Pulmoner tromboembolide güncel tanı ve tedavi

Pulmoner tromboembolizm (PTE), genellikle derin ven trombozunun (DVT) bir komplikasyonudur. Bacak derin venlerinde meydana gelen trombüslerden kopan parçaların pulmoner arter ve/veya dallarını tıkaması sonucu gelişir. PTE ve DVT'nin genellikle birlikte seyretmesi sebebiyle, iki olay birlikte venöz tromboembolizm (VTE) olarak da ifade edilir. Hastaların yarısından fazlası tanı konulmadan kaybedildiğinden gerçek insidans belirsizdir. Son dekatta tanı ve tedaviyle ilgili birçok yeni gelişmeye rağmen PTE halen akciğerin, tanısı zor ve ölümle sonuçlanabilen hastalıklardan biridir. Bu derlemede PTE tanı ve tedavisinde klasik ve güncel yaklaşımlar birlikte değerlendirildi

Anahtar Kelime:

Konular: Hematoloji Hücre Biyolojisi

Santral seröz koryoretinopatili olguların spektral domain optik koherens tomografi bulguları

Öz:

Amaç: Bu çalışmada Santral Seröz Koryoretinopati (SSKR) tanısı alan olgular, akut veya kronik hastalık durumuna ve Optik Koherens Tomografi (OKT) bulgularına göre karşılaştırılmıştır.Yöntemler: 3 aydan uzun süreli semptom ve bulguları olan hastalar kronik SSKR kronik olarak kabul edildi. Akut ve kronik SSKR hastalarının başvuru anındaki OKT bulguları kaydedildi. Gruplar, görme keskinliği, Hiperreflektif noktalar (HRN), subretinal sıvı (SRS), pigment epitel dekolmanı (PED) gibi OKT bulguları açısından karşılaştırıldı. Bulgular: Akut ve kronik hastalar ayrı ayrı değerlendirildiğinde PED'in eşlik ettiği akut SSKR olgularının görme keskinliği daha düşük subretinal sıvı yükseklikleri daha yüksek olduğu saptandı. Kronik hastalarda ise PED olan olguların subretinal sıvı yükseklikleri daha fazla iken görme keskinliklerinde istatistiksel anlamlı bir fark bulunmadı. HRN varlığının akut ve kronik hastalarda görme keskinliği ve sıvı yüksekliğine ortalamasına etkisi olmadığı görülmüştür. İç segment dış segment bileşkesi (IS/OS) bandında bozulma olan hastaların görme keskinlikleri diğer hastalardan farklı bulunmadı. Sonuçlar: Sonuç olarak bu çalışmada gruplar arasında IS/OS bandında bozulma, HRN ve PED varlığı açısından fark saptanmadı. PED olan hastalarda subretinal sıvı yüksekliği iki grupta da daha yüksek bulundu. Ayrıca PED olan akut hastalarda görme keskinliği de daha düşük saptandı.

Anahtar Kelime:

Konular: Hematoloji Hücre Biyolojisi

Spectral domain optical coherence tomography findings of the patients with central serous chorioretinopathy

Öz:

Objective: In this study, optical coherence tomography (OCT) findings of the patients with a diagnosis of acute or chronic central serous chorioretinopathy (CSCR) were investigated.Methods: Patients with symptoms and signs longer than 3 months were considered as chronic CSCR. OCT findings of acute and chronic CSCR were recorded at admission. Between the groups, following parameters were compared; visual acuity, hyper reflective dots (HRD), subretinal fluid height (SFH) presence of pigment epithelial detachment (PED), status of photoreceptor inner-outer segment (IS/OS) line.Results: When acute and chronic patients evaluated separately, in acute patients accompanied by PED had lower visual acuity and higher SRF height. In patients with chronic CSCR subretinal fluid of patients with PED was greater than the others however there were no statistically significant differences in visual acuity. Presence of HRD had no effect on the average visual acuity SRF height in patients with acute and chronic CSCR. Also IS/OS line integrity had no effect in visual acuity of the patients in our study.Conclusion: Between the groups there was no difference in terms of IS/OS line distortion, presence of HRD, PED. Height of SRF in patients with PED was higher in both groups. In addition, in acute patients with PED visual acuity was also found to be lower.

Anahtar Kelime:

Konular: Hematoloji Hücre Biyolojisi

Current diagnosis and treatment in pulmonary thromboembolism

Öz:

Pulmonary thromboembolism (PTE), is usually a complication of deep vein thrombosis (DVT). Pulmonary thromboembolism develops as a result of obstruction of pulmonary artery and / or branches with pieces that ruptured from the deep vein thrombosis of the leg. Pulmonary thromboembolism and DVT is also referred as venous thromboembolism (VTE) because of two events often remain together. The true incidence is uncertain because of more than half of the patients can be lost before the diagnosis. Despite the many new developments in the last decade on the diagnosis and treatment, PTE is still one of the difficult to diagnose and fatal diseases of lungs. Classical and contemporary approaches to the diagnosis and treatment of PTE were evaluated together in this review. J Clin Exp Invest 2013; 4 (3): 405-410

Anahtar Kelime:

Konular: Hematoloji Hücre Biyolojisi

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

Castro-Correia J, Coutinho MF, Rosas V, Maia J. Long- term follow-up of central serous retinopathy in 150 pa- tients. Doc Ophthalmol Adv Ophthalmol 1992;81:379- 386.
Sandler DA, Martin JF. Autopsy proven pulmonary embo- lism in hospital patients: Are we detecting enough deep vein thrombosis? J R Soc Med 1989; 82: 203-205.
Wang M, Munch IC, Hasler PW, et al. Central se- rous chorioretinopathy. Acta Ophthalmol (Copenh) 2008;86:126-145.
Wittram C, Maher MM, Yoo AJ, et al. CT angiography of pulmonary embolism: Diagnostic criteria and causes of misdiagnosis. Radiographics 2004; 24: 1219-1238.
Yannuzzi LA. Type-A behavior and central serous cho- rioretinopathy. Retina Phila Pa 1987;7:111-131.
Goldhaber SZ. Pulmonary embolism. Lancet 2004; 363: 1295-1305.
Yalcinbayir O, Gelisken O, Akova-Budak B, et al. Cor- relation of spectral domain optical coherence tomog- raphy findings and visual acuity in central serous cho- rioretinopathy. Retina 2013;34:705-712.
Tsai AW, Cushman M, Rosamond WD, et al. Cardiovascu- lar risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiol- ogy. Arch Intern Med 2002; 162: 1182-1189.
Nicholson B, Noble J, Forooghian F, Meyerle C. Central serous chorioretinopathy: update on pathophysiology and treatment. Surv Ophthalmol 2013;58:103-126.
Heit JA, Cohen AT, Anderson FA, VTE Impact Assessment Group. Estimated annual number of incident and recur- rent, non-fatal and fatal venous thromboembolism (VTE) events in the U. S. Blood 2005;106:267-272.
Liew G, Quin G, Gillies M, Fraser-Bell S. Central se- rous chorioretinopathy: a review of epidemiology and pathophysiology. Clin Experiment Ophthalmol 2013;41:201-214.
Wiener RS, Schwartz LM, Woloshin S. Time trends in pul- monary embolism in the United States: evidence of over diagnosis. Arch Intern Med 2011;171:831-835.
Sahin A, Bez Y, Kaya MC, et al. Psychological distress and poor quality of life in patients with central serous chorioretinopathy. Semin Ophthalmol 2014;29:73-76.
Li XY, Fan J, Cheng YQ, et al. Incidence and prevention of venous thromboembolism in acutely ill hospitalized el- derly Chinese. Chin Med J 2011; 124: 335-340.
Türkcü FM, Yüksel H, Sahin A, et al. Effects of smoking on visual acuity of central serous chorioretinopathy patients. Cutan Ocul Toxicol 2014;33:115-119.
Stein PD, Kayalı F, Olson RE. Estimated case fatality rate of pulmonary embolism 1979 to 1998. Am J Cardiology 2004; 93:1197-1199.
Türkcü FM, Yüksel H, Yüksel H, et al. Serum dehy- droepiandrosterone sulphate, total antioxidant ca- pacity, and total oxidant status in central serous cho- rioretinopathy. Graefes Arch Clin Exp Ophthalmol 2014;252:17-21.
Carson JL, Kelley MA, Duff A, et al. The clinical course of pulmonary embolism. N Engl J Med 1992; 326: 1240- 1245.
Türkcü FM, Sahin A, Bez Y, et al. Vision-related qual- ity of life in patients with chronic central serous chorio- retinopathy. Semin Ophthalmol 2013 Oct 28; doi:10.3 109/08820538.2013.839818
Mitchell RN, Cotran RS: Hemodynamic disorders, throm- bosis and shock. In: Cotran RS, ed. Robbins Pathologic basis of disease. 6th ed. Philadelphia: WB Saunders, 1999:13-130.
Maruko I, Iida T, Ojima A, Sekiryu T. Subretinal dot- like precipitates and yellow material in central serous chorioretinopathy. Retina 2011;31:759-765.
Torbicki A, Van Beek EJR, Charbonnier B, et al. Guide- lines on diagnosis and management of acute pulmonary embolism Eur Heart J 2000;21:1301-1336.
Nair U, Ganekal S, Soman M, Nair K. Correlation of spectral domain optical coherence tomography find- ings in acute central serous chorioretinopathy with visual acuity. Clin Ophthalmol Auckl NZ 2012;6:1949- 1954.
Torbicki A, Perrier A, Konstantinides S, et al. Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Man- agement of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) [practice guideline]. Eur Heart J 2008; 29:2276-2315.
Uji A, Murakami T, Nishijima K, et al. Association Be- tween Hyperreflective Foci in the Outer Retina, Status of Photoreceptor Layer, and Visual Acuity in Diabetic Macular Edema. Am J Ophthalmol 2012;153:710-717. e1.
British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax 2003; 58: 470-484.
Shin HJ, Chung H, Kim HC. Association between in- tegrity of foveal photoreceptor layer and visual out- come in retinal vein occlusion. Acta Ophthalmol (Co- penh) 2011;89:e35-e40.
Yung G L, Fedullo P F, Pulmonary Thromboembolic Dis- ease, Fishman A P, Elias J A, Fishman JA, Grippi MA, Senior RM, Pack AI, Fishman's Pulmonary Diseases and Disorders, Fouth Edition, Philadelphia, Pennsylvania, Mc Graw Hill Medical, 2008; 1423-1447.
Shin HJ, Lee SH, Chung H, Kim HC. Association be- tween photoreceptor integrity and visual outcome in diabetic macular edema. Graefes Arch Clin Exp Oph- thalmol 2012;250:61-70.
Luca Masotti, MD, Roberto Cappelli, MD. Risk manage- ment in acute pulmonary embolism. www.intechopen. com
Miniati M, Prediletto R, Formichi B, et al. Accuracy of clin- ical assessment in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med 1999; 159: 864-871.
Stein PD, Fowler SE, Goodman LR, et al. Multi- detector computed tomography for acute pulmonary embolism. N Engl J Med 2006; 354: 2317-2327.
Cogo A, Lensing AWA, Kopman MMW, et al. Compres- sion ultrasonograpy for diagnostic management of pa- tients with clinically suspected deep vein thrombosis: prospective cohort study. Br Med J 1998; 316: 17-20.
Stein PD, Chenevert TL, Fowler SE, et al: Gadolinium- enhanced magnetic resonance angiography for pulmo- nary embolism: A multicenter prospective study (PIOPED III. Ann Intern Med 2010; 152: 434-443.
The PIOPED Investigators. Value of the ventilation/perfu- sion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagno- sis (PIOPED). JAMA 1990; 263: 2753-2759.
Richman PB. Simplifying the evaluation of pulmonary embolism. Chest 2006; 129: 1400-1402.
Wells PS, Rodger M. Diagnosis of pulmonary embolism: when is imaging needed? Clin Chest Med 2003; 24:13-28.
Stein PD, Sostman HD, Bounameaux H, et al. Challeng- es in the diagnosis of acute pulmonary embolism. Am J Med 2008; 121: 565-571.
Binder L, Pieske B, Olschewski M, et al. N-terminal pro- brain natriuretic peptide or troponin testing followed by echo- cardiography for risk stratification of acute pulmo- nary embolism. Circulation 2005; 112: 1573-1579.
Puls M, Dellas C, Lankeit M, et al. Heart-type fatty acid binding protein permits early risk stratification of pulmo- nary embolism. Eur Heart J 2007; 28: 224-229.
Kearon C, Kahn SR, Agnelli K, et al. Antithrombotic ther- apy for venous thromboembolic disease. ACCP evidence based clinical practice guidelines (8th Edition). Chest 2008; 133: 454-545.

APA	Selimoğlu Şen H, YÜKSEL H, ABAKAY Ö, TÜRKÇÜ F, ŞAHİN M, OZKURT Z, ÇINAR T, CİNGÜ A, ÇAÇA İ (2013). Pulmoner tromboembolide güncel tanı ve tedavi. , 405 - 410.
Chicago	Selimoğlu Şen Hadice,YÜKSEL Harun,ABAKAY ÖZLEM,TÜRKÇÜ Fatih Mehmet,ŞAHİN Muhammed,OZKURT ZEYNEP,ÇINAR Tuba,CİNGÜ Abdullah Kürşat,ÇAÇA İhsan Pulmoner tromboembolide güncel tanı ve tedavi. (2013): 405 - 410.
MLA	Selimoğlu Şen Hadice,YÜKSEL Harun,ABAKAY ÖZLEM,TÜRKÇÜ Fatih Mehmet,ŞAHİN Muhammed,OZKURT ZEYNEP,ÇINAR Tuba,CİNGÜ Abdullah Kürşat,ÇAÇA İhsan Pulmoner tromboembolide güncel tanı ve tedavi. , 2013, ss.405 - 410.
AMA	Selimoğlu Şen H,YÜKSEL H,ABAKAY Ö,TÜRKÇÜ F,ŞAHİN M,OZKURT Z,ÇINAR T,CİNGÜ A,ÇAÇA İ Pulmoner tromboembolide güncel tanı ve tedavi. . 2013; 405 - 410.
Vancouver	Selimoğlu Şen H,YÜKSEL H,ABAKAY Ö,TÜRKÇÜ F,ŞAHİN M,OZKURT Z,ÇINAR T,CİNGÜ A,ÇAÇA İ Pulmoner tromboembolide güncel tanı ve tedavi. . 2013; 405 - 410.
IEEE	Selimoğlu Şen H,YÜKSEL H,ABAKAY Ö,TÜRKÇÜ F,ŞAHİN M,OZKURT Z,ÇINAR T,CİNGÜ A,ÇAÇA İ "Pulmoner tromboembolide güncel tanı ve tedavi." , ss.405 - 410, 2013.
ISNAD	Selimoğlu Şen, Hadice vd. "Pulmoner tromboembolide güncel tanı ve tedavi". (2013), 405-410.

APA	Selimoğlu Şen H, YÜKSEL H, ABAKAY Ö, TÜRKÇÜ F, ŞAHİN M, OZKURT Z, ÇINAR T, CİNGÜ A, ÇAÇA İ (2013). Pulmoner tromboembolide güncel tanı ve tedavi. Journal of Clinical and Experimental Investigations, 5(2), 405 - 410.
Chicago	Selimoğlu Şen Hadice,YÜKSEL Harun,ABAKAY ÖZLEM,TÜRKÇÜ Fatih Mehmet,ŞAHİN Muhammed,OZKURT ZEYNEP,ÇINAR Tuba,CİNGÜ Abdullah Kürşat,ÇAÇA İhsan Pulmoner tromboembolide güncel tanı ve tedavi. Journal of Clinical and Experimental Investigations 5, no.2 (2013): 405 - 410.
MLA	Selimoğlu Şen Hadice,YÜKSEL Harun,ABAKAY ÖZLEM,TÜRKÇÜ Fatih Mehmet,ŞAHİN Muhammed,OZKURT ZEYNEP,ÇINAR Tuba,CİNGÜ Abdullah Kürşat,ÇAÇA İhsan Pulmoner tromboembolide güncel tanı ve tedavi. Journal of Clinical and Experimental Investigations, vol.5, no.2, 2013, ss.405 - 410.
AMA	Selimoğlu Şen H,YÜKSEL H,ABAKAY Ö,TÜRKÇÜ F,ŞAHİN M,OZKURT Z,ÇINAR T,CİNGÜ A,ÇAÇA İ Pulmoner tromboembolide güncel tanı ve tedavi. Journal of Clinical and Experimental Investigations. 2013; 5(2): 405 - 410.
Vancouver	Selimoğlu Şen H,YÜKSEL H,ABAKAY Ö,TÜRKÇÜ F,ŞAHİN M,OZKURT Z,ÇINAR T,CİNGÜ A,ÇAÇA İ Pulmoner tromboembolide güncel tanı ve tedavi. Journal of Clinical and Experimental Investigations. 2013; 5(2): 405 - 410.
IEEE	Selimoğlu Şen H,YÜKSEL H,ABAKAY Ö,TÜRKÇÜ F,ŞAHİN M,OZKURT Z,ÇINAR T,CİNGÜ A,ÇAÇA İ "Pulmoner tromboembolide güncel tanı ve tedavi." Journal of Clinical and Experimental Investigations, 5, ss.405 - 410, 2013.
ISNAD	Selimoğlu Şen, Hadice vd. "Pulmoner tromboembolide güncel tanı ve tedavi". Journal of Clinical and Experimental Investigations 5/2 (2013), 405-410.