Heart Failure Predictors in a Group of Patients with Myocardial Infarction.

AIM: The present study considers of the prevalence of heart failure (HF) in patients suffering from acute myocardial infarction (AMI) in the University Hospital Centre of Tirana (UHCT) "Mother Theresa"; the demographic and clinical characteristics of the sample during hospitalization; and the main predictors of heart failure occurrence inside the group of patients suffering an AMI. MATERIAL AND METHODS: During a period of study from 2013-2015 we studied demographic and clinical data from 587 consecutive patients presenting with AMI; Framingham criteria were adopted for classifying patients with HF upon admission. RESULTS: A Killip class ≥ 2 was the main diagnostic criterion of HF during hospitalisation. HF was identified in 156 patients (26.6%). The subgroup with HF had significant differences when compared with the other patients with regard to age, sex (male), heart rate upon admission, systolic blood pressure on admission, previous episodes of AMI, glycemia on admission, previous antihypertensive treatment, previous revascularization procedures, peripheral vascular disease, chronic renal disease, ejection fraction (EF), anemia, and atrial fibrillation presence. Independent predictors for HF occurrence in the logistic regression model were EF, previous revascularization, peripheral vascular disease, age, sex, previous AMI, systolic blood pressure upon admission, and anaemia. CONCLUSION: As a conclusion, HF seems to be a common occurrence after AMI, in spite of changes in the epidemiological profile of the acute coronary syndrome. An increase in the incidence is registered as well, parallel to a decrease in the mortality following AMI. Attention must be shown for highly risked subpopulations, aged persons, patients with the previous coronary disease, and concomitant conditions.

Prevalence and Correlates of Drug-drug Interactions in the Regional Hospital of Gjilan, Kosovo.

AIM: Our aim was to assess the prevalence and socioeconomic and clinical correlates of drug-drug interactions among the adult population of transitional Kosovo. METHODS: A cross-sectional study was conducted including a representative sample of 1921 patients aged ≥18 years (mean age: 57.8±11.2 years; 50.3% women; overall response: 96%) from the regional hospital of Gjilan, Kosovo, during 2011-2013. Potential drug-drug-interactions were assessed and clinical data as well as demographic and socioeconomic information were collected. Binary logistic regression was used to assess the correlates of drug-drug interactions. RESULTS: Upon multivariable adjustment for all the demographic and socioeconomic factors as well as the clinical characteristics, drug-drug interactions were positively and significantly related to older age (OR=2.1, 95%CI=1.3-2.8), a lower educational attainment (OR=1.4, 95%CI=1.1-1.9), a longer hospitalization period (OR=2.7, 95%CI=2.1-3.6), presence of three groups of diseases [infectious diseases (OR=1.7, 95%CI=1.3-2.4), cardiovascular diseases (OR=1.8, 95%CI=1.4-2.6), respiratory diseases (OR=1.6, 95%CI=1.2-2.5)], presence of comorbid conditions (OR=3.2, 95%CI=2.3-4.4) and an intake of at least four drugs (OR=5.9, 95%CI=4.6-7.1). CONCLUSIONS: Our study provides important evidence on the prevalence and socioeconomic and clinical correlates of drug-drug interactions among the hospitalized patients in the regional hospital of Gjilan, Kosovo. Findings from our study should raise the awareness of decision-makers and policy makers about the prevalence and determinants of drug-drug interactions in the adult population of post-war Kosovo.

Dexamethasone efficacy on bacterial meningitis--a retrospective analysis of Albanian adult patients.

BACKGROUND: Research on the effects of corticosteroids in bacterial meningitis (BM) yielded conflicting results. While some studies reveal that corticosteroids improve the outcomes in BM treatments, others provide strong evidence that patients do not profit from this treatment. We investigated the factors that may impact the dexamethasone efficacy in patients with BM. METHODOLOGY: In this retrospective study, we analyzed the medical records of patients with probable acute bacterial meningitis hospitalized between 2002 and 2008 at the Infectious Diseases Department, University Hospital Centre "Mother Theresa" of Tirana, Albania. They were all treated with dexamethasone. For study purposes, patients were divided into two subgroups: 1) Severely ill patients (Glasgow Coma Scale [GCS] or= 13. RESULTS: Sixty-seven patients analyzed had a mean age of 43.8 +/- 17.0 years old, forty-five (67.2%) of whom were males. The mean recovery time (RT) was 3.5 +/- 1.3 days, and four (6%) died. In the severely ill subgroup (GCS

A comparative, longitudinal study of stress in student nurses in five countries: Albania, Brunei, the Czech Republic, Malta and Wales.

BACKGROUND AND AIMS: Stress amongst nursing students is a global issue. There is an absence of published international comparative studies which investigate this and so this paper sets out to explore the sources of stress among nursing students throughout their course of study and to determine whether they were more stressed by academic or clinical factors across five different countries (Albania, Brunei, the Czech Republic, Malta and Wales). Although each country, within this study, has a unique culture, a cross-cultural comparison can be made in an attempt to better understand stress in the student nursing population. METHODS: The study was undertaking using a descriptive quantitative design using the Stress in Nurse Education Questionnaire with 1707 nursing students across the five countries. RESULTS: The mean score for the total sample for all the items on the stress scale was 52.3 (SD 17.1). The sample from Wales had the lowest mean score and those in Brunei had the highest. Students in Brunei and Malta were more stressed by the academic elements of the course than by the clinical elements. Whereas for those students in the Czech Republic For students in Wales and in Albania - Korçe there were no differences in stress experienced between the academic and clinical elements of the course. The results indicated that there were no significant differences in total stress scores by year of study for students in Albania - Tirana, Albania-Korçe, Malta and Wales. In Brunei however, ANOVA revealed that there were significant differences in total stress scores by year of study. Further analysis revealed that students in year 3 scored higher on the overall scale than students in year 1. The individual item on the stress scale with highest mean in the Albania - Korçe and the Albania-Tirana sample was "The death of a patient" whilst the Bruneian sample, Maltese sample and Welsh sample opted for "Revising for and sitting examinations" and the Czech sample chose: "Continuous pressure to meet deadlines for assessments". CONCLUSIONS: This study has succeeded as the first of its kind to compare and contrast levels and sources of stress amongst an international sample. The findings indicate that student nurses worldwide do share much in common while still retaining individual cultural features relating to stress throughout their course of study.