The aim of the study was to assess whether current guidelines for diagnosis and treatment of acute ST-elevation myocardial infarction (STEMI) in daily clinical practice are adequately applied in the ...Belgrade Emergency Medical Service (EMS). A retrospective research included 2,982 STEMI patients who were cared for by EMS teams. Therapy consisting of morphine, oxygen, nitroglycerin and aspirin (MONA) was applied. Dual antiaggregation therapy (aspirin 325 mg + ticagrelor 180 mg or clopidogrel 600 mg) was administered to patients with primary percutaneous coronary intervention (PCI) indicated. With electrocardiographic monitoring included, the patients were transported directly to PCI unit with announcement of the arrival. Response times I-V were measured. There was an increasing trend in the number of STEMI patients. A rapid increase in the use of dual antiaggregation therapy (MONA and clopidogrel or MONA and ticagrelor) was reported from year to year, as well as a dramatic increase in the use of ticagrelor compared to clopidogrel. The time from receiving the call to the arrival on the scene was 13.72 minutes, and the time from receiving the call to hospital arrival was 52.83 minutes. Our physicians care for STEMI patients in accordance with the current international and local recommendations.
Introduction: Breast cancer is the most common form of malignancy in women. It affects about one million women worldwide every year and the incidence continues to rise. As a result of the ...introduction of screening procedures into everyday practice, advanced diagnostic procedures, and modern surgical and oncological treatment, breast cancer is nowadays a well-controlled disease, often completely curable. However, in clinical practice, we do still encounter locally advanced forms of breast cancer with bleeding as a frequent complication of ulcerated tumours. This is a life-threatening emergency that in most cases must be corrected with palliative surgical procedures. The objective: To present the complication of haemorrhage in breast cancer patients to emergency medicine specialists and other doctors, to help them recognise and treat such patients appropriately. Methodology: The PubMed database and Google Scholar were searched for relevant articles based on specific keywords. Conclusion: Recognising haemorrhage as a complication of breast cancer and providing adequate and timely surgical treatment significantly improves the rate of survival and quality of life even in patients with terminal cancer.
An abdominal aortic aneurysm rupture (AAAR) is an acute, potentially fatal clinical condition which needs to be treated surgically as soon as possible. The process of making the diagnosis and ...providing treatment for patients with this clinical condition exceeds by far the resources and capabilities of the Emergency Medical Service. However, if the possibility of this diagnosis is taken into account during first contact, initial treatment and transport of these patients to the hospital, it is possible to significantly shorten the time before the patient is taken to the operating room and the bleeding put under control. This is crucial for the survival of these patients. Therefore, the Emergency Medical Service does not have a passive role in treating patients with this condition, but rather is a crucial link that enables an adequate initial treatment and quick transport to a hospital capable of providing surgical treatment and is key to their survival. A standardized and generally accepted system of initial care and transport that is universally applicable in all healthcare systems for patients with AAAR does not exist, but teamwork and addressing possible problems in providing adequate care on all levels does provide a larger number of patients with a chance to survive the condition that is almost synonimous to death.
With the creation of a global computer network, the internet, all manner of information has become available to scientists and everyone else around the world. The exchange of information gives ...scientists insight into the most recent scientific discoveries while enabling them at the same time to use the information for their research. Scientists and experts must be sure that their colleagues' research is valid, objective and the results complete. These scientific research characteristics represent scientific honesty. Scientific misconduct can take various forms and can be present in all phases of the scientific research process, but most commonly takes the form of fabrication, falsification and plagiarism. The reasons for scientific misconduct can be personal, professional and financial. There is also a "grey zone", which consists of data manipulation and selection, reference citing mistakes, multiple and salami publications, problematic authorships. Every type of misconduct has a detrimental effect on the scientific community. In the public eye, scientists are benevolent seekers of truth with high moral integrity, whose work is of key value to society. Any type of scientific misconduct serves to dishonour the scientific community but also brings confusion into the work of other researchers, therefore significantly slowing down scientific discovery in whole. Digitalization and technological advancement significantly contribute to the early discovery, elimination and sanctioning of any kind of research misconduct. A significant improvement in solving these problems can be achieved through adequate education of young researchers and introducing laws that precisely define penalties for breaking the code of good scientific practice.
Background The incidence of cancer is constantly increasing, but thanks to better diagnosis, screening and introduction of new cytotoxic drugs, survival of patients is prolonged and for some ...malignant diseases it is long-standing.In such patients, occasionally, a life-threatening conditions may occur but it does not necessarily have to be associated with underlying disease or administered specific therapy. Enable emergency medical doctors to easily recognize the most common urgent conditions that occur in patients with malignant diseases in order to be able to treat them in an appropriate manner. Metods A PubMed database comprehensive search was conducted to identify all relevant articles according to assigned key words. Conclusion Recognition of emergency conditions in cancer patients and adequate treatment lead to a reduction in morbidity and mortality and can prolong the survival or improve quality of life even when the patient is at the terminal stage of the disease.
Introduction. Treating patients suffering from acute myocardial infarction with ST elevation (STEMI) represents a challenge and new treatment possibilities with better outcomes are always sought. The ...Emergency Medical Aid Service holds the key role in prehospital care of patients with STEMI and administers dual antiplatelet therapy: MONA (Morphine, Oxygen, Nitroglycerin, Aspirin) + clopidogrel or ticagrelor, with the aim of enhancing the reperfusion effect. Objective: To determine the incidence of prehospital treatment of STEMI with dual antiplatelet therapy, as well as the time passed from the first contact with the 194 operator to the admission of the patient to the hospital. Methods: Retrospective analysis of the period between January 1st 2014. and December 31st 2017. The diagnosis was based on medical history as described by the patient, clinical findings and ecg tracings. In patients diagnosed with STEMI, dual antiplatelet therapy was administered and monitored. Time passed from the first contact with the 194 operator to admission to the hospital was also measured. Results: Out of the total number of 8843 patients with acute coronary syndrome, who were treated by the Emergency Medical Aid Service, 2982 were diagnosed with STEMI. Dual antiplatelet therapy was administered to 40.29% of the patients in 2014, while that percentage grew to 70.01% in 2017. Of that percentage in 2017, 60.38% received MONA and ticagrelor, while 9.63% received MONA and clopidogrel. Women have been proven to suffer from STEMI at a later age (70.17±13.05 years of age) than men (61.89±13.43 years of age). Also, 75% of the patients are admitted to the hospital within 65.77 minutes from the moment of the first contact with the 194 operator. Conclusion: During the period in question, a significant rise in application of antiplatelet therapy has been noted. The transfer time of STEMI patients is an important factor of prehospital treatment. Continuous education of Emergency Medical Aid teams enables advances of diagnostic and therapeutic measures in prehospital conditions. .
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