inhalation of water-soluble paints is considered to be relatively safe. However, our observations in these emergency cases suggest that, even if pulmonary edema is not severe immediately after the exposure, new lesions may appear later and existing lesions may worsen. Follow-up imaging is thus necessary for about two weeks. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=CT%20scan" title="CT scan">CT scan</a>, <a href="https://publications.waset.org/abstracts/search?q=intoxication" title=" intoxication"> intoxication</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20edema" title=" pulmonary edema"> pulmonary edema</a>, <a href="https://publications.waset.org/abstracts/search?q=water-soluble%20paint" title=" water-soluble paint"> water-soluble paint</a> </p> <a href="https://publications.waset.org/abstracts/74622/ct-scan-transition-of-pulmonary-edema-due-to-water-soluble-paint-inhalation" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/74622.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">173</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">279</span> Capture-recapture to Estimate Completeness of Pulmonary Tuberculosis with Two Sources</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Ratchadaporn%20Ungcharoen">Ratchadaporn Ungcharoen</a>, <a href="https://publications.waset.org/abstracts/search?q=Lily%20Ingsrisawang"> Lily Ingsrisawang</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Capture-recapture methods are popular techniques for indirect estimation the size of wildlife populations and the completeness of cases in epidemiology and social sciences. The aim of this study was to estimate the completeness of pulmonary tuberculosis cases confirmed by two sources of hospital registrations and surveillance systems in 2013 in Nakhon Pathom province, Thailand. Several estimators of population size were considered: the Lincoln-Petersen estimator, the Chapman estimator, the Chao’s lower bound estimator, the Zelterman’s estimator, etc. We focus on the Chapman and Chao’s lower bound estimators for estimating the completeness of pulmonary tuberculosis from two sources. The retrieved pulmonary tuberculosis data from two sources were analyzed and bootstrapped for 30 samples, with 241 observations from source 1 and 305 observations from source 2 per sample, for additional exploration of the completeness of pulmonary tuberculosis. The results from the original data show that the Chapman’s estimator gave the estimation of a total 360 (95% CI: 349-371) pulmonary tuberculosis cases, resulting in 57% estimated completeness cases. But the Chao’s lower bound estimator estimated the total of 365 (95% CI: 354-376) pulmonary tuberculosis cases and its estimated completeness cases was 55.9%. For the results from bootstrap samples, the Chapman and the Chao’s lower bound estimators gave an estimated 347 (95% CI: 309-385) and 353 (95% CI: 315-390) pulmonary tuberculosis cases, respectively. If for two sources recoding systems are available, record-linkage and capture-recapture analysis can be useful for estimating the completeness of different registration system. Both Chapman and Chao’s lower bound estimator approaches produce very close estimates. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=capture-recapture" title="capture-recapture">capture-recapture</a>, <a href="https://publications.waset.org/abstracts/search?q=Chao" title=" Chao"> Chao</a>, <a href="https://publications.waset.org/abstracts/search?q=Chapman" title=" Chapman"> Chapman</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20tuberculosis" title=" pulmonary tuberculosis"> pulmonary tuberculosis</a> </p> <a href="https://publications.waset.org/abstracts/23818/capture-recapture-to-estimate-completeness-of-pulmonary-tuberculosis-with-two-sources" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/23818.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">516</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">278</span> Cadaveric Study of Lung Anatomy: A Surgical Overview</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Arthi%20Ganapathy">Arthi Ganapathy</a>, <a href="https://publications.waset.org/abstracts/search?q=Rati%20Tandon"> Rati Tandon</a>, <a href="https://publications.waset.org/abstracts/search?q=Saroj%20Kaler"> Saroj Kaler</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: A thorough knowledge of variations in lung anatomy is of prime significance during surgical procedures like lobectomy, pneumonectomy, and segmentectomy of lungs. The arrangement of structures in the lung hilum act as a guide in performing such procedures. The normal pattern of arrangement of hilar structures in the right lung is eparterial bronchus, pulmonary artery, hyparterial bronchus and pulmonary veins from above downwards. In the left lung, it is pulmonary artery, principal bronchus and pulmonary vein from above downwards. The arrangement of hilar structures from anterior to posterior in both the lungs is pulmonary vein, pulmonary artery, and principal bronchus. The bronchial arteries are very small and usually the posterior most structures in the hilum of lungs. Aim: The present study aims at reporting the variations in hilar anatomy (arrangement and number) of lungs. Methodology: 75 adult formalin fixed cadaveric lungs from the department of Anatomy AIIMS New Delhi were observed for variations in the lobar anatomy. Arrangement of pulmonary hilar structures was meticulously observed, and any deviation in the pattern of presentation was recorded. Results: Among the 75 adult lung specimens observed 36 specimens were of right lung and the rest of left lung. Seven right lung specimens showed only 2 lobes with an oblique fissure dividing them and one left lung showed 3 lobes. The normal pattern of arrangement of hilar structures was seen in 22 right lungs and 23 left lungs. Rest of the lung specimens (14 right and 16 left) showed a varied pattern of arrangement of hilar structures. Some of them showed alterations in the sequence of arrangement of pulmonary artery, pulmonary veins, bronchus, and others in the number of these structures. Conclusion: Alterations in the pattern of arrangement of structures in the lung hilum are quite frequent. A compromise in knowledge of such variations will result in inadvertent complications like intraoperative bleeding during surgical procedures. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=fissures" title="fissures">fissures</a>, <a href="https://publications.waset.org/abstracts/search?q=hilum" title=" hilum"> hilum</a>, <a href="https://publications.waset.org/abstracts/search?q=lobes" title=" lobes"> lobes</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary" title=" pulmonary"> pulmonary</a> </p> <a href="https://publications.waset.org/abstracts/77925/cadaveric-study-of-lung-anatomy-a-surgical-overview" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/77925.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">224</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">277</span> NO2 Exposure Effect on the Occurrence of Pulmonary Dysfunction the Police Traffic in Jakarta</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Bambang%20Wispriyono">Bambang Wispriyono</a>, <a href="https://publications.waset.org/abstracts/search?q=Satria%20Pratama"> Satria Pratama</a>, <a href="https://publications.waset.org/abstracts/search?q=Haryoto%20Kusnoputranto"> Haryoto Kusnoputranto</a>, <a href="https://publications.waset.org/abstracts/search?q=Faisal%20Yunus"> Faisal Yunus</a>, <a href="https://publications.waset.org/abstracts/search?q=Meliana%20Sari"> Meliana Sari</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction/objective: The impact of the development of motor vehicles is increasing the number of pollutants in the air. One of the substances that cause serious health problems is NO2. The health impacts arising from exposure to NO2 include pulmonary function impairment. The purpose of this study was to determine the relationship of NO2 exposure on the incidence of pulmonary function impairment. Methods: We are using a cross-sectional study design with 110 traffic police who were divided into two groups: exposed (police officers working on the highway) and the unexposed group (police officers working in the office). Election subject convenient sampling carried out in each group to the minimum number of samples met. Results: The results showed that the average NO2 in the exposed group was 18.72 ppb and unexposed group is 4.14 ppb. Pulmonary dysfunction on exposed and unexposed groups showed that FVC (Forced Vital Capacity) value are 88.68 and 90.27. And FEV1 (Forced Expiratory Volume in One) value are 94.9 and 95.16. Some variables like waist circumference, Body Mass Index, Visceral Fat, and Fat has associated with the incidence of Pulmonary Dysfunction (p < 0.05). Conclusion: Health monitoring is needed to decreasing health risk in Policeman. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=NO2" title="NO2">NO2</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20dysfunction" title=" pulmonary dysfunction"> pulmonary dysfunction</a>, <a href="https://publications.waset.org/abstracts/search?q=police%20traffic" title=" police traffic"> police traffic</a>, <a href="https://publications.waset.org/abstracts/search?q=Jakarta" title=" Jakarta"> Jakarta</a> </p> <a href="https://publications.waset.org/abstracts/62743/no2-exposure-effect-on-the-occurrence-of-pulmonary-dysfunction-the-police-traffic-in-jakarta" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/62743.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">255</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">276</span> Scattering Operator and Spectral Clustering for Ultrasound Images: Application on Deep Venous Thrombi</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Thibaud%20Berthomier">Thibaud Berthomier</a>, <a href="https://publications.waset.org/abstracts/search?q=Ali%20Mansour"> Ali Mansour</a>, <a href="https://publications.waset.org/abstracts/search?q=Luc%20Bressollette"> Luc Bressollette</a>, <a href="https://publications.waset.org/abstracts/search?q=Fr%C3%A9d%C3%A9ric%20Le%20Roy"> Frédéric Le Roy</a>, <a href="https://publications.waset.org/abstracts/search?q=Dominique%20Mottier"> Dominique Mottier</a>, <a href="https://publications.waset.org/abstracts/search?q=L%C3%A9o%20Fr%C3%A9chier"> Léo Fréchier</a>, <a href="https://publications.waset.org/abstracts/search?q=Barth%C3%A9l%C3%A9my%20Hermenault"> Barthélémy Hermenault</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Deep Venous Thrombosis (DVT) occurs when a thrombus is formed within a deep vein (most often in the legs). This disease can be deadly if a part or the whole thrombus reaches the lung and causes a Pulmonary Embolism (PE). This disorder, often asymptomatic, has multifactorial causes: immobilization, surgery, pregnancy, age, cancers, and genetic variations. Our project aims to relate the thrombus epidemiology (origins, patient predispositions, PE) to its structure using ultrasound images. Ultrasonography and elastography were collected using Toshiba Aplio 500 at Brest Hospital. This manuscript compares two classification approaches: spectral clustering and scattering operator. The former is based on the graph and matrix theories while the latter cascades wavelet convolutions with nonlinear modulus and averaging operators. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=deep%20venous%20thrombosis" title="deep venous thrombosis">deep venous thrombosis</a>, <a href="https://publications.waset.org/abstracts/search?q=ultrasonography" title=" ultrasonography"> ultrasonography</a>, <a href="https://publications.waset.org/abstracts/search?q=elastography" title=" elastography"> elastography</a>, <a href="https://publications.waset.org/abstracts/search?q=scattering%20operator" title=" scattering operator"> scattering operator</a>, <a href="https://publications.waset.org/abstracts/search?q=wavelet" title=" wavelet"> wavelet</a>, <a href="https://publications.waset.org/abstracts/search?q=spectral%20clustering" title=" spectral clustering"> spectral clustering</a> </p> <a href="https://publications.waset.org/abstracts/80700/scattering-operator-and-spectral-clustering-for-ultrasound-images-application-on-deep-venous-thrombi" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/80700.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">479</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">275</span> Design and Development of a Bi-Leaflet Pulmonary Valve</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Munirah%20Ismail">Munirah Ismail</a>, <a href="https://publications.waset.org/abstracts/search?q=Joon%20Hock%20Yeo"> Joon Hock Yeo</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Paediatric patients who require ventricular outflow tract reconstruction usually need valve construction to prevent valvular regurgitation. They would face problems like lack of suitable, affordable conduits and the need to undergo several operations in their lifetime due to the short lifespan of existing valves. Their natural growth and development are also of concern, even if they manage to receive suitable conduits. Current prosthesis including homografts, bioprosthetic valves, mechanical valves, and bovine jugular veins either do not have the long-term durability or the ability to adapt to the growth of such patients. We have developed a new design of bi-leaflet valve. This new technique accommodates patients’ annular size growth while maintaining valvular patency. A mock circulatory system was set up to assess the hemodynamic performance of the bi-leaflet pulmonary valve. It was found that the percentage regurgitation was acceptable and thus, validates this novel concept. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=bi-leaflet%20pulmonary%20valve" title="bi-leaflet pulmonary valve">bi-leaflet pulmonary valve</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20heart%20valve" title=" pulmonary heart valve"> pulmonary heart valve</a>, <a href="https://publications.waset.org/abstracts/search?q=tetralogy%20of%20fallot" title=" tetralogy of fallot"> tetralogy of fallot</a>, <a href="https://publications.waset.org/abstracts/search?q=mock%20circulatory%20system" title=" mock circulatory system"> mock circulatory system</a> </p> <a href="https://publications.waset.org/abstracts/86147/design-and-development-of-a-bi-leaflet-pulmonary-valve" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/86147.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">162</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">274</span> Algorithm for Quantification of Pulmonary Fibrosis in Chest X-Ray Exams</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Marcela%20de%20Oliveira">Marcela de Oliveira</a>, <a href="https://publications.waset.org/abstracts/search?q=Guilherme%20Giacomini"> Guilherme Giacomini</a>, <a href="https://publications.waset.org/abstracts/search?q=Allan%20Felipe%20Fattori%20Alves"> Allan Felipe Fattori Alves</a>, <a href="https://publications.waset.org/abstracts/search?q=Ana%20Luiza%20Menegatti%20Pavan"> Ana Luiza Menegatti Pavan</a>, <a href="https://publications.waset.org/abstracts/search?q=Maria%20Eugenia%20Dela%20Rosa"> Maria Eugenia Dela Rosa</a>, <a href="https://publications.waset.org/abstracts/search?q=Fernando%20Antonio%20Bacchim%20Neto"> Fernando Antonio Bacchim Neto</a>, <a href="https://publications.waset.org/abstracts/search?q=Diana%20Rodrigues%20de%20Pina"> Diana Rodrigues de Pina</a> </p> <p class="card-text"><strong>Abstract:</strong></p> It is estimated that each year one death every 10 seconds (about 2 million deaths) in the world is attributed to tuberculosis (TB). Even after effective treatment, TB leaves sequelae such as, for example, pulmonary fibrosis, compromising the quality of life of patients. Evaluations of the aforementioned sequel are usually performed subjectively by radiology specialists. Subjective evaluation may indicate variations inter and intra observers. The examination of x-rays is the diagnostic imaging method most accomplished in the monitoring of patients diagnosed with TB and of least cost to the institution. The application of computational algorithms is of utmost importance to make a more objective quantification of pulmonary impairment in individuals with tuberculosis. The purpose of this research is the use of computer algorithms to quantify the pulmonary impairment pre and post-treatment of patients with pulmonary TB. The x-ray images of 10 patients with TB diagnosis confirmed by examination of sputum smears were studied. Initially the segmentation of the total lung area was performed (posteroanterior and lateral views) then targeted to the compromised region by pulmonary sequel. Through morphological operators and the application of signal noise tool, it was possible to determine the compromised lung volume. The largest difference found pre- and post-treatment was 85.85% and the smallest was 54.08%. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=algorithm" title="algorithm">algorithm</a>, <a href="https://publications.waset.org/abstracts/search?q=radiology" title=" radiology"> radiology</a>, <a href="https://publications.waset.org/abstracts/search?q=tuberculosis" title=" tuberculosis"> tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=x-rays%20exam" title=" x-rays exam"> x-rays exam</a> </p> <a href="https://publications.waset.org/abstracts/39759/algorithm-for-quantification-of-pulmonary-fibrosis-in-chest-x-ray-exams" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/39759.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">418</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">273</span> Trend and Incidence of Tuberculosis, Yemen, 2019 to 2021</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Zainab%20A.%20Alaghbri">Zainab A. Alaghbri</a>, <a href="https://publications.waset.org/abstracts/search?q=Labiba%20A."> Labiba A.</a>, <a href="https://publications.waset.org/abstracts/search?q=Esam%20A."> Esam A.</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Tuberculosis (TB) is the fourth leading cause of death in Yemen and is considered a major priority by the Ministry of Public Health. The war in Yemen has led to the emergence of one of the worst humanitarian crises in the world. These circumstances may lead to exacerbate the situation of tuberculosis. This study aims to describe the trend and incidence of TB in north and east governorates, Yemen 2019-2021 and provide recommendations for interventions. A descriptive analysis was conducted during July to September 2022. Data of TB cases were obtained from the national tuberculosis program as soft copy. The Data included the TB case collected and diagnosed during 2019-2021. The data contains the following variables: Sex, age, governorates, smear-positive cases, extra-pulmonary cases, and treatment outcomes. 16791 TB cases were notified for an overall case notification rate 65.5/100000 for all forms (smear positive and Extra-pulmonary), There was a slightly declined in 2020 and 2021 by 1%. Both the pulmonary smear positive and Extra pulmonary rates were slightly decreased from 8.8 to 7.7 and 13.5 to 12.8 / 100, 000 populations respectively. For Tuberculosis cases by type of patient, the incidence of extra-pulmonary was the highest (12,9, 11.3 and 12,2/100000) over the three years. However, the incidence of pulmonary failure was the lowest. The majority of cases were in the age group 25-34. The overall treatment success rate for smear-positive patients was 88%. Of the 627 patients with documented unsuccessful outcomes (e.g., failure, death, and default), 165 (23%) died, 52 (8.3%) failed treatment, and 410 (65%) defaulted. Overall, the magnitude of tuberculosis decreased over the periods reviewed. The proportion of Extra-pulmonary TB was the highest. The success rate achieved after treatment was below the levels established by the WHO End Tuberculosis Strategy (90%). Failure to complete treatment may be responsible for the low success rate. Monitoring and addressing the risk factors that were associated with treatment outcomes and duration may help improve the likelihood of achieving favorable outcomes among cases of smear-positive pulmonary TB. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=tuberculosis" title="tuberculosis">tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=trend" title=" trend"> trend</a>, <a href="https://publications.waset.org/abstracts/search?q=incidence" title=" incidence"> incidence</a>, <a href="https://publications.waset.org/abstracts/search?q=yemen" title=" yemen"> yemen</a> </p> <a href="https://publications.waset.org/abstracts/171629/trend-and-incidence-of-tuberculosis-yemen-2019-to-2021" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/171629.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">97</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">272</span> High-Dimensional Single-Cell Imaging Maps Inflammatory Cell Types in Pulmonary Arterial Hypertension</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Selena%20Ferrian">Selena Ferrian</a>, <a href="https://publications.waset.org/abstracts/search?q=Erin%20Mccaffrey"> Erin Mccaffrey</a>, <a href="https://publications.waset.org/abstracts/search?q=Toshie%20Saito"> Toshie Saito</a>, <a href="https://publications.waset.org/abstracts/search?q=Aiqin%20Cao"> Aiqin Cao</a>, <a href="https://publications.waset.org/abstracts/search?q=Noah%20Greenwald"> Noah Greenwald</a>, <a href="https://publications.waset.org/abstracts/search?q=Mark%20Robert%20Nicolls"> Mark Robert Nicolls</a>, <a href="https://publications.waset.org/abstracts/search?q=Trevor%20Bruce"> Trevor Bruce</a>, <a href="https://publications.waset.org/abstracts/search?q=Roham%20T.%20Zamanian"> Roham T. Zamanian</a>, <a href="https://publications.waset.org/abstracts/search?q=Patricia%20Del%20Rosario"> Patricia Del Rosario</a>, <a href="https://publications.waset.org/abstracts/search?q=Marlene%20Rabinovitch"> Marlene Rabinovitch</a>, <a href="https://publications.waset.org/abstracts/search?q=Michael%20Angelo"> Michael Angelo</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Recent experimental and clinical observations are advancing immunotherapies to clinical trials in pulmonary arterial hypertension (PAH). However, comprehensive mapping of the immune landscape in pulmonary arteries (PAs) is necessary to understand how immune cell subsets interact to induce pulmonary vascular pathology. We used multiplexed ion beam imaging by time-of-flight (MIBI-TOF) to interrogate the immune landscape in PAs from idiopathic (IPAH) and hereditary (HPAH) PAH patients. Massive immune infiltration in I/HPAH was observed with intramural infiltration linked to PA occlusive changes. The spatial context of CD11c+DCs expressing SAMHD1, TIM-3 and IDO-1 within immune-enriched microenvironments and neutrophils were associated with greater immune activation in HPAH. Furthermore, CD11c-DC3s (mo-DC-like cells) within a smooth muscle cell (SMC) enriched microenvironment were linked to vessel score, proliferating SMCs, and inflamed endothelial cells. Experimental data in cultured cells reinforced a causal relationship between neutrophils and mo-DCs in mediating pulmonary arterial SMC proliferation. These findings merit consideration in developing effective immunotherapies for PAH. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20arterial%20hypertension" title="pulmonary arterial hypertension">pulmonary arterial hypertension</a>, <a href="https://publications.waset.org/abstracts/search?q=vascular%20remodeling" title=" vascular remodeling"> vascular remodeling</a>, <a href="https://publications.waset.org/abstracts/search?q=indoleamine%202-3-dioxygenase%201%20%28IDO-1%29" title=" indoleamine 2-3-dioxygenase 1 (IDO-1)"> indoleamine 2-3-dioxygenase 1 (IDO-1)</a>, <a href="https://publications.waset.org/abstracts/search?q=neutrophils" title=" neutrophils"> neutrophils</a>, <a href="https://publications.waset.org/abstracts/search?q=monocyte-derived%20dendritic%20cells" title=" monocyte-derived dendritic cells"> monocyte-derived dendritic cells</a>, <a href="https://publications.waset.org/abstracts/search?q=BMPR2%20mutation" title=" BMPR2 mutation"> BMPR2 mutation</a>, <a href="https://publications.waset.org/abstracts/search?q=interferon%20gamma%20%28IFN-%CE%B3%29" title=" interferon gamma (IFN-γ)"> interferon gamma (IFN-γ)</a> </p> <a href="https://publications.waset.org/abstracts/156849/high-dimensional-single-cell-imaging-maps-inflammatory-cell-types-in-pulmonary-arterial-hypertension" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/156849.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">173</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">271</span> Bronchoscopy and Genexpert in the Diagnosis of Pulmonary Tuberculosis in the Indian Private Health Sector: A Short Case Series</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=J.%20J.%20Mathew">J. J. Mathew</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=pulmonary" title="pulmonary">pulmonary</a>, <a href="https://publications.waset.org/abstracts/search?q=tuberculosis" title=" tuberculosis"> tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=bronchoscopy" title=" bronchoscopy"> bronchoscopy</a>, <a href="https://publications.waset.org/abstracts/search?q=genexpert" title=" genexpert"> genexpert</a> </p> <a href="https://publications.waset.org/abstracts/47668/bronchoscopy-and-genexpert-in-the-diagnosis-of-pulmonary-tuberculosis-in-the-indian-private-health-sector-a-short-case-series" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/47668.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">245</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">270</span> Pulmonary Complication of Chronic Liver Disease and the Challenges Identifying and Managing Three Patients</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Aidan%20Ryan">Aidan Ryan</a>, <a href="https://publications.waset.org/abstracts/search?q=Nahima%20Miah"> Nahima Miah</a>, <a href="https://publications.waset.org/abstracts/search?q=Sahaj%20Kaur"> Sahaj Kaur</a>, <a href="https://publications.waset.org/abstracts/search?q=Imogen%20Sutherland"> Imogen Sutherland</a>, <a href="https://publications.waset.org/abstracts/search?q=Mohamed%20Saleh"> Mohamed Saleh</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Pulmonary symptoms are a common presentation to the emergency department. Due to a lack of understanding of the underlying pathophysiology, chronic liver disease is not often considered a cause of dyspnea. We present three patients who were admitted with significant respiratory distress secondary to hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. The first is a 27-year-old male with a 6-month history of progressive dyspnea. The patient developed a severe type 1 respiratory failure with a PaO₂ of 6.3kPa and was escalated to critical care, where he was managed with non-invasive ventilation to maintain oxygen saturation. He had an agitated saline contrast echocardiogram, which showed the presence of a possible shunt. A CT angiogram revealed significant liver cirrhosis, portal hypertension, and large para esophageal varices. Ultrasound of the abdomen showed coarse liver echo patter and enlarged spleen. Along with these imaging findings, his biochemistry demonstrated impaired synthetic liver function with an elevated international normalized ratio (INR) of 1.4 and hypoalbuminaemia of 28g/L. The patient was then transferred to a tertiary center for further management. Further investigations confirmed a shunt of 56%, and liver biopsy confirmed cirrhosis suggestive of alpha-1-antitripsyin deficiency. The findings were consistent with a diagnosis of hepatopulmonary syndrome, and the patient is awaiting a liver transplant. The second patient is a 56-year-old male with a 12-month history of worsening dyspnoea, jaundice, confusion. His medical history included liver cirrhosis, portal hypertension, and grade 1 oesophageal varices secondary to significant alcohol excess. On admission, he developed a type 1 respiratory failure with PaO₂ of 6.8kPa requiring 10L of oxygen. CT pulmonary angiogram was negative for pulmonary embolism but showed evidence of chronic pulmonary hypertension, liver cirrhosis, and portal hypertension. An echocardiogram revealed a grossly dilated right heart with reduced function, pulmonary and tricuspid regurgitation, and pulmonary artery pressures estimated at 78mmHg. His biochemical markers showed impaired synthetic liver function with an INR of 3.2, albumin of 29g/L, along with raised bilirubin of 148mg/dL. During his long admission, he was managed with diuretics with little improvement. After three weeks, he was diagnosed with portopulmonary hypertension and was commenced on terlipressin. This resulted in successfully weaning off oxygen, and he was discharged home. The third patient is a 61-year-old male who presented to the local ambulatory care unit for therapeutic paracentesis on a background of decompensated liver cirrhosis. On presenting, he complained of a 2-day history of worsening dyspnoea and a productive cough. Chest x-ray showed a large pleural effusion, increasing in size over the previous eight months, and his abdomen was visibly distended with ascitic fluid. Unfortunately, the patient deteriorated, developing a larger effusion along with an increase in oxygen demand, and passed away. Without underlying cardiorespiratory disease, in the presence of a persistent pleural effusion with underlying decompensated cirrhosis, he was diagnosed with hepatic hydrothorax. While each presented with dyspnoea, the cause and underlying pathophysiology differ significantly from case to case. By describing these complications, we hope to improve awareness and aid prompt and accurate diagnosis, vital for improving outcomes. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=dyspnea" title="dyspnea">dyspnea</a>, <a href="https://publications.waset.org/abstracts/search?q=hepatic%20hydrothorax" title=" hepatic hydrothorax"> hepatic hydrothorax</a>, <a href="https://publications.waset.org/abstracts/search?q=hepatopulmonary%20syndrome" title=" hepatopulmonary syndrome"> hepatopulmonary syndrome</a>, <a href="https://publications.waset.org/abstracts/search?q=portopulmonary%20syndrome" title=" portopulmonary syndrome"> portopulmonary syndrome</a> </p> <a href="https://publications.waset.org/abstracts/137549/pulmonary-complication-of-chronic-liver-disease-and-the-challenges-identifying-and-managing-three-patients" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/137549.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">121</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">269</span> Adequacy of Second-Generation Laryngeal Mask Airway during Prolonged Abdominal Surgery</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Sukhee%20Park">Sukhee Park</a>, <a href="https://publications.waset.org/abstracts/search?q=Gaab%20Soo%20Kim"> Gaab Soo Kim</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Purpose: We aimed to evaluate the adequacy of second-generation laryngeal mask airway use during prolonged abdominal surgery in respect of ventilation, oxygenation, postoperative pulmonary complications (PPC), and postoperative non-pulmonary complications on living donor kidney transplant (LDKT) surgery. Methods: In total, 257 recipients who underwent LDKT using either laryngeal mask airway-ProSeal (LMA-P) or endotracheal tube (ETT) were retrospectively analyzed. Arterial partial pressure of carbon dioxide (PaCO2 and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery were compared between two groups. In addition, PPC including pulmonary aspiration and postoperative non-pulmonary complications including nausea, vomiting, hoarseness, vocal cord palsy, delirium, and atrial fibrillation were also compared. Results: PaCO2 and PFR during surgery were not significantly different between the two groups. PPC was also not significantly different between the two groups. Interestingly, the incidence of delirium was significantly lower in the LMA-P group than the ETT group (3.0% vs. 10.3%, P = 0.029). Conclusions: During prolonged abdominal surgery such as LDKT, second-generation laryngeal mask airway offers adequate ventilation and oxygenation and can be considered a suitable alternative to ETT. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=laryngeal%20mask%20airway" title="laryngeal mask airway">laryngeal mask airway</a>, <a href="https://publications.waset.org/abstracts/search?q=prolonged%20abdominal%20surgery" title=" prolonged abdominal surgery"> prolonged abdominal surgery</a>, <a href="https://publications.waset.org/abstracts/search?q=kidney%20transplantation" title=" kidney transplantation"> kidney transplantation</a>, <a href="https://publications.waset.org/abstracts/search?q=postoperative%20pulmonary%20complication" title=" postoperative pulmonary complication"> postoperative pulmonary complication</a> </p> <a href="https://publications.waset.org/abstracts/100086/adequacy-of-second-generation-laryngeal-mask-airway-during-prolonged-abdominal-surgery" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/100086.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">148</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">268</span> Developing HRCT Criterion to Predict the Risk of Pulmonary Tuberculosis</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Vandna%20Raghuvanshi">Vandna Raghuvanshi</a>, <a href="https://publications.waset.org/abstracts/search?q=Vikrant%20Thakur"> Vikrant Thakur</a>, <a href="https://publications.waset.org/abstracts/search?q=Anupam%20Jhobta"> Anupam Jhobta</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Objective: To design HRCT criterion to forecast the threat of pulmonary tuberculosis. Material and methods: This was a prospective study of 69 patients with clinical suspicion of pulmonary tuberculosis. We studied their medical characteristics, numerous separate HRCT-results, and a combination of HRCT findings to foresee the danger for PTB by utilizing univariate and multivariate investigation. Temporary HRCT diagnostic criteria were planned in view of these outcomes to find out the risk of PTB and tested these criteria on our patients. Results: The results of HRCT chest were analyzed, and Rank was given from 1 to 4 according to the HRCT chest findings. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Rank 1: Highly suspected PTB. Rank 2: Probable PTB Rank 3: Nonspecific or difficult to differentiate from other diseases Rank 4: Other suspected diseases • Rank 1 (Highly suspected TB) was present in 22 (31.9%) patients, all of them finally diagnosed to have pulmonary tuberculosis. The sensitivity, specificity, and negative likelihood ratio for RANK 1 on HRCT chest was 53.6%, 100%, and 0.43, respectively. • Rank 2 (Probable TB) was present in 13 patients, out of which 12 were tubercular, and 1 was non-tubercular. • The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of the combination of Rank 1 and Rank 2 was 82.9%, 96.4%, 23.22, and 0.18, respectively. • Rank 3 (Non-specific TB) was present in 25 patients, and out of these, 7 were tubercular, and 18 were non-tubercular. • When all these 3 ranks were considered together, the sensitivity approached 100% however, the specificity reduced to 35.7%. The positive likelihood ratio and negative likelihood ratio were 1.56 and 0, respectively. • Rank 4 (Other specific findings) was given to 9 patients, and all of these were non-tubercular. Conclusion: HRCT is useful in selecting individuals with greater chances of pulmonary tuberculosis. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=pulmonary" title="pulmonary">pulmonary</a>, <a href="https://publications.waset.org/abstracts/search?q=tuberculosis" title=" tuberculosis"> tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=multivariate" title=" multivariate"> multivariate</a>, <a href="https://publications.waset.org/abstracts/search?q=HRCT" title=" HRCT"> HRCT</a> </p> <a href="https://publications.waset.org/abstracts/142334/developing-hrct-criterion-to-predict-the-risk-of-pulmonary-tuberculosis" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/142334.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">172</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">267</span> Stress Hyperglycaemia and Glycaemic Control Post Cardiac Surgery: Relaxed Targets May Be Acceptable</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Nicholas%20Bayfield">Nicholas Bayfield</a>, <a href="https://publications.waset.org/abstracts/search?q=Liam%20Bibo"> Liam Bibo</a>, <a href="https://publications.waset.org/abstracts/search?q=Charley%20Budgeon"> Charley Budgeon</a>, <a href="https://publications.waset.org/abstracts/search?q=Robert%20Larbalestier"> Robert Larbalestier</a>, <a href="https://publications.waset.org/abstracts/search?q=Tom%20Briffa"> Tom Briffa</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=cardiac%20surgery" title="cardiac surgery">cardiac surgery</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism" title=" pulmonary embolism"> pulmonary embolism</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolectomy" title=" pulmonary embolectomy"> pulmonary embolectomy</a>, <a href="https://publications.waset.org/abstracts/search?q=cardiopulmonary%20bypass" title=" cardiopulmonary bypass"> cardiopulmonary bypass</a> </p> <a href="https://publications.waset.org/abstracts/141697/stress-hyperglycaemia-and-glycaemic-control-post-cardiac-surgery-relaxed-targets-may-be-acceptable" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/141697.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">162</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">266</span> A Prospective Randomised Observational Study of Obstructed Total Anamalous Pulmonary Venous Connection (TAPVC) Repair Patients</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Sanjeev%20Singh">Sanjeev Singh</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=inhaled%20nitric%20oxide" title="inhaled nitric oxide">inhaled nitric oxide</a>, <a href="https://publications.waset.org/abstracts/search?q=milrinone" title=" milrinone"> milrinone</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20artery%20hypertension" title=" pulmonary artery hypertension"> pulmonary artery hypertension</a>, <a href="https://publications.waset.org/abstracts/search?q=total%20anomalous%20pulmonary%20venous%20connection" title=" total anomalous pulmonary venous connection"> total anomalous pulmonary venous connection</a> </p> <a href="https://publications.waset.org/abstracts/191851/a-prospective-randomised-observational-study-of-obstructed-total-anamalous-pulmonary-venous-connection-tapvc-repair-patients" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/191851.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">21</span> </span> </div> </div> <ul class="pagination"> <li class="page-item disabled"><span class="page-link">&lsaquo;</span></li> <li class="page-item active"><span class="page-link">1</span></li> <li class="page-item"><a class="page-link" href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism&page=2">2</a></li> <li class="page-item"><a class="page-link" href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism&page=3">3</a></li> <li class="page-item"><a class="page-link" href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism&page=4">4</a></li> <li class="page-item"><a class="page-link" href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism&page=5">5</a></li> 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