INTRODUCTION Large population-based observational trials have shown atrial fibrillation (AF) to be an independent risk factor for increased mortality. OBJECTIVE To examine all-cause mortality and cardiovascular mortality of patients with AF compared to corresponding mortality in general population of Serbia. METHODS This longitudinal observational study included patients with nonvalvular AF as the main indication for in-hospital and/or outpatient treatment at the Clinical Centre of Serbia, Belgrade, during the period 1992-2007, if the latest date of the first diagnosed AF was early January 2003, so that the total follow-up could last at least 5 years (minimum 1 year prospectively), or until death. Patients with acute causes of AF, advanced left ventricular systolic dysfunction (LVEF < or = 25%), preexcitation, known malignancy or any advanced chronic disease and patients with poorly documented history of previous AF were not included. To compare mortality of study population with mortality of general population, we used standardized mortality ratio (SMR) and chi-square test, p < 0.05. RESULTS Out of 1100 patients (389 females, 35.4%), aged 52.7 +/- 12.2 years, with total follow-up 9.94 +/- 6.05 years (prospective 5.75 +/- 4.28, retrospective 4.21 +/- 5.51), 40% had no underlying disease; others most frequently had arterial hypertension. AF was paroxysmal in 665 (60.5%), persistent in 225 (20.5%) and permanent in 210 patients (19.1%). Newly diagnosed AF was documented in 1058 patients (96.2%). Until the end of the study, 85 patients died (7.7%). Cardiovascular death was noted in 62 patients (72.9%), most frequently in form of sudden death (27/85, 31.7%), death from congestive heart failure (18/85, 21.2%) and stroke (14/85, 16.5%). Most patients (67/85, 78.8%) had AF at the time of death. SMR for all-cause mortality was 2.43 (p < 0.0001) and for cardiovascular mortality 3.03 (p < 0.0001). CONCLUSION All-cause mortality and cardiovascular mortality of AF patients are higher than corresponding mortality in general population of Serbia, despite active treatment.

INTRODUCTION Acute heart failure (AHF) is one of the most common diseases in emergency medicine, associated with poor prognosis and high in-hospital and long-term mortality. OBJECTIVE To investigate clinical presentation of patients with de novo AHF and acute worsening of chronic heart failure (CHF) and to identify differences in blood levels of biomarkers and echocardiography findings. METHODS This prospective study comprised 64 consecutive patients being grouped according to the onset of the disease into patients with the de novo AHF (45.3%), and patients with acute worsening of CHF (54.7%). RESULTS Acute congestion (60%) was the most common manifestation of de novo AHF, whereas pulmonary oedema (43.1%) was the most common manifestation of acutely decompensated CHF. Patients with acutely decompensated CHF had significantly higher blood values of creatinine (147.10 vs 113.16 micromol/l; p < 0.05), urea (12.63 vs. 7.82 mmol/l; p < 0.05), BNP (1440.11 vs. 712.24 pg/ml; p < 001) and NTproBNP (9097.00 vs. 2827.70 pg/ml; p < 0.01) on admission, and lower values of M-mode left ventricular ejection fraction (LVEF) during hospitalization (49.44% vs. 42.94%; p < 0.05). The follow-up after one year revealed still significantly higher BNP (365.49 vs. 164.02 pg/ml; p < 0.05) and lower average values of both LVEF in patients with acutely worsened CHF (46.62% vs. 54.41% and 39.52% vs. 47.88%; p < 0.05). CONCLUSION Considering differences in clinical severity on admission, echocardiography and natriuretic peptide values during hospitalization and after one year follow-up, de novo AHF and acutely worsened CHF are two different subgroups of the same syndrome.

BackgroundStride interval persistence, a term used to describe the correlation structure of stride interval time series, is thought to provide insight into neuromotor control, though its exact clinical meaning has not yet been realized. Since human locomotion is shaped by energy efficient movements, it has been hypothesized that stride interval dynamics and energy expenditure may be inherently tied, both having demonstrated similar sensitivities to age, disease, and pace-constrained walking.FindingsThis study tested for correlations between stride interval persistence and measures of energy expenditure including mass-specific gross oxygen consumption per minute (), mass-specific gross oxygen cost per meter (VO2) and heart rate (HR). Metabolic and stride interval data were collected from 30 asymptomatic children who completed one 10-minute walking trial under each of the following conditions: (i) overground walking, (ii) hands-free treadmill walking, and (iii) handrail-supported treadmill walking. Stride interval persistence was not significantly correlated with (p > 0.32), VO2 (p > 0.18) or HR (p > 0.56).ConclusionsNo simple linear dependence exists between stride interval persistence and measures of gross energy expenditure in asymptomatic children when walking overground and on a treadmill.

This research aimed to evaluate the sassafras (Ocotea odorifera) and eucalyptus (Eucalyptus viminalis) essential oils on the control of larvae and adults of lesser mealworm (Alphitobius diaperinus), comparing their insecticide potential. The essential oils were produced through water vapor extraction in a semi industrial scale. Contaminated paper filter technique was applied to evaluate the insect mortality. In the current experiment twelve concentrations were included for evaluation and among them one control (solvent) in order to settle the mortality rate and LC50 of the two tested essential oils. The larvae were more susceptible then the adults to sassafras essential oil exposure and less susceptible than the adults, when exposed to eucalypt essential oil. Larvae as well as adults of A. diaperinus were more susceptible to the sassafras (LC50 adults 0.26mL l-1 and larvae 0.12mL l-1) than the eucalyptus essential oil (LC50 adults 1.37mL l-1 and larvae 1.72mL l-1), by contact intoxication (Ocotea odorifera: Larvae y=3,3916+1,4699logx; Adult y=0,9486+2,8576logx; e Eucaliptus viminalis: Larvae y=1,3643+1,6254logx; Adult y=1,4487+1,6623logx). It is concluded that the essential oils of sassafras and eucalyptus can be used to control lesser mealworm and used as a new integrated strategy for management of this pest.

BackgroundElectrodermal reactions (EDRs) can be attributed to many origins, including spontaneous fluctuations of electrodermal activity (EDA) and stimuli such as deep inspirations, voluntary mental activity and startling events. In fields that use EDA as a measure of psychophysiological state, the fact that EDRs may be elicited from many different stimuli is often ignored. This study attempts to classify observed EDRs as voluntary (i.e., generated from intentional respiratory or mental activity) or involuntary (i.e., generated from startling events or spontaneous electrodermal fluctuations).MethodsEight able-bodied participants were subjected to conditions that would cause a change in EDA: music imagery, startling noises, and deep inspirations. A user-centered cardiorespiratory classifier consisting of 1) an EDR detector, 2) a respiratory filter and 3) a cardiorespiratory filter was developed to automatically detect a participant's EDRs and to classify the origin of their stimulation as voluntary or involuntary.ResultsDetected EDRs were classified with a positive predictive value of 78%, a negative predictive value of 81% and an overall accuracy of 78%. Without the classifier, EDRs could only be correctly attributed as voluntary or involuntary with an accuracy of 50%.ConclusionsThe proposed classifier may enable investigators to form more accurate interpretations of electrodermal activity as a measure of an individual's psychophysiological state.

A combined test performed at the 12th week of gestation enables us to classify the pregnancy as high risk (risk higher than 1:300) or low risk (risk lower than 1:300) for congenital foetal anomalies, with great accuracy of 85 - 90%. According to the available data, the frequency of false positive results is estimated at around 5%. The objective of the study was to examine possible correlation between the serum marker values and amniocentesis results in prenatal diagnostics of congenital foetal anomalies. The study included 745 pregnant women monitored by the Genetic Counselling Service of the Clinic of Gynaecology and Obstetrics of the Clinics Centre Kragujevac. The subjects were included in the study under condition that CRL (embryonic crown-rump length) was from 45 to 84 mm and that the gestational age was at 11-13+6 weeks. Free beta HCG and PAPP-A were determined from venous blood using commercial DPS-USA tests. Tests were based on the analytic principle of the immuno-chemiluminescence technique and were performed by application of the automatic Immulite 2000 analyzer by DPC-USA. The foetal nuchal translucency thickness (NT) and CRL were measured by Colour Doppler. The chromosome identification was performed after a certain number of cell divisions by stopping the cell division in metaphase of mitosis when the chromosomes were the most distinguishable. The foetal karyotype was prepared using G bands. In the total sample of pregnant women (n=745), there were six cases of pathological foetal karyotype. A statistical paradox in the frequency of congenital foetal anomalies in favour of younger population was noticed. A high coefficient of Spearman's rank correlation suggests great importance of the combined test in the detection of congenital foetal anomalies (p<0,05). A high consistency was also proved for components of biochemical screening and ultrasonographic markers. The combined test, as a method of prenatal screening in the first trimester of pregnancy, if used at 11 - 13+6 weeks' gestation and for CRL of 45-84 mm, has a great importance in the detection of congenital foetal anomalies.

We have evaluated objectively pain tolerance in transrectal ultrasound-guided prostate biopsy (TRUS) using local periprostatic per rectal anesthesia as compared to the conventional method. From November 2008 to May 2009, 90 patients underwent transrectal ultrasound-guided prostate biopsy at Department of Urology, Clinical Center University Sarajevo. 90 patients who fulfilled the inclusion criteria were randomized into 3 groups of 30 patients each. Group 1 received periprostatic local anesthesia with 2% lidocaine, group 2 received Voltaren supp placed in rectum an hour before biopsy while group 3 received no local anesthesia. Pain scale responses were analyzed for each aspect of the biopsy procedure with a visual analog scale of 0-none to 10-maximal. There was no difference between the 3 groups in pain scores during digital rectal examination, intrarectal injection and probe insertion. The mean pain scores during needle insertion in group 1 receiving periprostatic nerve block and in group 2 receiving Voltaren supp were 3,10 +/- 2,32 and 5,15 +/- 2,01 respectively. In group 3 (no local anesthesia), mean pain scores were 6,06 +/- 2,95 which was found to be significantly different (p < 0,001). However, morbidity after the biopsy was not statistically different between all 3 groups. TRUS-guided prostate biopsy is a traumatic and painful experience, but the periprostatic blockage use is clearly associated with more tolerance and patient comfort during the exam. It is an easy, safe, acceptable and reproducible technique and should be considered for all patients undergoing TRUS biopsy regardless of age or number of biopsies.