Ablation of ventricular arrhythmias above semilunar valves.

Aritmije iz izgonskog trakta desne ili lijeve klijetke mogu imati svoje ishodište u supravalvularnim miokardnim ekstenzijama. Medikamentozna terapija je tradicionalno neuspješna, pa se kod simpomatskih slučajeva ili onih kod kojih se razvije aritmijom inducirana kardiomiopatija treba odlučiti za interventno rješenje. Za njihovu uspješnu eliminaciju ablacijom mapiranje i primjena radiofrekventne energije mora se učiniti iznad semilunarnih valvula, u regijama koje imaju specifične anatomske osobitosti. U ovom preglednom radu donosimo kratak osvrt na anatomsku podlogu ovih aritmija i intraproceduralne korake koji vode uspješnoj i sigurnoj ablaciji, kao i pregled vlastitog iskustva.Arrhythmias from the right and left ventricular outflow tract may stem from supravalvular myocardial extensions. Medical therapy has traditionally been unsuccessful, so in symptomatic cases or those in which arrhythmia-induced cardiomyopathy develop we should opt for an intervention. Mapping and use of radiofrequency energy has to be performed above semilunar valves for their successful elimination by ablation, in the regions that have specific anatomical features. This review article provides a brief overview of the anatomical substrate of these arrhythmias and intraprocedural steps that lead to successful and safe ablation, as well as an overview of our own experience

“Double fire” — a rare and commonly unrecognized arrhythmia.

Dvojna fiziologija provođenja atrioventrikularnim (AV) čvorom, odnosno prisutnost tzv. sporog puta, prema raznim studijama, elektrofiziološkim ispitivanjem se može dokazati u do čak 35% ljudi. Međutim, kod samo manjeg broja on ima i klinički značaj. Prikazujemo slučaj pacijentice s vrlo rijetkom elektrofiziološkom manifestacijom aktivnog sporog puta, dvostrukog odgovora ventrikula na jedan atrijski kompleks. Problem je uspješno rješen radiofrekventnom ablacijom. Ovakav način provođenja AV čvorom vjerovatno je i znatno češći nego što se opisuje u literaturi, ali se na žalost rijetko prepoznaje te je uglavnom refraktoran na medikamentoznu terapiju.Dual atrioventricular node (AV) pathway physiology or the presence of so-called slow conduction pathway is according to various studies demonstrable in up to 35% of normal people during electrophysiology study (EPS). In only a small number of them, it has a clinical significance. We present a case of a patient with a very rare electrophysiological manifestation of active slow pathway, double ventricular response to one atrial complex. The problem was successfully treated with radiofrequency ablation. This form of conduction via AV node is probably much more common than it was previously described in the literature, but unfortunately it is rarely recognized and is generally refractory to medical therapy

Helicobacter Pylori Infection and Acute Myocardial Infarction

The aim of this investigation was to determine whether H. pylori infection is an independent risk factor for acutemyocardial infarction (AMI), determine is there a link between H. pylori infection and severity of disease. In this prospective, single centre study, were enrolled 100 patients with AMI and control group was consisted 93 healthy individuals. The results of this study showed no difference between H. pylori seropositivity distribution in the investigate and control group (29 vs. 26 %) and there was no significant difference on the severity of the disease. There was significant association in the patients with three and more risk factors, where the patients with lower blood pressure (124.4/77.4 vs. 145.9/87.7 mmHg) and better controled diabetes (HbA1c 6.1 % vs. 6.9 %) had greater risk for AMI if they are H. pylori seropositive. The largemulticentric trials would be needed to define a precise role of H. pylori infection on the developement of AMI

Helicobacter Pylori Infection and Acute Myocardial Infarction

The aim of this investigation was to determine whether H. pylori infection is an independent risk factor for acutemyocardial infarction (AMI), determine is there a link between H. pylori infection and severity of disease. In this prospective, single centre study, were enrolled 100 patients with AMI and control group was consisted 93 healthy individuals. The results of this study showed no difference between H. pylori seropositivity distribution in the investigate and control group (29 vs. 26 %) and there was no significant difference on the severity of the disease. There was significant association in the patients with three and more risk factors, where the patients with lower blood pressure (124.4/77.4 vs. 145.9/87.7 mmHg) and better controled diabetes (HbA1c 6.1 % vs. 6.9 %) had greater risk for AMI if they are H. pylori seropositive. The largemulticentric trials would be needed to define a precise role of H. pylori infection on the developement of AMI

Towards sustainability of lactic acid and poly-lactic acid polymers production

Lactic acid (LA) is a platform chemical which can be produced biotechnologically on agricultural residues, wastes and by-products and further used for production of biodegradable, biocompatible LA polymers. These polymers are mostly used for high-end applications but they have potential for much wider application with decrease in production costs. Available technologies and strategies are reviewed in order to point out the issues, challenges and solutions relevant to increase sustainability and competitiveness of LA production on agricultural residues and wastes. Data on chemical composition, regional and seasonal availability of agricultural residues, wastes and by-products are lacking to provide predictable and effective combining for LA production. Precision agriculture, remote sensing and integration with data on chemical composition can help in better planning and more adequate exploitation of available sources in future. Novel pretreatments for the most abundant lignocellulosic feedstocks, which allow utilization of carbohydrates in LA production and side streams like lignin in other biorefineries are needed. Integration of pretreatment, hydrolysis and fermentation under non-sterile conditions or open fermentation mode should enable easier scale up and decrease energy consumption and costs without sacrificing LA purity. Capital investments in improvement of the available technologies are high. Support from policy makers stimulating production of LA polymers from second and third generation feedstocks will help in research, development and faster adoption on larger scale. For production of LA polymers with tailored properties, it is essential to choose the most productive method for LA production and separation from these complex substrates. The shift in research interest from LA polymerization towards "green" processing of LA polymers products is occurring and that will be the additional driving force for the field in future