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Current behavior of sudden cardiac arrest and sudden death

Review

. 2020;90(2):200-206.

doi: 10.24875/ACM.19000157.

Humberto Rodríguez-Reyes 
¹
, Mayela Muñoz-Gutiérrez 
¹
, José L Salas-Pacheco 
¹

Affiliations

Affiliation

• ¹ Departamento de Investigación, Sociedad Cardiovascular y Arritmias (SOCAyA), Aguascalientes, México.

• PMID:

  32459200

• DOI:

  10.24875/ACM.19000157

Free article

Review

Humberto Rodríguez-Reyes et al.

Arch Cardiol Mex.

2020.

Free article

. 2020;90(2):200-206.

doi: 10.24875/ACM.19000157.

Authors

Humberto Rodríguez-Reyes 
¹
, Mayela Muñoz-Gutiérrez 
¹
, José L Salas-Pacheco 
¹

Affiliation

• ¹ Departamento de Investigación, Sociedad Cardiovascular y Arritmias (SOCAyA), Aguascalientes, México.

• PMID:

  32459200

• DOI:

  10.24875/ACM.19000157

Sudden cardiac arrest (SCA) and sudden death (SD) continues to be a global public health problem, although the true incidence is unknown, it is estimated that they are responsible for 30% of cardiac origin mortality and may represent 20% of total mortality in adults. Unfortunately, the majority of cases occur in the general population, at the out-of-hospital level, in homes and in people who were not known to have heart disease. Although the majority of SCD victims are considered to be of cardiac origin and more frequent ischemic, it is not possible to rule out other causes only with the clinical diagnosis. Autopsy, histological and toxicological studies are necessary in all victims of SCA and SD to determine the precise cause of death; when these studies are carried out, causes of non-cardiac origin have been found in up to 40% of victims. The type of arrhythmia responsible for an episode of SCA and SD has changed over the years, now asystole and pulseless electrical activity (PEA) are detected more frequently than ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT). These and other aspects that we consider important in the current behavior of SCA and SD are analyzed in this article.

El paro cardíaco súbito (PCS) y la muerte súbita (MS) continúan siendo un problema de salud pública mundial; aunque su verdadera incidencia se desconoce, se calcula que producen el 30% de la mortalidad de origen cardíaco y pueden representar el 20% de la mortalidad total en los adultos. Desafortunadamente, la mayor parte de los casos se presenta en la población general, de forma extrahospitalaria, en los hogares y en personas que no se conocían portadoras de cardiopatía. Aunque se considera que la mayoría de las víctimas de PCS es de origen cardíaco, y que es más frecuente el isquémico, no es posible descartar otras causas sólo con el diagnóstico clínico. Son necesarios la necropsia y los estudios histológicos y toxicológicos en todas las víctimas de PCS y MS para determinar la causa precisa de la muerte; cuando estos estudios se efectúan se han encontrado causas de origen no cardíaco hasta en 40% de las personas. El tipo de arritmia causante de un episodio de PCS y MS ha cambiado a través de los años; ahora se detectan con mayor frecuencia asistolia y actividad eléctrica sin pulso (AESP) que la fibrilación ventricular (FV) o la taquicardia ventricular sin pulso (TVSP). Estos y otros aspectos de importancia en el comportamiento actual del PCS y la MS se analizan en este artículo.

Keywords:

Actividad eléctrica sin pulso; Asistolia; Electric activity without pulse; Fibrilación ventricular; Muerte súbita; Paro cardíaco súbito; Pulseless ventricular tachycardia; Sudden cardiac arrest Sudden death; Taquicardia ventricular sin pulso; Ventricular fibrillation.

Copyright: © 2020 Permanyer.

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Ultimate X #5 | uncannyxmen.net

“The Path of the righteous man and defender is beset on all sides by the iniquity of the selfish and the tyranny of evil men.” I’ve always liked that quote and not for the reason most people think. Most people think that it’s from the Bible, Ezekiel 25:17. They’re sure of it.

Scotch Plains, New Jersey. Jimmy Hudson is trying to score some beer but the vendor isn’t fooled and demands some ID. When Jimmy can’t produce it, the man tells him to get lost. Angrily, Jimmy almost unsheathes his claws but gets a hold of his temper and leaves the shop.

Outside, a man addresses him and asks if he needs someone to buy beer for him. Couldja? Jimmy asks brightly and offers money. He doesn’t want his money, Sabretooth replies and knocks him to the ground. He wants his life!

If there’s one thing I’ve learned in my line of work… most people are wrong. It’s not from the Bible at all. Oh, there’s a little of 25:17 in there when you get to the end of the whole speech. But that first part? About “the righteous man?” Sonny Chiba. In a 1976 martial arts film called “Karate Chiba.” Good flick.

Sabretooth claws away at the boy. Doesn’t know much about him and his old man, Sabretooth states. Nobody wanted Wolverine dead more than him and he got to that party too late. But when he heard he had a kid, claws and all, he just had to smell it for himself.

Hope he got a good last whiff, Jimmy snarls and strikes Sabretooth’s face with his own claws, ‘cause now it’s gonna be impossible without a nose! Sabretooth instinctively drops Jimmy and holds the remains of his nose.

Why would anybody believe something that you can so easily prove isn’t true? Because the truth is hard. And if you tell a “falsehood” enough – I’m not even going to call it a lie – it can become the truth. Trust me. It’s the business I’m in.

Sabretooth states Jimmy that is nowhere near as good as he was on his worst day. But he can’t be looking in his rearview mirror waiting for him to get better. He gets ready for the killing strike, but is suddenly gone in the blink of an eye. Jimmy, heavily bleeding, falls unconscious.

Woke up one morning to find that our government made it okay to hunt mutants. Because – and here comes the “truth” – all mutants are terrorists. Forget about all the good the X-Men had done. Or the sacrifices they’d made. Remember… “…beset on all sides by the iniquity of the selfish and the tyranny of evil men.”

Magneto was the straw that broke the camel’s back. “Playing God” with a reenactment of the great flood will do that. In doing so, he decimated the mutant population.

Route 22 hotel, New Jersey. Jean Grey aka Karen Grant and her group have gathered Jimmy. Karen bandages him and tells him he is not going to die on her watch. A panicked Liz Allen asks why he doesn’t heal. Karen admits she doesn’t know why. Derek Morgan suggests they go after Sabretooth. Get to him before he gets to them! Liz panics she doesn’t want to die like that.

Enough! Karen orders telepathically. Liz is thinking about running, Karen states. She can see it in her head. Then get out of her head, Liz retorts. She is giving her the creeps! Karen explains they have to stay strong and together. It’s how they stay safe. How are they safe when this can happen? Derek shouts. Karen reminds him that Jimmy broke curfew. He went out alone. This is what happens.

They go after Sabretooth, that puts them in Pietro’s crosshairs. He’s got Mystique on his side as well. They aren’t ready for that. So they just get a pass? Derek asks. She didn’t say that. But they are going to need a lot more than his wings and Liz’s fire. A lot more.

There’s maybe a couple of handfuls of mutants left. Maybe. All I knew was… they were going to need help.

Wearing a hooded jacket, Karen goes to the city shelter. Telepathically she addresses one of the soup kitchen volunteers. “You’re a hard man to find, Dr. Banner.” He replies in thoughts that he doesn’t want to be found. She knows the feeling. Jean, isn’t it? he asks. “Karen,” she corrects him. Jean is in the past. Some of them don’t have the luxury of burying the past, Banner points out. Is that why the world’s leading authority on gamma radiation now spends his life hiding in a homeless shelter in the shadow of the Triskelion? She takes her tray to a table and eats.

Banner replies that sometimes he is almost grateful for how hated and feared mutants are. Maybe someday everyone’ll forget about the Hulk. Karen offers something better. A chance for the Hulk to be seen as a hero. Banner points out that he can’t control the Hulk. She’ll handle that, Karen promises. Why him? Mutants have always looked after mutant business. How can he be sure he is not a mutant? she asks. Think about their origin and tell her she’s wrong.

How did she find him? Karen promises she’ll give him everything he needs to know if he does something for her first.

Magneto’s self-righteous path hinged on the belief that mutants were the next rung up on the evolutionary ladder. “Homo-superior.” One small problem. There was no such thing. We made our own monsters. I was there.

Torch’s Bar, Brooklyn, New York. Sabretooth sits there downing shots. Someone behind him announces he is in his seat. Snarling, Sabretooth turns around, announcing he picked the wrong guy on the wrong night. Tell him about it, the Hulk replies with a grin.

In an effort to duplicate the Super-Soldier program, whose sole gift was Captain America, we manipulated mankind’s genetic code. That’s how mutants came to be.

The Hulk hits Sabretooth so hard he flies through the wall. Hulk. Smash. He leers.

Mutants weren’t born. They were built in a lab by some very smart men creating a legacy that rivaled the boys who came up with the atomic bomb.

Continuing the beating, the Hulks remarks that it’s different when you’re on the receiving end. When you’re the little guy. He threatens to mess Sabretooth up so bad it won’t matter what healing factor he has. He continues the beating. More? he asks Karen. More, she agrees telepathically. “My kinda girl,” he grins. He then gets ready to bring down both fists as hard as he can and tells Sabretooth to remember he brought this on himself.

Before his fists connect, Sabretooth has disappeared at superspeed, but this time Quicksilver is stopped by a telekinetic forcefield. There’s no running away, Karen, flanked by Derek and Liz, tells him. It’s not going to be as easy this time. No it’s not, Quicksilver agrees. His people, a heavily armed Mystique and Teddy as the new Blob, are there as well.

Charles Xavier saw the hope mutants could inspire… Magneto saw the fear. They’re both dead now. Some say “victims of,” others say “martyrs to” their own beliefs. But their children live on.

Derek urges they finish this now. Karen warns Pietro he is not going to win this. Pietro tells her to tell her people to stay down and he’ll do the same. Mystique announces she has the kill shot, referring to the Hulk. She’s got squat! the Hulk boasts.

Karen wonders why Pietro would leave himself vulnerable to her without Magneto’s helmet. Because he knew it would come to this, he smiles. He wanted her to see how vulnerable they are.

Derek claims he’s lying, they went after Jimmy. Mystique assures him that, if they wanted them dead, they’d be. Not gonna happen, the Hulk boasts.

Liz asks Teddy why he is dressed like that, referring to his military fatigues. He suggests she come to him and find out. He’s the hero now! Is that what he’s told them? Karen asks Quicksilver. That the Brotherhood are the good guys now? There are no more good guys, Pietro retorts. Can’t she see that? They fought that war and lost. There are so few mutants left, they shouldn’t be fighting each other. Tell that to Jimmy Hudson! Karen shoots back. Pietro agrees that what Sabretooth did was unsanctioned and unwarranted. And if Victor had a jaw left, Pietro would have him apologize. Jimmy isn’t dead. Karen has her “eye for an eye.”

Karen’s eyes flare with energy as she threatens if they come at her again or anyone under her protection, she will kill every last one of them. The Brotherhood takes up Sabretooth. Now which one of them sounds like his father? Quicksilver asks mildly.

Is she just going to let them go? Derek protests. Why? Because tonight, this one time, Pietro was right, she admits.

The war that began with a lie is very real… as if the truth never mattered.

Back in the motel, Jimmy regains consciousness and asks what he missed. It stopped raining, the Hulk informs him. Jimmy panics. Karen informs him the Hulk is with them. Derek shrugs. Right, the Hulk is with them, Jimmy repeats, incredulous. The Hulk adds that they made a deal. He plays enforcer for Karen’s kids and she tells him everything. Starting with how they found him. They have help, she replies. From who? Derek presses. No more secrets! She was supposed to meet him now anyway, she agrees.

So we each have our role to play. Even me, Nick Fury.

Nick Fury enters the motel. Not sure how he feels about the “no more secrets” thing. He’s out! the Hulk announces. SHIELD will be onto them. This isn’t about SHIELD! Fury explains. He took this on his own because it’s the right thing to do. And from what Jean – Karen – has told him, that’s what all of them are here for. He is not happy about being the former director of the nation’s top security force. Or what this government’s policy on mutants is at the moment. So, if they want to leave or have a big boo-hoo fest because he’s involved, go ahead, but remember: They are here tonight and most likely alive because he’s been part of the solution and not part of the problem!

He’s right, Karen admits, smiling. She may not like the guy but he does tend to be right.

Oddly enough, it was Wolverine who came up with the whole idea. If the world was going to come to an end – and it did for him – he wanted there to be a plan “B”.

They are not a team, Karen announces. There is no school, no uniforms. There will be no X-Men. They will train and learn in the field. As long as the mutant registration act is enforced, anyone with a gift is in jeopardy. Some won’t want to join them. Some will need to be rescued. And some don’t even now they need their help yet. The world is now a very complicated place. Fortunately, they have help. Fury gets them the intel that will keep them one step ahead of the government. But they don’t work for him. They make their own rules, which means, if they get caught, they’re on their own!

Maybe it was because he knew he had a son out there. When you got a kid you tend to care about tomorrow.

Karen continues that they won’t limit themselves to mutants. If Captain America needs their help, they’ll be there. They can go where others can’t. Where others won’t. They don’t have borders. They’ll change identities as needed. They are here to fight for anyone who can’t. A righteous force!

Isn’t that what they called the X-Men, when they first showed up? “The Tomorrow People?”

The world may not know them or even want them, Karen continues, but they are here to make up for the past and bring about a better future.

Wundagore, halfway around the world.

Pietro informs Sabretooth that he got lucky. With what they have to accomplish, they need all the luck they can get, and he won’t have it wasted on any more of this foolishness! Does he need to remind him how clear their mission is? The US government has declared war on mutants. They are seeking a “cure” – a way to take their gifts away from them! This has to be stopped!

What about the Hulk? Sabretooth demands. Or even “Karen?” The Brotherhood might be right, but they got the power! “So do we”, Pietro replies with a smile and holds his hand out to a woman in red who joins him. His sister, the Scarlet Witch, has returned to them. Soon, very soon, she promises, the world will learn what they can do is unstoppable…

Now let’s see what tomorrow brings…

the author of the text on the napkin: mjinnocent — LiveJournal

Evan’s scribbles on the napkin (the image of the napkin is here) can be squinted for a long time and still not make out half of the words. But the researchers of the Michael Jackson case still made out ALL the words. How did they do it? And so that they read in Gutierrez’s book “the description that Geordie made” – and then they saw ALL THESE words on a piece of paper.

You know what happens when you can’t make out someone’s handwriting and ask: “What’s that word?”. They answer you that, for example, this word is “sun”. Then you look at the text again, and you see that it is true, it is written: “the sun.” But you only see it after you’ve been told what’s there, otherwise you wouldn’t have guessed.

So Gutierrez would not have guessed what was scrawled on a napkin if he had not known in advance what was written there.

Victor Gutiérrez has worked closely with Evan Chandler and his brother Ray Charmatz (Ray later changed his last name to “Chandler”) since May 1993. However, that napkin with a drawing and inscriptions, as well as other letters and documents that Gutierrez published in his book, Gutierrez received not from the hands of the Chanler brothers, but in some cunning way – either he stole these documents from the Chandler house, or received them from Larry Feldman.

Generally speaking, from what Gutierrez recounts in his book, the picture that emerges is that he seems to have stopped associating with the Chandlers shortly after the “napkin drawing” was made:

“Tuesday, January 11th (1994): I met with Geordie’s attorney, Larry Feldman, that same evening to see how the case was progressing. Feldman told me that he had been looking for me for three months through private detective Sandra Sutherland. During our conversation, Feldman expressed concern about how difficult it is to find more children to testify against Jackson. ”

Three months ago from January 11 is October 11. So, somewhere from the beginning to the middle of October, Gutierrez disappeared from the radar (which, apparently, did not prevent him from dictating a napkin text to Evan over the phone). I guess he was hiding from Pellicano, in October Pellicano was still working. Well, probably, the Chandler brothers were not too disposed towards him, after on December 20, during the inspection of Jackson’s body, it turned out that the description that he provided them with was absolutely incorrect.

And, as we can see, Gutierrez went to Feldman, not to the Chandlers, to find out “how things are going.”

Note Feldman’s “concern”. Why would you need other kids, Feldman, if Geordie’s description turned out to be true, huh? And we note that Feldman hired a private detective to look for Gutierrez, clearly not in order to complain to him about his life. It was after this conversation, and certainly not for free, that Gutierrez organized the “Neverland Five” – five former Neverland employees, who back in October-December 1993 testified to the police IN FAVOR of Michael, in May 1994 suddenly turned 180 degrees and began to sell dirty stories to the tabloids.

And on May 9, 1994, on Diane Diamond’s TV show Hard Mine, Gutierrez himself appeared and presented his future book under the magnificent title ‘In the Closet: Inside the Michael Jackson Criminal Investigation’ to the astonished public. And in this program, he presented “documents” and photographs of the Chandlers. After that, the police became interested in the papers that Gutierrez had. In his book, Gutiérrez expresses surprise that the police did not know about these papers before, and that the Chandlers did not pass these “evidence” to the police themselves:

“On Monday May 9th, I presented to the world excerpts from Geordie’s diary as a preview of my book. The presentation included photos of Jackson in pajamas in Geordie’s room. It also included Geordie’s suicide note and other interesting stuff. I did not expect that for the district attorneys and detectives of Santa Barbara and Los Angeles it would be surprise . I thought that Geordie had told them everything and that they had seen these pictures.

The District Attorneys contacted Larry Feldman and demanded that Geordie’s complete diary be handed over to them, but Feldman refused to give them the evidence. I got calls from colleagues who heard the DA say that if I didn’t give them the diary and photos, they would legally force me to do so.

How did I get these photos and the diary? Jackson’s investigators and lawyers asked. Jackson’s lawyers became worried because Jackson paid $20 million to keep the boy quiet. Jackson’s people were worried they were paying for nothing as the truth would come out through this book.”

“I thought Geordie told them everything…”. Or rather, he thought it was EVAN who told them and showed them everything. In Hardcopy, he presented these papers as EVAN CHANDLER’S DIARY – in fact, this was Evan’s diary, since Evan collected all these papers for his book. It was only later that Gutierrez turned “Evan’s diary” into “Jordie’s diary”.

And then – he “thought”, you understand? Gutierrez’s surprise means that by May 1994 he no longer communicated with the Chandlers, and how the Chandlers did with these “documents”, Gutierrez could only “think” and guess – he DID NOT KNOW.

This is where the “napkin” apparently became an official document, since Gutiérrez had to hand it over to the police. Evan, of course, would not give the police a piece of paper with his own handwriting and the words “my theory.”

And on May 24, 1994, everything that Gutierrez spilled to the public in the Hard Mine appeared in the tabloid newspaper The Globe. (here about it).

But back to the “napkin”.

So Gutierrez got the napkin at a time when he was no longer in contact with the Chandlers. So, Evan Chandler could not “decipher” his handwriting for him. And Gutierrez would not have been able to correctly parse EVERY word illegibly scrawled on this napkin if he did not know IN ADVANCE what is written there. And he could know this in advance only if he was the author of the text. That is, if IT IS HE who dictated the text to Evan Chandler.

Also, in Guierrez’s book, “Geordie’s description” is presented not as a transcript from a napkin, but as a completely separate story, complete and detailed – and it exactly corresponds to the synopsis on the napkin.

“Description of Geordie” from Gutierrez’s book:

“October 24, 1993 at 11:45 p.m. Geordie’s lawyers asked him to document his description of Jackson’s genitals.

The details that the minor drew on the napkin will later serve as an official document. Geordie outlined: Michael is circumcised. He has short pubic hair. His scrotum is marked with pink and brown. Like a cow, not white, but pink. His body smells oily. He has brown patches on his ass, on his left buttock. The description included a drawing of Jackson’s penis with dark markings. A copy of this drawing is exclusively printed in this book.

Geordie also described orgies with Brett Barnes: Brett is uncircumcised. He masturbated and played with his penis. Brett would pull back the foreskin and tell us [Michael and Jordie] ‘look, look, but I can pull it all the way out because it hurts’… that in Brett’s case there was a penetration. And Evan obediently wrote down all these details of the fecal character on a napkin. In fact, half of what’s on the napkin is about Brett Barnes.