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Abstract

In the summer of 1977/78, materials for determining the age and growth rate of Pseudochaenichthys georgianus Norman, 1937 were obtained in the South Georgia region. The 11—51 cm long fishes were of the age 1+ to 13+. The curvilinear relationship between the body length and the otolith radius took an S shape. In the first four years annual increments are almost identical and start to decrease in the following years. Spawning may occur in the 5th or 6th year of life, and hatching of larvae from eggs laid in autumn (IV—VI) takes place at the end of winter (IX of X). Larvae and juvenile fish lead an exclusively pelagic life, while older fish feed in near-bottom layers: when resources are scare there they seek food in the pelagial.

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Authors and Affiliations

Juliusz Chojnacki
Piotr Palczewski
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Abstract

Background and Aim: Patients with acute pulmonary embolism (APE) associated with hemodynamic instability, i.e. high-risk APE (HR-APE), are at risk for early mortality and require urgent reperfusion therapy with thrombolysis or embolectomy. However, a considerable proportion of HR-APE subjects is not reperfused but only anticoagulated due to high bleeding risk. The aim of the present study was to assess the management of HR-APE in a single large-volume referral center.

Methods: A single-center retrospective study of 32 HR-APE subjects identified among 823 consecutive patients hospitalized for symptomatic APE.

Results: Out of 32 subjects with HR-APE (19 women, age 69 ± 19 years), 20 patients were unstable at admission and 12 subsequently deteriorated despite on-going anticoagulation. Thrombolysis was applied in 20 (62.5%) of HR-APE subjects, limited mainly by classical contraindications in the remainder. Percutaneous pulmonary embolectomy was performed in 4 patients. In-hospital PE-related mortality tended to be higher, albeit insignifi cantly, in the patients who developed hemodynamic collapse during the hospital course compared to those unstable at admission (67% vs. 40%, p = 0.14). Also, survival was slightly better in 22 patients treated with thrombolysis or percutaneous embolectomy in comparison to 10 subjects who received only anticoagulation (54% vs. 40%, p = 0.2). Major non-fatal bleedings occurred in 7 of 20 patients receiving thrombolysis (35%) and in 2 (17%) of the remaining non-thrombolysed 12 HR-APE subjects.

Conclusions: Hemodynamically instability, corresponding to the definition of HR-APE, affects about 4% of patients with APE, developing during the hospital course in approximately one-third of HR-APE subjects. As almost 40% of patients with HR-APE do not receive thrombolytic therapy for fear of bleeding, urgent percutaneous catheter-assisted embolectomy may increase the percentage of patients with HR-APE undergoing reperfusion therapy. Further studies are warranted for a proper identification of initially stable intermediate-risk APE subjects at risk of hemodynamic collapse despite appropriate anticoagulation.

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Authors and Affiliations

Aleksandra Furdyna
Michał Ciurzyński
Marek Roik
Marzanna Paczyńska
Dominik Wretowski
Krzysztof Jankowski
Anna Lipińska
Piotr Bienias
Maciej Kostrubiec
Andrzej Łabyk
Janusz Trzebicki
Piotr Palczewski
Katarzyna Kurnicka
Barbara Lichodziejewska
Szymon Pacho
Piotr Pruszczyk

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