Effect of frequent ventricular ectopia on progression of dilated cardiomyopathy

Dilated cardiomyopathy (DCM) is the most common form of cardiomyopathy. Various conditions may result in DCM, most commonly ischemic heart disease, metabolic/infiltrative diseases and genetic disorders. There are approximately 50 different genes known that cause DCM. Most affected genes are TTN that encode titin. DCM may lead to various rhythmic disorders, especially sustained ventricular tachycardia and ventricular fibrillation. In this article we present a case of 61 years old patient with primary dilated cardiomyopathy who was addmited to our hospital due to acute heart failure. Earlier genetic analysis showed that patient has mutation for titin, protein that is responsible for passive elasticity of caridac smooth muscle cells. Due to two episodes of ventricular tachycarida the ablation was performed, after which implantable cardioverter-defibrillator (ICD) was inserted for primary prevention of further malignant ventricular tachyarrhythmias. Hemodynamic properties and poor left ventricular systolic function were corrected by using optimal medical therapy like eplerenone and sacubitril/valsartan. Patient has developed coronary heart disease and percutaneous coronary intervention was performed with stent implantation. Because of still present ventricular ectopic which lead to further myocardial dysfunction and progression of heart failure, additional ablation is needed. Dilated cardiomyopathy is important cause of heart failure and sudden cardiac death (SCD), especially in young individuals. It is of great importance to recognize and treat it adequately, and also to detect possible cause of it. Further investigetions should be done in order to improve treatment for heart failure that will enhance left ventricular systolic function

Presbyopia Correction During Cataract Surgery with Multifocal Intraocular Lenses

Introduction: The first generations of multifocal intraocular lenses (MFIOLs) were designed to provide patients good distance and near vision, but intermediate was not satisfactory. Trifocal, a bifocal of low-add and quadrifocal MFIOLs were invented, offering possibility to correct vision for distance, near, and intermediate tasks. The novel IOL, extended range of vision (EROV), is covering mostly intermediate and distance vision, with lower level of photic phenomena

Aortic Stenosis

Aortalna stenoza (AS) suženje je ušća aorte koje može biti prirođeno ili stečeno, a incidencija raste s dobi. Bikuspidalna aortalna valvula često je udružena s drugim srčanim i aortalnim greškama. Bolesnici mogu biti klinički asimptomatski ili simptomatski (uglavnom u uznapredovaloj fazi). U procjeni težine aortalne stenoze osim ultrazvuka srca izvode se ergometrija, MSCT i MR srca. Vrlo je važno dobro procijeniti stupanj aortalne stenoze, osobito kod niskoga transvalvularnoga gradijenta. Zamjena aortalne valvule može biti kirurška (biološki ili mehanički zalistak) ili manje invazivna, transkateterska (TAVI).Aortic stenosis (AS) is a narrowing of the aortic valves. AS can be congenital or acquired, and the incidence increases with age. Bicuspid aortic valve is often associated with other cardiac and aortic anomalies. Clinically, patients can be asymptomatic or symptomatic (mainly in advanced stage). Echocardiography, exercise test, MSCT and MR are non-invasive methods of choice. Assessment of stenosis severity is very important, especially in low transvalvular gradient. Surgical valve replacement is performed with biological or mechanical valves; another, less invasive method is transcatheter aortic replacement (TAVI)

Analiza širenja pukotine u strojarskim konstrukcijama

U radu je izvršena eksperimentalna analiza širenja pukotine kod čelika DIN 42CrMo4V. Ovaj materijal u poboljšanom stanju ima visoku čvrstoću i žilavost. Koristi se za statički i dinamički opterećene konstrukcijske dijelove, posebno za veće presjeke s visokim opterećenjem. Cilj rada je pronaći mogućnost što točnijeg i preciznijeg eksperimentalnog određivanja karakteristika pukotine kod trodimenzijskih problema mehanike loma. Izrađene su epruvete sa zarezom s iniciranom greškom tipa pukotine u cilju određivanja udarnih svojstava i parametara mehanike loma. Ova ispitivanja omogućuju uspostavljanje ovisnosti geometrije pokretne pukotine i uvjeta naprezanja za njeno daljnje širenje. Time je moguće odrediti iznose parametara koji opisuju ponašanje materijala, kako u linearno-elastičnoj tako i u elasto-plastičnoj mehanici loma

Combined atrial septal defect and pulmonic stenosis in an adult patient

Atrijski septalni defekt (ASD) u kombinaciji sa stenozom plućne arterije (PS) rijedak je u odraslih bolesnika. U zadnje vrijeme povećava se broj izvještaja o perkutanome liječenju ovih dvaju poremećaja jer je dokazano da su učinkoviti i izvedivi. Ovdje se prikazuje slučaj odrasloga bolesnika s teškim PS-om povezanim s ASD-om, koji je liječen kirurški zbog nepovoljne anatomije koja je onemogućila perkutano liječenje.Atrial septal defect (ASD) combined with pulmonic stenosis (PS) is a relatively uncommon condition in adult patients. Recently, reports on percutaneous therapy of PS and ASD have increased, since percutaneous therapy has been demonstrated to be effective as well as feasible. This report is about an adult patient with severe PS and associated ASD, who was treated surgically because of unfavourable anatomy which precluded the use of a percutaneous device