IntroductionThe acute coronary syndrome is a leading cause of heart death among adults. The treatment of such patients begins during the first contact with the doctor who is in most cases neither an internist or cardiologist, but an emergency medicine specialist or general practitioner working in the emergency department. For that reason it is of great importance to educate doctors who will be able to establish a fast and precise diagnosis, start therapy and organize quick transport to the nearest catheterization room or coronary unit.ObjectiveThe primary objective was to measure frequency of patient's visits to the Emergency Department because of an acute coronary syndrome. The Secondary objective was to examine the choice of treatment in pre-hospital conditions.MethodologyThrough the statistical retrospective analysis we collected the data from the Emergency Department protocols for the period between June 1, 2008 and December 31, 2008.ResultsIn 14,986 patients during the six-month period, 343 of them had acute coronary syndrome. Men were more affected ((59.5%) than women (40.5%). Most cases belonged to the age group from 65 to 80 years (39.6%) and prevalence after 50 years shows abrupt growth. According to the diagnoses, most patients had unstable pectoral angina (42%) and then followed stenocardia (31%) and AIM (27%). Other therapy included NTG (22%), antihypertensives (21%), acetyl-salicylic acid (20%), analgesics (13%), antiarrhythmics (4%). Fifty-seven percent of the patients had complications. STEMI was diagnosed in 69% of patients, and most often the anterior wall was involved (35%).ConclusionThe diagnosis of acute coronary syndrome was established in 343 patients based on the clinical image, electrocardiographic changes and level of cardiospecific enzymes (troponin T).

IntroductionCerebrovascular disease include all disorders in which a part of brain is transiently or persistently damaged by ischemia or bleeding and/or where one or more blood vessels of brain are primarily damaged by pathological processes. The research confirmed the influence of risk factors.ObjectiveThe primary objective was to measure frequency of patients with cerebrovascular diseases in the Emergency Service during the period from September 1, 2008 to March 1, 2009. The secondary objective was to prove co-morbidity between the risk factors and cerebrovascular diseases.MethodNumerical indicators for patients with cerebrovascular diseases are extracted retrospectively by statistical work-up for the six-month period. The data indicating the risk factors predisposing cerebrovascular diseases are obtained through the (hetero)anamnesis.ResultsFrom the overall number of 24,600 patients, 127 patients had a diagnosis of cerebrovascular diseases. The frequency of cerebrovascular diseases is linearly increasing with age; after the age of 50, frequency is doubled. The frequency of cerebrovascular diseases is higher in women than in men, the role of heredity is significant, and risk factors influenced development of cerebrovascular diseases as follows: 50.40% of patients had hypertension, 16.54% diabetes mellitus, 48.82% smoking cigarettes, 40.94% obesity, 20.47% alcohol abuse, 11.02% migraine-like headaches, 30.71% cardiovascular diseases and 22.05% hyperlipidemias.ConclusionCerebrovascular diseases are increasing in developing countries. The main reason is poor control of risk factors. In the majority of cases it is possible to produce decrease of frequency of cerebrovascular diseases by elimination and reduction of risk factors through the change of life style. Pre-hospital urgent concept of therapy and improving of organization of emergency service will contribute to decreasing mortality and morbidity of cerebrovascular diseases.

Uvod Akutni gastroenterokolitis (AGE) je čest uzrok morbiditeta i mortaliteta u svjetu. Postoji više uzročnika AGE, a najčešći su virusi i bakterije. Virusni AGE može imati ozbiljan tok posebno u nororođenčadi, male djece, odraslih i imunokompromitovanih. Najvažnije je prepoznati i spriječiti komplikacije, dehidrataciju liječiti pravovremeno i primjeniti terapiju u skladu sa težinom kliničke slike. Ciljevi rada bili su utvrditi broj djece koji su se u tromjesečnom periodu javili zbog gastroenteritisa i febrilnog stanja, u dječiju ambulantu Službe hitne medicinske pomoći Doma zdravlja u Banja Luci (SHMP DZ BL), ispitati kakav je bio terapijski izbor u prehospitalnim uslovima i odrediti koliko je djece upućeno na hospitalni tretman. Metod rada Retrospektivnom analizom prikupljeni su podaci iz protokola dječije ambulante o 478 djeteta koji su se javili u SHMP DZ BL u periodu od 01.10.2017.-31.12.2017. godine. Evidentirani su podaci o ispitanicima (dob, pol, temperatura, laboratorijski nalazi, dijagnoza, terapija i broj upućene djece na hospitalni tretman). U razmatranje su uzeti pacijenti sa dijagnozom, Dg.: Gastoenteritis acuta i St. Febrilis, kao i ostala febrilna stanja. Rezultati Od ukupnog broja djece, 245 (51,26%) su muškog pola, a 233 (48,74%) su ženskog pola. Najviše je bilo djece (161-33,68%) školskog uzrasta u dobi preko 7 godina. 316 djeteta je bilo febrilno sa rasponom temperature od 37,5 o do 39 o C. Od urađenih 275 laboratorijskih nalaza, 216 je patoloških. Kod 89,54% je uključena terapija probioticima i nadoknada tečnosti oralnim putem. Antibiotska terapija je primenjena kod 37,87% pacijenta, za 3,35% djece je dat savjet roditeljima, 4,90% je dobilo antipiretsku terapiju a samo kod 0,42% uključena infuzija. Na Kliniku za infektivne bolesti je upućeno 21 dijete (4%), na Pedijatriju 29 djece (6%), a njih 428 (90%) je liječeno ambulantno. Zaključak Kod liječenja virusnog gastroenteritisa važno je nadomjestiti izgubljenu tekućinu i elektrolite, odnosno soli i minerale. Za obnovu crijevne mikroflore treba obavezno uključiti probiotičke proizvode. U lakšim slučajevima najvažnije je ublažiti simptome bolesti a u težim oblicima bolesti spriječiti nastanak dehidratacije infuzionim otopinama, te po potrebi hospitalizovati. Vakcinu protiv rotavirusa trebalo bi uvrstiti u kalendar vakcina, naročito za rizične skupine djece. Ključne riječi: virusni gastroenteritis, dehidratacija, prevencija, liječenje UVOD Akutni gastroenterokolitis (AGE) je čest uzrok morbiditeta i mortaliteta u svjetu. Postoji više uzročnika AGE, a najčešći su virusi i bakterije. U ostale spadaju: para-ziti, toksini, alergija na hranu, lekovi. Virusni gastroenterokolitis se često naziva "stomačni grip". Virusi predstavljaju značajan procenat svih slučajeva u svim dobnim skupinama. Najčešći među njima su rota, noro, astro i adeno virusi.