Наукові роботи молодих вчених. Кафедра пропедевтики внутрішньої медицини № 1, основ біоетики та біобезпеки
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Item Application of chest X-ray in pulmonology(2014) Praharaj, Pooja; Pytetska, NatalyaA chest x-ray is an x-ray of the chest, lungs, heart, large arteries to detect diffrerent pulmonary diseases. Patient has to stand in front of the x-ray machine. You will be told to hold your breath when the x-ray is taken. Two images are usually taken. You will need to stand against the machine, and then sideways. How to prepare for the test. Tell the health care provider if you are pregnant. Chest x-rays are generally not done during the first 6 months of pregnancy. How the test will feel. There is no discomfort. The film plate may feel cold. The doctor may order a chest x-ray if you have any of the following symptoms: • a persistent cough; • chest injury; • chest pain; • coughing up blood; • difficulty breathing. It may also be done if you have signs of tuberculisis, lung cancer, or other chest or lung diseases. A serial chest x-ray is one that is repeated. It may be done to look at or monitor changes found on a previous chest x-ray. Abnormal results may be due to many things, including: In the lungs: collapsed lung, collection of fluid around the lung, lung cancer, lung tumor, malformation of the blood vessels, pneumonia, scarring of lung tissue, tuberculosis. Abnormal results may also be due to: achalasia, acute bronchitis, alpha-1 antitrypsin deficiency, aortic dissection, atelectasis, atrial myxoma, blastomycosis, breast cancer, bronchial adenoma, bronchial asthma, bronchiectasis, bronchiolitis, bronchopulmonary dysplasia, byssinosis (cotton dust lung disease), caplan syndrome, idiopathic diffuse interstitial pulmonary fibrosis, industrial bronchitis, Legionnaire’s disease, malignant hypertension, myocarditis, necrotizing vasculitis, neuroblastoma, occupational asthma, pulmonary tuberculosis, pulmonary veno-occlusive disease, Q fever, rheumatoid lung disease, sarcoidosis, senile cardiac amyloid, systemic sclerosis (scleroderma), viral pneumonia, Wilms tumor. Risks. There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is very low compared with the benefits. Pregnant women and children are more sensitive to the risks of x-rays.Item Modern examination technique in pulmonology. Bronchoscopy(2014) Akewusola, Nimat Adeola; Pytetska, NatalyaPulmonology is a medical specialty that deals with diseases involving the respiratory tract. Pulmonology is synonymous with pneumology, respirology and respiratory medicine. Pulmonology is known as chest medicine and respiratory medicine in some countries and areas. Pulmonology is considered a branch of internal medicine, and is related to intensive care medicine. Pulmonology often involves managing patients who need life support and mechanical ventilation. Pulmonologists are specially trained in diseases and conditions of the chest, particularly pneumonia, asthma, tuberculosis, emphysema, and complicated chest infections. Examination of the lungs. Bronchoscopy. Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.A bronchoscope is a device used to see the inside of the airways and lungs. The scope can be flexible or rigid. A flexible scope is almost always used. It is a tube less than 1/2-inch wide and about 2 feet long. In rare cases, a rigid bronchoscope is used.The scope is passed through your mouth or nose through your windpipe (trachea) and into your lungs. Going through the nose is a good way to look at the upper airways. Going through the mouth allows the doctor to use a larger bronchoscope. If a flexible bronchoscope is used, you will probably be awake but sedated. During the procedure: • You will likely get medicines through a vein (intravenously) to help you relax. Or you may be asleep under general anesthesia, especially if a rigid scope is used. • A numbing drug (anesthetic) will be sprayed in your mouth and throat. If bronchoscopy is done through the nose, numbing jelly will be placed in one nostril. • The scope is gently inserted. It will likely make you cough at first. The coughing will stop as the numbing drug begins to work. • The doctor may send saline solution through the tube. This washes the lungs and allows the doctor to collect samples of lung cells, fluids, and other materials inside the air sacs. This part of the procedure is called a lavage. • Sometimes, tiny brushes, needles, or forceps may be passed through the bronchoscope to take very small tissue samples (biopsies) from your lungs. • The doctor can also place a stent in the airway or view the lungs with ultrasound during the procedure. • Sometimes ultrasound is used to view the lymph nodes and tissues around the airways.Item Modern examination methods in pulmonology(2014) Nongo, Tersoo; Pytetska, NatalyaPulmonology is known as chest medicine and respiratory medicine in some countries and areas. Pulmonology is considered a branch of internal medicine, and is related to intensive care medicine. In addition to qualitative establishment of diagnosis the aim of modern investigational procedures is quantitative analysis of disease extension and of functional impairment. The most important endoscopic-bioptical techniques for establishment of diagnosis are bronchoscopy and thoracoscopy. In bronchology flexible bronchoscopy with a relative share of about 90% clearly holds now a dominant position versus the rigid technique. Suspected cancer is the most prominent indication (ca. 60%). Visible intrabronchial lesions can be diagnosed in more than 90%. In extrabronchial and peripheral bronchopulmonary disease technical aids like transbronchial needle aspiration (TBNA), bronchoalveolar lavage (BAL) or transbronchial biopsy (TBB) are required, resulting in a diagnostic yield, that may range between 30 and 90% depending on the particular disease entity. Thoracoscopy is the second most important endoscopic procedure and accounts for about 1/10 of the investigational frequency of bronchoscopy. PROCEDURES • Laboratory investigation of blood (blood tests). Sometimes arterial blood gas measurements are also required. • Spirometry (the determination of lung volumes in time by breathing into a dedicated machine; response to bronchodilatators and diffusion of carbon monoxide) • Bronchoscopy with bronchoalveolar lavage (BAL), endobronchial and transbronchial biopsy and epithelial brushing • Chest X-rays • CT scanning (MRI scanning is rarely used) • Scintigraphy and other methods of nuclear medicine • Positron emission tomography (especially in lung cancer) Devices Used: Spirometer, Bronchoscope, X-ray tubes, CT-Scanner, Scintigraph, PET-CT scanners etc.Item Pulmonary angiography in modern clinical practice(2014-12-04) Honchar, Oleksii; Ashcheulova, Tetyana; Kovalyova, Olga; Ivanchenko, Svitlana; Гончарь, Алексей Владимирович; Ащеулова, Татьяна Вадимовна; Ковалева, Ольга Николаевна; Иванченко, Светлана Владимировна; Гончарь, Олексій Володимирович; Ащеулова, Тетяна Вадимівна; Ковальова, Ольга Миколаївна; Іванченко, Світлана ВолодимирівнаItem Positron emission tomography (PET scan)(2014-12-04) Honchar, Oleksii; Ashcheulova, Tetyana; Kovalyova, Olga; Ivanchenko, Svitlana; Гончарь, Алексей Владимирович; Ащеулова, Татьяна Вадимовна; Ковалева, Ольга Николаевна; Иванченко, Светлана Владимировна; Гончарь, Олексій Володимирович; Ащеулова, Тетяна Вадимівна; Ковальова, Ольга Миколаївна; Іванченко, Світлана ВолодимирівнаItem Diagnostical use of bronchography(2014-12-04) Honchar, Oleksii; Ashcheulova, Tetyana; Kovalyova, Olga; Ivanchenko, Svitlana; Гончарь, Алексей Владимирович; Ащеулова, Татьяна Вадимовна; Ковалева, Ольга Николаевна; Иванченко, Светлана Владимировна; Гончарь, Олексій Володимирович; Ащеулова, Тетяна Вадимівна; Ковальова, Ольга Миколаївна; Іванченко, Світлана ВолодимирівнаItem Evolution of examination method in pulmonology, spirometry(KhNMU, 2014-04) Bankole, Oluwalorisuna Yomi; Kochubiei, OksanaPulmonology is the medical specialty dealing with disease involving the respiratory tract. The spirograph is a major diagnostic instrument, which is useful in cases of asthma, COPD, and the diagnosis of many other respiratory diseases. History One of the first major discoveries relevant to the field of Pulmonology was the discovery of pulmonary circulation. Major Contributions before 19th century. The earliest known history of the concept of spirometry goes back to the time of the Roman Empire, specifically between 129-200 AD. Greek doctor and philosopher, Claudius Galen, performed a volumetric experiment on human ventilation. He had a boy breathe in and out of a bladder and discovered that after a period of time, the volume of gas did not change. After this, Around 1681, Giovanni Alfonso Borelli attempted to measure the volume of air inspired in one breath by sucking a liquid up a tube and measuring its volume. One thing he did that is still performed today is block off the nostrils. During the early 1700’s, J. Jurin was the first known scientist to record absolute measurements of air volumes. He measured a tidal volume of 650 mL and also a maximal expiration of 3610 mL. Major Contributions during the 19th century. At the beginning of the 1800’s, Sir Humphry Davy used a gasometer to measure various volumes and capacities. He took his own measurements, which turned out to be a vital capacity of 3110 mL, a tidal volume of 210 mL, and, using a hydrogen dilution method, a residual volume of 590-600 mL. The gasometer he used was a complex instrument with an ingenious counterweight used to balance the increased weight of the gasometer when the gas enters from the silk bag. Invention of the spirometer. By the 1840’s, John Hutchinson, a surgeon, had begun his work with spirometers. He invented the spirometer to measure vital capacity, which he believed to be a powerful indicator of longevity. His spirometer consisted of a calibrated bell inverted in water, which captured exhaled air from the lungs. According to Eckert, Hutchinson recorded the vital capacities of over 4000 persons with his spirometer. Less than ten years after Hutchinson came out with his spirometer, Wintrich developed a spirometer that was easier to use. He performed tests on over 4000 people and concluded that the three parameters that determine vital capacity are body height, weight, and age. Later in 1859, E. Smith developed a portable spirometer, on which he measured gas metabolism. In 1866, Salter added a kymograph to the spirometer in order to record time while obtaining air volumes. T.G. Brodie was the first to use a dry bellow wedge spirometer in 1902, which is the precursor of the Fleisch spirometer. Modern spirometry. Spirometry falls under the broader concept of calorimetry. Calorimetry is the accurate quantification of energy expenditure during rest and physical activity. And there are open circuit (which measures energy expenditure in physical activity) and closed (used less frequently during physical activity) circuit spirometry. In conclusion, the history of spirometry consists of various researchers, concepts, and equipment. It began in the 2nd century with measurements of ventilatory volumes, progressed into more complex measurement of lung functions using a variety of techniques. Now, after years of experiments, it is an accurate way to measure energy expenditure.