1. Germs, ironically nicknamed “bugs” continue to be our concern, for they are a real threat. But when it comes for “bad bugs”, what are we going to do?
   Adrian Man et al studied the etiology of bacteriemic syndromes and bacterial susceptibility of blood culture isolates in a Romanian county hospital, namely, the County Emergency Clinical hospital of Tîrgu Mureș, Romania. They analyzed for three years all the blood cuture isolates [1].
   For any speciality besides microbiology, the process of understanding the general picture of microbiological results is painful. Denominations change, fresh insights into the bugs’ metabolism are paramount, bacteria seem to be more inteligent than predicted. Thus a whole arsenal has to be used to defeat bugs, strategies were developed, even the media and the patients are very sensitive to “killer bugs”.
   The workload to come up in time with reliable results seems to be considerable. Useful results mean for me: a result you can trust discriminating contamination from infection and information received within short time (better in less then 6 hours from admission). This could make a difference in outcome.
   When looking at the reported results, we learn that:
   1.The rate of blood culture positivity is 8%, which is quite low compared to other reports [1].
   2.For blood cultures, discrimination between contamination and etiological involvement is “still a problem” [1].
   For the severe septic patient, lack of reliable results as decribed is a real challenge. While contamination needs not to be treated with antibiotics, infection on the contary, requires target oriented medication. Only that the target is blurred. One can see it in 8% of the blood cultures, and less than this figure has an evidence-based suppport. Thus roughly >90% of the septic patients are exposed to empiric antimicrobials based on suspicions or on previously described local epidemiologic patterns.
   At the end of the day we can get a delayed bacterial result that cannot explain the critical condition of the patient. The identified germ may be a “bad bug”, still an epiphenomenon to a patient with multiple system organ failure of onother origin then septic.
   Bacterial results from blood culture imply a disproportionate workload for maginal benefits. Should we give up then to attempt bug identification, or should we reconsider our practcie? I have no doubts that strict adherence to sampling and handling blood protocols is mandatory. Otherwise, we will continue to escalate misunderstandings between microbiologists and clinicians. These snapshots of blood culture results will continue to be of limited use, a genuine waste of means. And yes, please handle everything with clean hands!

Weather is predictable with a certain margin of error. Despite the general predictions, certain meteorological events are necessary. Take for instance the snow. A Christmas without snow is unconceivable in our geographical region. However, as unpredictable as weather seems to be lately, we lived an unprecedented snowless Christmas. Without the joy of winter, we lived the Christmas through the carols. Music and poetry, the hope for redemption. They are a must, the very core and meaning of Christmas, but is it enough to actually get into the magic of Christmas!?
The falling snowflakes are associated with the protection of the nourishing earth. Vanishing beauty and frailty are mandatory for survival.
So do the authors of the articles we publish. They need to publish to fulfill their job positions. They depend on it. It becomes so vain and uncommon to publish for the sake of art. It is paramount also to publish in a well positioned medical journal, that is, bearing a high citation index. However, archiving this is quite a performance merely when the author is a beginner. He needs mentoring and coaching. Our mentors instead, have come to an age characterized by excellent clinical performance, but significantly less communication abilities, be them computer related. [More]

Recent progresses in imaging and computer technologies stimulated an impressive development in many medical fields. Among them, electrophysiology (EP) is currently one of the fastest developing fields, a significant number of new techniques and tools being launched every year in the market of EP products. New methodologies have been developed to record intracardiac electrophysiology signals and to treat cardiac arrhythmia, well-known examples being represented by 3D applications of intracardiac navigation for diagnosis and treatment of rhythm or conduction disturbances.
Taking into consideration the 3D nature of different techniques for intracardiac navigation, a strong interlink has been developed throughout the years between electrophysiology and cardiac imaging. Complex procedures like CARTO or EnSite navigation are actually based on an association between 3D cardiac imaging and EP, relying on 3D imagistic representations of EP recordings. When available, intracardiac echocardiographic guidance is also used for assisting complicated CARTO ablation procedures.
For sure, due to the extreme complex spatial 3D representations associated with modern complex EP techniques, they could appear nowadays as “science fiction” for those not familiarized with the complexity of these interventions, and “science fiction” EP technology requires “science fiction” imaging techniques. [More]