Heart MRI Images Analysis in Case of Arrythmogenic Right Ventricular Cardiomyopathy (ARVC)

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is a cause of sudden cardiac death in otherwise healthy young adults. (ARVD/C) is an inherited cardiomyopathy characterized by life-threatening ventricular arrhythmias and slowly progressive ventricular dysfunction. To diagnose ARVC is indicated by the Task Force of ARVC criteria in 1994 and then revised in 2010 set by the WHO/ISFC. To identify clinical characteristics of ARVC using CMR. The design of this study was qualitative descriptive, which was done by the observational method using MRI 1.5 Tesla. The subject was an adult patient who did Cardiac MRI examination in National Cardiovascular Centre Harapan Kita in March 2018. The collected data were diagnostic images of CMR sequence. Then, it compared with the diagnostic criteria of ARVC which was indicated by Task Force. The result of this study of several ARVC diagnostic criteria in Cardiac MRI examination with T1 Black Blood sequence is clear and accurate in indicating the presence of fat infiltration, CINE sequence is clear in visualizing the dilatation in the right ventricle, wall motion abnormalities, accordion sign, bulging, and LGE clearly shows fibrosis. The detection of right ventricular enlargement, fatty infiltration, fibrosis, and wall motion abnormalities in CMR is useful in the diagnosis of ARVC

Loopography Examination for Colon Cancer Cases in Tangerang District Public Hospital

Loopography examination technique is a radiological examination technique in lower digestive tract (colon) by inserting a positive contrast media into the colon through an artificial hole in abdominal area. This examination aims to evaluate the anatomy and physiology function from distal section of colon to anus with ca colon clinical. This research was conducted in radiology installation of Tangerang District General Hospital during November to December 2018, using a qualitative descriptive method with a literature study approach and interview. The results found that loopography examination in Tangerang District General Hospital did not require special preparation. The kind of contrast media used is a water-soluble contrast media such as iohexol with a ratio of 1: 3 mixed with NaCl. This loopography contrast media can be inserted through the clean stoma or anal. The routine projections performed for loopography examination in Tangerang District General Hospital are Plan photos of Abdomen, Antero Posterior (AP) and Lateral. But sometimes Oblique projection is also used as an addition if is less obvious anatomy due to overlap/superposition

Angiogenic factors and their soluble receptors predict organ dysfunction and mortality in post-cardiac arrest syndrome

INTRODUCTION: Post-cardiac arrest syndrome (PCAS) often leads to multiple organ dysfunction syndrome (MODS) with a poor prognosis. Endothelial and leukocyte activation after whole-body ischemia/reperfusion following resuscitation from cardiac arrest is a critical step in endothelial injury and related organ damage. Angiogenic factors, including vascular endothelial growth factor (VEGF) and angiopoietin (Ang), and their receptors play crucial roles in endothelial growth, survival signals, pathological angiogenesis and microvascular permeability. The aim of this study was to confirm the efficacy of angiogenic factors and their soluble receptors in predicting organ dysfunction and mortality in patients with PCAS. METHODS: A total of 52 resuscitated patients were divided into two subgroups: 23 survivors and 29 non-survivors. The serum levels of VEGF, soluble VEGF receptor (sVEGFR)1, sVEGFR2, Ang1, Ang2 and soluble Tie2 (sTie2) were measured at the time of admission (Day 1) and on Day 3 and Day 5. The ratio of Ang2 to Ang1 (Ang2/Ang1) was also calculated. This study compared the levels of angiogenic factors and their soluble receptors between survivors and non-survivors, and evaluated the predictive value of these factors for organ dysfunction and 28-day mortality. RESULTS: The non-survivors demonstrated more severe degrees of organ dysfunction and a higher prevalence of MODS. Non-survivors showed significant increases in the Ang2 levels and the Ang2/Ang1 ratios compared to survivors. A stepwise logistic regression analysis demonstrated that the Ang2 levels or the Ang2/Ang1 ratios on Day 1 independently predicted the 28-day mortality. The receiver operating characteristic curves of the Ang2 levels, and the Ang2/Ang1 ratios on Day 1 were good predictors of 28-day mortality. The Ang2 levels also independently predicted increases in the Sequential Organ Failure Assessment (SOFA) scores. CONCLUSIONS: We observed a marked imbalance between Ang1 and Ang2 in favor of Ang2 in PCAS patients, and the effect was more prominent in non-survivors. Angiogenic factors and their soluble receptors, particularly Ang2 and Ang2/Ang1, are considered to be valuable predictive biomarkers in the development of organ dysfunction and poor outcomes in PCAS patients

Implementation of earlier antibiotic administration in patients with severe sepsis and septic shock in Japan: a descriptive analysis of a prospective observational study.

BACKGROUND: Time to antibiotic administration is a key element in sepsis care; however, it is difficult to implement sepsis care bundles. Additionally, sepsis is different from other emergent conditions including acute coronary syndrome, stroke, or trauma. We aimed to describe the association between time to antibiotic administration and outcomes in patients with severe sepsis and septic shock in Japan. METHODS: This prospective observational study enrolled 1184 adult patients diagnosed with severe sepsis based on the Sepsis-2 criteria and admitted to 59 intensive care units (ICUs) in Japan between January 1, 2016, and March 31, 2017, as the sepsis cohort of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis and Trauma (FORECAST) study. We compared the characteristics and in-hospital mortality of patients administered with antibiotics at varying durations after sepsis recognition, i.e., 0-60, 61-120, 121-180, 181-240, 241-360, and 361-1440 min, and estimated the impact of antibiotic timing on risk-adjusted in-hospital mortality using the generalized estimating equation model (GEE) with an exchangeable, within-group correlation matrix, with "hospital" as the grouping variable. RESULTS: Data from 1124 patients in 54 hospitals were used for analyses. Of these, 30.5% and 73.9% received antibiotics within 1 h and 3 h, respectively. Overall, the median time to antibiotic administration was 102 min [interquartile range (IQR), 55-189]. Compared with patients diagnosed in the emergency department [90 min (IQR, 48-164 min)], time to antibiotic administration was shortest in patients diagnosed in ICUs [60 min (39-180 min)] and longest in patients transferred from wards [120 min (62-226)]. Overall crude mortality was 23.4%, where patients in the 0-60 min group had the highest mortality (28.0%) and a risk-adjusted mortality rate [28.7% (95% CI 23.3-34.1%)], whereas those in the 61-120 min group had the lowest mortality (20.2%) and risk-adjusted mortality rates [21.6% (95% CI 16.5-26.6%)]. Differences in mortality were noted only between the 0-60 min and 61-120 min groups. CONCLUSIONS: We could not find any association between earlier antibiotic administration and reduction in in-hospital mortality in patients with severe sepsis

Neutrino oscillations and uncertainty relations

We show that coherent flavor neutrino states are produced (and detected) due to the momentum-coordinate Heisenberg uncertainty relation. The Mandelstam-Tamm time-energy uncertainty relation requires non-stationary neutrino states for oscillations to happen and determines the time interval (propagation length) which is necessary for that. We compare different approaches to neutrino oscillations which are based on different physical assumptions but lead to the same expression for the neutrino transition probability in standard neutrino oscillation experiments. We show that a Moessbauer neutrino experiment could allow to distinguish different approaches and we present arguments in favor of the 163Ho-163Dy system for such an experiment.Comment: Some small changes in section 2, results unchanged. Added referenc