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Los procesos infecciosos del sistema nervioso central (SNC) son una urgencia médica que requiere diagnóstico y tratamiento correcto, eficaz y oportuno para abatir sus altas tasas de morbilidad y mortalidad y aminorar las secuelas permanentes. El objetivo planteado para la investigación será hacer un bosquejo del manejo de la encefalitis y la meningitis según el diagnóstico del paciente a través de la revisión bibliográfica. Se propone realizar una búsqueda de los articulo científicos y publicaciones académicas disponibles en la web para, a través del resumen y análisis de literatura se construya una especie de paso a paso para el manejo de las enfermedades asociadas a procesos infecciosos del sistema nervioso central. En los estudios revisados podemos resaltar que, la encefalitis y la meningitis, aun cuando tienen síntomas solapados, y sus consecuencias pueden ser permanentes en cuanto a las secuelas que deje o fatales, su origen es distinto y con ello su tratamiento. En el manejo primordial de los procesos infecciosos del sistema nervioso central (SNC) es del tiempo, tanto del diagnóstico, como del inicio del tratamiento efectivo y exacto y finalmente de la evaluación del cese o resistencia del virus o bacteria en el paciente.

Aims Remote monitoring is an effective strategy to improve patients' outcomes and reduce hospitalization in patients with cardiac implantable electronic devices. However, data on patients' satisfaction are scarce. The aim of the current study was to assess patients' satisfaction, ease of use and impact on daily activities of the remote monitoring and to investigate whether there are differences among different devices and different manufacturers. Methods A modified Home Monitoring Acceptance and Satisfaction Questionnaire telephone survey on the perceived quality of the different systems was performed with all patients followed with remote monitoring for at least 3 months. Results Among 604 patients with remote monitoring screened by telephone, 466 patients (77%) answered the questionnaire [142 patients (30.5%) had a pacemaker, 317 patients (68%) had an implantable cardioverter defibrillator, and seven patients (1.5%) had an implantable loop recorder]. Ninety-seven percent of patients were satisfied by the remote monitoring system during the entire follow-up and found it easy to use. Similarly, 85% of patients did not experience any restriction in daily activities, and for 99% of patients it did not affect their privacy. Importantly, for the vast majority of patients, remote monitoring gave a great (56.7%) or moderate (33.4%) sense of security. Conclusion Daily impact of cardiac implantable electronic devices still remains a challenging issue for caregivers. The introduction of remote monitoring allowed closer follow-up and improved outcomes. Our results highlighted patients' satisfaction, who also felt safer, with the remote monitoring, its ease of use, and the absence of any disturbances in patients' everyday activities or in their privacy.

Dilated cardiomyopathy (DCM) is a heart muscle disease characterized by left ventricular or biventricular dilatation or systolic dysfunction without either pressure or volume overload or coronary artery disease sufficient to explain the dysfunction. It is pivotal to exclude possible removable causes of left ventricular dysfunction because this has prognostic implications. A comprehensive integrated approach, including third-level diagnostic tools, should be systematically implemented in clinical practice to remove every possible reversible cause through specific therapeutic interventions. This issue appears essential to promote left ventricular reverse remodeling and subsequent outcome improvement. Thus, the clinical approach to a suspected DCM requires a step-by-step work-up. In this chapter, we dissect the “red flags approach” to DCM with particular focus on easily missed diagnosis.

Background: Implantable cardioverter-defibrillators (ICD) have a pivotal role in preventing major arrhythmic events in patients with severely reduced left ventricular ejection fraction (LVEF). Device replacement strategy is still controversial in patients without severely reduced left ventricular ejection fraction (LVEF) at the end of battery life. Objective: To evaluate the long-term arrhythmic outcome of patients with ICD or and cardiac resynchronization therapy defibrillators (CRT-D) with normal or intermediate LVEF at the time of device replacement. Methods: All consecutive patients with reduced ejection fraction heart failure, both from ischemic and non-ischemic origin, implanted with ICD or CRT-D for primary prevention from 2002 to 2009, were considered. The study population included patients without previous ICD interventions and without severe dysfunction (i.e. LVEF ≥ 35%) 60 [53–65] months after implantation (average battery duration). The outcome measure was the occurrence of appropriate ICD interventions in the long-term. Results: Among the 255 patients (150 ICDs; 105 CRT-D) evaluated, 45 (18%) had LVEF ≥ 35% without ICD interventions 5-year follow-up after implantation (15 ICD [10%]; 30 CRT-D [29%]). In the long term, ICD interventions were 4 (27%) in the ICD group and 5 (17%) in the CRT-D group. Conclusions: Despite the absence of severe left ventricular dysfunction at the time of battery replacement, a not negligible number of patients with ICD and CRT-D maintained a high risk of appropriate interventions in the long term, suggesting the opportunity of replacing the ICD regardless the amount of LV dysfunction. © 2019 Elsevier B.V.

Multifunction radars based on active phased arrays are well known and widely studied systems. The concepts of bistatic architecture, conformal array and digital beam forming (DBF) are combined in this paper to define a novel multifunction radar for point defense. The conical shape of the antenna overcomes the significant limitations in the azimuth coverage of 360° of fixed-faces phased arrays due to the beam scanning up to 45°. The usage of separate transmit/receive arrays and the DBF technique adds the operational flexibility and the possibility of multiple simultaneous functions, with an optimal time-energy resources exploitation. After a short description of its technological demonstrator, some significant design trade-off, and operating aspects of the proposed architecture, called d-Radar, are described, showing the main differences with respect to the classical, four faces, and phased-array multifunction radar architecture. It is described how the operating modes can be made more and more similar to a “staring” or “ubiquitous” radar permitting an instantaneous detection and location of short-range, low-elevation targets for sea and ground operations. Finally, some remarks about the resources management and scheduling are shown with the results from a case of study.

This paper presents the experimental results relevant to a conical array formed by 216 passive array columns, each composed by 8 radiating elements, in terms of the embedded single column radiation patterns and sidelobes profile of the directive beam obtained grouping in array a suitable number of columns with an appropriate weighting function. Each step of the design is described, starting from the isolated radiating element, then inserting it into a radiating column, and finally in the complete conical array. For each stage of design, the comparison between the theoretical model and the measurement is reported. This array has been developed for a new 2D ubiquitous radar, named Omega360, that will be realized by Seastema, a Fincantieri SpA Company.

A novel multifunction phased array radar is introduced, characterized by conformal arrays, extensive usage of digital beam forming and separation between Tx and Rx arrays. Some significant design trade-off and radar operating aspects are described, including the radar management and scheduling, showing the main differences with respect to the classical, four faces phased array multifunction radar architecture.