Results show that the Croatian translation of the US HSOPSC is compatible in 11 of the original 12 dimensions. Results suggest that for the purposes of research in Croatia, the dimensions 'Staffing', 'Communication openness', and 'Organisational learning-continuous improvement' should be revised. For example, the use of question A7 ('We use more agency/temporary staff than is best for patient care') in the context of European healthcare systems should be adapted or removed for the Croatian version of the US HSOPSC questionnaire.

Regional centro-axial anaesthesia, primarily spinal block, is the preferred method of anaesthesia for elective caesarean section because it entails fewer risks for the mother and the foetus compared to general anaesthesia. The most common side effect associated with spinal block is hypotension due to sympatholysis, occurring in up to 75% of cases. Spinal block-induced sympatholysis leads to vasodilatation and consequently causes maternal hypotension, which may compromise uterine blood flow and foetal circulation, and thus cause foetal hypoxia, bradycardia and acidosis. The selection of the most efficient treatment strategy to achieve haemodynamic stability during spinal anaesthesia for caesarean section continues to be one of the main challenges in obstetric anaesthesiology. A number of measures for the prevention and treatment of spinal block-induced hypotension are used in clinical practice, such as preloading and coloading with crystalloid and/or colloid infusion, wrapping of lower limbs with compression stockings or bandages, administering an optimal dose of local anaesthetic and achieving an optimal spinal block level, left tilt positioning, and administering inotropes and vasopressors. Instead of administering vasopressors after a drop in blood pressure has already occurred, the latest algorithms recommend a prophylactic administration of vasopressor infusion. The preferred vasoconstrictor in this case is phenylephrine, which is associated with a lower incidence of foetal acidosis, and maternal nausea and vomiting compared to other vasoconstrictors.

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SUMMARY -Patient safety culture (PCS) has a crucial impact on the safety practices of healthcare delivery systems. Th e purpose of this study was to assess the state of PSC in Croatian hospitals and compare it with hospitals in the United States. Th e study was conducted in three public general hospitals in Croatia using the Croatian translation of the Hospital Survey Th is suggests that a more comprehensive system for the improvement of patient safety within the framework of the Croatian healthcare system needs to be developed. Our fi ndings also help confi rm that HSOPSC is a useful and appropriate tool for the assessment of PSC. HSOPSC highlights the PSC components in need of improvement and should be considered for use in national and international benchmarking.

The authors report on an atypical clinical picture of an acute abdomen syndrome caused by the rupture of an atypically located pyosalpinx in a 9-year old girl.A perforated right-sided pyosalpinx was found at two locations, firmly adhering to a vesicouterine excavation. Right-sided salpingectomy, appendectomy, pelvic cavity lavage and drainage of the Douglas cavity were performed. The pathohistology indicated a perforated pyosalpinx and catarrhal appendicitis. On bacteriological analysis, Escherichia coli was isolated from the vaginal discharge and from the pus collected from the small pelvis.