This study is aimed to estimate spatial variability of normal QRS loops trajectories in successiv... more This study is aimed to estimate spatial variability of normal QRS loops trajectories in successive cardiac cycles analyzed in XYZ phase space among 27 young and 27 older subjects, both male and female. Among young subjects, 10 individuals were professional football players, while the remaining 17 were students without regular physical activities. Modified three-axial leads (Frank's lead system) were used continually to record high-resolution ECG (1 kHz sampling rate) at rest during 200 seconds by Biopac Student Lab System. Variability of all the three spherical coordinates of the ventricular electrical vector in five characteristic positions regarding the R peak was analyzed. It was found that although fractal dimensions were not gender-dependent (p > 0.05), the calculated values in all tested five positions were greater in young than in older individuals (p < 0.05). Besides that, among young subjects, several fractal dimensions were greater in athletes than in physically ...
Adiponectin, secreted by fat tissue, is down - regulated in obesity and may be involved in obesit... more Adiponectin, secreted by fat tissue, is down - regulated in obesity and may be involved in obesity-related disorders. It has anti-inflammatory, antiatherosclerotic and antidiabetic effect. Obesity is a strong predictor for hypertension and cardiovascular diseases. Recent studies showed that adiponectin level has important role in metabolic disorders, arterial hypertension and ischemic heart disease but its effect on left ventricular hypertrophy (LVH) has not been fully clarified. The aim of this research is to determine whether the protective effect of adiponectin against development of left ventricular hypertrophy is decreased in hypertensive overweight patients. The study included 61 adult, overweight hypertensive patients, with body mass index in range 25-30 kg/m2. Patients had regular morning glucose serum values and regular creatinine level. They were divided into four groups, according to sex and the presence of LVH. There were 16 female and 15 male hypertensive patients with ...
Posljednjih godina znatno se povećava broj zahvata intervencijske kardiologije. Iako od velike ko... more Posljednjih godina znatno se povećava broj zahvata intervencijske kardiologije. Iako od velike koristi za bolesnika, koronarne su intervencije zahvati koji uključuju izloženost visokim dozama zračenja. Mjerenje doza koje su bolesnici primili pri radiološkim zahvatima u Republici Hrvatskoj propisano je zakonom, ali se ono, u pravilu, ne primjenjuje. U KBC-u Osijek uveden je priručnik za kontrolu kvalitete u koronarnim intervencijama. Priručnik, osim provjera tehničkih karakteristika uređaja, propisuje i stalno mjerenje apsorbiranih doza bolesnicima u intervencijskoj kardiologiji te njihovu analizu. Rezultati prvih istraživanja pokazuju da su se mjerene doze snizile tijekom vremena i u skladu su s literaturom, ali i dalje postoji mogućnost dodatne optimizacije opreme i načina rada. Pri visokim dozama zračenja koje bolesnici primaju tijekom koronarnih intervencija postoji mogućnost ozljeda kože uzrokovanih zračenjem koje često ostanu neprepoznate. Zbog toga se bolesnici koji su ozračeni dozama pri kojima postoji rizik od ozljede upozoravaju te pozivaju na kontrolne preglede. Do sada nije zabilježena nijedna ozljeda kože, ali je postupak uveden kao redovit. Ovaj je rad jedan u nizu koraka koji je potrebno učiniti da bi se bolesnici što bolje zaštitili od nepoželjnih učinaka zračenja.
Abstract: Authors evaluate the importance of door-to-balloon time, and symptom onset-to-balloon t... more Abstract: Authors evaluate the importance of door-to-balloon time, and symptom onset-to-balloon time (total ischemic time) for prognosis of patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention ( ...
Journal of Cardiovascular Development and Disease, 2021
The growing body of evidence shows a significant difference in the circadian rhythm of cardiovasc... more The growing body of evidence shows a significant difference in the circadian rhythm of cardiovascular disease based on biological sex. The incidence of cardiovascular disease varies between women and men. Additionally, biological sex is vital for the timely application of therapy—chronotherapy, which benefits both sexes. This study aimed to examine the potential difference of single nucleotide polymorphisms (SNPs) of the circadian rhythm genes ARNTL, CLOCK, CRY2 and PER2 in women and men with myocardial infarction. A cross-sectional study was conducted, including 200 patients with myocardial infarction. Altogether, ten single nucleotide polymorphisms in the ARNTL, CLOCK, CRY2 and PER2 genes were analyzed. The Chi-square test yielded statistically significant differences in CLOCK gene rs11932595 polymorphism in a recessive genotype model between women and men with a p-value of 0.03 and an odds ratio 2.66, and a corresponding 95% confidence interval of 1.07 to 6.66. Other analyzed pol...
The circadian rhythm regulates various physiological mechanisms, and its disruption can promote m... more The circadian rhythm regulates various physiological mechanisms, and its disruption can promote many disorders. Disturbance of endogenous circadian rhythms enhances the chance of myocardial infarction (MI), showing that circadian clock genes could have a crucial function in the onset of the disease. This case-control study was performed on 1057 participants. It was hypothesized that the polymorphisms of one nucleotide (SNP) in three circadian clock genes (CLOCK, ARNTL, and PER2) could be associated with MI. Statistically significant differences, estimated by the Chi-square test, were found in the distribution of alleles and genotypes between MI and no-MI groups of the CLOCK (rs6811520 and rs13124436) and ARNTL (rs3789327 and rs12363415) genes. According to the results of the present study, the polymorphisms in the CLOCK and ARNTL genes could be related to MI.
The patient was a 34-year-old woman presented to the emergency department with a chest pain. Duri... more The patient was a 34-year-old woman presented to the emergency department with a chest pain. During the last two years she took replacement therapy with levothyroxine because of lymphocytic thyroiditis. The ECG upon admittance verifies tall T waves in the precordial leads and the subsequent ECG shows a negativation of the T wave in the precordial leads. In the patient's echocardiographic findings, dyskinesia of the apical anterior segment is found, in laboratory findings increased levels of cardioselective biomarkers are present. Afterwards, a coronary angiography is done and no significant stenosis was detected in any coronary arteries, and ventriculography showed hypokinesia anterior mid segments. Considering all this, the diagnosis of Takotsubo cardiomyopathy is set, iatrogenically caused by thyrotoxicosis in combination with the recent Caesarean section.
Radiation exposure rises with growing number of computed tomography, nuclear cardiological exams,... more Radiation exposure rises with growing number of computed tomography, nuclear cardiological exams, coronary angiography and fluoroscopy leading to a higher risk of patient overexposure to radiation. It is estimted that 40% of radiation exposure is due to cardiological procedures. Interventional cardiologists and cardiac electrophysiologists are two to three times more exposed to radiation than diagnostic radiolodists. In high volume cath labs the most experienced interventional cardiologists have annual exposure about 5mSv and lifetime exposure increases cancer risk by 1%. There are two main biolgical effects of radiation: tissue reaction (determinstic effects) that becomes evident days or months after exposure and incude skin injuries and cataract, and scholastic effect which is related with potential and future harm damaging DNA or indirectly (free radicals and reactive oxygen specises) leading to cancer manifestation after many years. Increased cancer risk is for doses more than 50mSv. Risk is 3-4 times higher in children than in adults, 38% higher in females than in males, 50% lower in octogenerians than in 50 year-old old patients. Some tissues are more sensitive than others. Highest radiosensitivity organs are breast, colon, lung and stomach.
The aim of the study was to evaluate the influence of door-to-balloon time and symptom onset-to-b... more The aim of the study was to evaluate the influence of door-to-balloon time and symptom onset-to-balloon time on the prognosis of patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) in the Croatian Primary PCI Network. A total of 1190 acute STEMI patients treated with primary PCI were prospectively investigated in eight centers across Croatia (677 non-transferred, 513 transferred). All patients were divided according to door-to-balloon time in three subgroups (< 90, 90-180, and > 180 minutes) and according to symptom onset-to-balloon time in three subgroups (<180, 180-360, and > 360 minutes). The postprocedural Thrombolysis in Myocardial Infarction flow, in-hospital mortality, and major adverse cardiovascular events (mortality, pectoral angina, restenosis, reinfarction, coronary artery by-pass graft and cerebrovascular accident rate) in six-month follow-up were compared between the subgroups. The Cro...
Pubertal growth of heart was analyzed. Growth rates of "diastolic variables" of heart s... more Pubertal growth of heart was analyzed. Growth rates of "diastolic variables" of heart size were compared with that of 'systolic', and both with growth intensities of some body structures and functions that are related to cardiac growth. Longitudinal echocardiographic, ergometric and anthropometric measurements were performed in 84 healthy boys, aged 11.5 years at the beginning and 14.5 at the end of study. Diastolic thickness of left ventricular walls increased by a mean rate of 15% and systolic by 36% (p < 0.001). As a result, percent systolic wall thickening increased from 20% to 41% during the 3 years (p < 0.001). Other measures of cardiac contractility increased in the same manner. Increase in measures of cardiac preload and afterload corresponds to the increase in heart "diastolic" and "systolic" variables, respectively. The study gave evidences for an increase in cardiac contractility during puberty. Coexistence of two simultaneous g...
2013;8(7-8):235. Cardiologia CROATICA Exact Test. Kod usporedbe numeriËkih s nominalnim varijabla... more 2013;8(7-8):235. Cardiologia CROATICA Exact Test. Kod usporedbe numeriËkih s nominalnim varijablama, za varijable s normalnom raspodjelom vrijednosti primijenjen je parametrijski Studentov t-test, a za one koje nemaju normalnu raspodjelu koriπteni su neparametrijski testovi Mann-Whitney i Kruskal-Wallis. Razina statistiËke zna-Ëajnosti za sve testove kojima se provode usporedbe iznosi p<0,05.
Essential thrombocythemia (ET), a chronic myeloproliferative disease, is characterized by an incr... more Essential thrombocythemia (ET), a chronic myeloproliferative disease, is characterized by an increased number of platelets and risk of vascular thrombosis. A case of a patient treated for ET who had acute myocardial infarction (MI) and reinfarction within a month is presented. A 55-year-old male patient was hospitalized because of subacute inferolateral non-ST-segment-elevation MI, without risk factors for cardiovascular diseases. The patient has been treated for ET for the past 8 years, received anagrelide for the past two years. The first coronary-angiography did not detect significant stenosis of epicardial vessels; the patient was discharged in stable condition with anagrelide therapy. Two weeks later, the patient had an acute anterolateral ST-segment-elevation MI. Primary percutaneous coronary intervention showed thrombus in the distal part of the left anterior descending coronary artery. Percutaneous transluminal coronary angioplasty was performed and eptifibatide was administered after the procedure. There was no residual stenosis, prescribed therapy included clopidogrel and low-molecular-weight heparin. Anagrelide therapy was replaced with hydroxyurea (HU) and acetylsalicylic acid (ASA). It is necessary to treat ET in line with the standard treatment protocol for coronary diseases. In the treatment of high-risk hematology patients anagrelide proved to be a worse option than the combination of HU and ASA. <Learning objective: It is known that the myeloproliferative disorders carry the risk of vascular thrombosis and myocardial infarction. The occurrence of vascular events is usually the first sign of the disease. A case of a patient with history of hematological disease, who was receiving active treatment and was well-regulated with oral medication, is presented here. Various approaches to treatment of such patients are possible and treatment decision-making is important for clinicians. Therefore, this article presents both our view on this issue and an overview of the literature in this area.>
Background: New resuscitation guidelines that were proposed by the European Resuscitation Council... more Background: New resuscitation guidelines that were proposed by the European Resuscitation Council in 2010 have introduced a new method of cardiopulmonary resuscitation (CPR) by chest compressions only for untrained individuals. Objectives: We conducted this study to evaluate differences in attitudes towards CPR among medical doctors, surgeons and anesthesiologists in Osijek University Hospital. A call for help, chest-compression-only resuscitation, mouth-to-mouth ventilation and teamwork were recognized as critical points that may influence the outcome. Unfamiliarity with these methods may be indicative of a lack of education in resuscitation and may result in poor outcomes for victims. Patients and Methods: An anonymous survey was conducted on 190 medical professionals: 93 medical doctors, 70 surgeons, and 27 anesthesiologists during year 2012 (mean age 41.9 years). The questions were related to previous education in resuscitation, current resuscitation practices and attitudes towards cardiopulmonary resuscitation. Data were analyzed using ANOVA and Fisher exact test. A P value of < 0.05 was considered statistically significant. Results: The only difference between groups was regarding the male and female ratio, with more male surgeons (45, 55, and 11, P < 0.001). All doctors considered CPR as important, but only anesthesiologists knew how often guidelines in CPR change. Approximately 45% of medical doctors, 48% of surgeons and 77% of anesthesiologists reported that they have renewed their knowledge in CPR within the last five years, whereas 34%, 25% and 22% had never renewed their knowledge in the CPR (P = 0.01 between surgeons anesthesiologists). Furthermore, chest-compression-only was recognized as a valuable CPR technique by 25.8% of medical doctors, 14.3% of surgeons and 59.3% of anesthesiologists (P < 0.001). Anesthesiologists estimated a high risk of infection transmission (62%) and were more likely to refuse mouth-to-mouth ventilation when compared to surgeons (25% vs.10%, P = 0.01). Anesthesiologists are most often called for help by their colleagues, only rarely surgeons call their departmental colleagues and nurses to help in CPR. Conclusions: An insufficient formal education in CPR was registered for all groups, reflecting the lack of familiarity with new CPR methods. A team education, involving doctors and nurses may improve familiarity with CPR and patient outcomes.
Intervention Network for patients with ST-segment elevation acute myocardial infarction. American... more Intervention Network for patients with ST-segment elevation acute myocardial infarction. American Journal of Cardiology, 105 (9). pp.
This study is aimed to estimate spatial variability of normal QRS loops trajectories in successiv... more This study is aimed to estimate spatial variability of normal QRS loops trajectories in successive cardiac cycles analyzed in XYZ phase space among 27 young and 27 older subjects, both male and female. Among young subjects, 10 individuals were professional football players, while the remaining 17 were students without regular physical activities. Modified three-axial leads (Frank's lead system) were used continually to record high-resolution ECG (1 kHz sampling rate) at rest during 200 seconds by Biopac Student Lab System. Variability of all the three spherical coordinates of the ventricular electrical vector in five characteristic positions regarding the R peak was analyzed. It was found that although fractal dimensions were not gender-dependent (p > 0.05), the calculated values in all tested five positions were greater in young than in older individuals (p < 0.05). Besides that, among young subjects, several fractal dimensions were greater in athletes than in physically ...
Adiponectin, secreted by fat tissue, is down - regulated in obesity and may be involved in obesit... more Adiponectin, secreted by fat tissue, is down - regulated in obesity and may be involved in obesity-related disorders. It has anti-inflammatory, antiatherosclerotic and antidiabetic effect. Obesity is a strong predictor for hypertension and cardiovascular diseases. Recent studies showed that adiponectin level has important role in metabolic disorders, arterial hypertension and ischemic heart disease but its effect on left ventricular hypertrophy (LVH) has not been fully clarified. The aim of this research is to determine whether the protective effect of adiponectin against development of left ventricular hypertrophy is decreased in hypertensive overweight patients. The study included 61 adult, overweight hypertensive patients, with body mass index in range 25-30 kg/m2. Patients had regular morning glucose serum values and regular creatinine level. They were divided into four groups, according to sex and the presence of LVH. There were 16 female and 15 male hypertensive patients with ...
Posljednjih godina znatno se povećava broj zahvata intervencijske kardiologije. Iako od velike ko... more Posljednjih godina znatno se povećava broj zahvata intervencijske kardiologije. Iako od velike koristi za bolesnika, koronarne su intervencije zahvati koji uključuju izloženost visokim dozama zračenja. Mjerenje doza koje su bolesnici primili pri radiološkim zahvatima u Republici Hrvatskoj propisano je zakonom, ali se ono, u pravilu, ne primjenjuje. U KBC-u Osijek uveden je priručnik za kontrolu kvalitete u koronarnim intervencijama. Priručnik, osim provjera tehničkih karakteristika uređaja, propisuje i stalno mjerenje apsorbiranih doza bolesnicima u intervencijskoj kardiologiji te njihovu analizu. Rezultati prvih istraživanja pokazuju da su se mjerene doze snizile tijekom vremena i u skladu su s literaturom, ali i dalje postoji mogućnost dodatne optimizacije opreme i načina rada. Pri visokim dozama zračenja koje bolesnici primaju tijekom koronarnih intervencija postoji mogućnost ozljeda kože uzrokovanih zračenjem koje često ostanu neprepoznate. Zbog toga se bolesnici koji su ozračeni dozama pri kojima postoji rizik od ozljede upozoravaju te pozivaju na kontrolne preglede. Do sada nije zabilježena nijedna ozljeda kože, ali je postupak uveden kao redovit. Ovaj je rad jedan u nizu koraka koji je potrebno učiniti da bi se bolesnici što bolje zaštitili od nepoželjnih učinaka zračenja.
Abstract: Authors evaluate the importance of door-to-balloon time, and symptom onset-to-balloon t... more Abstract: Authors evaluate the importance of door-to-balloon time, and symptom onset-to-balloon time (total ischemic time) for prognosis of patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention ( ...
Journal of Cardiovascular Development and Disease, 2021
The growing body of evidence shows a significant difference in the circadian rhythm of cardiovasc... more The growing body of evidence shows a significant difference in the circadian rhythm of cardiovascular disease based on biological sex. The incidence of cardiovascular disease varies between women and men. Additionally, biological sex is vital for the timely application of therapy—chronotherapy, which benefits both sexes. This study aimed to examine the potential difference of single nucleotide polymorphisms (SNPs) of the circadian rhythm genes ARNTL, CLOCK, CRY2 and PER2 in women and men with myocardial infarction. A cross-sectional study was conducted, including 200 patients with myocardial infarction. Altogether, ten single nucleotide polymorphisms in the ARNTL, CLOCK, CRY2 and PER2 genes were analyzed. The Chi-square test yielded statistically significant differences in CLOCK gene rs11932595 polymorphism in a recessive genotype model between women and men with a p-value of 0.03 and an odds ratio 2.66, and a corresponding 95% confidence interval of 1.07 to 6.66. Other analyzed pol...
The circadian rhythm regulates various physiological mechanisms, and its disruption can promote m... more The circadian rhythm regulates various physiological mechanisms, and its disruption can promote many disorders. Disturbance of endogenous circadian rhythms enhances the chance of myocardial infarction (MI), showing that circadian clock genes could have a crucial function in the onset of the disease. This case-control study was performed on 1057 participants. It was hypothesized that the polymorphisms of one nucleotide (SNP) in three circadian clock genes (CLOCK, ARNTL, and PER2) could be associated with MI. Statistically significant differences, estimated by the Chi-square test, were found in the distribution of alleles and genotypes between MI and no-MI groups of the CLOCK (rs6811520 and rs13124436) and ARNTL (rs3789327 and rs12363415) genes. According to the results of the present study, the polymorphisms in the CLOCK and ARNTL genes could be related to MI.
The patient was a 34-year-old woman presented to the emergency department with a chest pain. Duri... more The patient was a 34-year-old woman presented to the emergency department with a chest pain. During the last two years she took replacement therapy with levothyroxine because of lymphocytic thyroiditis. The ECG upon admittance verifies tall T waves in the precordial leads and the subsequent ECG shows a negativation of the T wave in the precordial leads. In the patient's echocardiographic findings, dyskinesia of the apical anterior segment is found, in laboratory findings increased levels of cardioselective biomarkers are present. Afterwards, a coronary angiography is done and no significant stenosis was detected in any coronary arteries, and ventriculography showed hypokinesia anterior mid segments. Considering all this, the diagnosis of Takotsubo cardiomyopathy is set, iatrogenically caused by thyrotoxicosis in combination with the recent Caesarean section.
Radiation exposure rises with growing number of computed tomography, nuclear cardiological exams,... more Radiation exposure rises with growing number of computed tomography, nuclear cardiological exams, coronary angiography and fluoroscopy leading to a higher risk of patient overexposure to radiation. It is estimted that 40% of radiation exposure is due to cardiological procedures. Interventional cardiologists and cardiac electrophysiologists are two to three times more exposed to radiation than diagnostic radiolodists. In high volume cath labs the most experienced interventional cardiologists have annual exposure about 5mSv and lifetime exposure increases cancer risk by 1%. There are two main biolgical effects of radiation: tissue reaction (determinstic effects) that becomes evident days or months after exposure and incude skin injuries and cataract, and scholastic effect which is related with potential and future harm damaging DNA or indirectly (free radicals and reactive oxygen specises) leading to cancer manifestation after many years. Increased cancer risk is for doses more than 50mSv. Risk is 3-4 times higher in children than in adults, 38% higher in females than in males, 50% lower in octogenerians than in 50 year-old old patients. Some tissues are more sensitive than others. Highest radiosensitivity organs are breast, colon, lung and stomach.
The aim of the study was to evaluate the influence of door-to-balloon time and symptom onset-to-b... more The aim of the study was to evaluate the influence of door-to-balloon time and symptom onset-to-balloon time on the prognosis of patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) in the Croatian Primary PCI Network. A total of 1190 acute STEMI patients treated with primary PCI were prospectively investigated in eight centers across Croatia (677 non-transferred, 513 transferred). All patients were divided according to door-to-balloon time in three subgroups (< 90, 90-180, and > 180 minutes) and according to symptom onset-to-balloon time in three subgroups (<180, 180-360, and > 360 minutes). The postprocedural Thrombolysis in Myocardial Infarction flow, in-hospital mortality, and major adverse cardiovascular events (mortality, pectoral angina, restenosis, reinfarction, coronary artery by-pass graft and cerebrovascular accident rate) in six-month follow-up were compared between the subgroups. The Cro...
Pubertal growth of heart was analyzed. Growth rates of "diastolic variables" of heart s... more Pubertal growth of heart was analyzed. Growth rates of "diastolic variables" of heart size were compared with that of 'systolic', and both with growth intensities of some body structures and functions that are related to cardiac growth. Longitudinal echocardiographic, ergometric and anthropometric measurements were performed in 84 healthy boys, aged 11.5 years at the beginning and 14.5 at the end of study. Diastolic thickness of left ventricular walls increased by a mean rate of 15% and systolic by 36% (p < 0.001). As a result, percent systolic wall thickening increased from 20% to 41% during the 3 years (p < 0.001). Other measures of cardiac contractility increased in the same manner. Increase in measures of cardiac preload and afterload corresponds to the increase in heart "diastolic" and "systolic" variables, respectively. The study gave evidences for an increase in cardiac contractility during puberty. Coexistence of two simultaneous g...
2013;8(7-8):235. Cardiologia CROATICA Exact Test. Kod usporedbe numeriËkih s nominalnim varijabla... more 2013;8(7-8):235. Cardiologia CROATICA Exact Test. Kod usporedbe numeriËkih s nominalnim varijablama, za varijable s normalnom raspodjelom vrijednosti primijenjen je parametrijski Studentov t-test, a za one koje nemaju normalnu raspodjelu koriπteni su neparametrijski testovi Mann-Whitney i Kruskal-Wallis. Razina statistiËke zna-Ëajnosti za sve testove kojima se provode usporedbe iznosi p<0,05.
Essential thrombocythemia (ET), a chronic myeloproliferative disease, is characterized by an incr... more Essential thrombocythemia (ET), a chronic myeloproliferative disease, is characterized by an increased number of platelets and risk of vascular thrombosis. A case of a patient treated for ET who had acute myocardial infarction (MI) and reinfarction within a month is presented. A 55-year-old male patient was hospitalized because of subacute inferolateral non-ST-segment-elevation MI, without risk factors for cardiovascular diseases. The patient has been treated for ET for the past 8 years, received anagrelide for the past two years. The first coronary-angiography did not detect significant stenosis of epicardial vessels; the patient was discharged in stable condition with anagrelide therapy. Two weeks later, the patient had an acute anterolateral ST-segment-elevation MI. Primary percutaneous coronary intervention showed thrombus in the distal part of the left anterior descending coronary artery. Percutaneous transluminal coronary angioplasty was performed and eptifibatide was administered after the procedure. There was no residual stenosis, prescribed therapy included clopidogrel and low-molecular-weight heparin. Anagrelide therapy was replaced with hydroxyurea (HU) and acetylsalicylic acid (ASA). It is necessary to treat ET in line with the standard treatment protocol for coronary diseases. In the treatment of high-risk hematology patients anagrelide proved to be a worse option than the combination of HU and ASA. <Learning objective: It is known that the myeloproliferative disorders carry the risk of vascular thrombosis and myocardial infarction. The occurrence of vascular events is usually the first sign of the disease. A case of a patient with history of hematological disease, who was receiving active treatment and was well-regulated with oral medication, is presented here. Various approaches to treatment of such patients are possible and treatment decision-making is important for clinicians. Therefore, this article presents both our view on this issue and an overview of the literature in this area.>
Background: New resuscitation guidelines that were proposed by the European Resuscitation Council... more Background: New resuscitation guidelines that were proposed by the European Resuscitation Council in 2010 have introduced a new method of cardiopulmonary resuscitation (CPR) by chest compressions only for untrained individuals. Objectives: We conducted this study to evaluate differences in attitudes towards CPR among medical doctors, surgeons and anesthesiologists in Osijek University Hospital. A call for help, chest-compression-only resuscitation, mouth-to-mouth ventilation and teamwork were recognized as critical points that may influence the outcome. Unfamiliarity with these methods may be indicative of a lack of education in resuscitation and may result in poor outcomes for victims. Patients and Methods: An anonymous survey was conducted on 190 medical professionals: 93 medical doctors, 70 surgeons, and 27 anesthesiologists during year 2012 (mean age 41.9 years). The questions were related to previous education in resuscitation, current resuscitation practices and attitudes towards cardiopulmonary resuscitation. Data were analyzed using ANOVA and Fisher exact test. A P value of < 0.05 was considered statistically significant. Results: The only difference between groups was regarding the male and female ratio, with more male surgeons (45, 55, and 11, P < 0.001). All doctors considered CPR as important, but only anesthesiologists knew how often guidelines in CPR change. Approximately 45% of medical doctors, 48% of surgeons and 77% of anesthesiologists reported that they have renewed their knowledge in CPR within the last five years, whereas 34%, 25% and 22% had never renewed their knowledge in the CPR (P = 0.01 between surgeons anesthesiologists). Furthermore, chest-compression-only was recognized as a valuable CPR technique by 25.8% of medical doctors, 14.3% of surgeons and 59.3% of anesthesiologists (P < 0.001). Anesthesiologists estimated a high risk of infection transmission (62%) and were more likely to refuse mouth-to-mouth ventilation when compared to surgeons (25% vs.10%, P = 0.01). Anesthesiologists are most often called for help by their colleagues, only rarely surgeons call their departmental colleagues and nurses to help in CPR. Conclusions: An insufficient formal education in CPR was registered for all groups, reflecting the lack of familiarity with new CPR methods. A team education, involving doctors and nurses may improve familiarity with CPR and patient outcomes.
Intervention Network for patients with ST-segment elevation acute myocardial infarction. American... more Intervention Network for patients with ST-segment elevation acute myocardial infarction. American Journal of Cardiology, 105 (9). pp.
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