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"Henti jantung masih merupakan penyebab kematian utama di dunia. Walau telah ada kemajuan dalam hal tatalaksana kegawatdaruratan kardiovaskular, angka ketahanan hidup mereka dengan henti jantung di luar rumah sakit tetap rendah. Pedoman resusitasi jantung paru dan kegawatdaruratan kardiovaskular meski telah diperbaharui namun pendekatan terhadap keadaan henti jantung di luar rumah sakit masih jauh dari optimal. Hal ini memberi peluang bagi resusitasi kardioserebral untuk menjadi alternatif resusitasi pada keadaan henti jantung di luar rumah sakit. Resusitasi kardioserebral layak menggantikan resusitasi jantung paru pada keadaan henti jantung di luar rumah sakit karena telah terbukti memperbaiki ketahanan hidup dan fungsi serebral pada pasien dengan henti jantung.

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AbstractCardiac arrest remains a leading cause of death in the world. Although advances in emergency cardiac care has been achieved, the survival rate of those with out-of-hospital cardiac arrest remains low. Guidelines for CPR and emergency cardiovascular care though have been updated, their approach to out-of-hospital cardiac arrest is far from optimal. This provides an opportunity to advocate cardiocerebral resuscitation as an alternative to traditional cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Because cardiocerebral resuscitation results in improved survival and cerebral function in patients with witnessed cardiac arrest and a shockable rhythm whom have greatest chance of survival, it should replace CPR especially for out-of-hospital cardiac arrest."

"This authoritative reference provides practical, easy-to-use guidance on the histopathologic diagnosis of gynecologic lesions. This visual resource clearly describes the cardinal clinical, gross, and microscopic features of each lesion, as well as the staging system for tumors at each site. Clinical correlations of surgical pathology, clinical data, and immunohistochemical data help in weighing all of the available evidence to form the most decisive diagnoses. "

"Cognitive Screening Instruments: A Practical Approach provides a practical and structured overview of some of the most commonly used and easily available cognitive screening instruments applicable in the outpatient clinic and bedside setting. Dementia and cognitive disorders are now recognised as an increasing public health problem, both in terms of patient numbers and cost, as populations age throughout the world. Despite this, many patients with dementia never receive a formal diagnosis, with implications for their appropriate care and management. Diagnostic tests which identify cases of dementia therefore have an important role. Expert authors from around the world equip the reader of Cognitive Screening Instruments: A Practical Approach with clear instructions on the usage of each screening instrument, its strengths and weaknesses, the time required for administration, and rules on scoring, such as how to correct for variations in the patient's age or education, and suggested cut-off scores. Cognitive Screening Instruments: A Practical Approach is a handy, illustrated guide and a valuable diagnostic aid for practitioners working closely with patients with dementia and mild cognitive impairment. This volume will be of use both to clinicians and to professionals in disciplines allied to medicine who are called upon to assess patients with possible cognitive disorders, including neurologists, old age psychiatrists, neuropsychologists, primary care physicians, dementia support workers, and members of memory assessment teams."

"Clinical cardiac MRI is a comprehensive textbook intended for everyone involved in magnetic resonance imaging of the heart. It is designed both as a useful guide for newcomers to the field and as an aid for those who routinely perform such studies. Providing theoretical background information, this illustrated volume examines imaging acquisition and potential pitfalls. It presents guidelines on the interpretation of clinical data in a range of cardiac pathology that can be encountered. In this second edition, the aim has been to maintain the same quality while incorporating the newest insights and developments in this rapidly evolving domain of medical imaging. Finally, the selection of 100 real-life cases, added as online material, will further enhance the value of this textbook."

"ABSTRAKSepsis adalah disfungsi organ yang mengancam jiwa akibat gangguan regulasi pejamu sebagai respons terhadap infeksi. Renjatan sepsis adalah subset sepsis dengan abnormalitas sirkulasi, selular, dan metabolisme yang berkaitan dengan risiko kematian. Penelitian ini bertujuan untuk menilai peran ekokardiografi, biomarker kardiovaskular, fungsi ginjal dan saturasi oksigen vena sebagai prediktor kematian pasien renjatan sepsis. Pada pemeriksaan ekokardiografi dinilai fungsi diastolik E/e rsquo;, Fraksi Ejeksi Bilik Kiri, Indeks Kardiak, TAPSE, sedangkan biomarker kardiovaskular dinilai Troponin I dan NT Pro BNP, dengan disain penelitian kohort prospektif. Tempat penelitian di Rumah Sakit Umum Kabupaten Tangerang, Banten. Selama periode 2 tahun penelitian ada 111 pasien masuk dalam kriteria renjatan sepsis yaitu adanya infeksi, hipotensi MAP < 65 mmHg dan Laktat darah > 2 mmol/L. Pada hari pertama dan kelima dilakukan pemeriksaan ekokardiografi dan laboratorium darah pada semua pasien renjatan sepsis. Pada pengamatan selama 10 hari diperoleh pasien yang meninggal 64 58 dan yang hidup 47 42 . Rerata umur pasien 48 18 tahun. Analisis bivariat ditemukan Fraksi Ejeksi Bilik Kiri abnormal memiliki risiko kematian 1,6 kali dibanding normal RR 1,6; p = 0,034 . Biomarker Troponin I abnormal menunjukkan risiko kematian 1,6 kali dibanding normal RR 1,6; p = 0,004 . Pasien dengan gangguan fungsi ginjal memiliki risiko kematian 1,5 kali RR 1,5; p = 0,024 . Pasien dengan Troponin I abnormal dengan atau tanpa gangguan fungsi ginjal menunjukkan peningkatan risiko kematian, demikian pula pada pasien dengan Troponin I normal yang disertai gangguan fungsi ginjal. Hasil analisis multivariat menunjukkan prediktor kematian pasien renjatan sepsis adalah kadar Troponin I dan Fraksi Ejeksi Bilik Kiri RR 1,83; IK95 1,049 ? 3,215; p = 0,043 dan RR 1,99; IK95 1,009 ? 3,956; p = 0,047 Simpulan: Troponin I dan Fraksi Ejeksi Bilik Kiri merupakan prediktor kematian pasien renjatan sepsis. Kata kunci :Ekokardiografi, Kematian, NT Pro BNP, Renjatan Sepsis, Troponin I.

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ABSTRACTSepsis is a life threatening organ dysfunction caused by host regulation disorder in response to infections. Septic shock is a subset of sepsis with circulatory, cellular, and metabolic abnormalities associated with the risk of mortality. The aim of this study is to assess the role of echocardiography, cardiovascular biomarker, renal function and oxygen vein saturation as predictors of mortality in patients with septic shock. In this study, echocardiography examination including diastolic function E e 39 , Left Ventricle Ejection Fraction LVEF , Cardiac Index CI , and TAPSE, whereas cardiovascular biomarker Troponin I and NT Pro BNP were assessed. Research design of this study is cohort perspective. The study took place in Tangerang Regional General Hospital, Banten Province. During two years of research, there were 111 patients included in septic shock category, which indicated by the presence of infections, hypotension MAP 65 mmHg and serum lactate 2 mmol L. On the first and the fifth day, examinations on echocardiography and laboratory blood test were conducted on each patient of septic shock. During ten days of observation, 64 patients died 54 and 47 patients were survived 42 . The mean age of the patients was 48 18 years old. Bivariate analysis showed abnormal LVEF had 1.6 times higher mortality risk than normal RR 1.6 p 0.034 . Abnormal Troponin I biomarker showed 1.6 higher mortality risk, compared to normal RR 1.6 p 0.004 . The patients with kidney function disorder had 1.5 times higher mortality risk RR 1.5 p 0.024 . Patients with abnormal Troponin I with or without kidney function disorder showed increase in mortality risk. Normal Troponin I with kidney function disorder also increase in mortality risk. Multivariate analysis showed Troponin I and Left Ventricular Ejection Fraction as predictors of mortality in patients with septic shock RR 1.83 CI95 1.049 3.215 p 0.043 dan RR 1.99 CI95 1.009 3.956 p 0.047 In conclusion, Troponin I biomaker and Left Ventricular Ejection Fraction are predictors of mortality in patients with septic shock. Keyword Echocardiography, Death, NT Pro BNP, Septic Shock, Troponin I "