This paper presents the results of quantitative research to survey ecological awareness among pupils in terms of three interlinked components: knowledge, attitudes and behavior. The survey participants were 529 secondary school pupils from the city of Zagreb, and the instrument used was a survey questionnaire. The analysis of the results shows that Zagreb secondary school pupils are environmentally aware to some extent but that there is room for improvement in regard to their familiarity with certain concepts in the area of ecology and changing behavior related to environmental protection. The survey identified statistically significant differences in pro-environmental behavior among respondents based on gender and class year in a number of situations. The results indicate the need to continually work on raising awareness of ecological issues and environmental protection, especially in terms of familiarising pupils with fundamental ecological concepts and pro-environmental behavior.
Background: Brugada syndrome (BS) is a disorder characterized by syncope or sudden death associated with one of several electrocardiographic (ECG) patterns characterized by incomplete right bundle branch block and ST elevation in the anterior precordial leads. Patients with BS are prone to develop ventricular tachyarrhythmias that may lead to syncope, cardiac arrest, or sudden cardiac death. Case report. A 58-year-old woman is the first described case of Brugada syndrome in Serbia with intermittent typical changes in basic electrocardiography (ECG): ST segment elevation in the precordial chest leads like dome or coved - major form or type I. For the last 27 years the patient had suffered of palpitations and dizziness, without syncopal events. Her sister had died suddenly during the night in sleep. During 24-hour Holter monitoring the patient had ventricular premature beats during the night with R/T phenomenon and during the recovery phase of exercise testing had rare premature ventricular beats as the consequence of parasympatethic stimulation. Late potentials were positive. Echocardiography revealed left ventricular ejection fraction of 60%. We performed coronary angiography and epicardial coronary arteries were without significant stenosis and structural heart disease was excluded. In the bigining of the electrophysiological study ECG was normal, and after administration of Propaphenon i.v. Brugada syndrome unmasked with appearance of type I ECG pattern. A programed ventricular stimulation induced non sustained ventricular tachycardia. One-chamber implantable cardioverter defibrillator was implanted and the patient was treated with a combination od amiodarone and metoprolol per os. After one-year follow-up, there were no episodes of ventricular tachycardia and ventricular fibrillation. Conclusion. Brugada syndrome is a myocardial disorder which prognosis and therapy are related to presence of ventricular fibrillation or ventricular tachycardia. Electrophysiologicaly induced malignant ventricular disorders class I are indication for implantation of cardioverter defibrilator, as also occurred in presented patient.
Atrioventricular Re‐entry Tachycardia (AVRT) occurs in patients with accessory pathways (AP) via a re‐entry circuit between the AV node and the AP. Anterograde conduction through the AP causes antidromic AVRT with wide QRS complexes, which may mimic ventricular tachycardia (VT). We report a 59‐year‐old male with ischemic cardiomyopathy (EF 35%) and recurrent wide QRS tachycardia who was referred for ICD implantation. Electrophysiology study identified a left posterolateral AP, and radiofrequency ablation successfully eliminated pre‐excitation. ICD implantation was subsequently performed without complications. Antidromic AVRT should be considered in the differential diagnosis of wide QRS tachycardia, and catheter ablation remains a safe and effective treatment.
Background/Aim. Numerous trials have shown a high success of radiofrequency ablation (RFA) in the treatment of the patients with cardiac arrhythmias. We aimed to examine the RFA initial success in treatment of different cardiac arrhythmias and the RFA success after 6 months of followup. Second aim was to evaluate influence of all clinical and echocardiography parameters on initial and 6-month success and failure of RFA. Methods. The present study included 320 consecutive patients with atrial and ventricular arrhythmias in which RFA was performed during 2014 in the Institute for Cardiovascular Diseases ?Dedinje?, Belgrade, Serbia. We evaluated the initial RFA success and success of this procedure after 6-month follow-up. We also investigated the prognostic role of clinical and echocardiography parameters on initial and 6-month success and failure of RFA. Results. The RFA initial success for RFA of atrioventriculas (AV) node and AV nodal reentrant tachycardia (AVNRT) was 100%, RFA of pulmonary veins 99%, RFA of atrial flutter 92%, RFA of premature ventricular complexes (PVC) and the Wolf-Parkinson-White (WPW) syndrome 87%, RFA of ventricular tachycardia 85% and RFA of atrial tachycardia 78%. The success of RFA after 6 months of follow-up for RFA of the AV node was 100%, RFA of AVNRT 94%, RFA of atrial flutter 90%, RFA of WPW syndrome 86%, RFA of pulmonary veins 79% (paroxysmal atrial fibrillation 88% and persistent atrial fibrillation 63% with a significant difference p < 0.05), RFA of PVC 78%, RFA of ventricular tachycardia 77% and RFA of atrial tachycardia 67%. Conclusion. This study proved a very high RFA initial success in treatment of cardiac arrhythmias and a satisfactory RFA success after 6 months of follow-up. Only the prognostic value had the type of atrial fibrillation in the group with catheter ablated pulmonary veins: after 6-month follow-up, the patients with paroxysmal atrial fibrillation had a significantly better outcome than those with persistent form.
This study introduces the pulmonary vein isolation outcome degree (PVIOD) as a new semiquantitative measure for the efficacy of atrial fibrillation (AF) catheter ablation and reports the determination of predictors associated with PVIOD. The median follow-up periods of 117 patients after the first and last ablation were, respectively, 82 (IQR 15) and 72 (IQR 30) months. PVIOD 1 included 32.5% of patients, those with successful single pulmonary vein isolation (PVI); PVIOD 2 included 29.1% of subjects, those with success after multiple procedures; PVIOD 3 comprised 14.5% of patients, those with clinical success; and PVIOD 4 included 23.9% of cases, those with procedural and clinical failure. In the multivariate ordinal logistic regression analysis, PVIOD 1–4 were independently associated with longstanding persistent AF with paroxysmal AF as the referent category (odds ratio (OR), 3.5; 95% confidence interval (95% CI), 1.1–10.7 (p = 0.031)), left atrial (LA) diameter (OR, 1.2; 95% CI, 1.1–1.3 (p = 0.001)) and left ventricular ejection fraction (LVEF) (OR, 0.9; 95% CI, 0.86–1.0 (p = 0.038)). LA size > 41 mm, LVEF ≤ 50% and longstanding persistent AF are strong predictors of AF recurrence. PVIOD 1–4 offer the most exact long-term prognosis of PVI. The purpose of the present article is to expand the quantitative measure of procedural success in the medical and biological fields.
U radu su predstavljeni rezultati kvantitativnog istraživanja kojemu je cilj bio ispitati ekološku osviještenost učenika u njezinim trima međusobno isprepletenim komponentama: znanje, stavovi i ponašanja. U istraživanju je sudjelovalo 529 učenika srednjih škola u gradu Zagrebu, a kao instrument je korišten anketni upitnik. Analiza rezultata pokazala je da su zagrebački srednjoškolci u određenoj mjeri ekološki osviješteni, no da ima prostora za napredak kad je riječ o njihovoj upoznatosti s određenim pojmovima u području ekologije te promjeni ponašanja povezanog sa zaštitom i očuvanjem okoliša. U ispitivanju razlika u ponašanju i praksama učenika prema spolu i pripadnosti razredu utvrđena je statistički značajna razlika u nekoliko situacija. Rezultati pokazuju da je potrebno i dalje kontinuirano raditi na osvještavanju ekoloških problema i zaštite okoliša, pogotovo u domeni upoznatosti učenika s temeljnim ekološkim pojmovima i proekološkim ponašanjem.