Search

Parameter estimation of Fricke-Morse model of biological tissue is widely used in bioimpedance data processing and analysis. Complex nonlinear least squares (CNLS) data fitting is often used for parameter estimation of the model, but limitations such as high processing time, converging into local minimums, need for good initial guess of model parameters and non-convergence have been reported. Thus, there is strong motivation to develop methods which can solve these flaws. In this paper a novel real-time method for parameter estimation of Fricke-Morse model of biological cells is presented. The proposed method uses the value of characteristic frequency estimated from the measured imaginary part of bioimpedance, whereupon the Fricke-Morse model parameters are calculated using the provided analytical expressions. The proposed method is compared with CNLS in frequency ranges of 1 kHz to 10 MHz (beta-dispersion) and 10 kHz to 100 kHz, which is more suitable for low-cost microcontroller-based bioimpedance measurement systems. The obtained results are promising, and in both frequency ranges, CNLS and the proposed method have accuracies suitable for most electrical bioimpedance (EBI) applications. However, the proposed algorithm has significantly lower computation complexity, so it was 20-80 times faster than CNLS.

Regular physical activity and maintaining fitness reduce the risk of chronic cardiovascular and metabolic diseases, reduce the risk of exacerbation of existing diseases, maintain physical and mental health, and contribute to healthy and successful aging in the elderly. It is of particular importance during the prolonged COVID-19 pandemic. The aim of this review is to present relevant knowledge about the effects of restrictions and social distancing established with the aim of suppressing the COVID-19 pandemic, on physical activity and mental health of elderly people. During the pandemic, numerous authors have reported a decrease in the share of physically active population and those that used to exercise regularly. The time spent in activity decreases, energy expenditure decreases, and the time spent sedentary increases although the results in all segments related to physical activity are not consistent. Lockdown measures significantly worsen insomnia, sleep quality, feelings of loneliness, anxiety and depression in older people, especially in women. During the restrictive measures caused by the COVID-19 pandemic, physical activity and exercise significantly contribute to the maintenance and improvement of physical and mental health., (Sestre Milosrdnice University Hospital.)

Aims: Natriuretic peptide (NP) uptake varies in Emergency Departments (EDs) across Europe. The 'Peptide for Life' (P4L) initiative, led by Heart Failure Association, aims to enhance NP utilization for early diagnosis of heart failure (HF). We tested the hypothesis that implementing an educational campaign in Western Balkan countries would significantly increase NP adoption rates in the ED., Methods and Results: This registry examined NP adoption before and after implementing the P4L-ED study across 10 centres in five countries: Bosnia and Herzegovina, Croatia, Montenegro, North Macedonia, and Serbia. A train-the-trainer programme was implemented to enhance awareness of NP testing in the ED, and centres without access received point-of-care instruments. Differences in NP testing between the pre-P4L-ED and post-P4L-ED phases were evaluated. A total of 2519 patients were enrolled in the study: 1224 (48.6%) in the pre-P4L-ED phase and 1295 (51.4%) in the post-P4L-ED phase. NP testing was performed in the ED on 684 patients (55.9%) during the pre-P4L-ED phase and on 1039 patients (80.3%) during the post-P4L-ED phase, indicating a significant absolute difference of 24.4% (95% CI: 20.8% to 27.9%, P < 0.001). The use of both NPs and echocardiography significantly increased from 37.7% in the pre-P4L-ED phase to 61.3% in the post-P4L-ED phase. There was an increased prescription of diuretics and SGLT2 inhibitors during the post-P4L-ED phase., Conclusions: By increasing awareness and providing resources, the utilization of NPs increased in the ED, leading to improved diagnostic accuracy and enhanced patient care., (© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Aim: To assess whether the number of patients with a cardiac chief complaint and their characteristics differed between before and after two major earthquakes that struck Croatia in 2020., Methods: We collected data on all visits of patients with a cardiac chief complaint examined in the emergency departments of six hospitals nearest to the epicenters. Patients seen during the 7 days before the earthquake were compared with those seen on the day and during the 6 days after the earthquake., Results: Patients seen after the earthquake were younger (68 [59-79] vs 72.5 [65-80]; P<0.001) and less frequently had cardiovascular disease (32.9% vs 42.8%; P<0.001). This group less frequently had the primary diagnosis of acute myocardial infarction (AMI) (15.6% vs 21.9%; P=0.005), heart failure (9.3% vs 19.4%; P<0.001), dysregulated hypertension (13.9% vs 19.4%; P=0.01), but more frequently had non-anginal chest discomfort (28.8% vs 18.0%; P<0.001). In a subgroup analysis of patients seen in hospitals located within 20 km from the epicenter, significantly more patients seen after the earthquake compared with those seen before the earthquake presented with AMI (14.5% vs 22.8%; P=0.028), acute elevation of blood pressure (10% vs 21.8%, P=0.001), and paroxysmal arrhythmias treated with electrocardioversion (0.9% vs 4.5%, P=0.022)., Conclusion: After two moderately strong earthquakes, hospitals within 20 km from the epicenter saw a significant increase in acute cardiac conditions such as elevated blood pressure, AMI, and cardioverted arrhythmias. Eventually, these earthquakes had no impact on the outcomes of the studied population.

Sedentary lifestyle and obesity increase the risk of coronary disease (CAD). The aims of this prospective study were to estimate the trends in physical activity (PA) level, accuracy of the Baecke's/LRC-PA questionnaires, and trends in obesity parameters (body mass index-BMI/waist-to-hip ratio-WHR) in patients with acute coronary syndrome (ACS) in the last two decades. We grouped 209 patients with ACS (UAP-unstable angina, STEMI-ST-elevation myocardial infarction, NSTEMI-non STEMI) by year of admission (Group 2002-05/Group 2017) and compared them by the levels of PA (Baecke's/LRC-PA questionnaires) and obesity parameters (BMI, WHR). Group 2017 had higher WHR (1.02 vs. 0.97) and leisure PA index (LI) (3.00 vs. 2.50), as well as less high and very low activity patients (P<0.05). Patients with UAP/STEMI had higher WHR in 2017 (1.02 vs. 0.96, 1.02 vs. 0.99, respectively) (P<0.05) and had lower LI in 2002-05 (2.50 vs. 3.25, 2.75 vs. 3.50, respectively) (P<0.05). In conclusion, leisure PA and WHR was increased in the study period both in patients with ACS and in the general population. We emphasize the usage of more precise methods for evaluation of PA and obesity (Baecke's/Four-point LRC-PA questionnaires, WHR), and that only increased PA with dietary changes leads to reduction of central obesity and risk of ACS.

Introduction: FIFA World Cup represent one of the world's greatest phenomena. The spectators watch the matches of national teams with great emotional involvement. It is well documented fact that emotional stress can be a trigger of unwanted cardiovascular (CV) event., Aim: The aim of this retrospective study was to determine whether there had been an increase in the number of the emergency admissions for CVD in the Emergency Room and Clinic for Cardiovascular Diseases of the Sestre milosrdnice University Hospital Centre during and after the matches that the Croatian national team played in the FIFA World Cup 2018., Methods: The hospital's database was examined for the dates when Croatia played its matches, plus two more days after each match. An unexposed period that included the same dates in 2017 and 2019 was formed., Results: 1093 cases were assessed. The incidence of CV admissions during the exposed period was 1.15 (95% confidence interval [CI]; 1.02 to 1.31) times higher than during the unexposed period. There was a 1.30 (95% CI; 1.1 to 1.54) times higher incidence in women compared to the unexposed period. Arrhythmias and angina pectoris were the CVDs that occurred more frequently in the exposed period., Conclusion: This study showed that watching Croatian national team's matches and cheering represented an additional risk for a CV incident, especially in women.

Legacy landmines in post-conflict areas are a non-discriminatory lethal hazard and can still be triggered decades after the conflict has ended. Efforts to detect these explosive devices are expensive, time-consuming, and dangerous to humans and animals involved. While methods such as metal detectors and sniffer dogs have successfully been used in humanitarian demining, more tools are required for both site surveying and accurate mine detection. Honeybees have emerged in recent years as efficient bioaccumulation and biomonitoring animals. The system reported here uses two complementary landmine detection methods: passive sampling and active search. Passive sampling aims to confirm the presence of explosive materials in a mine-suspected area by the analysis of explosive material brought back to the colony on honeybee bodies returning from foraging trips. Analysis is performed by light-emitting chemical sensors detecting explosives thermally desorbed from a preconcentrator strip. The active search is intended to be able to pinpoint the place where individual landmines are most likely to be present. Used together, both methods are anticipated to be useful in an end-to-end process for area surveying, suspected hazardous area reduction, and post-clearing internal and external quality control in humanitarian demining., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Humanitarian demining is a worldwide effort and the range of climates and environments prevent any one detection method being suitable for all sites, so more tools are required for safe and efficient explosives sensing. Landmines emit a chemical flux over time, and honeybees can collect the trace residues of explosives (as particles or as vapour) on their body hairs. This capability was exploited using a passive method allowing the honeybees to freely forage in a mined area, where trace explosives present in the environment stuck to the honeybee body, which were subsequently transferred onto an adsorbent material for analysis by a fluorescent polymer sensor. Potential false positive sources were investigated, namely common bee pheromones, the anti-varroa pesticide Amitraz, and the environment around a clean apiary, and no significant response was found to any from the sensor. The mined site gave a substantial response in the optical sensor films, with quenching efficiencies of up to 38%. A model was adapted to estimate the mass of explosives returned to the colony, which may be useful for estimating the number of mines in a given area., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Anthropometric parameters have a role in diagnosing obesity, which increases the risk of acute coronary syndrome (ACS). The aim of the study was to assess the impact of obesity and physical activity level on the severity and long-term prognosis of ACS. A total of 116 patients with ACS were analyzed according to baseline (demography, medical history, anthropometry), severity (clinical presentation, in-hospital complications, laboratory, echocardiography, coronary angiography) and prognostic parameters (major adverse cardiovascular events during a six-year period). The levels of obesity and physical activity (Baecke/Lipid Research Clinics physical activity questionnaires) were compared with a sample of the Croatian general population. Study results showed the subjects with a higher number of narrowed coronary arteries (CAs) to have higher body mass index (BMI) and waist circumference (WC); those with stenosed left anterior descending artery and anterior myocardial infarction (MI) had higher BMI; waist-to-hip ratio (WHR) positively correlated with creatine kinase and negatively with left ventricle ejection fraction (p<0.05). Inactive patients more often had multi-vessel coronary disease and anterior MI; patients with a higher leisure physical activity index had a lower number of affected CAs, lower rate of stent implantations and lower stent length, while those with a higher work physical activity index had a lower rate of anterior MI (p<0.05). During the follow-up, inactive patients had more strokes and deaths (p<0.05). Our patients had higher body weight, WC and WHR, as well as lower leisure time and total physical activity indices than the general population (p<0.05). In conclusion, ACS is less severe and has better long-term prognosis in less obese patients with a higher level of physical activity. Patients with ACS are more obese and have lower total, as well as leisure time physical activity indices than the general population.

We report two cases of inferior vena cava (IVC) thrombosis after the retrieval of veno-arterial extracorporeal membrane oxygenation cannulas. In both patients, the venous cannula tips were placed in the upper half of the right atrium, enabling adequate blood drainage. During support, uneventful periods of IVC collapse were detected. After decannulation, thrombotic formations resembling a mold of the venous cannula were detected in both patients. Whether the IVC collapse caused IVC thrombosis during VA-ECMO support remains to be determined in further trials.

As an esthetic trait, ray floret color has a high importance in the development of new sunflower genotypes and their market value. Standard methodology for the evaluation of sunflower ray florets is based on International Union for the Protection of New Varieties of Plants (UPOV) guidelines for sunflower. The major deficiency of this methodology is the necessity of high expertise from evaluators and its high subjectivity. To test the hypothesis that humans cannot distinguish colors equally, six commercial sunflower genotypes were evaluated by 100 agriculture experts, using UPOV guidelines. Moreover, the paper proposes a new methodology for sunflower ray floret color classification - digital UPOV (dUPOV), that relies on software image analysis but still leaves the final decision to the evaluator. For this purpose, we created a new Flower Color Image Analysis ( FloCIA ) software for sunflower ray floret digital image segmentation and automatic classification into one of the categories given by the UPOV guidelines. To assess the benefits and relevance of this method, accuracy of the newly developed software was studied by comparing 153 digital photographs of F 2 genotypes with expert evaluator answers which were used as the ground truth. The FloCIA enabled visualizations of segmentation of ray floret images of sunflower genotypes used in the study, as well as two dominant color clusters, percentages of pixels belonging to each UPOV color category with graphical representation in the CIE (International Commission on Illumination) L ∗ a ∗ b ∗ (or simply Lab) color space in relation to the mean vectors of the UPOV category. Precision (repeatability) of ray flower color determination was greater between dUPOV based expert color evaluation and software evaluation than between two UPOV based evaluations performed by the same expert. The accuracy of FloCIA software used for unsupervised (automatic) classification was 91.50% on the image dataset containing 153 photographs of F 2 genotypes. In this case, the software and the experts had classified 140 out of 153 of images in the same color categories. This visual presentation can serve as a guideline for evaluators to determine the dominant color and to conclude if more than one significant color exists in the examined genotype., (Copyright © 2020 Zorić, Cvejić, Mladenović, Jocić, Babić, Marjanović Jeromela and Miladinović.)

Improving organization and patient care quality in intensive care units is increasingly important as intensive care unit diagnostic and therapeutic procedures account for a growing proportion of hospital services. We identified the lack of comprehensive national and international registries available in the contemporary literature. This paper aims to describe and analyze cardiac intensive care unit (CICU) network at the national level in Croatia and its comparison with more developed countries. Thirty-four representatives from all Croatian acute hospitals (response rate of 100%) filled in a web based questionnaire on CICU organization and competence during September and October 2016. Organization and available technical procedures for health care in general, and especially in very expensive CICU treatment, highly depends on gross domestic product (GDP) per capita . That is why one could expect that Croatia, with the second lowest GDP among European Union countries and 4.7 CICU per million inhabitants will have worse results in this field in comparison with most of these countries. Results such as one nurse responsible for a mean of 2.7 CICU patients, 52% of cardiologists among physicians during working hours but 37% during night shifts, 24/7 transesophageal echocardiography in only 26.5% of CICUs, one-third without therapeutic hypothermia, and 23.5% without extracorporeal membrane oxygenation treatment are some of these results, revealing much room for improvement. This representative, nationwide sample of Croatian CICUs also demonstrated considerable variation of key elements of structures with respect to hospital size, academic status and financial issues, as well as a trend towards current guidelines. This kind of investigation is very important for proposing standards, reimbursement master plan, or quality assessment of the national health system.

Aim: To determine whether therapeutic hypothermia (TH) improves survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors., Methods: This retrospective cohort study enrolled patients treated for OHCA with a return of spontaneous circulation admitted to the Cardiac Intensive Care Unit from October 2000 until March 2019. Data were collected from medical archives. Propensity score matching was used. The primary endpoint was death during hospital stay and secondary endpoint was cerebral performance category (CPC) score at discharge., Results: Out of 152 patients included in the study, 58 (38.7%) underwent TH treatment. After matching (which left 70 patients in the analysis), death during hospital stay occurred less often in TH group (28.6% vs 57.1%, P=0.029), while the difference in CPC score was not significant. Cox proportional hazards model showed the predictors of death during hospital stay to be TH (hazard ratio [HR] 0.29, 95% confidence interval [CI] 0.13-0.68, P=0.004), initial Glasgow Coma Scale score of 3 (HR 7.55, 95% CI 1.44-39.63, P=0.017), and heart failure (HR 2.35, 95% CI 1.02-5.34, P=0.045). TH was not an independent predictor of CPC score. Mann-Whitney U test and linear regression model showed that TH was associated with higher gain in GCS., Conclusion: TH was associated with better survival and certain variables suggesting improved neurological outcomes, suggesting that TH is a vital treatment option for comatose OHCA survivors.

Aim: To determine the relationship between plasminogen activator inhibitor-1 (PAI-1) activity rise during the first 24 hours of ST-elevation myocardial infarction (STEMI) treatment and death after 5 years., Methods: From May 1, 2009 to March 23, 2010, 87 STEMI patients treated with primary percutaneous coronary intervention (PCI) at the Sestre Milosrdnice University Hospital Center were consecutively enrolled in prospective single-center cohort study. PAI-1 activity was determined on admission and 24 hours later. The primary end-point was death after 5 years. The predictive value of PAI-1 activity variables as biomarkers of death was assessed using receiver operating characteristic (ROC) curve, independent predictors of death were assessed using multivariate Cox regression, and covariates independently related to higher PAI-1 activity rise were assessed using linear regression., Results: Two patients died during the hospital treatment and 11 during the follow-up. PAI-1 activity rise had the largest area under curve (0.748) for predicting death rate (optimal cut-off point 3.7 U/mL, sensitivity 53.8%, specificity 90.5%). Patients with PAI-1 activity rise higher than 3.7 U/mL had significantly higher mortality (P<0.001). Kaplan-Meier survival curve diverged within the first year after STEMI. Independent predictors of death were PAI-1 rise and final Thrombolysis in Myocardial Infarction flow. PAI-1 activity rise was independently related to heart failure, thrombus aspiration, and body weight., Conclusion: PAI-1 activity rise higher than 3.7 U/mL is associated with higher 5-year death rate in STEMI patients treated with primary PCI.

The aim of this study was to investigate the controversial influence of anthropometry on clinical severity and prognosis of acute ST-elevation myocardial infarction (STEMI). We prospectively analyzed 250 patients with acute STEMI treated with primary percutaneous coronary intervention (September 2011 – September 2012). They were grouped according to the following anthropometric parameters: body mass index (BMI) (<25.0, 25.0-29.9, ≥30.0 kg/m²), waist circumference (WC) (<102/88, ≥102/88 cm), waist-to-hip ratio (WHR) (<0.90/0.85, ≥0.90/0.85) and waist-to-height ratio (WHtR) (<53/49, 53/49-62/57, ≥63/58). The groups were analyzed by baseline, as well as severity (clinical, laboratory, echocardiography, coronary angiography, in-hospital complications) and prognostic parameters (major adverse cardiovascular events and sick leave duration during 12-month follow up). Patients with BMI <25.0 kg/m2 had the highest rates of dyspnea and those with BMI ≥30.0 kg/m² had the longest hospitalization and widest stents; patients with WHR ≥0.90/0.85 had higher rates of significantly stenosed proximal/middle coronary segments, while those with WHtR ≥63/58 had the highest rates of heart failure and total in-hospital complications (p<0.05). BMI <25.0 kg/m2 increased (odds ratio (OR) 2.00, confidence interval (CI) [1.09-3.68], p=0.026) and BMI 25.0-29.9 kg/m2 reduced (OR 0.52, CI [0.30-0.91], p=0.022) the risk of dyspnea; WHR≥0.90/0.85 increased the risk of significant proximal/middle coronary segment stenosis (OR 3.34, CI [1.13-9.86], p=0.029) and WHtR ≥63/58 the risk of heart failure (OR 2.05, CI [1.13-3.71], p=0.017) and total in-hospital complications (OR 1.94, CI [1.13-3.33], p=0.017) (p<0.05). In conclusion, WHR and WHtR are better anthropometric parameters than BMI in predicting acute STEMI severity, while WC has no influence on it. Anthropometry has no influence on prognosis.

The aim of this retrospective study (February 2012-September 2014) was to assess the role of head-up tilt-table test in patients with unexplained syncope. It was performed on 235 patients at Clinical Department of Cardiology, Sestre milosrdnice University Hospital Center. Patients were classified according to test indications: group A (convulsive syncope, n = 30), group B (suspected vasovagal syncope, n = 180), and group C (paroxysmal vertigo, n = 25). The groups were analyzed and compared according to demographic data (age and gender), referral specialist (cardiologist, neurologist, and others), and test results (positive/negative) with specific response (cardioinhibitory, vasodepressor, or mixed). Groups A and B were referred most frequently by neurologists and cardiologists (p < 0.05). The test was positive in 34 (14.5%) of all evaluated patients (5 in group A and 29 in group B), of which 13 (38.2%) had cardioinhibitory, 11 (32.4%) mixed and 10 (29.4%) vasodepressor response. In the cardioinhibitory subgroup, three patients (23.1%, 2 males/1 female, mean age 28.5 years) with normal electroencephalography were on antiepileptics. During head-up tilt-table testing, they had bradycardia (heart rate 30.0 ± 5.0 beats/min) and prolonged asystole (13.7 ± 11.0 seconds) with development of typical convulsions. These three subjects got a permanent pacemaker (atrial/ventricular stimulation, heart rate control) and anticonvulsive therapy was slowly withdrawn with no syncope recurrence during 24-month follow up. In conclusion, head-up tilt-table test has an important role in the evaluation of patients with unexplained syncope and in differential diagnosis of vasovagal syncope. The indication for pacemaker implantation, strictly following the European Society of Cardiology guidelines, proved to be effective in preventing syncope relapses in patients with cardioinhibitory convulsive syncope.

The authors investigated trends in the Croatian primary Percutaneous Coronary Intervention (pPCI) Network results among three consecutive time intervals (2005-2007, first phase; 2008-2009, second phase; and 2010-2011, third phase). Data on 5650 patients with acute myocardial infarction with ST-elevation (STEMI) transferred or directly admitted and treated with pPCI in 11 Croatian PCI centers during the study period were collected and analyzed. The number of patients with acute STEMI treated with pPCI per year rose continuously during the study period (581 vs. 1272 vs. 1949 patients/year). The patient risk profile worsened during the study period: age (60 vs. 61 vs. 63 years; p<0.01), anterior myocardial wall involvement (43% vs. 44% vs. 51%; p<0.01), shock rate (7% vs. 9% vs. 11%; p<0.05), and percentage of transferred patients (42% vs. 36% vs. 46%; p<0.01). While the door-to-balloon time shortened (108 vs. 98 vs. 75 min; p<0.01), the symptom onset-to-door time increased (130 vs. 175 vs. 195 min; p<0.01), but without statistically significant influence on the total ischemic time. Multivariate log-linear analysis eliminated influence of a higher risk profile on the results of treatment and yielded no statistically significant changes in final TIMI 3 flow (Thrombolysis In Myocardial Infarction 3), in-hospital mortality, and six-month mortality rate, but revealed a significant increase in the rate of angina pectoris (12 vs. 22 vs. 36%; p<0.01) and other major adverse cardiovascular events (MACE; 6 vs. 23 vs. 14%; p<0.01) during follow up. In conclusion, the Croatian pPCI Network continuously ensures very good results of STEMI treatment in this economically less developed European country despite worsening of the risk profile in treated patients and opening of new, less experienced PCI centers. The higher percentage of MACE over time could be explained by changes in the pPCI strategy introduced over time (the culprit lesion only) and higher availability of PCI centers for additional PCI after acute STEMI. However, there is room for improvement, especially in reducing prehospital delay.

Objectives: To investigate the aspects of return to work, socio-economic and quality of life aspects in 145 employed patients under 60 years of age treated with primary percutaneous coronary intervention for acute ST-elevation myocardial infarction., Material and Methods: During hospital treatment demographic and clinical data was collected. Data about major adverse cardiovascular events, rehabilitation, sick leave, discharge from job and retirement, salary, major life events and estimation of quality of life after myocardial infarction were obtained after follow-up (mean: 836±242 days)., Results: Average sick leave was 126±125 days. Following myocardial infarction, 3.4% of patients were discharged from their jobs while 31.7% retired. Lower salary was reported in 17.9% patients, major life events in 9.7%, while 40.7% estimated quality of life as worse following the event. Longer hospitalization was reported in patients transferred from surrounding counties, those with inferior myocardial wall and right coronary artery affected. Age, hyperlipoproteinemia and lower education degree were connected to permanent working cessation. Significant salary decrease was observed in male patients. Employer type was related to sick leave duration. Impaired quality of life was observed in patients who underwent in-hospital rehabilitation and those from surrounding counties. Longer sick leave was observed in patients with lower income before and after myocardial infarction. These patients reported lower quality of life after myocardial infarction., Conclusions: Inadequate health policy and delayed cardiac rehabilitation after myocardial infarction may lead to prolonged hospitalization and sick leave as well as lower quality of life after the event, regardless of optimal treatment in acute phase of disease., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Aim: To assess the efficacy of propafenone in prevention of atrioventricular nodal reentrant tachycardia (AVNRT) and orthodromic atrioventricular tachycardia (AVRT) based on the clinical results of arrhythmia recurrence and find the electrophysiological predictor of propafenone effectiveness., Methods: This retrospective study included 44 participants in a 12-month period, who were divided in two groups: group A - in which propafenone caused complete ventriculo-atrial block and group B - in which propafenone did not cause complete ventriculo-atrial block., Results: Group A had significantly lower incidence of tachycardia than group B (95% vs 70.8%, P=0.038), and complete ventriculo-atrial block predicted the efficacy of propafenone oral therapy in the prevention of tachycardia (sensitivity 87.5%, specificity 52.8%, positive predictive value 95%, negative predictive value 29.2%). Patients with AVNRT in group B who did not experience the recurrences of tachycardia had significantly shorter echo zone before intravenous administration of propafenone than the patients who experienced episodes of sustained tachycardia (median 40 ms [range 15-60 ms] vs 79 ms [range 50-180 ms], P=0.008)., Conclusion: In patients with non-inducible tachycardia, complete ventriculo-atrial block can be used as an electrophysiological predictor of the efficacy of propafenone oral therapy in the prevention of tachycardia. In patients with non-inducible AVNRT, but without complete ventriculo-atrial block, propafenone was more effective in patients with shorter echo zone of tachycardia.

In the last year, different diseases possibly linked to Helicobacter pylori infection but localized outside of the stomach have been investigated. There are, in fact, several studies concerning cardiovascular diseases, hematologic disorders, neurologic diseases, metabolic, hepatobiliary diseases, and other conditions. Some of those studies, such as those on sideropenic anemia and idiopathic thrombocytopenic purpura, are quite large and well conducted, while in other cases there are just small or isolated studies or even case reports. Nonetheless, there is much interest among researchers all over the world for such a topic as demonstrated by the large number of studies published in the last year., (© 2012 Blackwell Publishing Ltd.)

The aim of the study was to evaluate the influence of door-to-balloon time and symptom onset-to-balloon time on the prognosis of patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) in the Croatian Primary PCI Network. A total of 1190 acute STEMI patients treated with primary PCI were prospectively investigated in eight centers across Croatia (677 non-transferred, 513 transferred). All patients were divided according to door-to-balloon time in three subgroups (< 90, 90-180, and > 180 minutes) and according to symptom onset-to-balloon time in three subgroups (<180, 180-360, and > 360 minutes). The postprocedural Thrombolysis in Myocardial Infarction flow, in-hospital mortality, and major adverse cardiovascular events (mortality, pectoral angina, restenosis, reinfarction, coronary artery by-pass graft and cerebrovascular accident rate) in six-month follow-up were compared between the subgroups. The Croatian Primary PCI Network ensures results of treatment of acute STEMI comparable with randomized studies and registries abroad. None of the result differences among the door-to-balloon time subgroups was statistically significant. Considering the symptom onset-to-balloon time subgroups, a statistically significant difference at multivariate level was highest for in-hospital mortality in the subgroup of patients with longest onset-to-balloon time (4.5 vs. 2.6 vs. 5.7%; p = 0.04). Door-to-balloon time is one of the metrics of organization quality of primary PCI network and targets for quality improvement, but without an impact on early and six-month follow-up results of treatment for acute STEMI. Symptom onset-to-balloon time is more accurate for this purpose; unfortunately, reduction of the symptom onset-to-balloon time is more complex than reduction of the former.