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Since the introduction of 3D mapping systems, the use of x-rays in electrophysiology procedures has significantly decreased. The goal of this study was to analyze the frequency of x-ray use in pediatric electrophysiology in relation to age or body mass, indication for the procedure, and arrhythmia substrate. Th is retrospective, cross-sectional study included all pediatric procedures in two centers, Gottsegen Cardiovascular Center, Budapest, Hungary and Sestre milosrdnice University Hospital Center, Zagreb, Croatia. Patient data included weight, age, sex, presence of structural heart disease, indication for the electrophysiology study, arrhythmia substrate, and x-ray use. A total of 914 participants were analyzed, mean age 13.25 years and mean mass 53.20 kg. Of all procedures, 62.04% were performed without and 37.96% with fluoroscopy. Th ere were no statistically significant differences in the frequency of x-ray use when comparing the groups by sex (p=0.181), age (p=0.380) or mass (p=0.120). Left-sided accessory pathways required x-ray use most frequently, whereas unknown substrates and of the known substrates atrioventricular nodal reentry tachycardia required it least frequently (p

Anemija zbog manjka željeza ili sideropenična anemija najčešći je oblik anemije u populaciji. Sideropenična anemija može nastati uslijed gastrointestinalnih bolesti, ginekoloških i drugih kroničnih krvarenja, može biti dio kliničke slike nefroloških i drugih bolesti i stanja, može doprinositi srčanom zatajenju u kardioloških bolesnika te pogoršavati ishode operativnih zahvata. Zbog navedenoga potreban je timski rad u liječenju sideropenične anemije, važno je otkriti i liječiti uzrok koji je doveo do gubitka željeza te liječiti anemiju nadoknadom željeza. Cilj je ovog rada prikazati pregled literature i klinička iskustva različitih nehematoloških specijalističkih usmjerenja u liječenju sideropenične anemije parenteralnim pripravcima željeza u različitim tercijarnim centrima u Hrvatskoj. U radu su opisani pristupi i postupnici u zbrinjavanju sideropenije i sideropenične anemije parenteralnim željezom iz aspekta gastroenterologa, ginekologa, nefrologa, kardiologa te anesteziologa, sa specifičnostima pojedinih bolesti i pristupa njihovom liječenju. U zaključku, novi visokodozni pripravci parenteralnog željeza unaprijedili su mogućnosti liječenja sideropenične anemije i primjenjuju se sve više u dnevnim bolnicama i odjelima različitih struka u Hrvatskoj, a ne samo u hematološkim dnevnim bolnicama ili odjelima.

Background: Relative-tachycardia (RT), a phenomenon of unproportionately high heart-rate elevation in response to fever, has been previously attributed to unfavourable outcomes in severe-inflammatory-response-syndrome (SIRS). Relative heart-rate to body-temperature ratio (RHR) and its prognostic associations in patients with severe and critical coronavirus disease 2019 (COVID-19) have not been investigated. Methods: We retrospectively analyzed heart-rate and body-temperature data at admission in patients who were hospitalized due to COVID-19 at a tertiary center from March 2020 to June 2021. After excluding patients with known heart rate affecting medications (beta-blockers and other antiarrhythmics) and atrial fibrillation, a total of 3490 patients were analyzed. Patients were divided into quartiles based on RHR on admission, with patients belonging to the 1st quartile designated as having relative-bradycardia (RB) and patients belonging to 4th quartile designated as having RT. Comparisons with baseline clinical characteristics and the course of treatment were done. Results: There were 57.5% male patients. Median age was 69 years. Most patients had severe or critical COVID-19 at admission. Median heart-rate at the time of hospital admission was 90/min, median body-temperature was 38 °C, and median RHR was 2.36 with interquartile-range 2.07–2.65. RB in comparison to middle-range RHR was significantly associated with older age, higher comorbidity burden, less severe COVID-19 and less pronounced inflammatory profile, and in comparison to RT additionally with higher frequency of hyperlipoproteinemia but lower frequency of obesity. RT in comparison to middle-range RHR was significantly associated with younger age, more severe COVID-19, lower comorbidity burden, lower frequency of arterial hypertension, higher frequency of diabetes mellitus, and more pronounced inflammatory profile. In multivariate analyses adjusted for clinically meaningful parameters, RB patients experienced more favorable survival compared to RT, whereas RT patients experienced higher mortality in comparison to RB and middle-range RHR patients, independently of older age, male sex, higher comorbidity burden and higher COVID-19 severity. Conclusions: Heart rate and axillary temperature are an indispensable part of a clinical exam, easy to measure, at effectively no cost. RT at admission, as a sign of excessive activation of the sympathetic nervous system, is independently associated with fatal outcomes in COVID-19 patients.

Contemporary cardiology offers potent treatment options for acute coronary syndrome. Occasionally, the most challenging part of the patient care occurs after percutaneous coronary intervention (PCI). Complications such as acute renal failure requiring renal replacement therapy, need for mechanical ventilation, infections, septic syndrome requiring vasopressor therapy, and stroke may influence short- and long-term outcome of such patients. In this paper, we present a case of an elderly lady treated with left main PCI due to acute non-ST elevation myocardial infarction. The case was complicated with all above listed events, however, the outcome was favourable.