Original Papers

Recurrent venous thromboembolic events – a prospective study

Abstract

The reccurency rate after venous thromboembolism(VTE) is high and risk factors for recurrentthromboembolic events were investigated only on asmall scale. Objectives: estimating the cumulativeincidence of recurrent venous thromboembolism after afirst episode of venous thromboembolism, identificationof risk factors for recurrent venous thromboembolism, ofthe optimal methods of diagnosis and establish a propertreatment protocol. Method: we conducted a prospectivestudy for 2 years on 401 patients with objectively verifiedsymptomatic VTE. Medical records were reviewed forall patients during follow-up and episodes of recurrentthromboembolism were recorded. Results: the incidenceof recurrent venous thromboembolic events at 2 yearswas 16.54% after a first episode of VTE. The incidenceof fatal pulmonary embolism after 2 years was 4.54%. Proximal deep venous thrombosis (DVT), malignancyand history of venous thromboembolism predictan increased risk of recurrent events. PostoperativeDVT and long-term oral anticoagulant treatmentinvolve a lower risk of recurrent events. Sex, age, initialantithrombotic therapy or immobilization did notaffect the risk of a recurrent event. Correctly managedanticoagulant therapy decreases the reccurency rate. Conclusions: The recurrence rate after a symptomaticDVT is high. Patients with proximal DVT, diagnosedcancer, short-term oral anticoagulant treatment or ahistory of thromboembolic events had a higher risk ofrecurrent events, while patients with postoperative DVT,but without neoplasia had a lower recurrence rate.

Keywords: recurrent venous thromboembolism,risc factors, prevention, correct therapy

Article

Evaluation of COPD patients using CAT-COPD ASSESSMENT TEST

Abstract

Introduction. Purposes and objectives. CAT test is asimple questionnaire that quantifies the impact ofCOPD on patients and doctor-patient communication;it is a complex questionnaire that evaluates the lungfunction and the impact on quality of life. The scoreranges from 0 to 40. The higher the score, the bigger thehealth problems are. This questionnaire can be usedin any language and country, by all COPD patients. Method and materials. We evaluated 71 COPDpatients from Clinical Hospital "Victor Babeş" Craiovabetween 2010-2011. These patients were included ina respiratory rehabilitation program of 16 sessionsof physical exercises and education for 8 weeks. Results and discussions. The average final score waswith 12.86 % lower than baseline score. The average CATscore after rehabilitation for COPD stage I recorded thebest decrease with 16.23%. The program of respiratoryrehabilitation has a positive impact no matter BMI. Conclusions. CAT questionnaire is a sensitive test,easy to fill in that improves the doctor patientcommunication with a great impact on quality of life.

Keywords: CAT, COPD, pulmonary rehabilitation

Different protocols for cryobiopsy versus forceps biopsy in diagnosis of patients with endobronchial tumors

The effect of smoking by family members and friends on the incidence of smoking among high school students

Abstract

Objective: Smoking is the most important preventablecause of death. According to the global youth tobaccosurvey (GYTS) presented by WHO, 25% of smokers smokedtheir first cigarette before the age of 10; hence, it is ofgreat importance to investigate the effect of smokingof family members and friends on smoking incidenceof adolescents. Materials and methods: This analyticcross-sectional study was conducted on the basis of GYTSquestionnaire. The studied population consisted of 3000high school students who were selected randomly. Datawas collected by applying the questionnaires which werefulfilled by students anonymously without supervisionof school authorities. The results were analyzed withSPSS 11.5 software employing chi-square test. Results: The studied population included 1842 boys (61.4%)and 1158 girls (38.6%) with the mean age of 16.1 years.In terms of smoking habit, 827 students (27.6%) wereoccasional smokers, 122 students (4.2%) were regularsmokers, 518 students (17.3%) used another type oftobacco, and 1533 students (51.1%) were non-smokers.In terms of gender, 77.6% of occasional smokers weremales and 22.4% of them were females. At the sametime, males and females made up 80.3% and 19.7% ofregular smokers, respectively. Also, males and femalesmade up 71.1% and 28.9% of students using anothertype of tobacco, respectively. In terms of smoker familymembers and friends, 1860 students (85.6%) of non-smokerstudents had no smoker in their families and only 313(14.4%) had at least one smoker in family, while 61.5% ofsmoker students had at least one smoker family member(p<0.001). Similarly, 50.3% of smoker students had anumber of smoker friends, while only 13% of non-smokerstudents had smoker friends. In terms of economic statusthis study showed that 22.4% of smoker students and20.7% of non-smoker ones had high pocket money. Conclusion: This study showed that the incidence ofsmoking among high school students significantlycorrelated with the incidence of smoking among theirfriends and family members (p < 0.001). This study alsoshowed that the economic status (based on the amount ofpocket money) has little or no effect on the incidence ofsmoking among high school students (p value: 0.863).

Keywords: smoking, smoker, student, family member,friend, pocket money