CORRELATES OF IN-HOSPITAL MORTALITY IN PATIENTS WITH ACUTE CORONARY SYNDROME IN KOSOVO.

It has been demonstrated that pre-hospital emergency care reduces in-hospital mortality in patients admitted with acute coronary syndrome (ACS). The aim of this study was to analyze the relationship between pre-hospital emergency care and in-hospital mortality in ACS patients treated at the University Clinical Centre of Kosovo Emergency Department (UCCK ED). This observational clinical study included 1498 ACS patients treated at UCCK ED and followed-up by phone call for one year after discharge from the hospital. According to multivariate Cox regression analysis, age (HR=2.37, 95% CI 1.67-3.52), pre-hospital emergency care (HR=3.92, 95% CI 2.35-6.54), STEMI (HR=6.17, 95% CI 3.22-15.31), diabetes mellitus (HR=3.01, 95% CI 1.98-3.78), left ventricular ejection fraction <40% (HR=17.63, 95% CI 11.2-30.54) and ex-smoking (HR=2.34, 95% CI 1.57-3.85) were significant predictors of mortality in ACS patients. In-hospital mortality of patients admitted with ACS remains high in Kosovo as compared with developed countries. A better strategy for pre-hospital emergency care in Kosovo is recommended to save lives in these high-risk patients.

Partially Divided Flexor Tendon Injuries: Should They Be Repaired or Not?

The correct management of partially divided flexor tendon injuries is still controversial. Opinions vary regarding whether partially divided flexor tendon injuries should be repaired. Flexor tendon injuries are common because the tendons lie close to the skin. The tendons are therefore exposed to injuries like lacerations and crush injuries, and occasionally they can rupture from where they are joined to the bone. Tendon injuries are the second most common hand injuries in orthopedic patients.

Biomechanical and Macroscopic Evaluations of the Effects of 5-Fluorouracil on Partially Divided Flexor Tendon Injuries in Rabbits.

BACKGROUND: The main goals of flexor tendon surgery are to restore digital motion by providing tendon healing and to preserve tendon gliding. Our purpose was to investigate the effects of 5-fluorouracil (5-FU) on tendon adhesions in partially divided profundus flexor tendons (flexor digitorum profundus [FDPs]) following surgical repair and in partially divided FDPs without surgical repair, and to compare the results of the repair versus the nonrepair of zone two injuries via macroscopic and biomechanical evaluations of tendon adhesions. METHODS: We used 32 adult male European rabbits (Oryctolagus cunniculus) weighing from 2.5 to 3.5 kg. The study was performed on the deep flexor tendons of the second and third digits of the right hind paws of the rabbits; thus, a total of 64 tendons were examined in this study. RESULTS: Based on the results achieved in our experimental study, the load (N) significantly increased in subgroup 1a in which the tendons were surgically repaired and were not treated with 5-FU compared with subgroup 2a in which tendons were surgically repaired and treated with 5-FU. CONCLUSIONS: The load (N) significantly increased in subgroup 1a in which the tendons were surgically repaired and were not treated with 5-FU compared to subgroup 2a in which the tendons were surgically repaired and treated with 5-FU. Therefore, these results revealed a decrease in adhesion formation in the subgroup that was treated with 5-FU due to increased resistance to tendon adhesions during their excursion through the tendon sheath, which in this case required greater traction force.

A retrospective study of 572 patients with hand burns treated at the Department of Plastic Surgery Kosovo during the period 2000-2010.

Hands participate in everyday human activities and they are the most vulnerable parts of a human body. The objective of this study is to understand the common causes of hand burns, the methods of surgical interventions, duration of hospitalization and distribution of hand burns in 11 year period regarding the age. This is a retrospective study that included 572 patients with hand burns treated at the Department of Plastic Surgery Kosovo during the period 2000-2010. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Data processing was done with the statistical package InStat 3. From statistical parameters were calculated structural index, arithmetic median and standard deviation. Data testing is done with X (2) test and the difference is significant if P<0.05. The Ministry of Health of our country should make efforts to organize training for health workers about treatment for minor burns in order to reduce the number of referral patients from other primary (Familiar Medicine) and secondary centers (regional Hospitals).

A retrospective study of 22 patients with necrotising fasciitis treated at the University Clinical Center of Kosovo (2005-2010).

Necrotising fasciitis (NF) is a destructive invasive infection of skin, subcutaneous tissue and deep fascia. The aim of the study is to determine the causative agents of NF, its localisation, predisposing factors and comorbid conditions, duration of treatment and distribution of NF in different age groups and over the years. We conducted a retrospective study including 22 patients with NF from 2005 to 2010 in the University Clinical Center of Kosovo. The data were collected and analysed from the archives and protocols of the University Clinical Center of Kosovo. The average age of patients was 56·9 years. In eight cases or 36·4% of total patients studied, NF was caused by monobacterial agents with a predominance of Pseudomonas aeruginosa (five cases or 22·7% of total infections). Polybacterial agents were responsible for NF infection in other 14 cases (63·6%). Majority of the patients had other comorbidities like diabetes, trauma and prior history of surgical interventions. Diabetes was present in 17 patients or 77·3%. The remaining five patients (22·7%) had previous trauma and recent surgical intervention. Average length of treatment was 43 days. The hospital mortality rate in our case series was 22·6%. Early identification and diagnosis of NF significantly improves outcome and reduces mortality.