Kantuk merupakan salah satu penyebab utama kecelakaan dalam lalu lintas, industri manufaktur, maupun pada bidang lain. Untuk itu, sistem yang dapat mendeteksi kantuk secara dini merupakan hal yang ...sangat penting dalam rangka mengurangi angka kecelakaan akibat kantuk. Kantuk dapat dianalisis melalui Heart Rate Variability (HRV) dari sinyal EKG yang menunjukkan perubahan aktivitas saraf otonom. Pengklasifikasi Random Forest diketahui berkinerja sangat baik serta kuat terhadap overfitting. Oleh karena itu, pada makalah ini dikembangkan sistem deteksi kantuk menggunakan sinyal elektrokardiogram (EKG) dan Random Forest. Sistem deteksi kantuk dilatih menggunakan rekaman EKG dari database DROZY yang dilengkapi Karolinska Sleepiness Scale (KSS). Fitur masukan sistem diekstraksi berdasarkan metode ranah waktu dan ranah frekuensi. Tingkat kantuk diklasifikasikan berdasarkan KSS yang disederhanakan menjadi dua kelas, yaitu kantuk dan terjaga. Random Forest divalidasi dengan metode Out-of-Bag (OOB). Efek dari variasi jumlah estimator dan max feature terhadap kinerja sistem dievaluasi. Fitur diurutkan berdasarkan kepentingannya dan dikombinasikan sebagai masukan sistem dengan berbagai panjang segmentasi EKG. Kinerja terbaik sistem deteksi kantuk yaitu rata-rata akurasi 94,61%, sensitivitas 96,67%, dan specificity 91,67%, yang diperoleh dengan segmentasi 40 detik.
ABSTRAKData World Health Organization (WHO) pada tahun 2014 menunjukkan bahwa di Indonesia sebanyak 37% dari seluruh penyebab kematian adalah penyakit yang berhubungan dengan jantung. Kehadiran ...teknologi dan pemanfaatan Internet of Things (IoT) diharapkan dapat membantu mengurangi resiko kematian akibat penyakit jantung tersebut. Pada penelitian ini, pengukuran dan pengamatan sinyal jantung melalui tele-auskultasi sinyal elektrokardiogram (EKG) dilakukan. Untuk mengamankan sinyal EKG dalam proses transmisi melalui jaringan Internet digunakan metode anonimasi sinyal berbasis algoritma Jusak-Seedahmed. Hasil pengujian menunjukkkan bahwa algoritma Jusak-Seedahmed dapat melakukan proses anonimasi dan proses rekonstruksi sinyal dengan baik. Pengujian korelasi silang antara sinyal hasil rekonstruksi dan sinyal EKG asli sebelum anonimasi menghasilkan korelasi sebesar 1 pada lag=0. Sinyal EKG hasil rekonstruksi ditampilkan dalam aplikasi mobile untuk memudahkan analisis oleh dokter.Kata kunci: elektrokardiogram, keamanan, anonimasi, IoT, FFT ABSTRACTBased on the latest data released by the World Health Organization in 2014, deaths caused by cardiovascular disease in 2012 have reached 37% of the total number of non-communicable diseases deaths in Indonesia. Therefore, it is expected that the applications of the Internet of Things (IoT) might be used to reduce the risk of death due to the heart related problems. In this research, a tele-auscultation technique for measuring and monitoring electrocardiogram (ECG) signal was built. To secure transmission of the ECG signal over the Internet, we implemented a recently proposed Jusak-Seedahmed algorithm. Our examinations showed that the algorithm performed the anonymization and reconstruction processes well. Crosscorrelation analysis showed that correlation between the reconstructed and the original ECG signal at lag=0 was 1. Furthermore, a mobile-based application had been built to display the reconstructed ECG signal for further analysis.Keywords: electrocardiogram, security, anonimization, IoT, FFT
Objectives. Pericarditis, takotsubo cardiomyopathy and early repolarization syndrome (ERS) are well-known to mimic ST elevation myocardial infarction (STEMI). We aimed to study whether ECG findings ...of reciprocal ST depression, PR depression, ST-segment convexity or terminal QRS distortion can discriminate between ST elevation due to ischemia and non-ischemic conditions. Design. Eighty-five patients with STEMI and 94 patients with non-ischemic ST elevation were included. All patients had acute chest pain and at least 0.1 mV ST elevation. Presence of PR depression, ST-segment convexity, terminal QRS distortion or reciprocal ST depression was assessed in each ECG. Results. In anterior ST elevation, ST depression in lead II (≥0.025 mV) occurred in 40% of patients with STEMI but in none of the non-ischemic cases. In inferior ST elevation, ST depression in lead I (≥0.025 mV) was present in 83% of patients with STEMI but in none of the non-ischemic cases. Chest-lead PR depression was uncommon in STEMI (12%) compared to non-ischemic cases (38%; p < .001). Convex ST elevation occurred in 22% of STEMI cases and in 9% of non-ischemic cases (p = .01). Terminal QRS distortion was more prevalent in STEMI (40%) than in non-ischemic ST elevation (7%). In multivariable analysis, reciprocal ST depression was associated with an ischemic diagnosis, whereas ST depression in aVR and chest-lead PR depression were associated with a non-ischemic diagnosis. Conclusions. Identification of true STEMI among patients with different ST-elevation etiology may be improved by considering reciprocal ST depression, ST depression in aVR and chest-lead PR depression.
Redovita tjelesna aktivnost vrlo je značajna za zdravlje čovjeka, no intenzivna tjelesna aktivnost može povećati rizik od iznenadne srčane smrti u predisponiranih osoba. Ovaj problem posebno je ...značajan kod sportaša, koji imaju 2,8 puta veći rizik od iznenadne srčane smrti u usporedbi s populacijom koja se ne bavi sportom. Iznenadnu srčanu smrt mogu uzrokovati brojne genetičke i stečene bolesti koje je u velikoj mjeri moguće dijagnosticirati preventivnim pregledima
sportaša. Iako su uzroci brojni, ventrikularna tahiaritmija najčešći je zajednički patološki mehanizam koji narušava funkciju srca, što potvrđuje važnost opremanja sportskih dvorana uređajima za vanjsku defibrilaciju. Većina sportaša nema nikakve simptome koji bi nas upozorili na skrivenu bolest srca, zbog čega mnoga stručna društva snažno podržavaju uvođenje preventivnih pregleda sportaša kao strategije za rano otkrivanje “tihih” srčanih bolesti, iako se ne slažu
oko opsega tog pregleda. Uspješnost talijanskog programa preventivnih pregleda potvrđena je smanjenjem smrtnosti sportaša za čak 90 % nakon uvođenja redovitih preventivnih pregleda sportaša, koji su uključivali elektrokardiogram. Hrvatska već dugi niz godina ima infrastrukturu I stručno educiran kadar, u vidu specijalista medicine rada i sporta te specijalista sportske medicine, za uspješno provođenje preventivnih pregleda sportaša po uzoru na talijanski model. Stoga je cilj ovoga teksta podizanje svijesti o problemu iznenadne srčane smrti koji je u velikoj mjeri moguće spriječiti uspostavljanjem kvalitetnih zakonskih okvira te uvažavanjem stručnih smjernica Hrvatskog društva za sportsku medicinu.
U ovom radu su prikazani postupci dijagnosticiranja i klasificiranja bolesti srca, koja se naziva Brugada sindrom, na temelju konfiguracije signala električne aktivnosti srca. Prikazi signala ...akcijskog potencijala srca i signala elektrokardiograma u obliku krivulja pružaju informacije o pravilnosti ili nepravilnosti električne srčane aktivnosti odnosno o pravilnom ili nepravilnom radu srčanog mišića. Kako je elektrokardiogram najpouzdaniji alat za dijagnosticiranje i klasifikaciju ovog sindroma, opisani su para-metri tj. konfiguracije elektrokardiograma na temelju kojih se otkriva Brugada sindrom i klasificiraju definirani tipovi tog sindroma. Razumijevanje poveznica Brugada sindroma i parametara elektrokardiogramskog signala pomaže liječnicima da lakše upoznaju i shvate Brugada sindrom, što je veoma značajno za dijagnosticiranje, ali i za postupak terapije i liječenja ove bolesti.
This paper presents procedures for diagnosing and classifying heart disease called Brugada syndrome based on the configu-ration of the heart’s electrical signal. Representations of the action potential of the heart and electrocardiograms in the form of curves (signals, i.e., the display of these signals) provide information on the regularity or irregularity of electrical cardiac activity, or on the correct or incorrect work of the heart muscle. Since the electrocardiogram is the most reliable tool for diagnosing and classifying this syndrome, the parameters i.e., configurations of the electrocardiogram are described, on the basis of which Brugada syndrome is detected and the defined types of this syndrome are classified. Understanding the links between Brugada syndrome and electrocardiogram signal parameters helps doctors to study and understand Brugada syndrome more easily, which is very impor-tant for diagnosing but also for the procedure of therapy and treatment of this disease.
The aim of this retrospective observational case series was to determine electrocardiographic (ECG) manifestations in patients poisoned with methanol and see whether they could predict mortality. We ...also wanted to see whether there was an association between ECG changes and time elapsed between ingestion and treatment, age, sex, seizure, coma (Glasgow Coma Scale ≤8), arterial blood gas (ABG) parameters, and serum potassium levels on hospital admission. The study included 42 patients aged 31.14±12.5 years. Twenty-five survived and 17 died. Almost all patients had one or more abnormal ECG findings, including heart rate, rhythm, and conduction abnormalities. However, we found no significant difference between survivors and non-survivors. QTc interval did not correlate with time elapsed between ingestion and treatment, age, sex, seizure and coma, HCO
, or serum potassium level. Similarly, T waves showed no correlation with serum potassium. ECG abnormalities did not correlate with coma or seizure. Even though cardiotoxicity in methanol poisoning is high, none of the ECG abnormalities found in our study predicted mortality. This however does not rule out the need to routinely run ECG for cardiotoxicity in every single patient poisoned by methanol.
Cilj je ovog retrospektivnoga opservacijskog istraživanja bio utvrditi elektrokardiografske (EKG) manifestacije u bolesnika otrovanih metanolom te vidjeti mogu li one poslužiti kao pretkazatelji smrtnosti. Također smo željeli utvrditi postoji li povezanost između promjena na EKG-u i vremena proteklog od unosa metanola do liječenja, zatim dobi, spola, epileptičkog napadaja, kome (≤8 prema ljestvici Glasgow), nalaza plinske analize arterijske krvni te razina kalija u serumu u trenutku hospitalizacije. Ispitivanje je obuhvatilo 42 bolesnika u dobi od 31.14±12.5 godine. Dvadeset i petero je preživjelo trovanje, a 17-ero umrlo. Gotovo su svi bolesnici imali jedan abnormalni EKG parametar ili više njih među kojima brzinu otkucaja srca, srčani ritam i provodljivost. Nismo međutim našli značajnih razlika između preživjelih i umrlih. QTc interval nije korelirao s vremenom proteklim od unosa metanola do liječenja, s dobi, spolom, epileptičkim napadajem, komom, HCO
odnosno razinama kalija u serumu. Isto tako, T valovi nisu korelirali s kalijem u serumu. Abnormalni EKG nalazi nisu korelirali s komom i epileptičkim napadajima. Premda je kardiotoksičnost značajna kod trovanja metanolom, nijedan abnormalni EKG nalaz nije mogao predvidjeti smrtnost. To međutim ne isključuje potrebu za rutinskim EKG pregledima radi otkrivanja kardiotoksičnosti u svih bolesnika otrovanih metanolom.
Dugong dugon yang merupakan mamalia laut, terdaftar sebagai spesies langka yang dilindungi. Sampai saat ini, belum banyak laporan yang tersedia tentang nilai fisiologis normal dari mamalia ini, ...sehingga menyulitkan dokter hewan dalam memeriksa dan mendiagnosis penyakit pada hewan ini. Oleh karena itu dilakukan studi tentang nilai normal elektrokardiogram (EKG), frekuensi jantung, respirasi, dan suhu tubuh dari seekor Dugong dugon dengan menggunakan alat pemantau pasien (Patient monitor). Parameter yang diukur adalah frekuensi jantung, respirasi, suhu tubuh, dan nilai EKG: gelombang P, komplek QRS, interval PR, interval QT, dan mean electricity axis (MEA). Hasil perekaman menunjukkan bahwa nilai normal frekuensi jantung, respirasi dan suhu tubuh berturut-turut adalah (45,73+4,10) denyut/menit, (10,11+3,44) inspirasi/menit, dan (31,42+0,41)0C. Tidak ada perbedaan yang nyata antara nilai EKG normal pada hantaran I (dada kanan) dan hantaran II. Sementara itu, pada hantaran III menunjukkan nilai voltase yang isoelektris (0 mV). Pada Lead II, gelombang P menunjukkan durasi (0,05+0,02) detik dengan voltase (0,03+0,01) mV, gelombang R menunjukkan voltase (0,07+0,02) mv dengan durasi QRS komplek (0,06+0,01) detik, interval PR (0,26+0,01) detik, interval QT (0,21+0,11) detik, axis jantung (MEA: +90 sampai -135 ) condong ke kanan, dengan irama jantung reguler. Nilai normal Dugong dugon ini menunjukkan karakteristik yang spesifik dibanding nilai normal pada anjing, hal ini mungkin karena adana perbedaan ekologis, struktur anatomi, dan ketebalan dinding thoraks pada kedua hewan tersebut.
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