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Introduction: Hospitalizations of patients with atrial fibrillation (AF) lead to an explosion of expenditure on the public health system or private health expenses in family budgets. This study aims to estimate the duration and the cost of hospitalization for the public health system or the private cost to patients hospitalized after an AF episode. Material and Methods: Two hundred thirty-five consecutive patients (141 men and 94 women with an average age of 71.91 ± 12.2 years) who presented with AF to the Emergency Department of the General Hospital of Veroia during a single year were studied. We assessed the possible causes of arrhythmia, the duration and outcome of hospitalization, and the cost of hospitalization. We estimated the total cost by adding the price of the drugs used to cardiovert and the money spent on the patient's hospitalization. Results: The average hospitalization time was 2.37 ± 1.17 days, and the average cost of hospitalization (total cost) was 488.22 ± 170.34. There was a significant correlation between the severity of the episode and the total cost (r =0.78, p<0.0001), with 87.6 % of the total cost ( 427.76 ± 135.86) being related to the cost of hospitalization (imaging, laboratory, hospitalization) and the rest to the drug therapy cost. Amiodarone (97 patients, 41.1 %), flecainide (52 patients, 22 %), propafenone (68 patients, 28.8 %), vernakalant (two patients, 0.8 %), and quinidine (eight patients, 3.4 %) were utilized. Conclusion: The average cost of hospital care in patients with AF is significantly related to the severity of the episode. Effective drug therapy to reduce AF-provoking factors, such as antihypertensive therapy, combined with cardiovascular disease prevention in general, could reduce the morbidity and costs of AF-related hospitalizations. HIPPOKRATIA 2023, 27 (1):18-21.
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AIM: Beta-thalassaemia major (TM) affects oxygen flow and utilization and reduces patients' exercise capacity. The aim of this study was to assess phase I and phase II oxygen kinetics during submaximal exercise test in thalassaemics and make possible considerations about the pathophysiology of the energy-producing mechanisms and their expected exercise limitation. METHODS: Twelve TM patients with no clinical evidence of cardiac or respiratory disease and 10 healthy subjects performed incremental, symptom-limited cardiopulmonary exercise testing (CPET) and submaximal, constant workload CPET. Oxygen uptake (VO2), carbon dioxide output and ventilation were measured breath-by-breath. RESULTS: Peak VO2 was reduced in TM patients (22.3 +/- 7.4 vs. 28.8 +/- 4.8 mL kg(-1) min(-1), P < 0.05) as was anaerobic threshold (13.1 +/- 2.7 vs. 17.4 +/- 2.6 mL kg(-1) min(-1), P = 0.002). There was no difference in oxygen cost of work at peak exercise (11.7 +/- 1.9 vs. 12.6 +/- 1.9 mL min(-1) W(-1) for patients and controls respectively, P = ns). Phase I duration was similar in TM patients and controls (24.6 +/- 7.3 vs. 23.3 +/- 6.6 s respectively, P = ns) whereas phase II time constant in patients was significantly prolonged (42.8 +/- 12.0 vs. 32.0 +/- 9.8 s, P < 0.05). CONCLUSION: TM patients present prolonged phase II on-transient oxygen kinetics during submaximal, constant workload exercise, compared with healthy controls, possibly suggesting a slower rate of high energy phosphate production and utilization and reduced oxidative capacity of myocytes; the latter could also account for their significantly limited exercise tolerance.