ECG abnormality and predictor of new-onset atrial fibrillation in hypertension and diabetes mellitus population: An observational analytic study from cardiovascular outpatient clinic at a National Cardiovascular Center in Indonesia.

Background: Population-based studies have also found that diabetes mellitus (DM) and hypertension (HT) are independent risk factors for atrial fibrillation (AF). However, less is known about new-onset atrial fibrillation (NOAF) risk factors and its correlation with DM and HT. The aim of this study was to determine the prevalence and pattern of ECG abnormalities, and the predictor of NOAF in patients with HT and DM. Methods: This cross-sectional study was conducted at a tertiary hospital from May until December 2021. All medical record data from outpatients who had both diagnoses HT and DM were included in this study. Data from patients with unstable hemodynamics and lack of complete medical record data were excluded. Then, patient history, medical records, ECG, and laboratory information were reviewed. Results: There were 162 patients included in this study. Arrhythmia was found in 14.2% of the population, with new-onset AF (NOAF) as the most common finding with 8.6% incidence, followed by PVC (3.1%) and PAC (2.5%). Bivariate analysis showed that valvular heart disease, random blood glucose, LVEF, and infection status were associated with a higher incidence of NOA. Model from multivariate logistic regression showed that valvular heart disease and random blood glucose level were independently correlated with NOAF (p = .009). Conclusion: It can be concluded that random blood glucose level at a certain point and valvular heart disease can be used as a risk predictor of NOAF in the hypertension population with concomitant DM.

The Challenging Anticoagulant Therapy in COVID19 Patient with Associated Coagulopathy.

COVID-19 became a widespread infectious disease in late 2019. Indonesia currently has the highest COVID-19 mortality rate in Asia, between 4-5 percent. Interestingly, COVID-19-associated coagulopathy characterized by an increase of several procoagulant factor levels, including fibrinogen and D-dimer, that has been associated with higher mortality and unfavorable outcomes. We report a case of a 30-year-old male admitted to the hospital with a profuse vomiting and worsening fever, cough and shortness of breath, and was diagnosed with COVID-19-associated coagulopathy. Seven days after admission, he became deteriorated with significant reduction of oxygen saturation and his coagulation parameter levels were increased with highly suspicion of pulmonary embolism. He was treated with azithromycin, isoprinosine, lopinavir, and fondaparinux with thromboprophylaxis dosage since admission. The role of increased fondaparinux dosage at the time of clinical deterioration was then followed by clinical improvement and reduced D-dimer level. Anticoagulant therapy, mainly with fondaparinux, showed a better prognosis in patients with markedly elevated D-Dimer. Fondaparinux needs to be monitored appropriately to prevent bleeding and adverse. The patient was discharged from the hospital in an improved condition and normal D-Dimer levels. There was no bleeding event nor other major side effects had been found in this case. The decision for increasing dose of anticoagulant may be determined on individual basis, considering risks, benefits, and also the most important is clinical findings.

The fin whale, a marine top consumer, exposes strengths and weaknesses of the use of fluoride as ecological tracer.

Fluoride is retained in bone tissues of animals and its availability in the environment varies between regions according to natural and anthropogenic sources. These properties suggest this element as a suitable tracer of origin, distribution or movements of animals. In marine environments, krill builds-up fluoride concentrations that are transferred to its predators. In this study we examine the ability of bone fluoride concentrations to discriminate two separate populations of a krill consumer, the fin whale. Background levels of the sampling areas (Western Iceland and North-Western Spain) were determined through the analysis of krill samples. As expected, due to the high load of volcanic-derived fluoride in Icelandic waters, krill from W Iceland showed much higher fluoride concentrations than that from NW Spain. Concentrations in whales' bone were correlated with sex and age, increasing linearly with age in females and showing significantly lower values and a different age-related pattern of accumulation in males. Fluoride concentrations in whales' bone were much higher than in krill, indicating accumulation of the element but, rather unexpectedly, the area of origin had no influence on concentrations. This apparent contradiction may be explained either by the integration in bone of food consumed in other areas, or by the activation of homeostatic responses at very high levels of fluoride exposure. It is concluded that fluoride can be a useful tracer only if age and sex data are integrated into the analysis, year-round information on diet is available and/or the investigated population is exposed to mild levels of this element.

Intoxicación masiva por cocaína en un body packer / No disponible

No disponible

Pólipos colônicos na infância / Colonic polyps in infancy

Pólipos juvenis representam a lesäo polipóide mais comumente observada em pacientes pediátricos Geralmente, eles säo solitários e localizam-se no reto, sendo considerados um processo inflamatório, isentos de qualquer potencial de malignizaçäo. Necessitam ser diferenciados de outras lesöes poliposas que apresentam alto risco de malignizaçäo. Estudamos os aspectos clínicos e patológicos dos pólipos colônicos em 34 crianças com idades que variam de oito meses a 16 anos. Sangramento retal e prolapso do pólipo foram as manifestaçöes clínicas mais freqüentes. O estudo histológico revelou 30 casos de pólipo juvenil, um caso de polipose juvenil colônica, dois casos de polipose juvenil e adenomatosa e um caso de pólipo adenomatoso isolado de sigmóide. A diferenciaçäo anatomoclínica entre as várias lesöes polipóides é de importância fundamental, orientando a conduta terapêutica a ser tomada

Studies on the significance of hair root protein and DNA in protein-calorie malnutrition.

Hair root protein and DNA, serum nonessential amino acid/essential amino acid ratio, serum total protein, albumin, globulin and albumin/globulin ratio were estimated in children suffering from portein-calorie malnutrition (PCM) and the values compared to those obtained from healthy children. The data were presented in two ways: 1) classified as early malnutrition, marasmus, marasmic kwashiorkor, or kwasiorkor and the parameters compared 2) all the malnourished children were divided into four groups on the basis of percentage of body weight for age and the parameters compared. There was a progressive decrease in the content of hair root DNA and protein with the severity of PCM with these values decreasing to less than half of the normal values. In all types of PCM the serum albumin decreased significantly and the globulin increased while the total protein was altered only in the more severe stages. Differences in the serum consituents between groups were more pronounced when classified clinically than when grouped as percentage of normal body weight. Since hair root changes are progressive and of greater magnitude than those in the serum, hair root DNA and proteins might be useful chemical criteria in detectinc various stages of PCM, and further to help understand the pathogenesis of the condition.