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Introduction This study tried to investigate the impact of oXiris filter on both clinical and laboratory parameters in critically ill COVID-19 ICU patients receiving extracorporeal blood purification and the clinical setting for the initiation of therapy. Methods A consecutive sample of 15 ICU patients with COVID-19 was treated with oXiris membrane for blood purification or for support of renal function due to acute kidney injury. We have included 19 non treated ICU COVID-19 patients as a control group. Two chest X-rays were analyzed for determining the chest x-ray severity score. Results We have found a significant decrease of SOFA score, respiratory status improved and the chest X-ray severity score was significantly decreased after 72h of treatment. Il-6 significantly decreased after 72h of treatment while other inflammatory markers did not. Respiratory status in the control group worsened as well as increase in SOFA score and chest X-ray severity score. Survived patients have shorter time from the onset of symptoms before starting with extracorporeal blood purification treatment and shorter time on vasoactive therapy and invasive respiratory support than deceased patients. Conclusion Critically-ill patients with COVID-19 treated with extracorporeal blood purification survived significantly longer than other ICU COVID-19 patients. Treatment with oXiris membrane provides significant reduction of Il-6, leads to improvement in respiratory status, chest X-ray severity score, and reduction of SOFA score severity. Our results can suggest that ICU COVID-19 patients in an early course of a disease could be potentially a target group for earlier initiation of extracorporeal blood purification. This article is protected by copyright. All rights reserved.

RVD increases the risk of hospitalisations, while RVFWS may serve as an echocardiographic indicator in hemodynamically significant left side valvular disease and add value in risk stratification in multiple valve disease in case of aorticomitrak stenotic disease.

Diabetes mellitus (DM) is related to higher rates of complications after coronary revascularization.1 The efficiency of drug-coated balloon (DCB) percutaneous coronary intervention (PCI) has been shown for in- stent restenosis (ISR) and native small-vessel disease, however data on outcomes in DM is scarce.2 The aim is to compare the incidence of target lesion restenosis at follow-up (FUP) coronary angiography in patients with and without DM receiving DCB PCI.

U radu se opisuje slučaj bolesnika s konstriktivnim perikarditisom čija je prva manifestacija bila pojava atrijske fibrilacije.

The prevalence of coronary artery disease (CAD) increases in patients with end-stage liver disease, with part of them receiving the percutaneous coronary intervention (PCI) as a treatment option. Dual antiplatelet therapy (DAPT), a standard of care after PCI, could result in catastrophic consequences in this population. Before PCI and the start of DAPT, it is recommended to assess patient bleeding risk. Based on novel findings, liver cirrhosis does not necessarily lead to a significant increase in bleeding complications. Furthermore, conventional methods, such as the international normalized ratio, might not be appropriate in assessing individual bleeding risk. The highest bleeding risk among cirrhotic patients has a subgroup with severe thrombocytopenia (< 50 × 109/L) and elevated portal pressure. Therefore, every effort should be made to maintain thrombocyte count above > 50 × 109/L and prevent variceal bleeding. There is no solid evidence for DAPT in patients with cirrhosis. However, randomized trials investigating short (one month) DAPT duration after PCI with new drug-eluting stents (DES) in a high bleeding risk patient population can be implemented in patients with cirrhosis. Based on retrospective studies (with older stents and protocols), PCI and DAPT appear to be safe but with a higher risk of bleeding complications with longer DAPT usage. Finally, novel methods in assessing CAD severity should be performed to avoid unnecessary PCI and potential risks associated with DAPT. When indicated, PCI should be performed over radial artery using contemporary DES. Complementary medical therapy, such as proton pump inhibitors and beta-blockers, should be prescribed for lower bleeding risk patients. Novel approaches, such as thromboelastography and “preventive” upper endoscopies in PCI circumstances, warn clinical confirmation.

Dual antiplatelet therapy (DAPT) forms the basis for the treatment of all patients undergoing percutaneous coronary intervention (PCI) and patients who suffered acute coronary syndrome (ACS). Prasugrel and ticagrelor are potent P2Y12 receptor inhibitors that have demonstrated their superiority in patients with ACS in comparison with clopidogrel in multiple clinical trials. In a recent randomized clinical trial called ISAR REACT 5, prasugrel provided a statistically significant reduction in the rate of ischemic outcomes without an increase in bleeding complications, in comparison with ticagrelor. Similar results were also presented in a subsequent meta-analysis. Considering the above and according to current guidelines for non-ST elevation ACS, prasugrel is the P2Y12 inhibitor of choice in the treatment of patients undergoing PCI. On the other hand, ticagrelor is the treatment of choice in cases when prasugrel is contraindicated. However, in some patient populations (patients older than 75 and weighing less than 60 kg) and clinical scenarios (delayed invasive treatment), no clear recommendations can be made regarding therapy or treatment of choice due to inadequate evidence. Both agents are also indicated in situations when prolonged DAPT is required, although ticagrelor is the preferred choice. Finally, randomized studies on P2Y12 inhibitor monotherapy after 1 to 3 months of DAPT following PCI indicate a reduction in bleeding complications, but without any significant increase in ischemic complications, compared with classic DAPT. However, additional research is required in this area before introducing any changes to everyday clinical practice., Dvojna antiagregacijska terapija (DAPT) osnova je liječenja svih bolesnika koji su podvrgnuti perkutanoj koronarnoj intervenciji (PCI) i bolesnika s akutnim koronarnim sindromom (AKS). Prasugrel i tikagrelor potentni su inhibitori P2Y12 receptora, koji su u višestrukim kliničkim ispitivanjima pokazali superiornost u odnosu prema klopidogrelu u bolesnika s AKS-om. Prema nedavnom randomiziranom kliničkom istraživanju ISAR REACT 5, prasugrel je statistički značajno reducirao ishemijske ishode, bez povećanja krvarećih komplikacija u usporedbi s tikagrelorom. Slični su rezultati prikazani i u naknadnoj metaanalizi. S obzirom na navedeno, prasugrel je, prema postojećim smjernicama za AKS bez elevacije ST-segmenta, P2Y12 inhibitor izbora u liječenju bolesnika koji su podvrgnuti PCIju. S druge strane, tikagrelor je lijek izbora u situacijama kada je prasugrel kontraindiciran. Ipak, u određenim populacijama bolesnika (stariji od 75 godina života i lakši od 60 kilograma) i kliničkim scenarijima (odgođena invazivna obrada) ne može se jasno preporučiti terapija zbog nedostatka adekvatnih dokaza. Oba su lijeka indicirana i u situacijama kada je potrebna produljena DAPT, pri čemu tikagrelor ima prednost. Završno, randomizirana istraživanja o monoterapiji P2Y12 inhibitorom, koja je nastavljena nakon provedene PCI i 1 – 3 mjeseca primjene DAPT-a, upućuju na redukciju krvarećih komplikacija, a bez znatnog porasta u ishemijskim komplikacijama u usporedbi s klasičnim DAPT-om. Ipak, u tom su području potrebna daljnja istraživanja prije eventualne promjene svakodnevne kliničke prakse.

Recurrent pericarditis can occur in up to 30% of patients after acute episode of pericarditis and is associated with significantly impaired quality of life and morbidity1. High rate of recurrence remains despite treatment as nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, steroids or other immunosuppressants1. If medical therapy fails, in case of symptomatic constrictive hemodynamics, surgical approach-pericardiectomy is indicated. Therefore, imaging modalities have to distinguish between hemodynamic assessment, where echocardiography is first line imaging modality, and inflammation where other cardiac imaging modalities complement echocardiographic findings.

Invazivna alohtona vrsta europski mračnjak (Abutilon theophrasti Medik.) danas je jedna od najagresivnijih i najštetnijih korovnih vrsta u Hrvatskoj. Jakim habitusom s naglašeno velikim listovima vrlo brzo može zasjeniti uzgajanu kulturu uzrokujući značajne gubitke prinosa. Relativno krupno sjeme omogućuje mu nicanje i iz dubljih slojeva tla što zbog kontinuiranog nicanja s različitih dubina iz tla predstavlja problem u suzbijanju. Uz spomenuto, dormantnost sjemena ograničava prognozu nicanja i uspješno suzbijanje ove vrste. Kompeticija mračnjaka, osim morfološkim značajkama, izražena je i alelopatskim sposobnostima. Europski mračnjak eksudatima svih biljnih dijelova može izazvati inhibiciju rasta i razvoja biljaka u svojoj blizini. Za pouzdano i učinkovito suzbijanje europskog mračnjaka, osobito u kulturama slabijih kompetitivnih sposobnosti, nužno je integrirati sve raspoložive mjere suzbijanja

Infective endocarditis is related to a wide range of complications including septic embolizations such as spondylodiscitis. Risk factors associated with systemic include left-sided vegetation, large vegetation size, microbiology, age, diabetes, etc. Endocarditis might be difficult to diagnose and lead to invalid and late treatment.

Smaller stent diameter represents risk factor for target lesion failure (TLF). Drug coated balloons (DCB) could represent valid substitution for stents in selected patients.The aim of the study was to assess clinical and angiographic outcomes after percutaneous coronary interventions (PCI) using DBC in treatment of coronary arteries ≤ 2.5 mm.

Left atrial appendage (LAA) is the most common site for cardiac thrombus. This issue is especially addressed prior cardioversion of atrial fibrillation (Afib). In clinical practice, transesophageal echocardiography (TEE) is the most important diagnostic tool for analysis of LAA morphology, flow patterns and presence of thrombus. However, better echo machines allow more frequent visualization of spontaneous echo contrast (SEC), which by itself is not contraindication for cardioversion1. Distinguishing LAA thrombus from pectinate muscles and SEC is today improved by multimodality imaging, especially computed tomography (CT). Even though, the use of contrast echocardiography in this setting is still of most importance since it is safe, quick and easily available.

Although recent studies described platelet reactivity (PR) changes in days after transcatheter aortic valve implantation (TAVI), precise time course and duration of these changes have not been fully investigated. The aim of this study was to investigate PR pattern during and after TAVI in multiple time points. Study included 40 consecutive patients undergoing TAVI. All patients underwent the procedure on dual antiplatelet therapy. PR was measured in 7 time points: before induction of anesthesia (T1), after heparin administration (T2), 10 minutes after initial valve implantation (T3), at the end of procedure (T4), and on 3rd, 6th, and 30th postoperative day (T5-T7). PR was measured using impedance aggregometer using 3 different platelet aggregation agonists (arachidonic acid in ASPItest, adenosine diphosphate in ADPtest and thrombin receptor activating peptide 6 in TRAPtest). All patients underwent successful TAVI procedure. Mean PR on T1 was 22.9 ± 23.0 U for ASPItest, 40.5 ± 23.7 U for ADPtest and 91.7 ± 32.5 U for TRAPtest. There was no significant difference in PR on T2. On T3, significant reduction of PR in all 3 tests was observed [ASPI 10.4 ± 11.6 U (P = 0.001), ADP 24.2 ± 14.1 U (P < 0.001) and TRAP 69.3 ± 26.6 U (P < 0.001)]. PR nadir for all tests was reached on T5, with subsequent PR incline. PR values in all tests returned to baseline levels on T7. Our results show that successful TAVI procedure induces transient decrease in PR regardless of the platelet activation pathway.

Pokrovnom kulturom u širem smislu smatra se zasijana biljna vrsta ili smjesa više biljnih vrsta koja se ne žanje, već ostaje na poljoprivrednoj površini zbog povećanja plodnosti tla, vezanja atmosferskog dušika, smanjenja erozije tla, sprječavanja ispiranja i nakupljanja nitrata, potiskivanja korova te na druge načine pridonosi uspješnom uzgoju glavne kulture. U svjetskoj bibliografiji mnogobrojni su impresivni primjeri uporabe pokrovnih kultura za potiskivanje (gušenje) korova u različitim kulturama. Kao pokrovne kulture najčešće se navode vrste iz porodice mahunarki (djeteline, inkarnatka), kupusnjača (gorušica, uljana repica, divlja rotkva i dr.) te trava (raž, ječam, zob, pšenica, ljulj i dr.). Vrlo se često sjeme navedenih vrsta koristi u smjesi. Nadalje će se navesti radovi na temu pokrovnih usjeva koji se najčešće koriste u umjerenom klimatskom pojasu., A cover crop is a sown but unharvested plant species or mixed plant species which are used to add fertility and thilt to the soil, fix atmospheric nitrogen, reduce erosion, suppress weeds, trap and recycle excess soil nitrates and provide other benefits for the commercial crops. A number of impressive examples of the use of cover crops for weed control are available in literature. The most common form of cover cropping is planting of legume, such as clover, vetch, or grains such as rye, barley, wheat, oats or mixtures of the listed plant species.

Aim: Aim of the study was to compare angiographic and clinical outcomes after percutaneous coronary interventions (PCI) using drug coated balloons (DCB) between patients treated for “de novo” lesions and in-stent restenosis (ISR) in acute coronary syndrome (ACS). Patients and Methods: Study included 128 ASC patients treated with DCB between 2012 and 2019. All coronary angiographies were reviewed to determine indication, lesion complexity, vessel size and procedural success. Baseline and follow up clinical data were extracted from hospital digital database. Results: Mean patient age was 63.8 years, with the majority being men (75.8%, N=97). In total, 24 (18.8%) patients were treated for ISR. Comparison of clinical, angiographic and procedural characteristics between groups is presented in Table 1. Patients in the non-ISR group had more often multivessel disease (56.7 vs 25.0%, p=0.005), bifurcation PCI (45.0 vs 20.8%, p=0.042) and more DCB used in the index event (1.1±0.3 vs 1.0±0, p=0.004). Furthermore, they had more concomitant PCI with stent implantation in other lesions (75.9 vs 33.3%, p

Introduction: Recent studies described changes in platelet reactivity (PR) in days following transcatheter aortic valve implantation (TAVI).1 However, precise time course and duration of these changes have not been fully investigated. Aim of the study was to investigate PR changes during and after TAVI. Patients and Methods: Study included 40 consecutive patients with severe and symptomatic aortic stenosis undergoing transfemoral TAVI procedure. Patients’ clinical characteristics were collected from medical records. All patients who did not have chronic dual antiplatelet therapy received loading dose of aspirin and clopidogrel (300 mg) one day before the procedure followed by their standard maintenance doses. PR was measured in seven time points: before start of procedure (T1), after heparin administration (T2), 10 minutes after valve implantation (T3), at the end of procedure (T4), and on 3rd, 6th and 30th postoperative day (T5-7). PR was measured using impedance aggregometer in response to three platelet aggregation agonists using ASPI, ADP and TRAP test. Results: Mean patient age was 82.7 years with majority of patients being male 60% (N=25). All patients underwent successful transfemoral TAVI procedure using either self-expandable (N=25, 62.5 %) or balloon-expandable valve. Mean postimplantation gradient was 9.97±4.44 mmHg. More than mild paravalvular regurgitation persisted in 2 (5%) patients. Values of PR in each tested time point are presented in Table 1. There was no significant difference in PR between T1 and T2. After the valve implantation significant reduction of PR in all 3 tests was observed. PR continued to decline on consecutive measurements, with lowest values reached on 3rd post-TAVI day (T5). On T6, value of ASPI test were not significantly different to the ones measured on T1, while values of ADP and TRAP test remained significantly lower. By 30th post-TAVI day PR values reached levels not significantly different compared to T1. Conclusions: Presented results indicate that transfemoral TAVI induces transient decrease in PR regardless of the platelet activation pathway. Significant reduction of PR is observed 10 minutes after valve implantation with continuous decrease until 3rd day post-TAVI after which it is gradually increasing to pre-TAVI values.

Introduction Although recent studies described changes in platelet reactivity (PR) in days following transcatheter aortic valve implantation (TAVI), precise time course and duration of these changes have not been fully investigated. Purpose To investigate PR changes during and after TAVI. Methods Study included 42 consecutive patients with severe and symptomatic aortic stenosis undergoing TAVI procedure in our institution. Patients' clinical characteristics were collected from medical records. All patients who did not have chronic dual antiplatelet therapy received loading dose of aspirin and clopidogrel (300 mg) one day before the procedure followed by their standard maintenance doses for next three months. PR was measured in six time points: just before induction of anaesthesia (T1), after heparin administration (T2), at the end of procedure (T3), and on 3rd, 6th and 30th postoperative day (T4–6). PR was measured using impedance aggregometer (Multiplate® analyzer, Roche, Munich, Germany) in response to three platelet aggregation agonists: arachidonic acid (ASPItest), ADP (ADPtest) and thrombin receptor activating peptide-6 (TRAPtest). Results Mean patient age was 82.1 years with majority of patients being male 57.1% (N=24). Mean valve area and mean transvalvular gradient prior to procedure were 0.71±0.21 cm2 and 49.1±18.7 mmHg, respectively. All patients underwent successful TAVI procedure using either self-expandable (N=25, 59.5%) or balloon-expandable valve. Two patients (4.7%) underwent transapical TAVI, while transfemoral approach was used in all other patients. Mean postimplantation gradient was 10.2±7.1 mmHg. Mean PR on T1 was 24.3±23.1 U for ASPItest, 41.6±26.5 U for ADPtest and 90.1±33.3 U for TRAPtest. There was no significant difference in PR on T2. However, on T3, ignificant reduction of PR in all 3 tests was observed (ASPI 9.4±10.1 U (p=0.001), ADP 23.1±15.0 U (p Conclusions Our results show that successful TAVI procedure induces transient decrease in PR regardless of the platelet activation pathway. These findings add new knowledge in understanding complexed relations in intravascular milieu following TAVI. Further research on a larger number of patients is needed to confirm and asses clinical significance of these results. Acknowledgement/Funding Croatian Science Foundation

Aim: To investigate prevalence of arrythmias and thromboembolic events, as well as long term outcomes among patients diagnosed and treated of non-compaction cardiomyopathy (NCC) according to current recommendations in University Hospital Centre (UHC) Zagreb. Patients and Methods: A single center retrospective study was conducted. Patients newly diagnosed with NCC in UHC Zagreb during period 2009-2018 were analyzed. The diagnosis was confirmed by both echocardiography and cardiovascular magnetic resonance. Hospital database and charts were used for clinical data, echocardiography data was obtained from digital database using EchoPac. Patients were followed-up clinically and by the means of echocardiography. Results: 32 patients (pts), 18 men (53.25 %) were included. At the time of diagnosis (baseline), mean age was 47.7±15.4 years, majority of pts (84.38% of pts, N=27) were in functional NYHA class ≥2, with mean NT-proBNP values of 3870±6619 ng/L. Echocardiography revealed reduced left ventricular systolic function; baseline ejection fraction (EF) was 27.52±11.94%. Patients were discharged with heart failure therapy: beta-blockers (30 pts, 93.75%), angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (29 pts, 90.63%), angiotensin receptor– neprilysin inhibitor (1 pts, 3.13%), mineralocorticoid receptor antagonists (28 pts, 84.38%); and 26 pts (81.25%) required symptomatic diuretic use. Cardiac resynchronization therapy with defibrillator was implanted in 11 pts (34.38%) and implantable cardioverter defibrillator (ICD) in 16 pts (50%). At baseline, 9 pts (28.13%) were already receiving anticoagulation due to previous thromboembolic events (Table 1). At discharge, 17 pts (53.13%) were anticoagulated (warfarin in 14 pts, 82.35%, novel direct oral anticoagulants in 3 pts, 17.65%). Mean follow-up period was 3.42±3.31 years. At the end of follow up period, functional improvement was observed: 21.88% (N=7) pts were in NYHA ≥2 status (p

Sivi muhar (Setaria glauca L. P. Beauv.) uskolisna je korovna vrsta koja se redovito javlja u svim okopavinskim usjevima Hrvatske. Uspješnost ove vrste ogleda se u brzu plodonošenju, velikoj produkciji i dugovječnosti sjemena. Sivi muhar kozmopolit je u područjima umjerenog pojasa s arealom rasprostranjenosti između 55° sjeverne pa sve do 45° južne geografske širine. Sposoban je prilagoditi se različitim klimatskim uvjetima, pa u toplijim klimatima razvija veći, a u hladnijim klimatima manji biološki minimum (Tb). Za područje kontinentalne Hrvatske (Šašinovec) Tb iznosi 6,6 °C, a biološki vodni potencijal (Ψb) iznosi ‐0,71 MPa. Teže podnosi vodni stres, pa se javlja u godinama i područjima s većom količinom padalina. Sivi muhar niče iz plitkog sloja tla, odnosno iz dubine 1 – 5 cm. Odgovaraju mu različiti tipovi tala s pH vrijednošću od 6,1 do 8,0. Kao korovna vrsta na poljoprivrednim površinama Setaria glauca može uspostaviti veliku gustoću po jedinici površine i time uvelike utjecati na prinos poljoprivrednih kultura. Osim direktnih šteta, i indirektno šteti jer se povećavaju troškovi čišćenja uroda, a može biti i alternativni domaćin patogena, uzročnika bolesti usjeva., Yellow foxtail (Setaria glauca L.) is a narrow‐leaved weed species that occurs regularly in all row crops in continental Croatia. The success of this species may be attributed to rapid fruiting, large production of seeds and their longevity. This species is cosmopolitan in temperate zones with an area of distribution ranging from 55 °N to 45 °S latitude. It is able to adapt to different climatic conditions, so in warmer climates it develops higher, while in colder climate lower biological minimum (Tb). For the area of continental Croatia (Šašinovec) estimated Tb is 6.6 ° C, while biological water potential (Ψb) is ‐0.71 MPa. Yellow foxtail hardly tolerates water stress which is why it occurs in years and areas with higher rainfall. This species grows from a shallow layer of soil, ie from a depth of 1 ‐ 5 cm. It grows on different soil types with a pH of 6.1 to 8.0. As a weed species on agricultural land, Setaria glauca can establish a high density per unit area and thus greatly reduce the yield of cultivated crops. In addition to direct damage, this species is also responsible for increasing cleaning costs and may be an alternative host to crop diseases.

Uljna buča (Cucurbita pepo L.) ima dugu tradiciju uzgoja u Hrvatskoj, a zbog isplativosti proizvodnje povedava se interes za njezinim uzgojem. Prinosi sjemenaka uljne buče variraju u velikom rasponu od 500 do 1200 kg suhog sjemena po hektaru, u čemu veliku ulogu ima i uspješnost suzbijanja korova. U radu je opisana botanička pripadnost, morfologija i biologija te tehnologija uzgoja uljne buče. Prikazani su najčešdi korovi i njihov utjecaj na prinos i komponente prinosa u usjevu uljne buče, kritično razdoblje zakorovljenosti te čimbenici koji na njega utječu., Oil pumpkin Cucurbita pepo L. has a long production tradition in Croatia, and because of the profitability there is a growing trend in production. Oil pumpkin seed yields vary in the range of 500 to 1200 kg of dry seed per ha, and the effectiveness of weed control has an important role. The paper describes botanical affiliation, morphology and biology, and oil pumpkin production technology. The most common weeds and their impact on oil pumpkin yield and yield components, the critical period of weed competition and the factors affecting it are shown.

Case report: 45-year-old woman was hospitalized for severe chest pain. Her medical problem began four months earlier. ECG and echocardiographic findings were normal. Stress test was stopped because of chest pain at 8 METs. At the time of two-minute chest pain, the ECG recorded intermittent left branch block (Figure 1). The 24h Holter ECG showed the frequency dependent left bundle branch block (LBBB) but no chest pain episode. MSCT coronary artery detected normal coronary arteries. Cardiac MR was suggestive to myocarditis. Troponin and inflammatory parameters during the four months of follow-up remained normal. Considering the persistence of symptoms, coronary angiography was performed showing normal epicardial arteries. During angiography, the patient experienced chest pain at the time of right coronary artery (RCA) probing, and coronary artery spasm of the proximal RCA was obvious at the time (Figure 2). After the nitroglycerin bolus application, spasm disappears (Figure 3) and chest pain released. During the coronary angiography there was no ST-segment elevation, nor intermittent LBBB. Vasospastic angina has been diagnosed. The patient was further treated with calcium antagonists and long-acting nitrates resulting in clinical improvement. Discussion: Early diagnosis of variant angina is crucial to avoid major cardiac events1. In the case of large coronary artery spasm, the ECG can show impermanent ST elevation. LBBB was observed temporarily in our patient during stress test concomitant with chest pain but not in the 24h Holter ECG recording. Coronary vasospasm and myocarditis are both recognized mimics of ST-segment elevation myocardial infarction with normal coronary arteries. The occurrence of both pathologies in the same patient has rarely been described2. Our patient had no troponin increase recorded, and no inflammatory parameters. It is important to note that the diagnostic sensitivity and specificity of the CMR for pericarditis is under 100%3. The case confirms the complexity of vasospastic angina diagnosis, and the importance of understanding the diagnostic imaging limitations.

Aim. To investigate early outcomes after balloon aortic valve valvuloplasty (BAV) performed as palliative procedure in patients with decompensated unstable end-stage aortic stenosis (AS). Patients and Methods. A retrospective observational study was conducted in University Hospital Centre Zagreb. It included all patients who underwent lifesaving BAV, and had no options for surgical or transcatheter aortic valve replacement at the time, between 2015 and 2018. Clinical and echocardiographic characteristics before and after BAV procedure were recorded. Results. Study included 29 patients, mean age 80.2 (51-92) years, 65.5% women. Mean logistic Euroscore II was 24.1±21.1% and STS score 16.9±14.5%. Comorbidities included: coronary artery disease (48.28 %), diabetes mellitus (31.4 %), chronic renal insufficiency (58.6 %), peripheral artery disease (17.2 %) and atrial fibrillation (55.2 %). All patients were dependent on parenteral diuretics and 24.14 % on parenteral inotropic support. Echocardiographic parameter before and after BAV are presented in table 1. There was significant increase in indexed aortic valve area and decrease in pulmonary artery systolic pressure in overall population. There was no significant change in severity of aortic insufficiency. Inhospital mortality was 20.1 % (N=6). Periprocedural complications included: 1 (3.4%) myocardial infarction, 1 (3.4%) major bleeding, 1 (3.4%) acute kidney injury and 2 (6.9%) vascular access complications. All other patients have been successfully weaned of parenteral therapy within 4 days and discharged. Conclusion. BAV represents palliative treatment option in critically ill hemodynamically unstable patients with end-stage AS, who are not candidates for valve replacement.1 BAV provides clinical improvement due to increase AVA and decrease in PAPs, with acceptable mortality and complications rate.

Uljna buča (Cucurbita pepo L.) ima dugu tradiciju uzgoja u Hrvatskoj, a zbog isplativosti proizvodnje povedava se interes za njezinim uzgojem. Prinosi sjemenaka uljne buče variraju u velikom rasponu od 500 do 1200 kg suhog sjemena po hektaru, u čemu veliku ulogu ima i uspješnost suzbijanja korova. U radu je opisana botanička pripadnost, morfologija i biologija te tehnologija uzgoja uljne buče. Prikazani su najčešdi korovi i njihov utjecaj na prinos i komponente prinosa u usjevu uljne buče, kritično razdoblje zakorovljenosti te čimbenici koji na njega utječu.

Introduction: Age and gender may influence the incidence of aortic regurgitation (AR) and its severity. Significant aortic regurgitation (sAR) is often treated surgically especially when symptomatic or when systolic function declines.1-3 The aim of this study was to evaluate the outcomes in patients with sAR according to treatment strategy, age and gender differences in our study population. Methods: In this retrospective descriptive single-center study an overall of 107 patients (22 female, 85 male) with significant AR in the last 5 years were analyzed. Patients were treated according to valid recommendations, surgically (SUR) or conservatively (CON), except for 5 patients who refused surgery. Baseline and follow up (FU) data (AR severity, left ventricular ejection fraction (LVEF), ascending aorta diameter (AA), treatment, comorbidities and major adverse cardiac events during FU), from documented medical history and digital imaging data were collected and analyzed. Additional sub-analysis was performed according to sex and age differences (above vs. below the age of 50). For statistical analysis a Chi-Square test was used. Results: In the overall study population, during an average FU of 3.8 years, 16 patients (15%) developed major adverse cardiac events (MACE) with no statistically significant difference between gender (p=0.846). Forty-six (43%) patients were surgically treated (87% male, 13% female) and 61 (54%) conservatively. LVEF did not worsen in FU period (54.1%, vs. 53.8%). In SUR, median age was 54 years, severe AR was present in 93%, incidence of MACE was 21.7%, 80.4% patients were symptomatic and 14.5% had dilatation of AA more than 50 mm. In CON, MACE was present in 9.8% during FU (p=0.87), median age was 64 years. Intermediate AR (48% vs 6.5%) and AA from 40-49 mm (80 vs 35%) was present more frequently as well as arterial hypertension (82 vs 70%) and chronic renal disease (23.2 vs 16.6%). The incidence of MACE was not found to be age-related (p=0.426). Conclusion: In patients with sAR treated by either surgery or medication therapy only, during 3.8 years of FU, LVEF remained unchanged, while incidence of MACE was not found to be related to treatment strategy nor gender. In surgically treated patients, as expected, AR was more severe and AA was more dilated, while neither age nor gender had an impact on the incidence of MACE.

Introduction: More than mild paravalvular regurgitation (PVR) after transcatheter aortic valve implantation (TAVI) represents one of the negative predictive factor for survival and quality of life after TAVI1. However, quantification and definition of more than mild PVR remains to be unified. Most commonly used 3 stage grading scheme is often insufficient2. Aim of this research was to assess differences in incidence of more than mild PVR during and after TAVI comparing 3 and 5 grades staging schemes. Patients and Methods: Study included 40 patients that underwent TAVI between July 2016 and January 2019 in general anesthesia with transesophageal echocardiography (TEE) during procedure. TEE exams had to be sufficiently recorded to quantify PVR with both grading schemes. Parameters used for PVR quantification and differences between models are presented in Table 1. Results: After initial valve implantation 10 (25%) patients had more than mild PVR when quantified using 3 grade model compared to 19 (47.5%) using 5 grade model (p

U jednom od svojih prvih priručnika o korovima, poznati američki znanstvenik A.S. Crafts kaže „u početku nije bilo korova“. Ovim riječima autor je htio reći da do pojave pluga korova nije ni bilo. Upravo tako, jedna definicija korova glasi: „korove je stvorio plug“. I zaista, onoga trenutka kad se je čovjek počeo organizirano baviti poljoprivredom, korovi su postali dio njegove svakidašnjice. U razdoblju između dva svjetska rata, korovi se izučavaju kao zasebna cjelina u okviru biljne proizvodnje. Početkom pedesetih godina 20. stoljeća, odnosno s pronalaskom selektivnih herbicida i istraživanjem njihovih fizikalno-kemijskih i bioloških svojstava, herbologija je službeno postala dijelom zaštite bilja. U Hrvatskoj nesumnjivo najveće zasluge za razvoj herbologije imaju profesori Josip Kovačević i Josip Kišpatić. U to vrijeme herbološka djelatnost uglavnom se odvija u ondašnjem Institutu za zaštitu bilja Poljoprivrednog fakulteta u Zagrebu. Integracijom Instituta za zaštitu bilja, Zagreb i Poljoprivrednog fakulteta Sveučilišta u Zagrebu, 1. siječnja 1978. utemeljen je OOUR Instituta za zaštitu bilja, Fakulteta poljoprivrednih znanosti u Zagrebu s nekoliko odjela među kojima i Odjel za proučavanje i suzbijanje korova. Prema tome, 1. siječnja 1978. službeno se označava kao datum nastanka današnjeg Zavoda za herbologiju.

Takotsubo cardiomyopathy (TC) is a rare complication of electroconvulsive therapy (ECT), an effective and safe treatment for severe cases of depression and psychosis. There are reports on 16 patients who developed TC after ECT, and these were predominantly female patients treated with antidepressants for depressive disorder. We describe a case of a 40-year-old male patient, with a history of schizophrenia and heavy caffeine and nicotine use, treated for acute psychotic episode with haloperidol and clozapine. Propranolol was administered because of clozapine-induced tachycardia. After 8 weeks without therapeutic response, the patient was referred for standard ECT procedure, which included premedication and bifrontotemporal stimulation. Two hours later, the patient experienced gastric pain and had increased troponin and natriuretic peptide levels and ST-elevation. After inotrope and anticoagulant treatment and replacement of antipsychotics, the patient remained stable. Contrary to common opinion, previous adrenergic blockade in this patient did not prevent TC occurrence. TC pathophysiology remains unclear although it has been related to the burst of norepinephrine neurons. Psychosis has also been associated with catecholamine dysfunction, and excessive psychological stress with long-term norepinephrine dysfunction. Animal models have shown that ECT, clozapine, and nicotine and caffeine use could considerably increase catecholamine levels. Clinical understanding of rare cardiac ECT complications could improve early recognition of patients at risk for TC and ensure safe ECT protocols.

Herbicid glifosat (N‐fosfonometil glicin) u Hrvatskoj je prvi put registriran 1978., četiri godine nakon što je kao komercijalni proizvod Round‐up uveden u SAD. Danas je u Hrvatskoj na osnovi glifosata za primjenu u različitim kulturama i za različite namjene registriran 21 pripravak. Osim u poljoprivredi, primjenjuje i za druge namjene. Prema analizi podataka Fitosanitarnog infromacijskog sustava glifosat je najprodavaniji pesticid u Hrvatskoj. U razdoblju 2012.‐2017. u Hrvatskoj je prodano 217‐300 t glifosata, što čini 12‐15 % svih pesticida ili 27‐ 37 % svih herbicida. I u svijetu je glifosat najprodavaniji pesticid. U 2014. prodano je 826 mil. tona a.t. glifosata. Procedura ponovnog odobrenja (reregistracija) glifosata traje već neobično dugo, od 2012. do 2017., a postupak još nije dovršen. Odobrenje za primjenu na razdoblje od pet godina izglasano je (putem Žalbenog odbora) 26. 11. 2017., Herbicide glyphosate (N‐phosphonomethy glicine) has been registrated in Croatia since 1978. This was four years after Monsanto introduced Round‐up for the first time in USA. Today, 21 formulated products are used for weed control in agricultural and non‐agricultural areas in Croatia. According statistical analysis (database of Phytosanitary Information System), glyphosate is the most commercially used pesticide in Croatia. The use of glyphosate in the period 2012‐2017 varied beetwen 217‐300 t which is 12‐15% of all pesticides, or 27‐37% all sold herbicides in the pesticide market. Globally, glyphosate is mostly used pesticide. Total worlwide glyphosate use in agricultural and nonagricultural areas in 2014 was 826 mil.t. The aim of this paper is to review the process of the renewal of the glyphosate active supstance which was conducted by EFSA and relevant European Research institutions in the period from 2012 to 2017.

Potencijalno negativni utjecaj pesticida na zdravlje ljudi, okoliš i bioraznolikost utjecao je na smjer znanstvenih proučavanja korova i načina njihovoga suzbijanja. Analizom radnih sekcija pojedinih simpozija European Weed Research Society (od 14. Simpozija u Hamaru, Norveška, do 18. Simpozija u Ljubljani, Slovenija) utvrđen je fokus znanstvenih istraživanja u ovim područjima: biologija i ekologija korova, interakcija kultura‐korov, nekemijske mjere suzbijanja korova, integrirano suzbijanje korova, novi pristupi, tehnologije i izazovi, rezistentnost korova, invazivne vrste i kemijsko suzbijanje korova. Mnogi radovi obuhvaćaju više od jednog područja istraživanja, odnosno objedinjuju više načina i metoda proučavanja suzbijanja korova. Sva navedena područja istraživanja imaju podjednak udio u sadržaju simpozija, upućuje na prijeku potrebu da se sva raspoloživa znanja u području poznavanja korova integriraju u sustav suzbijanja korova., Potentially negative impact of pesticides on human health, environment and biodiversity has influenced on scientific researches in weed and weed managment. Analyzing the working sections of individual EWRS Symposium (from 14th Symposium at Hamar, Norway to 18th Symposium in Ljubljana, Slovenia), the focus was placed on the following areas of scientific research: weed biology, weed ecology, culture‐weed interaction, non‐chemical weed control, integrated weed control, new approaches, technology and challenges, weed resistance, invasive species and chemical weed control. Many papers cover more than one area of research. All these areas have the same share in the symposium content, All suggests the necessity of integrating all available knowledge in the field of weed control in the weed control system.

U tehnologiji uzgoja vinove loze plijevljenje mladica na stablu redovita je mjera. Obavlja se ručno, strojno ili primjenom herbicida (desikanata) prije nego što mladice odrvene. Do 2018. odobrenje je za ovu namjenu u Hrvatskoj imao jedino herbicid glufosinat, a odnedavno samo pripravak na osnovi pelargonske kiseline. Istraživanje učinka pelargonske kiseline na mladice na stablu vinove loze obavljeno je u Kutjevu 2016. na sorti graševina pripravkom VVH 86086 koji sadrži 680 g pelargonske kiseline na L pripravka. Primijenjen je u tri koncentracije (4, 6 i 8 %) s utroškom od 25 ml škropiva po stablu. Pri ocjenjivanju učinka mladice su po duljini razvrstane u tri kategorije (< 5 cm, 6 - 15 cm i 16 - 25 cm). Zasebno je ocjenjivan herbicidni učinak na lisnu masu mladice i na stabljiku mladice. Učinak na lisnu masu mladice, neovisno o duljini mladica, bio je odličan (89 - 100 %) već kod prvog ocjenjivanja (2 dana nakon tretiranja). Osam dana nakon tretiranja lisna je masa mladice potpuno propala. Učinak je na stabljiku mladice bio slabiji od učinka na lisnu masu, što se može tumačiti slabijim kontaktom škropiva sa stabljikom jer je prekrivena lisnom masom. Stabljika mladice sušila se znatno sporije od lisne mase. Konačni je učinak 42 dana nakon tretiranja (DNT) ipak bio potpun. Regeneracija mladica ili pojava adventivnih mladica nije zamijećena. Izboj novih mladica iz pupova u neposrednoj blizini tretiranih uočen je 21 DNT. Istraživanjem je ustanovljeno da se pripravci na osnovi pelargonske kiseline mogu koristiti za desikaciju mladica na stablu vinove loze.

Over the last ten years, transradial cardiac catheterization has been increasingly applied, primarily because of its lower incidence of complications compared to the femoral approach. However, one of the greatest flaws of the transradial approach is a relatively high incidence of catheterization failure (1%-5%). Anatomic variations of radial artery are ranked second among the reasons for this. Previous studies have not provided unambiguous data on the frequency of these anomalies. It was therefore the aim of this study to determine the frequency of anatomic variations using routine angiographies of radial artery during left heart catheterization. This was a retrospective study involving examination of 602 images of routine angiographies of radial artery performed during cardiac catheterization. The frequency of anatomic variations of radial artery was 8.8%, exclusive of tortuosities with a frequency of 12.7%. The most frequent anatomic variation was the high origin of radial artery, found in 31 (5.1%) subjects. Radioulnar loops, being one of the potential contraindications for the procedure, were reported in 2% of cases. Regression analysis revealed that age (p0.001), female sex (p = 0.015) and high origin (p = 0.034) considerably contributed to the development of tortuosity. The results indicated the incidence of tortuosity to increase linearly with age. Although it is not a contraindication for continuing with the procedure, we recommend that elderly patients have angiography of radial artery performed at the beginning of the procedure due to the higher frequency of tortuosity.

Introduction: Age and gender may influence the incidence of aortic regurgitation (AR) and its severity. Significant aortic regurgitation (sAR) is often treated surgically especially when symptomatic or when systolic function declines.1 The aim of this study was to evaluate the outcomes in patients with sAR according to treatment strategy, age and gender differences in our study population. Patients and Methods: In this retrospective descriptive single-centre study an overall of 107 patients (22 female, 85 male) with significant AR in the last 5 years were analyzed. Patients were treated according to valid recommendations, surgically (SUR) or conservatively (CON), except for 5 patients who refused surgery. Baseline and follow up (FU) data (AR severity, left ventricle ejection fraction (LVEF), ascending aorta diameter (AA), treatment, comorbidities and major adverse cardiovascular events (MACE) during FU), from documented medical history and digital imaging data were collected and analysed. Additional sub-analysis was performed according to sex and age differences (above vs. below the age of 50). For statistical analysis a Chi-Square test was used. Results: In the overall study population, during an average FU of 3.8 years, 16 patients (15%) developed MACE with no statistically significant difference between gender (p=0.846). Forty-six (43%) patients were surgically treated (87% male, 13% female) and 61 (54%) conservatively. LVEF did not worsen in FU period (54.1%, vs. 53.8%). In SUR, median age was 54 years, severe AR was present in 93%, incidence of MACE was 21.7%, 80.4% patients were symptomatic and 14.5% had dilatation of AA more than 50 mm. In CON, MACE was present in 9.8% during FU (p=0.87), median age was 64 years. Moderate AR (48% vs 6.5%) and AA from 40-49 mm (80 vs 35%) was present more frequently as well as arterial hypertension (82 vs 70%) and chronic renal disease (23.2 vs 16.6%). The incidence of MACE was not found to be agerelated (p=0.426). Conclusion: In patients with sAR treated by either surgery or medication therapy only, during 3.8 years of FU, LVEF remained unchanged, while incidence of MACE was not found to be related to treatment strategy nor gender. In surgically treated patients, as expected, AR was more severe and AA was more dilated, while neither age nor gender had an impact on the incidence of MACE.

The aims of this study were to evaluate diagnostic value of endoscopic ultrasound strain ratio elastography in patients with focal pancreatic masses and to determine the cutoff value between the pancreatic malignancies and inflammatory pancreatic masses using reference areas different than those used by other investigators. In a prospective single-center study, strain ratio was measured in patients with pancreatic masses. After the diagnosis was established, statistical analysis was used to compare the group with pancreatic malignancies to the one with inflammatory masses. Strain ratio cutoff of 7.59 provided 100% sensitivity, 95% specificity, and 97% overall accuracy for differentiation of patients with pancreatic malignancies from those with inflammatory masses. Our data show high sensitivity and specificity for the calculated strain ratio. Adjacent normal pancreatic tissue is adequate as a reference area based on the inclusion criteria. Diverse cutoff values and standardization of methods in the studies published so far require further investigations, before the implementation of the method in a routine clinical practice becomes possible.

Aortalna stenoza najčešća je bolest zalistaka u zemljama zapadne hemisfere. Njezina se prevalencija povećava sa starošću populacije te iznosi 2 – 4% u osoba starijih od 65 godina. Usprkos kardiokirurškoj operaciji gotovo trećina bolesnika nije operirana zbog visokog operativnog rizika i komorbiditeta. Transkateterska implantacija aortalnog zalistka (TAVI) danas je općepriznata metoda za liječenje teške aortalne stenoze kod bolesnika čiji je kardiokirurški rizik neprihvatljivo visok ili koji su iz nekoga drugog razloga proglašeni neoperabilnima. Tom se metodom, na kucajućem srcu, s pomoću katetera postavlja umjetna biološka valvula na mjesto degenerirane nativne valvule. U KBC-u Zagreb program TAVI provodi se od 2012. godine, od kada su učinjena 44 zahvata. Svi zahvati, kao i prijeoperacijske obrade, izvođeni su prema svim vrijedećim preporukama i smjernicama Europskog i Američkoga kardiološkog društva, što je rezultiralo jednakom uspješnošću zahvata. U ovom članku istaknute su najbitnije činjenice o metodi TAVI, nakon čega su prikazani rezultati KBC-a Zagreb., Aortic stenosis is the most common valvular heart disease in western countries. Prevalence is increasing with age and is between 2–4% in population aged 65 or above. Despite cardiac surgery, almost third of patients did not undergo surgery due to too high surgical risk and comorbidities. Transcatheter aortic valve implantation (TAVI) is globally approved method for treating sever aortic stenosis in patients whose surgical risk is too high or they are declared as inoperable due to some other medical condition. Using this method, artificial biological valve is implanted, on beating heart, just using catheters at the place of degenerate native valve. In UHC Zagreb TAVI program has started in 2012, and since then, 44 procedures were performed. All procedures, together with periprocedural management were done following recent recommendations and guidelines of the European and American heart societies. This has resulted in very favorable treatment success. In this article, the most important TAVI facts have been highlighted followed by analysis of our TAVI results from the UHC Zagreb.

Primjena zemljišnih herbicida ima za cilj postizanje produljenog (rezidualnog) učinka u suzbijanju korova tijekom vegetacijske sezone. Budući da osigurava zaštitu usjeva od korova tijekom duljeg vremena, rezidualnost smatramo poželjnim svojstvom. No i pored pozitivnih učinaka, rezidualni herbicidi imaju niz nedostataka. Rezidualni herbicidi, naročito rezidue onih herbicida koji u tlu ostaju u aktivnom obliku dulje od godine dana, mogu štetno djelovati na iduće kulture u plodoredu i na taj način znatno ograničiti plodored. Koliko će se dugo neki herbicid zadržati u tlu izravno ovisi o činiteljima koji utječu na razgradnju i premještanje aktivne tvari s mjesta primjene. Među najvažnijim takvim činiteljima jesu fizikalno‐kemijska svojstva herbicida, svojstva tla (sadržaj i tip koloida tla, pH i prisutne populacije mikroorganizama) i vremenske prilike (temperatura i vlažnost). Ti činitelji, izravno ili neizravno, a najčešće u interakciji, utječu na ponašanje herbicida u tlu. Kad postoji sumnja da bi rezidue nekog herbicida mogle oštetiti iduću kulturu u plodoredu, dva su načina s pomoću kojih se može predvidjeti ta opasnost: kemijskom analizom uzoraka tla ili metodom biotesta. Kvantitativna analiza uglavnom se provodi kemijskim metodama, a biološko testiranje provodi se mjerenjem biološkog odgovora biljke na prisutnost herbicida. Glavne prednosti biotesta nad skupim kemijskim analizama jesu jednostavnost izvođenja, reproduktivost i niska cijena. Osim toga, primjenom biotesta dobiva se pouzdan odgovor o ostatcima herbicida koji su određenoj biljci dostupni te odgovor da li ti ostatci izazivaju fitotoksičnost., The use of soil‐applied herbicides aims to provide prolonged (residual) weed control during the vegetation season. Despite positive sides, residual herbicides have also negative effect, especially those that stay active in soil longer than one year. That kind of residual herbicides can be quite damaging for the next crop in the crop rotation. Time of decay of these herbicides in soil depends on its numerous biotic and abiotic factors that influences degradation and movement of active substances from the applied zone. Among the most important factors are physical and chemical properties of herbicides, properties of soil (content and the type of soil colloids, pH and present population of microorganism) and weather conditions (temperature and humidity). Those factors have direct or indirect affect on the herbicides, but mostly they are in interaction. If there is a suspicion that residue of some herbicides could damage next crop in the crop rotation, there are two ways to predict that danger, chemical analysis and bioassay method. Quantitative analysis includes chemical methods while bioassay presents measuring of biological response of plants on used/applied herbicides. Main advantages of bioassay are simplicity of use, reproducibility and low price. Besides that, the use of bioassay gives us reliable answer about herbicide residues that are available to the certain plant and if they could to cause phototoxicity.