Introduction/Objective Pneumothorax is one of the most common complications of cardiac rhythm management (CRM) devices implantation. We aimed to assess the incidence of pneumothorax after implantation of these devices and to determine risk factors for this complication. Methods A retrospective, observational study included patients in whom CRM devices were implanted, pacing system was upgraded, or lead revision was performed during 2012 at the Pacemaker Center, Clinical Center of Serbia. We determined the connection between different variables, including sex, age, type of implanted device, prior history of chronic obstructive pulmonary disease, operator experience, venous access, the use of intravenous contrast during procedure, and the development of pneumothorax as the procedure-related complication, using multiple logistic regression. Results A total of 999 patients were included in this study. The patients’ mean age was 68.1 ± 9.2 years; 665 (66.6%) patients were male. The incidence of pneumothorax was 1.8% and an invasive treatment of this complication was required in 13 (72.2%) patients. Pneumothorax was more frequent in women (B = -2.136, p = 0.015), in patients with age > 75 years (B = 4.315, p = 0.001), venous access with subclavian vein puncture (B = 2.672, p = 0.045), and use of intravenous contrast during procedure (B = 3.155, p = 0.007). Conclusion Pneumothorax is a relatively rare complication of CRM device implantation, and for reducing its incidence, cephalic vein cut-down should be preferred to subclavian or axillary vein puncture as venous access, axillary vein puncture should not be avoided when cephalic vein cannot be found or used, and in the case of difficult vein puncture, contrast venography should be done immediately, before risky punctures.

Introduction/Objective: The efficacy and safety of bevacizumab (BEV) in combination with capecitabin and irinotecan in first-line therapy of patients with metastatic colorectal cancer (mCRC) were studied. In order to improve safety and efficacy of chemotherapy, as well as to reduce adverse reactions to a minimum, doses of active agents applied were changed in relation to previously employed schedules. Methods: Patients with histologically documented mCRC who have not previously received chemotherapy or had received adjuvant or neoadjuvant chemotherapy, which ended 6 months before capecitabin treatment (1000 mg/m2 per os from 2nd to 8th day of each cycle), irinotecan (175 mg/m2 every 2 weeks), plus bevacizumab (5 mg/kg i.v. every 2 weeks) were observed. Results: The study, conducted as a prospective one included 35 patients of both sexes. Overall response rate (ORR) of 28.6%, partial response (PR) of 28.6%, progressive disease (PD) of 28.6% and stable disease (SD) of 42.8% were found. Progression-free survival (PFS) of the patients analyzed was 11.3 months (95% CL: 9.1 - 12.9) while overall survival (OS) of the patients included was 25.2 months (95% CL: 17.4 - 28.4 months) and 117 adverse effects were recorded in 24 patients. Alopecia, nausea and vomiting, hemorrhage, hand-foot syndrome, diarrhea, abdominal pain, proteinuria, and hypertension (51.4%, 37.1%, 37.1%, 25.7%, 22.8%, 20.0%, 20.0% and 17.1%, respectively) were most frequently observed adverse effects. Conclusion(s): The results of this clinical trial support and recommend the use of bevacizumab plus capecitabin and irinotecan in the doses and schedule applied throughout this study as first-line treatment of mCRC patients.