Conmoci\uf3n cardiaca

La conmoci\uf3n cardiaca es fibrilaci\uf3n ventricular resultado de traumatismo contuso en el pecho y es un trarstorno que pone en peligro la vida; son indispensables las maniobras de reanimaci\uf3n temprana y la desfibrilaci\uf3n. Puede suceder durante encuentros deportivos o por abuso de ni\uf1o, y la mayor\ueda de los enfermos son varones menores de 16 a\uf1os de edad. El pron\uf3stico de la conmoci\uf3n cardiaca depende de la disponibilidad de la desfibrilaci\uf3n cardiaca. Los desfibriladores autom\ue1ticos en sitios convenientes cerca de encuentros deportivos, combinados con mejor\ueda en la educaci\uf3n de la reanimaci\uf3n cardiopulmonar. mejoran las probabilidades de.supervivencia despu\ue9s de este fen\uf3meno que no es frecuente. En los sobrevivientes se han observado anormalidades transitorias de la conducci\uf3n cardiaca y arritmias: por ello. se indica verificar la situaci\uf3n cardiaca saludable antes de reanudar las actividades deportivas

Moiré beatings in graphene on Ru(0001)

The moiré superstructure of a single layer of carbon on ruthenium, where 25×25 graphene honeycombs sit on 23×23 substrate unit cells, is determined from first principles. The density functional theory (DFT) calculations predict two kinds of structural units, Ω and Y, in the supercell, which are identified as moiré beatings or moirons. The related topographic bucklings, or "hills," have distinct carbon conformations and a height of 1.16 Å. The different moirons are observed with scanning tunneling microscopy (STM), and surface x-ray diffraction (SXRD) also discriminates the two. This connects ab initio DFT calculations with STM and SXRD experiments in unit cells containing more than 4000 atoms

Fontan-associated liver disease after heart transplant

BackgroundFontan associated liver disease (FALD) potentially impacts Fontan patients undergoing heart transplant. This multi-center study sought to identify pre-transplant risk factors and characterize any post-transplant liver recovery in those patients undergoing heart-alone transplant.MethodsReview of Fontan patients at 12 pediatric institutions who underwent heart transplant between 2001-2019. Radiologists reviewed pre and post-transplant liver imaging for fibrosis. Laboratory, pathology and endoscopy studies were reviewed.Results156 patients underwent transplant due to decreased ventricular function (49%), protein losing enteropathy (31%) or plastic bronchitis (10%); median age at transplant was 13.6 years (interquartile range IQR 7.8, 17.2) with a median of 9.3 years (IQR 3.2, 13.4) between the Fontan operation and transplant. Few patients had pre-transplant endoscopy (18%), and liver biopsy (19%). There were 31 deaths (20%). The median time from transplant to death was 0.5 years (95% Confidence Interval CI 0.0, 3.6). The five-year survival was 73% (95% CI 64%, 83%). Deaths were related to cardiac causes in 68% (21/31) and infection in 6 (19%). A pre-transplant elevation in bilirubin was a predictor of death. Higher platelet levels were protective. Immediate post-transplant elevations in creatinine, AST, ALT, and INR were predictive of death. Advanced liver fibrosis identified on ultrasound, computed tomography, or magnetic resonance imaging was not predictive of death. Liver imaging suggested some improvement in liver congestion post-transplant.ConclusionsElevated bilirubin, but not fibrosis on liver imaging, was associated with post-heart transplant mortality in Fontan patients in this multicenter retrospective study. Additionally, heart transplant may alter the progression of FALD.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/175868/1/petr14435_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/175868/2/petr14435.pd