IntroductionData on management of atrial fibrillation (AF) in the Balkan Region are scarce. To capture the patterns in AF management in contemporary clinical practice in the Balkan countries a prospective survey was conducted between December 2014 and February 2015, and we report results pertinent to the use of non-vitamin K antagonist oral anticoagulants (NOACs).MethodsA 14-week prospective, multicenter survey of consecutive AF patients seen by cardiologists or internal medicine specialists was conducted in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Montenegro, Romania, and Serbia (a total of about 50 million inhabitants).ResultsOf 2712 enrolled patients, 2663 (98.2%) had complete data relevant to oral anticoagulant (OAC) use (mean age 69.1 ± 10.9 years, female 44.6%). Overall, OAC was used in 1960 patients (73.6%) of whom 338 (17.2%) received NOACs. Malignancy [odds ratio (OR), 95% confidence interval (CI) 2.06, 1.20–3.56], rhythm control (OR 1.64, 1.25–2.16), and treatment by cardiologists were independent predictors of NOAC use (OR 2.32, 1.51–3.54) [all p < 0.01)], whilst heart failure and valvular disease were negatively associated with NOAC use (both p < 0.01). Individual stroke and bleeding risk were not significantly associated with NOAC use on multivariate analysis.ConclusionsNOACs are increasingly used in AF patients in the Balkan Region, but NOAC use is predominantly guided by factors other than evidence-based decision-making (e.g., drug availability on the market or reimbursement policy). Efforts are needed to establish an evidence-based approach to OAC selection and to facilitate the optimal use of OAC, thus improving the outcomes in AF patients in this large region.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-017-0589-5) contains supplementary material, which is available to authorized users.

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Introduction: The most common cause of myocardial ischemia is atherosclerotic epicardial coronary artery disease, present in 90% of patients. Risk factors positively correlate with the onset, development and subsequent complications of atherosclerotic disease. Aim: Determine the percentage frequency of classic risk factors for coronary disease in patients with non-ST segment elevation myocardial infarction (NSTEMI), with regard to gender. Methods: A retrospective study was conducted on 600 respondents, treated for NSTEMI at the Clinic for Internal Medicine of the University Clinical Center (UKC) Tuzla, in the period from June 2016 to December 2019. Results: Overall, smoking was the leading risk factor (65%), followed by hypertension (58%), hyperlipoproteinemia (39%), overweight (33%), positive family burden (30%) and diabetes mellitus (19%). In male patients, the leading risk factor was smoking, rating at 74%, while in female patients -it was hypertension at 67%. In younger groups of patients leading risk factors were smoking and a positive family burden. Conclusion: With adequate prevention and treatment measures, a significant reduction in the prevalence of the cardiovascular disease can be achieved, since the risk factors for its development have long been known. Quitting smoking is one of the most effective secondary prevention measure since it reduces the reinfarction risk rate by 50%. Knowledge of coronary risks, as well as success in reducing them, can greatly contribute to patients' overall sense of contentment and significantly raise their self-confidence.

Objective - To assess 25(OH)D status in children with Multisystem Inflammatory Syndrome (MIS-C) associated with SARSCoV-2 infection, and the association between serum levels of 25(OH)D and inflammatory marker values.Patients and methods - This retrospective study was conducted at the Clinic for Children’s Diseases, University Clinical Center, Tuzla in the period from November 2020 to November 2021.Results - The study included 23 children with MIS-C with a median age of 6.9 years, and 22 children with acute SARS-CoV-2 infection, with a median age of 1.1 years. Both groups of children had low serum levels of 25(OH)D in the range of deficiency; median levels of 25(OH)D in MIS-C children were lower (median 44.60 nmol/L) than in children with acute SARS-CoV-2 infection - median 52.45 nmol/L. There was no statistically significant difference in 25(OH) D levels between the two groups of children included in the study (P=0.33). The same number of children in both groups had adequate serum levels of 25(OH)D. The children in both groups had elevated markers of inflammation, but we did not find a significant correlation between the values of 25(OH)D and the inflammatory marker values.Conclusion - Deficiency of 25(OH) D could be one of the precipitating factors that lead to the development of both MIS-C - related SARS-CoV-2 and more severe forms of acute infection. 25(OH)D enriched food, as well as supplementation with 25(OH)D, should be considered a long-term strategy in all high-risk children and adolescents.

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