Takotsubo cardiomyopathy in a healthy twenty year old

Takotsubo cardiomyopathy, also known as Transient apical ballooning syndrome, stress-induced cardiomyopathy and broken-heartsyndrome, is a rare non-ischemic cardiomyopathy that presents as an acute coronary syndrome without evidence of obstructive atherosclerotic coronary disease. Its name is derived from the Japanese Takotsubo – an octopus trap, resembling the elliptical shape of the very typical akinetic left ventricular apex during systole on imaging studies. It is nowadays increasingly recognized as a new disease entity when faced with normal coronary arteries on angiography with the very typical left ventriculogram, often presenting with acute heart failure, arrhythmias or rarely ventricular rupturepeer-reviewe

Recent advances in cardiovascular medicines : thrombolytics

Thrombolytic therapy represents a major advance in reducing mortality following myocardial infarction. Pharmacists must be aware of the principles and problems of thrombolysis and the extant large studies conducted in hospitals and in the community. This article describes the various use and medicinal aspects of the various thrombolytic agents available on the market.peer-reviewe

Heart failure with preserved ejection fraction and diabetes mellitus

Heart failure with preserved ejection fraction (HFpEF) constitutes approximately 50% of heart failure patients. The prevalence of diabetes mellitus in HFpEF is high at 30-40%. The paper provides a systematic review of the pathophysiological features underlying HFpEF in diabetes mellitus. The importance of mechanisms other than left ventricular diastolic dysfunction underlying this important condition is emphasised. Thus, ventricular-arterial coupling & vascular dysfunction together with chronotropic incompetence & cardiovascular reserve dysfunction play an important role. The various morphologic and molecular features occurring in the myocardium and vasculature in diabetes secondary to hyperglycaemia and other metabolic disturbances are also discussed. These include microangiopathy, myocardial fibrosis, increased oxidative stress, impaired calcium homeostasis, activation of the cardiac renin-angiotensin system, autonomic neuropathy, endothelial dysfunction, re-expression of foetal gene response as well as stem cell involvement. Nonetheless, a lot is still unknown and further studies are needed to establish the underlying pathophysiological mechanisms with the hope that novel pharmacotherapies targeting this disease will be developed. In the meantime, cardiometabolic factors, including hyperglycaemia, hypertension and dyslipidaemia should be targeted and aggressively treated.peer-reviewe

Transcatheter device closure of atrial septal defect and patent foramen ovale in Malta

Significant atrial septal defects (ASD) are closed, surgically or through a transcatheter device, in order to avoid pulmonary hypertension in late life. A patent foramen ovale (PFO) may need to be closed because of transient shunt reversal resulting in transient ischaemic events or stroke. We report the Maltese experience to date in transcatheter closure of these defects. A total of 46 ASDs and 51 PFOs have been successfully closed at our unit (total 97), with very low complication rates, rates that compare very favourably with results from larger international centres.peer-reviewe

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Search for heavy resonances decaying to two Higgs bosons in final states containing four b quarks

A search is presented for narrow heavy resonances X decaying into pairs of Higgs bosons (H) in proton-proton collisions collected by the CMS experiment at the LHC at root s = 8 TeV. The data correspond to an integrated luminosity of 19.7 fb(-1). The search considers HH resonances with masses between 1 and 3 TeV, having final states of two b quark pairs. Each Higgs boson is produced with large momentum, and the hadronization products of the pair of b quarks can usually be reconstructed as single large jets. The background from multijet and t (t) over bar events is significantly reduced by applying requirements related to the flavor of the jet, its mass, and its substructure. The signal would be identified as a peak on top of the dijet invariant mass spectrum of the remaining background events. No evidence is observed for such a signal. Upper limits obtained at 95 confidence level for the product of the production cross section and branching fraction sigma(gg -> X) B(X -> HH -> b (b) over barb (b) over bar) range from 10 to 1.5 fb for the mass of X from 1.15 to 2.0 TeV, significantly extending previous searches. For a warped extra dimension theory with amass scale Lambda(R) = 1 TeV, the data exclude radion scalar masses between 1.15 and 1.55 TeV

Search for supersymmetry in events with one lepton and multiple jets in proton-proton collisions at root s=13 TeV

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Measurement of the top quark mass using charged particles in pp collisions at root s=8 TeV

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