Radiofrequency Ablation of Life-Threatening Supraventricular Tachycardia Due to a Posteroseptal Accessory Pathway in an Infant

Supraventricular tachycardia (SVT) in infants may be resistant to multiple medications and cause life-threatening symptoms. Despite the known risks, catheter ablation may be necessary in rare cases. We present a 4-month-old 4.5 kg infant who presented with SVT that was resistant to all antiarrhythmic medications, including a combination of propafenone, amiodarone and propranolol at maximal doses. The infant underwent successful radiofrequency ablation of a posteroseptal accessory pathway. Despite later recurrence, medical therapy with propafenone and propranolol at standard doses resulted in complete control of the tachycardia until one year of age, when all medications were stopped without further recurrences

Cardiopulmonary Resuscitation Update

BACKGROUND AND OBJECTIVES: Every 5 years experts, after reviewing literature and scientific evidence, update the guidelines on Cardiopulmonary resuscitation (CPR). The objective of this report is to review the main changes in resuscitation that occurred over the last 5 year period. CONTENTS: High-quality chest compressions with adequate rate and depth allowing full recoil of the chest with minimal interruptions is the mainstay of the recommended changes. The 30:2 compression ventilation ratio is maintained, but the former order is modified chest compressions first, followed by airway and breathing (C-A-B instead of A-B-C). Avoiding of excessive ventilation is also recommended. Chest compressions-only CPR in primary cardiac arrest victims, is an option for rescuers who are unable or unwilling to perform mouth to mouth ventilation. Advanced life support algorithm is simplified (regarding drugs, routes of administration, endotracheal intubation). Acute coronary syndromes (ACS) treatment has also been updated. Better practices for teaching and learning resuscitation skills are addressed. CONCLUSIONS: Updating CPR guidelines is important, and continuous education is recommended. This will improve the quality of resuscitation and survival of patients in cardiac arrest

Alström’s Syndrome, Leber’s Hereditary Optic Neuropathy, or Retinitis Pigmentosa? A Case of Misdiagnosis

A case of a patient with the Alström syndrome (AS) that was misdiagnosed as Leber’s hereditary optic neuropathy or retinitis pigmentosa for 13 years is presented. AS is a rare genetic disorder caused by mutations in the ALMS1 gene. AS may lead to abnormal ciliary formation and function. AS affects metabolism, and symptomatology includes type 2 diabetes mellitus (T2DM), obesity, hypogonadism and gynecomastia in males, progressive bilateral sensorineural hearing loss, cardiomyopathy, nonalcoholic fatty liver disease (NAFLD), cirrhosis, and chronic progressive kidney disease. The onset of the above symptoms may vary significantly. The ophthalmic manifestation is early onset cone-rod dystrophy that starts as progressive vision loss, photophobia, and nystagmus in the first months of life. An accurate diagnosis may enable specialists to facilitate a significantly positive effect in the everyday life of a patient. Genetic counseling may also be recommended for these patients. Diagnosis was confirmed by DNA testing, thus highlighting its necessity in everyday practice

On-Device Intelligence for Malfunction Detection of Water Pump Equipment in Agricultural Premises: Feasibility and Experimentation

The digital transformation of agriculture is a promising necessity for tackling the increasing nutritional needs on Earth and the degradation of natural resources. Toward this direction, the availability of innovative electronic components and of the accompanying software programs can be exploited to detect malfunctions in typical agricultural equipment, such as water pumps, thereby preventing potential failures and water and economic losses. In this context, this article highlights the steps for adding intelligence to sensors installed on pumps in order to intercept and deliver malfunction alerts, based on cheap in situ microcontrollers, sensors, and radios and easy-to-use software tools. This involves efficient data gathering, neural network model training, generation, optimization, and execution procedures, which are further facilitated by the deployment of an experimental platform for generating diverse disturbances of the water pump operation. The best-performing variant of the malfunction detection model can achieve an accuracy rate of about 93% based on the vibration data. The system being implemented follows the on-device intelligence approach that decentralizes processing and networking tasks, thereby aiming to simplify the installation process and reduce the overall costs. In addition to highlighting the necessary implementation variants and details, a characteristic set of evaluation results is also presented, as well as directions for future exploitation