Pub Date : 2019-08-20DOI: 10.5772/intechopen.88719
Jean-Marc Mercantini
This chapter concerns the formulation of a methodology and its implementation to elaborate a training simulator for medical staff who may be confronted with the critical situations of newborn resuscitation. The simulator reproduces the different cardiopulmonary pathological behaviors of newborns, the working environment of resuscitation rooms, and the monitoring and control environment of the learners by a teacher. Conceptual models of newborn behaviors combined with the cardiopulmonary resuscitation gestures have been developed. The methodological process is jointly using cognitive approaches with formal modeling and simulation. Cognitive approaches are mobilized to elaborate application ontologies to be the bases for the development of the conceptual models and the specification of the simulator. Ontologies have been developed on the bases of a corpus of academic documents, return on experience documents, and practitioner interviews, by means of the knowledge-oriented design (KOD) method. A discrete event formalism has been used to formalize the conceptual models of the newborn behaviors. As a result, a simulator has been built to train medical practitioners to face situations, which are reported to potentially cause errors, and thus improve the safety of the resuscitation gestures.
{"title":"Ontology-Based Modeling for Newborn Behavior Simulation during Cardiopulmonary Resuscitation","authors":"Jean-Marc Mercantini","doi":"10.5772/intechopen.88719","DOIUrl":"https://doi.org/10.5772/intechopen.88719","url":null,"abstract":"This chapter concerns the formulation of a methodology and its implementation to elaborate a training simulator for medical staff who may be confronted with the critical situations of newborn resuscitation. The simulator reproduces the different cardiopulmonary pathological behaviors of newborns, the working environment of resuscitation rooms, and the monitoring and control environment of the learners by a teacher. Conceptual models of newborn behaviors combined with the cardiopulmonary resuscitation gestures have been developed. The methodological process is jointly using cognitive approaches with formal modeling and simulation. Cognitive approaches are mobilized to elaborate application ontologies to be the bases for the development of the conceptual models and the specification of the simulator. Ontologies have been developed on the bases of a corpus of academic documents, return on experience documents, and practitioner interviews, by means of the knowledge-oriented design (KOD) method. A discrete event formalism has been used to formalize the conceptual models of the newborn behaviors. As a result, a simulator has been built to train medical practitioners to face situations, which are reported to potentially cause errors, and thus improve the safety of the resuscitation gestures.","PeriodicalId":178820,"journal":{"name":"Cardiac Diseases and Interventions in 21st Century","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130339120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-25DOI: 10.5772/INTECHOPEN.88134
Nagaeva Gulnora.
In 2015, a register of acute coronary events (acute coronary syndrome and acute myocardial infarction) was carried out in one of the districts of the city of Tashkent. The study included 782 patients, of which 491 (63.7%) were analyzed (hereinafter 100%) and the remaining 291 (36.3%) were dead (according to the civil registry office). The average age of patients was 58.3 (cid:1) 7.9 years. The features of the patient ’ s nosological structures were established separately for men and women when admitted to hospital and discharged from hospital, which will make it possible to further adjust the tactics of management of these categories of patients, taking into account their gender and other uncompensated risk factors.
{"title":"Characteristics of Acute Myocardial Damage in Uzbekistan: Data Register “RACSMI-Uz”","authors":"Nagaeva Gulnora.","doi":"10.5772/INTECHOPEN.88134","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.88134","url":null,"abstract":"In 2015, a register of acute coronary events (acute coronary syndrome and acute myocardial infarction) was carried out in one of the districts of the city of Tashkent. The study included 782 patients, of which 491 (63.7%) were analyzed (hereinafter 100%) and the remaining 291 (36.3%) were dead (according to the civil registry office). The average age of patients was 58.3 (cid:1) 7.9 years. The features of the patient ’ s nosological structures were established separately for men and women when admitted to hospital and discharged from hospital, which will make it possible to further adjust the tactics of management of these categories of patients, taking into account their gender and other uncompensated risk factors.","PeriodicalId":178820,"journal":{"name":"Cardiac Diseases and Interventions in 21st Century","volume":"279 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114613644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-05DOI: 10.5772/INTECHOPEN.85816
O. Karcioglu
Medicine has been recognized as an art of understanding and healing human illnesses and injuries for thousands of years. Warfare, economic turmoils, and all kinds of socioeconomic factors affect medical knowledge and practice in cardiac diseases, mostly prominent in the last centuries. After 1960s, breakthrough changes and innovations in cardiac biomarkers, electrocardiographic monitoring, defibrillation, therapeutic temperature management (TTM), capnography, and some other instruments have been launched, and these have been thought to mitigate the burden of cardiac diseases. Nowadays, it is obvious that electrocardiography, defibrillation, and cardiopulmonary resuscitation (CPR) are far from its current format in the 1950’s and 1960’s world. Out-of-hospital cardiac arrest (OHCA) remains a major death scenario in the middle-aged population all over the world. Despite all new major advances, survival for OHCA is, on average, approximately 10%, but substantial variability is visible among emergency medical services systems even in the most developed countries. Four kinds of fatal arrhythmias (ventricular fibrillation-VF, pulseless ventricular tachycardia, asystole, and pulseless electrical activity) result in a loss of cardiac function and sudden cardiac death. VF is one of the most deadly cardiac arrhythmias and certainly the most common one. It can be described as erratic, disorganized firing of impulses from the ventricles, producing no palpable pulses in the periphery. Literature data have shown that the earlier defibrillation and bystander CPR have been commenced, the lower is the patient mortality. Since considerable differences can affect people’s lives in this context, the role of medical command bears utmost importance to direct these patients to facilities with discrete capabilities [1]. Another aspect of the emergency life-saving interventions in these patients comprises urgent coronary revascularization. Since most patients presenting with OHCA and refractory VF suffer from an acute thrombotic coronary artery lesion, urgent coronary angiography with revascularization is critical.
{"title":"Introductory Chapter: Cardiac Disease - Plague in the Modern World","authors":"O. Karcioglu","doi":"10.5772/INTECHOPEN.85816","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85816","url":null,"abstract":"Medicine has been recognized as an art of understanding and healing human illnesses and injuries for thousands of years. Warfare, economic turmoils, and all kinds of socioeconomic factors affect medical knowledge and practice in cardiac diseases, mostly prominent in the last centuries. After 1960s, breakthrough changes and innovations in cardiac biomarkers, electrocardiographic monitoring, defibrillation, therapeutic temperature management (TTM), capnography, and some other instruments have been launched, and these have been thought to mitigate the burden of cardiac diseases. Nowadays, it is obvious that electrocardiography, defibrillation, and cardiopulmonary resuscitation (CPR) are far from its current format in the 1950’s and 1960’s world. Out-of-hospital cardiac arrest (OHCA) remains a major death scenario in the middle-aged population all over the world. Despite all new major advances, survival for OHCA is, on average, approximately 10%, but substantial variability is visible among emergency medical services systems even in the most developed countries. Four kinds of fatal arrhythmias (ventricular fibrillation-VF, pulseless ventricular tachycardia, asystole, and pulseless electrical activity) result in a loss of cardiac function and sudden cardiac death. VF is one of the most deadly cardiac arrhythmias and certainly the most common one. It can be described as erratic, disorganized firing of impulses from the ventricles, producing no palpable pulses in the periphery. Literature data have shown that the earlier defibrillation and bystander CPR have been commenced, the lower is the patient mortality. Since considerable differences can affect people’s lives in this context, the role of medical command bears utmost importance to direct these patients to facilities with discrete capabilities [1]. Another aspect of the emergency life-saving interventions in these patients comprises urgent coronary revascularization. Since most patients presenting with OHCA and refractory VF suffer from an acute thrombotic coronary artery lesion, urgent coronary angiography with revascularization is critical.","PeriodicalId":178820,"journal":{"name":"Cardiac Diseases and Interventions in 21st Century","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130375983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-29DOI: 10.5772/INTECHOPEN.85488
M. Stoia, S. Istratoaie, S. Pop, F. Anton, S. Criṣan, D. Blendea
Left ventricular (LV) lead positioning is one of the main contributors to the cardiac resynchronization therapy (CRT) response. Conventional left ventricular (LV) lead implantation faces several difficulties, which may ultimately affect lead stability and performance. Several imaging techniques have been proposed to overcome all these obstacles including multimodality cardiac imaging to help in preprocedural or intraprocedural identification of the latest activated areas of the LV. Emerging pacing strategies like LV multisite and multipoint pacing may help deliver an enhanced response to CRT, but prospective trials are warranted to confirm the superiority of this approach.
{"title":"The Importance of Lead Positioning to Improve Clinical Outcomes in Cardiac Resynchronization Therapy","authors":"M. Stoia, S. Istratoaie, S. Pop, F. Anton, S. Criṣan, D. Blendea","doi":"10.5772/INTECHOPEN.85488","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85488","url":null,"abstract":"Left ventricular (LV) lead positioning is one of the main contributors to the cardiac resynchronization therapy (CRT) response. Conventional left ventricular (LV) lead implantation faces several difficulties, which may ultimately affect lead stability and performance. Several imaging techniques have been proposed to overcome all these obstacles including multimodality cardiac imaging to help in preprocedural or intraprocedural identification of the latest activated areas of the LV. Emerging pacing strategies like LV multisite and multipoint pacing may help deliver an enhanced response to CRT, but prospective trials are warranted to confirm the superiority of this approach.","PeriodicalId":178820,"journal":{"name":"Cardiac Diseases and Interventions in 21st Century","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122367883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-21DOI: 10.5772/INTECHOPEN.84430
Mikel Leturiondo, S. R. D. Gauna, J. Gutiérrez, D. González-Otero, J. Ruiz, L. Leturiondo, P. Sáiz
Sudden cardiac arrest (SCA) is the sudden cessation of the heart’s effective pumping function, confirmed by the absence of pulse and breathing. Without appropriate treatment, it leads to sudden cardiac death, considered responsible for half of the global cardiac disease deaths. Cardiopulmonary resuscitation (CPR) is a key intervention during SCA. Current resuscitation guidelines emphasize the use of waveform capnography during CPR in order to enhance CPR quality and improve patient outcomes. Capnography represents the concentration of the partial pressure of carbon dioxide (CO 2 ) in respiratory gases and reflects ventilation and perfusion of the patient. Waveform capnography should be used for confirming the correct placement of the tracheal tube and monitoring ventilation. Other potential uses of capnography in resuscitation involve monitoring CPR quality, early identification of restoration of spontaneous circulation (ROSC), and determination of patient prognosis. An important role of waveform capnography is ventilation rate monitoring to prevent overventilation. However, some studies have reported the appearance of high-frequency oscillations synchronized with chest compressions superimposed on the capnogram. This chapter explores the incidence of chest compression artifact in out-of-hospital capnograms, assesses its negative influence in the automated detection of ventilations, and proposes several methods to enhance ventilation detection and capnography waveform.
{"title":"Waveform Capnography for Monitoring Ventilation during Cardiopulmonary Resuscitation: The Problem of Chest Compression Artifact","authors":"Mikel Leturiondo, S. R. D. Gauna, J. Gutiérrez, D. González-Otero, J. Ruiz, L. Leturiondo, P. Sáiz","doi":"10.5772/INTECHOPEN.84430","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84430","url":null,"abstract":"Sudden cardiac arrest (SCA) is the sudden cessation of the heart’s effective pumping function, confirmed by the absence of pulse and breathing. Without appropriate treatment, it leads to sudden cardiac death, considered responsible for half of the global cardiac disease deaths. Cardiopulmonary resuscitation (CPR) is a key intervention during SCA. Current resuscitation guidelines emphasize the use of waveform capnography during CPR in order to enhance CPR quality and improve patient outcomes. Capnography represents the concentration of the partial pressure of carbon dioxide (CO 2 ) in respiratory gases and reflects ventilation and perfusion of the patient. Waveform capnography should be used for confirming the correct placement of the tracheal tube and monitoring ventilation. Other potential uses of capnography in resuscitation involve monitoring CPR quality, early identification of restoration of spontaneous circulation (ROSC), and determination of patient prognosis. An important role of waveform capnography is ventilation rate monitoring to prevent overventilation. However, some studies have reported the appearance of high-frequency oscillations synchronized with chest compressions superimposed on the capnogram. This chapter explores the incidence of chest compression artifact in out-of-hospital capnograms, assesses its negative influence in the automated detection of ventilations, and proposes several methods to enhance ventilation detection and capnography waveform.","PeriodicalId":178820,"journal":{"name":"Cardiac Diseases and Interventions in 21st Century","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126756536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-05DOI: 10.5772/INTECHOPEN.80607
R. Linchak, S. Boytsov, A. Ardashev, A. Kuzovlev
Sudden cardiac arrest caused by cardiac and extracardiac pathology is one of the leading causes of death in developed countries. Public-access defibrillation is one of the key techniques for improvement of the pre-hospital and in-hospital resuscitation success and survival rates of resuscitated patients in the case of a sudden cardiac arrest caused by ventricular fibrillation and pulseless ventricular tachycardia. This book chapter will discuss the relation between the type of a sudden cardiac arrest and the survival rate and the “chain of survival” concept and the role of early public-access defibrillation, as well as the function of public-access defibrillation programs and the contribution of automated external defibrillators in pre-hospital and in-hospital resuscitation.
{"title":"Public-Access Defibrillation in Sudden Cardiac Arrest","authors":"R. Linchak, S. Boytsov, A. Ardashev, A. Kuzovlev","doi":"10.5772/INTECHOPEN.80607","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.80607","url":null,"abstract":"Sudden cardiac arrest caused by cardiac and extracardiac pathology is one of the leading causes of death in developed countries. Public-access defibrillation is one of the key techniques for improvement of the pre-hospital and in-hospital resuscitation success and survival rates of resuscitated patients in the case of a sudden cardiac arrest caused by ventricular fibrillation and pulseless ventricular tachycardia. This book chapter will discuss the relation between the type of a sudden cardiac arrest and the survival rate and the “chain of survival” concept and the role of early public-access defibrillation, as well as the function of public-access defibrillation programs and the contribution of automated external defibrillators in pre-hospital and in-hospital resuscitation.","PeriodicalId":178820,"journal":{"name":"Cardiac Diseases and Interventions in 21st Century","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121182606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-05DOI: 10.5772/INTECHOPEN.81420
D. Wieczorek
Phosphorylation of cardiac sarcomeric proteins plays a major role in the regulation of physiological performance of the heart. Tropomyosin, an essential thin filament protein, regulates muscle contraction and relaxation through its interactions with actin, myosin, and the troponin complex. Studies demonstrate that changes in tropomyosin phosphorylation occur both postpartum and in response to cardiac hypertrophy and heart failure. To address the significance of tropomyosin phosphorylation on cardiac function, we conducted experiments to ascertain the effects of constitutive pseudophosphorylation, dephosphorylation, and dephosphorylation in hypertrophic cardiomyopathic hearts. Recent work demonstrates that pseudophosphorylation of tropomyosin results in dilated cardiomyopathy. Tropomyosin dephosphorylation results in a compensated or physiological cardiac hypertrophic phenotype. In addition, we demonstrated that tropomyosin dephosphorylation phenotypically rescues hearts undergoing cardiac hypertrophy. In summary, these studies collectively demonstrate a significant biological and physiological role for tropomyosin phosphorylation under both normal and cardiomyopathic conditions.
{"title":"The Role of Tropomyosin in Cardiac Function and Disease","authors":"D. Wieczorek","doi":"10.5772/INTECHOPEN.81420","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.81420","url":null,"abstract":"Phosphorylation of cardiac sarcomeric proteins plays a major role in the regulation of physiological performance of the heart. Tropomyosin, an essential thin filament protein, regulates muscle contraction and relaxation through its interactions with actin, myosin, and the troponin complex. Studies demonstrate that changes in tropomyosin phosphorylation occur both postpartum and in response to cardiac hypertrophy and heart failure. To address the significance of tropomyosin phosphorylation on cardiac function, we conducted experiments to ascertain the effects of constitutive pseudophosphorylation, dephosphorylation, and dephosphorylation in hypertrophic cardiomyopathic hearts. Recent work demonstrates that pseudophosphorylation of tropomyosin results in dilated cardiomyopathy. Tropomyosin dephosphorylation results in a compensated or physiological cardiac hypertrophic phenotype. In addition, we demonstrated that tropomyosin dephosphorylation phenotypically rescues hearts undergoing cardiac hypertrophy. In summary, these studies collectively demonstrate a significant biological and physiological role for tropomyosin phosphorylation under both normal and cardiomyopathic conditions.","PeriodicalId":178820,"journal":{"name":"Cardiac Diseases and Interventions in 21st Century","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130742678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：