Low to High Frequency Ratio of Heart Rate Variability Spectra Fails to Describe Sympatho-Vagal Balance in Cardiac Patients

Heart rate variability (HRV) reflects an influence of autonomic nervous system on heart work. In healthy subjects, ratio between low and high frequency components (LF/HF ratio) of HRV spectra represents a measure of sympatho- vagal balance. The ratio was defined by the authorities as an useful clinical tool, but it seems that it fails to summarise sympatho-vagal balance in a clinical setting. Value of the method was re-evaluated in several categories of cardiac patients. HRV was analysed from 24-hour Holter ECGs in 132 healthy subjects, and 2159 cardiac patients dichotomized by gender, median of age, diagnosis of myocardial infarction or coronary artery surgery, left ventricular systolic function and divided by overall HRV into several categories. In healthy subjects, LF/HF ratio correlated with overall HRV negatively, as expected. The paradoxical finding was obtained in cardiac patients; the lower the overall HRV and the time-domain indices of vagal modulation activity were the lower the LF/HF ratio was. If used as a measure of sympatho-vagal balance, long-term recordings of LF/HF ratio contradict to clinical finding and time-domain HRV indices in cardiac patients. The ratio cannot therefore be used as a reliable marker of autonomic activity in a clinical setting

Low to High Frequency Ratio of Heart Rate Variability Spectra Fails to Describe Sympatho-Vagal Balance in Cardiac Patients

Heart rate variability (HRV) reflects an influence of autonomic nervous system on heart work. In healthy subjects, ratio between low and high frequency components (LF/HF ratio) of HRV spectra represents a measure of sympatho- vagal balance. The ratio was defined by the authorities as an useful clinical tool, but it seems that it fails to summarise sympatho-vagal balance in a clinical setting. Value of the method was re-evaluated in several categories of cardiac patients. HRV was analysed from 24-hour Holter ECGs in 132 healthy subjects, and 2159 cardiac patients dichotomized by gender, median of age, diagnosis of myocardial infarction or coronary artery surgery, left ventricular systolic function and divided by overall HRV into several categories. In healthy subjects, LF/HF ratio correlated with overall HRV negatively, as expected. The paradoxical finding was obtained in cardiac patients; the lower the overall HRV and the time-domain indices of vagal modulation activity were the lower the LF/HF ratio was. If used as a measure of sympatho-vagal balance, long-term recordings of LF/HF ratio contradict to clinical finding and time-domain HRV indices in cardiac patients. The ratio cannot therefore be used as a reliable marker of autonomic activity in a clinical setting

Differential diagnostic relevance of high resolution magnetic resonance in patients with possible multiple system atrophy (MSA) – a case report [Važnost uporabe magnetne rezonancije visoke rezolucije u dijagnostici moguće multiple sistemske atrofije - prikaz slučaja]

Multiple system atrophy (MSA) is sporadic, progressive neurodegenerative disorder characterized clinically by autonomic dysfunction, Parkinsonism (MSA-P), and cerebellar ataxia (MSA-C) in any combination. Parkinsonism is present in the majority of patients (80%). Early in the course of the disease autonomic dysfunctions are present in approximately 40% of patients, while the domination of cerebellar symptoms is present in 20% of all patients1,2. According to second consensus statement on diagnosis of MSA, to make the diagnosis of possible MSA, except Parkinsonism or a cerebellar syndrome, there must be one feature involving autonomic dysfunction plus one other additional that can include findings on history, clinical examination or changes in structural or functional imaging3. We present a case of 60-year old male with Parkinsonism and cerebellar symptoms accompanied with signs of autonomic nervous system involvment. Level of autonomic dysfunction was not the level required for the diagnosis of probable MSA. On initially performed 1.5T MRI, the most prominent neurodegenerative feature of brain stem, cerebellum and basal ganglia was atrophy, however features like »hot-cross bun« sign, »slit-like« putaminal rim and middle cerebellar peduncle hyperintensities were detected only after MR imaging on higher resolution (3T) device4. Our case points to the possibility that some typical structural changes that can help in diagnostic process may not be clearly visible on 1.5 T MRI devices. In such cases we suggest using 3T MRI device, if feasible, in order to demonstrate findings that may help in establishing the diagnosis of possible MSA

Rad za opće dobro u praksi sudova - 25 godina poslije

Rad na sažet način donosi pregled povijesnog razvoja instituta rada za opće dobro, prikaz zakonskih izmjena koje su se dogodile u proteklom 25-ogodišnjem razdoblju vezano uz zakonsko uređenje izricanja i izvršavanja rada za opće dobro te prikaz sadašnjeg zakonskog okvira kojim je uređeno to područje. Nadalje, rad donosi i prikaz sudske prakse (sentenci) svih sudskih instanci u Republici Hrvatskoj te statističke podatke vezane uz izricanje i izvršavanje rada za opće dobro u proteklih 25 godina. Uz prethodno navedeno, autori nastoje upozoriti na aktualne probleme koji se pojavljuju u praksi prilikom određivanja rada za opće dobro, njegova provođenja i izvršavanja te na navedene probleme ponuditi odgovore i rješenja

Spectrum of Phenomena of Multiple Myocardial Contractions during Each Single Cardiac Cycle

The phenomenon of multiple myocardial contractions during each single cardiac cycle, triggered by a single sinus node impulse, is the most intriguing echocardiographical topic among detectible modalities of irregular kinetics of interventricular septum. Tissue Doppler imaging based methods gave proofs of active contractions in cases presented herein. Broad spectrum of this phenomenon, which can be found both in healthy subjects and in patients is presented. Forms of multiple myocardial contractions during the same cardiac cycle presented in this analysis are: secondary systolic contraction, postsystolic and late postsystolic contraction, multiple (three- and fourfold) contractions with combination of secondary systolic and postsystolic contraction, and combination of regular systolic, secondary systolic or postsystolic contraction with pre-contraction as a part of possible preexcitation. Explanation of mechanism generating these phenomena could be found in possible existence of accessory, concealed slow pathways of cardiac conduction system

INCREASE OF WAVE HEIGHT DUE TO TRANSITION IN WIND DIRECTION – EXAMPLE: RIJEKA BAY

Surface wind wave dynamics were analyzed during wind transition from the third to the fourth quadrant, with the transition from Sirocco to Libeccio used as an example. This research is focused on the deep-water area in front of the Rijeka port. The analyses utilized a numerical model for wave generation, covering the entire Adriatic basin. Numerical simulations were conducted for relevant situations during the period 1998-2001. The numerical model was forced by the wind field obtained from the Aladin-HR atmospheric model. Numerical simulations were conducted in two steps, initially using hypothetical scenarios with homogenous and stationary wind fields, followed by simulations based on nonstationary wind fields from the Aladin-HR atmospheric model. The first step was used to confirm the hypothesis that significant wave heights rise during the transition of wind direction in the analyzed area. Model simulations in step two verified the assumption that the observed phenomenon can also occur in real atmospheric conditions.The results of the model simulations indicate the onset of a significant wave height increase during the transition of wind direction from the SSE to SW in a wider area that includes Kvarner and Rijeka bay. The increase in wind velocity results in a more noticeable significant wave height maximum

INCREASE OF WAVE HEIGHT DUE TO TRANSITION IN WIND DIRECTION – EXAMPLE: RIJEKA BAY

Surface wind wave dynamics were analyzed during wind transition from the third to the fourth quadrant, with the transition from Sirocco to Libeccio used as an example. This research is focused on the deep-water area in front of the Rijeka port. The analyses utilized a numerical model for wave generation, covering the entire Adriatic basin. Numerical simulations were conducted for relevant situations during the period 1998-2001. The numerical model was forced by the wind field obtained from the Aladin-HR atmospheric model. Numerical simulations were conducted in two steps, initially using hypothetical scenarios with homogenous and stationary wind fields, followed by simulations based on nonstationary wind fields from the Aladin-HR atmospheric model. The first step was used to confirm the hypothesis that significant wave heights rise during the transition of wind direction in the analyzed area. Model simulations in step two verified the assumption that the observed phenomenon can also occur in real atmospheric conditions.The results of the model simulations indicate the onset of a significant wave height increase during the transition of wind direction from the SSE to SW in a wider area that includes Kvarner and Rijeka bay. The increase in wind velocity results in a more noticeable significant wave height maximum

Effects of Different Postharvest Heat Treatments on Decreasing Decay, Reducing Chilling Injury and Maintaining Quality of Nectarine Fruit

The goal of this research was to evaluate the efficiency of heat treated nectarine fruit (Prunus persica var. nectarina ‘Diamond Ray’) on maintaining the quality parameters after 4 week storage in NA (normal atmosphere) at 0°C and 5 days at 20°C (shelf life). Fruits were harvested closer to “ready-to-eat” maturity from a commercial orchard near Zadar (Croatia). The investigated postharvest treatments were hot air (hot air treatment till fruit reaches 45°C near stone – HAT 45/24) and immersion in hot water at a temperature of 48 °C for 6 minutes (HWD 48) and 52°C for 2 minutes (HWD 52). Fruit quality parameters (firmness, soluble solids, total acidity, pH) were also investigated. HAT 45/24 reduced weight loss and maintained firmness more than control or hot water treatments. Overall, heat treatments had a pronounced effect on decreasing decay, reducing chilling injury and maintaining quality of climacteric nectarine fruit. These treatments may extend the storage life by preventing both pathological and physiological disorders

Differential Diagnostic Relevance of High Resolution Magnetic Resonance in Patients with Possible Multiple System Atrophy (MSA) – A Case Report

Multiple system atrophy (MSA) is sporadic, progressive neurodegenerative disorder characterized clinically by autonomic dysfunction, Parkinsonism (MSA-P), and cerebellar ataxia (MSA-C) in any combination. Parkinsonism is present in the majority of patients (80%). Early in the course of the disease autonomic dysfunctions are present in approximately 40% of patients, while the domination of cerebellar symptoms is present in 20% of all patients1,2. According to second consensus statement on diagnosis of MSA, to make the diagnosis of possible MSA, except Parkinsonism or a cerebellar syndrome, there must be one feature involving autonomic dysfunction plus one other additional that can include findings on history, clinical examination or changes in structural or functional imaging3. We present a case of 60-year old male with Parkinsonism and cerebellar symptoms accompanied with signs of autonomic nervous system involvment. Level of autonomic dysfunction was not the level required for the diagnosis of probable MSA. On initially performed 1.5T MRI, the most prominent neurodegenerative feature of brain stem, cerebellum and basal ganglia was atrophy, however features like »hot-cross bun« sign, »slit-like« putaminal rim and middle cerebellar peduncle hyperintensities were detected only after MR imaging on higher resolution (3T) device4. Our case points to the possibility that some typical structural changes that can help in diagnostic process may not be clearly visible on 1.5 T MRI devices. In such cases we suggest using 3T MRI device, if feasible, in order to demonstrate findings that may help in establishing the diagnosis of possible MSA

The Zagreb Indices 30 Years After

The original formulation of the Zagreb indices is presented and their relationship to topological indices such as self-returning walks, Platt, Gordon-Scantlebury and connectivity indices is discussed. Their properties are also listed. Modified Zagreb indices are introduced and the Zagreb complexity indices reviewed. Their use in QSPR is illustrated by modeling the structure-boiling point relationship of C3–C8 alkanes using the CROMRsel procedure. The obtained models are in fair agreement with experimental data and are better than many models in the literature. However, in general, the Zagreb indices do not contribute to the best structure-boiling point models of alkanes. Nevertheless, it is interesting to note that the best five-descriptor model that we found in the literature contains the Zagreb M2 index