Hypokalcemií indukovaná kardiomyopatie je vzácné, avšak závažné onemocnění, náročné z hlediska diagnostiky i léčby. těžká hypokalcemie na podkladě hypoparatyreózy může vyvolat vzácnou, nicméně potenciálně reverzibilní, formu dilatační kardiomyopatie. tato kazuistika popisuje případ 31leté ženy se srdečním selháním vyvolaným hypoparatyreózou po tyreoidektomii. Přes klasickou léčbu srdečního selhání přetrvával u pacientky její závažný stav až do úpravy hypokalcemie. léčba zahrnovala suplementaci kalcia a terapii vedenou podle příslušných doporučených postupů; následně došlo k významnému zlepšení. Proto je pro dosažení zlepšení – pokud byla klasická léčba srdečního selhání neúčinná – naprosto nezbytné monitorovat hodnoty kalcia v séru, zvláště u pacientů s tyreoidektomií v anamnéze. Při léčbě srdečního selhání je třeba být ostražitý a mít neustále na paměti možnou přítomnost hypokalcemie jako reverzibilní příčinu uvedené komplikace.
Hypocalcemia-associated cardiomyopathy, a rare but serious condition, presents challenges in diagnosis and management. Severe hypocalcemia resulting from hypoparathyroidism can precipitate rare yet reversible cases of dilated cardiomyopathy. This case report reported a 31-year-old woman with heart failure precipitated by hypoparathyroidism following thyroidectomy. Despite conventional heart failure treatments, her condition persisted until correction of hypocalcemia. Treatment involved calcium supplementation and guideline-directed heart failure therapy. Significant improvement was observed then. Hence, monitoring serum calcium levels is imperative when conventional heart failure therapies fail to yield improvement, particularly in patients with a history of thyroidectomy. Sustaining clinical awareness and vigilance concerning hypocalcemia is crucial in managing heart failure, considering its possibility as a reversible cause.
- MeSH
- dospělí MeSH
- hypokalcemie * etiologie MeSH
- hypoparatyreóza komplikace MeSH
- kardiomyopatie * diagnóza etiologie komplikace MeSH
- lidé MeSH
- thyroxin aplikace a dávkování MeSH
- tyreoidektomie škodlivé účinky MeSH
- vápník aplikace a dávkování MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Context: Paroxysmální supraventrikulární tachykardie (PSVt) je běžnou formou arytmie, která se často projevuje symptomy připomínajícími akutní koronární syndrom (AKS). Popis případu: Popisujeme případ 58letého muže s PSVt doprovázenou bolestí na hrudi a zvýšenými hodnotami troponinu naměřenými vysoce senzitivní metodou (high-sensitivity troponin, hs-tn). Koronarografické vyšetření prokázalo pomalý průtok krve koronárními tepnami v nepřítomnosti obstrukčního postižení. Pacientovy symptomy vymizely spontánně a echokardiografické parametry měly při jeho propouštění normální hodnoty. Závěry: Popisovaný případ ukazuje diagnostickou náročnost rozpoznávání AKS a upozorňuje na přechodné zvýšení hodnot troponinu při PSVt, možná v důsledku ischemie myokardu na podkladě rychlé srdeční frekvence. Při rozhodování o léčbě, zvláště v nepřítomnosti významné ischemické choroby, je nezbytné opřít se o klinické korelace a použít doplňkové diagnostické metody.
Background: Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia often presenting with symptoms mimicking acute coronary syndrome (ACS). Case presentation: We present a case of a 58-year-old man with PSVT accompanied by chest pain and elevated high-sensitivity troponin (hs-Tn) levels. Coronary angiography revealed slow coronary flow in absence of obstructive disease. The patient's symptoms resolved spontaneously, and echocardiographic findings normalized upon discharge. Conclusions: This case underscores the diagnostic challenge of individuating ACS and highlights the transient troponin elevation seen in PSVT, potentially due to myocardial ischemia secondary to rapid heart rates. Clinical correlation and adjunctive diagnostic modalities are crucial in guiding management decisions, especially in the absence of significant coronary artery disease.
- MeSH
- bolesti na hrudi etiologie MeSH
- elektrokardiografie MeSH
- komorová tachykardie * diagnostické zobrazování patologie MeSH
- koronární angiografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- spontánní remise MeSH
- troponin T * fyziologie krev MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- Klíčová slova
- sportovní kardiologie,
- MeSH
- kardiologie * dějiny metody organizace a řízení MeSH
- lidé MeSH
- sportovci * MeSH
- Check Tag
- lidé MeSH
- Klíčová slova
- sportovní kardiologie,
- MeSH
- kardiologie * metody organizace a řízení přístrojové vybavení MeSH
- lidé MeSH
- sportovci * MeSH
- Check Tag
- lidé MeSH
CONTEXT: Advance care planning (ACP) is relevant yet challenging with cognitive decline. OBJECTIVE: To provide evidence and consensus-based clinical recommendations for how to conduct ACP in dementia. METHODS: International Delphi study conducted by the European Association for Palliative Care 'ACP in dementia' taskforce with four online surveys (September 2021-June 2022). A panel of 107 experts from 33 countries and seven individuals with dementia contributed. The recommendations specific for dementia were initially based on two earlier Delphi studies and literature searches addressing guidance including the right timing and how to personalize ACP. We used conservative preregistered criteria for consensus. RESULTS: Thirty constitutive elements of ACP were identified (e.g., 'assess understanding of ACP'). Only five were deemed 'optional.' The panel estimated a median of four conversations could address elements to be addressed at least once. Recommendations included to assume capacity as a principle, conscious of the need to explore its fluctuation, to encourage engaging and playing active roles, and to establish connection and inform and prepare family. There was a consensus to offer ACP around dementia diagnosis, to raise end-of-life issues later, and to personalize ACP with flexibility, providing of information and exploring understanding. The advice of the persons with dementia pointed to a wish for a well-coordinated holistic approach. CONCLUSION: Consensus was reached, including in areas of ambiguity, to guide ACP in dementia. ACP should be embedded in a nonprescriptive, individualized approach that involves both the person with dementia and their families. Future studies may evaluate trade-offs between optimal ACP and feasible implementation.
- MeSH
- delfská metoda MeSH
- demence * terapie MeSH
- konsensus MeSH
- lidé MeSH
- paliativní péče MeSH
- péče o umírající MeSH
- předběžné plánování péče * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The cross-section measurement of Antimony (Sb) is pivotal to modify or stagnate the rate of neutron flux in nuclear reactors. Neutron induced reaction cross-section data for isotopes of Sb is meagre as per reported in EXFOR. A comprehensive attempt has been made to analyse the reaction cross-section of 121Sb and 123Sb at monoenergetic neutron energy of 14.96 ± 0.03 MeV. The experiment was performed at the Neutron and Ion Irradiation Facility, Institute for Plasma Research (IPR), Gujarat (India). The 27Al(n,α)24Na reaction is used to monitor the flux and to estimate the cross-section of (n,2n), (n,p) reactions using neutron activation technique. Monoenergetic neutrons generated by D-T fusion reaction were bombarded on the natural sample of Sb to induce radioactivity. A High Purity Germanium detector (HPGe) with a resolution of 2.1 keV at 1.33 MeV γ-ray energy of 60Co based on GENIE software was used for the counting of emitted gamma photo peaks. Calculated results are compared with the existing studies from EXFOR. The cross-section values are estimated using TALYS-2.0 statistical code by employing different input parameters, along with the latest Evaluated Nuclear data libraries (ENDF/B-VIII.0, JEFF-3.3). To obtain more precise data, uncertainties from various parameters are propagated using the correlation coefficients among all the parameters. This systematic detailed covariance analysis helps to reduce the present discrepancies and to refine the nuclear data.
- Publikační typ
- časopisecké články MeSH
The potentials of electrochemical processes in ideal aqueous media are related to the potential of a normal hydrogen electrode (NHE). However, in non-ideal media, the potentials of a metallocene redox couple are used as a reference. Such measurements with free metallocene in solution are complicated by adsorption and mass transport phenomena and solvation effects. Herein, a platinum electrode with an anchored ferrocene moiety (Pt,Fc) was used for cyclic voltammetric measurements of the potential of ferrocene/ferrocenium (Fc/Fc+) redox transformation in not only non-aqueous but, for the first time, aqueous solutions as well. This enabled us to eliminate the aforementioned problems associated with the application of free metallocene molecules in solution and, thus, to relate the midpoint potential (Epm) of the Fc/Fc+ redox couple to a NHE. After elimination of the liquid junction potential in an aqueous 0.1 M KCl solution at 25 °C, the average intraday Epm value obtained with freshly prepared Pt,Fc electrodes was found to be 0.312 ± 0.008 V versus the secondary Ag|AgCl electrode. The Pt,Fc electrode can be applied for the standardization of electrochemical measurements and investigation of solvation phenomena at interfaces in non-ideal media.
- Publikační typ
- časopisecké články MeSH
UNLABELLED: Potassium chlorate has long been utilized as an excellent oxidizing agent in pyrotechnics and explosives. As mixtures of potassium chlorate and any type of combustible material can be explosive, there is a potential risk of misuse in homemade explosives. Unlike commercial explosives, homemade chlorate and oil mixtures do not have a constant composition, which limits their understanding. This study reports the effects of two types of oil (motor oil and cooking oil) and their ratios (ranging from 2.5% to 40.0% (w/w)) on the explosive properties of such mixtures. The impact sensitivity was highest at a motor oil ratio of 5%. The friction sensitivity increased with an increasing oil ratio, reaching a maximum at an oil ratio of ~22.5%, and was close to those of primary explosives. The motor oil mixtures exhibited higher sensitivity than the cooking oil mixtures at oil ratios of 25.0% or less. A 10% oil mixture, which was close to the ratio of oxygen balance equal to zero, detonated in weak confinement, such as a paper cylinder. The highest detonation velocities in a polypropylene tube were ~2 300 and 2 550 m/s at a 10% ratio of motor oil and cooking oil, respectively. The velocities of the metal case wall, measured by photonic Doppler velocimetry, reached ~1 100 m/s near the end of acceleration. These results show that homemade chlorate and oil mixtures are capable of detonation and quite sensitive over a wide range of oil ratios, with sufficient power to cause damage in the vicinity. KEY POINTS: Simple mixtures of potassium chlorate and oil can be used as a homemade explosives.Oil types and ratios considerably affect the sensitivity and detonation velocity.Mixtures are sufficiently potent to generate hazardous fragments.Long-term storage causes an internal oil gradient.Mixtures with wide-ranging oil ratios can have highly sensitive points.
- Publikační typ
- časopisecké články MeSH
