Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS), characterized by neurodegeneration, axonal damage, demyelination, and inflammation. Recently, gut dysbiosis has been linked to MS and other autoimmune conditions. Namely, gut microbiota has a vital role in regulating immune function by influencing immune cell development, cytokine production, and intestinal barrier integrity. While balanced microbiota fosters immune tolerance, dysbiosis disrupts immune regulation, damages intestinal permeability, and heightens the risk of autoimmune diseases. The critical factor in shaping the gut microbiota and modulating immune response is diet. Research shows that high-fat diets rich in saturated fats are associated with disease progression. Conversely, diets rich in fruits, yogurt, and legumes may lower the risk of MS onset and progression. Specific dietary interventions, such as the Mediterranean diet (MD) and ketogenic diet, have shown potential to reduce inflammation, support neuroprotection, and promote CNS repair. Probiotics, by restoring microbial balance, may also help mitigate immune dysfunction noted in MS. Personalized dietary strategies targeting the gut microbiota hold promise for managing MS by modulating immune responses and slowing disease progression. Optimizing nutrient intake and adopting anti-inflammatory diets could improve disease control and quality of life. Understanding gut-immune interactions is essential for developing tailored nutritional therapies for MS patients.

Aim To examine safety and efficiency of electrocardioversion (EC) in elective treatment of atrial fibrillation and atrial flutter in the setting of Day Hospital by determining success rate, frequency of adverse events and possible cost benefit compared to admitting a patient into hospital. Methods This prospective observational cohort study was performed in Day Hospital and in Intensive Care Department of Internal Medicine Clinic, University Clinical Centre Tuzla from January 2019 to December 2022 and included 98 patients with a persistent form of atrial fibrillation (AF) or atrial flutter. The patients who were divided in two groups, 56 hospitalized and 42 patients accessed in Day Hospital. In all patients, medical history, physical examination, electrocardiogram (ECG) and transthoracic echocardiogram (TTE) evaluation was performed in addition to laboratory findings. Electrocardioversion was performed with a monophasic General Electric defibrillator in anterolateral electrode position with up to three repetitive shocks. Results In hospital setting group overall succes rate of electrocardioversion was 85%, with average 2.1 EC attemps, there was with one fatal outcome due to stroke, one case of ventricular fibrillation (VF) due to human error, and 6 minor adverse events; with average cost of was 1408.70 KM (720.23 €) per patient. In Day Hospital setting succes rate was 88%, with average 2 EC attempts, no major adverse events, 8 minor adverse events; and average cost was of 127.23 KM (65.05 €) per patient. Conclusion Performing elective electrocardioversion in Day Hospital setting is as safe as admitting patients into hospital but substantially more cost effective.

2Univerzitet of Tuzla, School of Medicine, Tuzla, Bosnia and Herzegovina KeYWORdS: myocardial infarction, exercise training, cardiovascular rehabilitation. citAtiON: Cardiol Croat. 2018;13(11-12):416. | https://doi.org/10.15836/ccar2018.416 *AddReSS fOR cORReSpONdeNce: Emir Bećirović, JZU Univerzitetski klinički centar Tuzla, Klinika za interne bolesti, Prof. dr Ibre Pasica, 75 000 Tuzla, Bosnia i Herzegovina. / Phone: +387-61-876-152 / E-mail: becirovic.emir@live.com ORcid: Emir Becirovic, https://orcid.org/0000-0002-4134-987X • Ammar Brkic, https://orcid.org/0000-0002-5436-3670 Esad Brkic, https://orcid.org/0000-0002-7784-328X • Tarik Brkic, https://orcid.org/0000-0003-2054-2571 Ermina Mujanovic, https://orcid.org/0000-0001-8154-586X • Amir Becirovic, https://orcid.org/0000-0002-7012-8064 Semir Hadzic, https://orcid.org/0000-0002-3308-8331 • Amila Jasarevic, https://orcid.org/0000-0003-4861-6683 Majda Skokic, https://orcid.org/0000-0001-5913-1863 • Esref Becirovic, https://orcid.org/0000-0003-3759-7878