This document provides new guidelines for managing patients with non-ST-elevation myocardial infarction (NSTEMI) in 2018. It recommends using high-sensitivity troponin assays for diagnosis and simplifying risk stratification to determine invasive management strategies. It also suggests using intensive/intermediate cardiac care units for NSTEMI patients and considering radial versus femoral approaches when using invasive strategies. The guidelines outline dual antiplatelet therapy algorithms for patients with or without oral anticoagulants, bleeding management during dual antiplatelet therapy, and switching between dual antiplatelet therapies.
Dokumen tersebut membahas tentang aritmia ventrikel yang meliputi:
1. Ventricular extrasystole (VES) atau premature ventricular contraction (PVC) yang disebabkan oleh fokus ektopik di ventrikel
2. Ventricular tachycardia yang disebabkan oleh tiga atau lebih VES dengan fokus yang berasal dari ventrikel kiri atau kanan
3. Ventricular fibrillation yang disebabkan oleh sejumlah fokus ektopik di ventrikel dengan gelombang fibrilasi yang cep
Dokumen tersebut membahas tentang sindroma koroner akut dan penyakit jantung iskemik kronis. Sindroma koroner akut merupakan penyumbatan arteri koroner secara akut yang menyebabkan infark miokardium, sedangkan penyakit jantung iskemik kronis ditandai dengan nyeri dada yang berulang akibat penyempitan pembuluh darah jantung secara bertahap. Dokumen ini juga menjelaskan faktor risiko, patof
Dokumen tersebut membahas tentang edema paru, yaitu penimbunan cairan di jaringan interstisial dan alveolus paru yang disebabkan peningkatan permeabilitas dinding pembuluh darah paru. Edema paru dapat disebabkan oleh ketidakseimbangan tekanan hidrostatik dan onkotik, perubahan permeabilitas membran alveolar-kapiler, atau gangguan sistem limfatik. Gejala klinisnya antara lain sesak napas, batuk, dan hip
Konsensus Penatalaksanaan Hipertensi PERHI 2019 membahas beberapa hal penting yaitu:
1. Tetap menggunakan definisi hipertensi TDS 140 mmHg dan/atau TDD 90 mmHg
2. Mencapai target TD lebih rendah dari sebelumnya tetapi tidak <120/70 mmHg
3. Melakukan evaluasi risiko kardiovaskular dan organ target serta penapisan hipertensi sekunder
222312121 cara-menjahit-luka-jenis-benang-dan-jarum-jahitDafid Rozi
油
Dokumen tersebut memberikan informasi mengenai jenis-jenis benang jahit bedah, jarum jahit, dan cara menjahit luka. Ada beberapa jenis benang seperti catgut, sintetis yang dapat diserap tubuh, dan sintetis yang tidak dapat diserap. Dokumen tersebut juga menjelaskan berbagai cara menjahit luka kulit seperti simpul tunggal, jelujur, dan matras.
Ringkasan dokumen tersebut adalah:
1. Sindroma koroner akut merupakan penyebab utama kematian di dunia.
2. Dokumen menjelaskan epidemiologi, faktor risiko, gejala, diagnosis, dan penatalaksanaan sindroma koroner akut.
3. Ada beberapa pilihan penatalaksanaan seperti trombolisis, angioplasti, atau operasi bypass koroner untuk sindroma koroner akut.
Resusitasi cairan dan elektrolit membahas tentang resusitasi cairan pada pasien perdarahan akut dan dehidrasi, termasuk pilihan cairan, algoritme resusitasi, dan penilaian status volume darah."
Tatalaksana Gagal Jantung Akut ( Acute Heart Failure Update)Isman Firdaus
油
Dr. Isman Firdaus memiliki berbagai spesialisasi kardiologi dan pengalaman kerja sebagai konsultan kardiologi intensif di beberapa rumah sakit. Dokumen ini membahas tentang gagal jantung akut, meliputi definisi, patofisiologi, faktor pemicu, gejala klinis, penilaian profil hemodinamik, dan algoritme penatalaksanaan cepat.
Dokumen tersebut membahas tentang fluida tubuh, termasuk fungsi, distribusi, perpindahan, gangguan keseimbangan, dan penilaian kebutuhan cairan. Dibahas pula berbagai jenis cairan infus, mekanisme, dan klasifikasi berdasarkan tonisitasnya."
Dokumen tersebut membahas tentang penatalaksanaan hipertensi krisis yang meliputi hipertensi emergensi dan hipertensi urgensi. Hipertensi emergensi ditandai dengan peningkatan tekanan darah yang disertai kerusakan organ target sedangkan hipertensi urgensi hanya menunjukkan peningkatan tekanan darah tanpa kerusakan organ target. Penurunan tekanan darah harus dilakukan secara hati-hati untuk mencegah komplikasi pada hip
Ini adalah kuliah saya untuk keperawatan gawat darurat di Akademi Keperawatan Panti Rapih. Kuliah ini memuat sindrom koroner akut, henti jantung, dan syok kardiogenik.
Update:
Tanggal 15 Oktober 2015, American Heart Association menerbitkan panduan baru untuk Cardiopulmonary Resuscitation & Emergency Cardiac Care. Panduan baru tersebut dapat diunduh di http://circ.ahajournals.org/content/132/18_suppl_2.toc
Dokumen tersebut membahas tentang perdarahan saluran cerna bagian atas dan bawah. Perdarahan saluran cerna bagian atas umumnya disebabkan oleh pecahnya varises esofagus, ulkus peptikum, dan gastritis erosiva. Tatalaksananya meliputi resusitasi, endoskopi untuk diagnosis dan terapi, serta profilaksis infeksi. Sedangkan perdarahan saluran cerna bagian bawah umumnya disebabkan oleh hemoroid, fisura ani, dan kanker kolon. Tatal
Edema serebri adalah akumulasi cairan di otak yang meningkatkan volume otak. Dapat terjadi peningkatan volume intraseluler maupun ekstraseluler. Gejalanya antara lain nyeri kepala, muntah, gangguan penglihatan, dan pernapasan. Pemeriksaan CT scan atau MRI dapat menunjukkan lokasi dan sebab edema. Penatalaksanaannya meliputi posisi kepala, analgesia, ventilasi, penanganan tekanan darah dan cairan, serta
Pasien laki-laki berusia 57 tahun dirujuk ke rumah sakit dengan keluhan nyeri dada dan jantung berdebar-debar. Pemeriksaan menunjukkan supraventrikular takikardi dengan laju jantung 180 kali/menit dan gangguan fungsi ventrikel kiri. Pasien menerima terapi amiodarone dan obat lainnya yang berhasil menurunkan laju jantung menjadi normal.
This document discusses the pathophysiology and management of critical hyperglycemia in patients with type 2 diabetes mellitus. It covers the diagnostic criteria and differences between ketoacidosis and hyperosmolar hyperglycemic state. It also provides protocols for managing ketoacidosis and hyperosmolar hyperglycemic state based on guidelines from PERKENI, including continuous insulin therapy. Additionally, it discusses glucose targets for inpatients and prevention strategies, as well as glycemic control for outpatients.
Autophagy and Apoptosis in Myoacardial Infarction, wecoc 2021.pptxIsman Firdaus
油
This document discusses cell death processes in myocardial infarction. It describes necrosis, apoptosis and autophagy as the main types of cell death that occur. Necrosis is unprogrammed cell death due to loss of membrane integrity. Apoptosis is programmed cell death involving caspases and Bcl-2 proteins. Autophagy is the self-digestion of cellular components and can be protective at early stages but excessive autophagy can lead to cell injury. Studies in rat models of myocardial infarction show increases in autophagy and apoptosis markers at different time points following coronary artery ligation. The conclusion is that autophagy and apoptosis both play important roles in cardiac response to ischemia.
Ringkasan dokumen tersebut adalah:
1. Sindroma koroner akut merupakan penyebab utama kematian di dunia.
2. Dokumen menjelaskan epidemiologi, faktor risiko, gejala, diagnosis, dan penatalaksanaan sindroma koroner akut.
3. Ada beberapa pilihan penatalaksanaan seperti trombolisis, angioplasti, atau operasi bypass koroner untuk sindroma koroner akut.
Resusitasi cairan dan elektrolit membahas tentang resusitasi cairan pada pasien perdarahan akut dan dehidrasi, termasuk pilihan cairan, algoritme resusitasi, dan penilaian status volume darah."
Tatalaksana Gagal Jantung Akut ( Acute Heart Failure Update)Isman Firdaus
油
Dr. Isman Firdaus memiliki berbagai spesialisasi kardiologi dan pengalaman kerja sebagai konsultan kardiologi intensif di beberapa rumah sakit. Dokumen ini membahas tentang gagal jantung akut, meliputi definisi, patofisiologi, faktor pemicu, gejala klinis, penilaian profil hemodinamik, dan algoritme penatalaksanaan cepat.
Dokumen tersebut membahas tentang fluida tubuh, termasuk fungsi, distribusi, perpindahan, gangguan keseimbangan, dan penilaian kebutuhan cairan. Dibahas pula berbagai jenis cairan infus, mekanisme, dan klasifikasi berdasarkan tonisitasnya."
Dokumen tersebut membahas tentang penatalaksanaan hipertensi krisis yang meliputi hipertensi emergensi dan hipertensi urgensi. Hipertensi emergensi ditandai dengan peningkatan tekanan darah yang disertai kerusakan organ target sedangkan hipertensi urgensi hanya menunjukkan peningkatan tekanan darah tanpa kerusakan organ target. Penurunan tekanan darah harus dilakukan secara hati-hati untuk mencegah komplikasi pada hip
Ini adalah kuliah saya untuk keperawatan gawat darurat di Akademi Keperawatan Panti Rapih. Kuliah ini memuat sindrom koroner akut, henti jantung, dan syok kardiogenik.
Update:
Tanggal 15 Oktober 2015, American Heart Association menerbitkan panduan baru untuk Cardiopulmonary Resuscitation & Emergency Cardiac Care. Panduan baru tersebut dapat diunduh di http://circ.ahajournals.org/content/132/18_suppl_2.toc
Dokumen tersebut membahas tentang perdarahan saluran cerna bagian atas dan bawah. Perdarahan saluran cerna bagian atas umumnya disebabkan oleh pecahnya varises esofagus, ulkus peptikum, dan gastritis erosiva. Tatalaksananya meliputi resusitasi, endoskopi untuk diagnosis dan terapi, serta profilaksis infeksi. Sedangkan perdarahan saluran cerna bagian bawah umumnya disebabkan oleh hemoroid, fisura ani, dan kanker kolon. Tatal
Edema serebri adalah akumulasi cairan di otak yang meningkatkan volume otak. Dapat terjadi peningkatan volume intraseluler maupun ekstraseluler. Gejalanya antara lain nyeri kepala, muntah, gangguan penglihatan, dan pernapasan. Pemeriksaan CT scan atau MRI dapat menunjukkan lokasi dan sebab edema. Penatalaksanaannya meliputi posisi kepala, analgesia, ventilasi, penanganan tekanan darah dan cairan, serta
Pasien laki-laki berusia 57 tahun dirujuk ke rumah sakit dengan keluhan nyeri dada dan jantung berdebar-debar. Pemeriksaan menunjukkan supraventrikular takikardi dengan laju jantung 180 kali/menit dan gangguan fungsi ventrikel kiri. Pasien menerima terapi amiodarone dan obat lainnya yang berhasil menurunkan laju jantung menjadi normal.
This document discusses the pathophysiology and management of critical hyperglycemia in patients with type 2 diabetes mellitus. It covers the diagnostic criteria and differences between ketoacidosis and hyperosmolar hyperglycemic state. It also provides protocols for managing ketoacidosis and hyperosmolar hyperglycemic state based on guidelines from PERKENI, including continuous insulin therapy. Additionally, it discusses glucose targets for inpatients and prevention strategies, as well as glycemic control for outpatients.
Autophagy and Apoptosis in Myoacardial Infarction, wecoc 2021.pptxIsman Firdaus
油
This document discusses cell death processes in myocardial infarction. It describes necrosis, apoptosis and autophagy as the main types of cell death that occur. Necrosis is unprogrammed cell death due to loss of membrane integrity. Apoptosis is programmed cell death involving caspases and Bcl-2 proteins. Autophagy is the self-digestion of cellular components and can be protective at early stages but excessive autophagy can lead to cell injury. Studies in rat models of myocardial infarction show increases in autophagy and apoptosis markers at different time points following coronary artery ligation. The conclusion is that autophagy and apoptosis both play important roles in cardiac response to ischemia.
Fluid management and Fluid Responsiveness in ICCU / ICU at ASMIHA workshop 2018Isman Firdaus
油
It is very important for cardiologist or intensivist to determined fluid overload vs loss fluid. Misconception of hypervolemic and hypovolemic state was very important.
Workshop of Low Cardiac Output Management, 2018Isman Firdaus
油
Low cardiac output or shock or circulatory failure was the terminal state of any disease including cardiovascular problem. It is consist distributive, volume, obstructive and cardiogenic circulatory failure leading multi organ failure and mortality. Hemodynamic monitoring is important evaluation to guide the medication and treatment.
This document discusses strategies for crossing chronic total occlusions (CTOs) during percutaneous coronary interventions, including single wire manipulation with escalation, parallel wiring, seesaw wiring, balloon anchoring, and intravascular ultrasound guided wiring. It emphasizes that while technology can make the process faster and more effective, operators must also remain flexible to deal with imperfections and adapt to different situations.
Angiografi koroner perkutan merupakan tindakan kateterisasi dengan menyemprotkan zat kontras ke dalam arteri koroner untuk melihat anatomi arteri koroner sehingga dapat mendeteksi ada atau tidaknya penyempitan (stenosis) yang dimonitor melalui sinar X
1. The patient presented with shortness of breath due to heart failure and developed lactic acidosis from low cardiac output and hypoxia. Analysis using base excess and Stewart method showed an unmeasured anion effect of -35 mEq/L, indicating acidosis from lactic acid.
2. A second patient arrested and developed lactic and ketoacidosis. Analysis again showed an unmeasured anion effect of -34 mEq/L, reflecting acidosis from lactic acid and ketones as well as respiratory acidosis.
3. A third patient on lasix developed alkalosis with hypokalemia. Analysis showed an alkalinizing effect of -18 mEq/L, consistent with
Dokumen tersebut memberikan informasi mengenai layanan kateterisasi jantung di Rumah Sakit Harapan Kita, mencakup pencapaian kinerja unit non rawat inap tahun 2017, fasilitas pelayanan bedah dan diagnostik invasif, layanan cathlab dan layanan unggulan baru 2014-2017 seperti EVAR, TAVI, dan tindakan aritmia. Dokumen ini juga membahas strategi peningkatan layanan rujukan kardiovaskular dan skema pendampingan intervensi
Cost Effectiveness Procedures in cathlab: Tips and TricksIsman Firdaus
油
1) The document discusses strategies for improving cost effectiveness in cardiac catheterization labs in Indonesia under the country's universal health coverage program. It analyzes costs based on procedures, devices, hospitalization, and remuneration.
2) Several strategies are proposed, including standardizing devices and implants for UHC patients, clinical pathways to standardize length of stays, and using national formularies. Teamwork, physician champions, and data-driven management are emphasized.
3) Metrics like door-to-balloon times for STEMI patients are discussed as important for monitoring performance and outcomes. Overall the document focuses on balancing clinical needs with budget constraints of Indonesia's universal health coverage.
Isicam, high bleeding risk pci,2016,ismanIsman Firdaus
油
The document summarizes a case study of a high bleeding risk patient who required urgent PCI prior to orthopedic surgery. The patient had multiple vessel disease including chronic total occlusions. The interventional cardiologist performed complex PCI using dual guidewires and drug-coated stents, which allowed for a shortened dual antiplatelet therapy duration of 1 month prior to surgery. The case highlights the importance of an individualized approach for high bleeding risk PCI patients, including consideration of drug-coated stents to balance risks of bleeding and restenosis.
1. Explain the physiological control of glomerular filtration and renal blood flow
2. Describe the humoral and autoregulatory feedback mechanisms that mediate the autoregulation of renal plasma flow and glomerular filtration rate
legal Rights of individual, children and women.pptxRishika Rawat
油
A legal right is a claim or entitlement that is recognized and protected by the law. It can also refer to the power or privilege that the law grants to a person. Human rights include the right to life and liberty, freedom from slavery and torture, freedom of opinion and expression, the right to work and education
Chair, Grzegorz (Greg) S. Nowakowski, MD, FASCO, discusses diffuse large B-cell lymphoma in this CME activity titled Addressing Unmet Needs for Better Outcomes in DLBCL: Leveraging Prognostic Assessment and Off-the-Shelf Immunotherapy Strategies. For the full presentation, downloadable Practice Aid, and complete CME information, and to apply for credit, please visit us at https://bit.ly/49JdxV4. CME credit will be available until February 27, 2026.
Creatines Untold Story and How 30-Year-Old Lessons Can Shape the FutureSteve Jennings
油
Creatine burst into the public consciousness in 1992 when an investigative reporter inside the Olympic Village in Barcelona caught wind of British athletes using a product called Ergomax C150. This led to an explosion of interest in and questions about the ingredient after high-profile British athletes won multiple gold medals.
I developed Ergomax C150, working closely with the late and great Dr. Roger Harris (1944 2024), and Prof. Erik Hultman (1925 2011), the pioneering scientists behind the landmark studies of creatine and athletic performance in the early 1990s.
Thirty years on, these are the slides I used at the Sports & Active Nutrition Summit 2025 to share the story, the lessons from that time, and how and why creatine will play a pivotal role in tomorrows high-growth active nutrition and healthspan categories.
PERSONALITY DEVELOPMENT & DEFENSE MECHANISMS.pptxPersonality and environment:...ABHAY INSTITUTION
油
Personality theory is a collection of ideas that explain how a person's personality develops and how it affects their behavior. It also seeks to understand how people react to situations, and how their personality impacts their relationships.
Key aspects of personality theory
Personality traits: The characteristics that make up a person's personality.
Personality development: How a person's personality develops over time.
Personality disorders: How personality theories can be used to study personality disorders.
Personality and environment: How a person's personality is influenced by their environment.
Chair, Joshua Sabari, MD, discusses NSCLC in this CME activity titled Modern Practice Principles in Lung CancerFirst Find the Targets, Then Treat With Precision: A Concise Guide for Biomarker Testing and EGFR-Targeted Therapy in NSCLC. For the full presentation, downloadable Practice Aid, and complete CME information, and to apply for credit, please visit us at https://bit.ly/3VomnBV. CME credit will be available until February 26, 2026.
BIOMECHANICS OF THE MOVEMENT OF THE SHOULDER COMPLEX.pptxdrnidhimnd
油
The shoulder complex acts as in coordinated fashion to provide the smoothest and greatest range of motion possible of the upper limb.
Combined motion of GH and ST joint of shoulder complex helps in:
Distribution of motion between other two joints.
Maintenance of glenoid fossa in optimal position.
Maintenance of good length tension
Although some amount of glenohumeral motion may occur while the other shoulder articulations remain stabilized, movement of the humerus more commonly involves some movement at all three shoulder joints.
Solubilization in Pharmaceutical Sciences: Concepts, Mechanisms & Enhancement...KHUSHAL CHAVAN
油
This presentation provides an in-depth understanding of solubilization and its critical role in pharmaceutical formulations. It covers:
Definition & Mechanisms of Solubilization
Role of surfactants, micelles, and bile salts in drug solubility
Factors affecting solubilization (pH, polarity, particle size, temperature, etc.)
Methods to enhance drug solubility (Buffers, Co-solvents, Surfactants, Complexation, Solid Dispersions)
Advanced approaches (Polymorphism, Salt Formation, Co-crystallization, Prodrugs)
This resource is valuable for pharmaceutical scientists, formulation experts, regulatory professionals, and students interested in improving drug solubility and bioavailability.
At Macafem, we provide 100% natural support for women navigating menopause. For over 20 years, we've helped women manage symptoms, and in 2024, we're proud to share their heartfelt experiences.
1. PERKI Guideline NSTEMI 2018
Isman Firdaus, MD
FIHA, FAPSIC, FAsCC, FESC, FSCAI
Departement of Cardiology and Vascular Medicine
National Cardiovascular Center, Harapan Kita, Jakarta
2. New Recommendation 2018
Diagnostic validation using hsTroponin
Simplification of Risk Stratification for invasive strategy
management
ICCU/Intermediate for NSTEMI pts
Radial vs femoral approach for invasive startegy
DAPT algorthyme with or without OAC
Bleeding management during DAPT
Switching DAPT
