Introduction The number of venous interventions continues to rise. The outcome of venous procedures is related to appropriate stent selection and implantation. Aim To compare the usefulness of magnetic resonance imaging (MRI) and intravascular ultrasound (IVUS) in the determination of target...

Bilateral cingulotomy is a procedure applied to patients with obsessive–compulsive disorder (OCD). This report presents the structural changes occurring within the forceps minor and arcuate fascicles nerve fibers after a successful bilateral anterior cingulotomy in the patient with refractory OCD. Cingulotomy mainly affects the values of FA, MD, and ADC in the treatment of the examined nerve bundles. This structural reorganization coexists with a good clinical effect. However, it is necessary to expand the study group and to investigate the correlation between the parameters of diffusion and anisotropy and the patient’s clinical condition (Y-BOCS scale).

Introduction: Computed tomographic pulmonary angiography (CTPA) is the basic examination in the diagnosis of acute pulmonary embolism (PE), however, it is overused many times in emergency units. The aim of this study was to assess the percentage of CTPA which is possible to avoid in patients considered for radiological imaging due to suspected PE. Material and methods: The retrospective analysis of clinical data and the calculation of PE probability rules (Wells score, Geneva score, blood D-dimer concentration, ECG) were performed in 700 consecutive patients who underwent CTPA due to suspected PE in a single university center between January 2017 and January 2020. Results: Suspected PE was confirmed by CTPA in 22.7% of considered patients. The independent risk factors for PE diagnosis in CTPA were: history of DVT, diagnosis of DVT on admission, and “PE-likely” score according to simplified Wells scale. Blood D-dimer concentration was associated with the lowest diagnostic accuracy of PE. The combination of simplified Geneva “PE-likely” score with standard or age-adjusted D-dimer cut-offs achieved 100% negative predictive value for PE. In relation to studied PE pre-test probability rules, use YEARS algorithm was associated with the greatest number of CTPAs which could be avoided (9.3%) with the risk < 1% of false-negative categorization. Conclusions: The combination of simplified Geneva “PE-likely” score with age-adjusted D-dimer cut-offs and YEARS algorithm were more effective than the PERC, original and simplified Wells and Geneva rules in safe exclusion of PE, which might reduce the absolute number of unnecessary CTPA. Introduction: Computed tomographic pulmonary angiography (CTPA) is the basic examination in the diagnosis of acute pulmonary embolism (PE), however, it is overused many times in emergency units. The aim of this study was to assess the percentage of CTPA which is possible to avoid in patients considered for radiological imaging due to suspected PE. Material and methods: The retrospective analysis of clinical data and the calculation of PE probability rules (Wells score, Geneva score, blood D-dimer concentration, ECG) were performed in 700 consecutive patients who underwent CTPA due to suspected PE in a single university center between January 2017 and January 2020. Results: Suspected PE was confirmed by CTPA in 22.7% of considered patients. The independent risk factors for PE diagnosis in CTPA were: history of DVT, diagnosis of DVT on admission, and “PE-likely” score according to simplified Wells scale. Blood D-dimer concentration was associated with the lowest diagnostic accuracy of PE. The combination of simplified Geneva “PE-likely” score with standard or age-adjusted D-dimer cut-offs achieved 100% negative predictive value for PE. In relation to studied PE pre-test probability rules, use YEARS algorithm was associated with the greatest number of CTPAs which could be avoided (9.3%) with the risk < 1% of false-negative categorization. Conclusions: The combination of simplified Geneva “PE-likely” score with age-adjusted D-dimer cut-offs and YEARS algorithm were more effective than the PERC, original and simplified Wells and Geneva rules in safe exclusion of PE, which might reduce the absolute number of unnecessary CTPA.

Introduction: Patient risk stratification is important in managing individuals with suspected acute pulmonary embolism (APE). The aim of this study was to determine risk factors for in-hospital mortality among real-world patients who had undergone computed tomography pulmonary angiography (CTPA) due to suspected APE. Material and methods: Retrospective analysis of clinical data extracted from the medical documentation of 700 consecutive patients in whom CTPA was performed due to APE suspicion. Results: APE was confirmed in 22.7% of the patients in the sample. In-hospital death was recorded in 10.1% and 12.4% of patients with and without APE confirmed in CTPA, respectively. APE-related death was diagnosed in 37.5% of the APE patients who died during hospitalization. Compared to patients who were discharged from hospital, those who died during hospitalization had a greater prevalence of comorbidities (e.g., neoplasm) and higher values of laboratory determinations and prognostic rule scores. An age-adjusted high-sensitivity troponin I (hs-TNI) cut-off and Pulmonary Embolism Severity Index (PESI) score were found to be independent risk factors of in-hospital death, but only in the whole study group and in patients without APE confirmed in CTPA. The area-under-the-curve value for all the parameters studied was lower than 0.6. Conclusions: Age-adjusted hs-TNI cut-off and PESI score were independent risk factors for in-hospital death in patients with APE suspicion. The predictive power of standard stratifying tools is insufficient in real-world patients with suspected APE. Patients with suspected APE require careful diagnosis and management of comorbidities because these may affect the in-hospital mortality rate. Introduction: Patient risk stratification is important in managing individuals with suspected acute pulmonary embolism (APE). The aim of this study was to determine risk factors for in-hospital mortality among real-world patients who had undergone computed tomography pulmonary angiography (CTPA) due to suspected APE. Material and methods: Retrospective analysis of clinical data extracted from the medical documentation of 700 consecutive patients in whom CTPA was performed due to APE suspicion. Results: APE was confirmed in 22.7% of the patients in the sample. In-hospital death was recorded in 10.1% and 12.4% of patients with and without APE confirmed in CTPA, respectively. APE-related death was diagnosed in 37.5% of the APE patients who died during hospitalization. Compared to patients who were discharged from hospital, those who died during hospitalization had a greater prevalence of comorbidities (e.g., neoplasm) and higher values of laboratory determinations and prognostic rule scores. An age-adjusted high-sensitivity troponin I (hs-TNI) cut-off and Pulmonary Embolism Severity Index (PESI) score were found to be independent risk factors of in-hospital death, but only in the whole study group and in patients without APE confirmed in CTPA. The area-under-the-curve value for all the parameters studied was lower than 0.6. Conclusions: Age-adjusted hs-TNI cut-off and PESI score were independent risk factors for in-hospital death in patients with APE suspicion. The predictive power of standard stratifying tools is insufficient in real-world patients with suspected APE. Patients with suspected APE require careful diagnosis and management of comorbidities because these may affect the in-hospital mortality rate.