Research of injuries of passengers in city buses as a consequence of non-collision effects

In this study, a research of injuries of passengers in city buses is presented, which are not a consequence of collision of buses with other objects. The number of injured passengers in the territory of Belgrade was registered, during three consecutive years. Most frequently injured body part was the head, while women over the age of 60 are the most vulnerable population of passengers. The most often reason for the appearance of injuries was the effect of acceleration. Also, it is pointed out to the importance of consideration of the problem of multiple injuries. These injuries are more complex than the individual ones, and they may indicate to the existence of greater omissions in the design of the interior of the bus. Proposals for certain system solutions, as well as some recommendations for designing are given, which can improve the safety of passengers who use the city bus as a means of transportation

Altered cytokine expression in Helicobacter pylori infected patients with bleeding duodenal ulcer

Objective Peptic ulcer disease is a condition in which an important role has infection with H. pylori. The most common complication of peptic ulcer is bleeding. The presence of H. pylori triggers local and systemic cytokine signaling which may affect processes such as healing, gastric or duodenal rupture, and carcinogenesis. In this study, we examined the concentrations of IL-1β, IL-6, IL-10, TNF, TGF-β and IL-17A in serum by enzyme immunoassay and their mRNA expressions in periulcer biopsies obtained from patients with bleeding peptic ulcer by means of real-time-PCR. Results We have shown that pro-inflammatory IL-6 and TNF concentrations in serum were significantly higher in patients who were infected with H. pylori, while the concentrations of TGF-β and IL-17A were significantly lower compared to non-infected subjects. IL-17A expression in periulcer mucosa was significantly higher in patients who were infected with H. pylori, while the expression of other cytokines, there was no significant difference compared to non-infected controls. Considering higher serum concentrations in non-infected subjects and higher IL-17A expression in mucosal tissue of infected patients, our data support the studies that found IL-17A has protective role in eradication of H. pylori infection in infected patients

Eritropoetin u procjeni ishoda liječenja kod bolesnika s politraumom

Polytrauma is a term describing patients with injuries involving multiple body regions that compromises function of the body and/or organ involved. The aim of the study was to evaluate the potential role of erythropoietin in predicting poorer outcome in trauma patients. This prospective study included 86 patients admitted to the Emergency Center of Serbia due to polytrauma assigned according to Injury Severity Score (ISS). The patients were further evaluated using the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores and erythropoietin levels. There was a significant difference among erythropoietin levels at admission, after 48 and 72 hours, and on day 7 of hospital stay, with significantly higher levels in patients with ISS values 49-75. Based on the results, ROC curves were used to identify cut-off levels to predict ISS score with critical clinical course. It was concluded that erythropoietin could be a good marker of injury severity. Further research has to be performed to determine the cut-off values of erythropoietin that are significant for injury severity.Politrauma je termin koji opisuje bolesnike s povredama koje uključuju više dijelova tijela i koje ugrožavaju funkciju ­tijela i/ili organa. Cilj studije je bio procijeniti potencijalnu ulogu eritropoetina u predviđanju lošeg ishoda kod bolesnika s poli­traumom. Ova prospektivna studija obuhvatila je 86 bolesnika koji su primljeni u Urgentni centar Srbije zbog politraume dijagnosticirane prema rezultatu težine povreda (Injury Severity Score, ISS). Bolesnici su dalje procijenjeni pomoću rezultata Akutnog fiziološkog bodovnog sustava i bodovnog sustava kronične procjene zdravlja II. te procjene insuficijencije organa i razine eritropoetina. Postojala je značajna razlika između razine eritropoetina kod prijma, poslije 48 i 72 sata te sedmog dana boravka u bolnici, sa znatno višim razinama kod bolesnika s vrijednostima ISS 49-75. Na osnovi rezultata krivulje ROC su primijenjene za identifikaciju graničnih vrijednosti kako bi se predvidio rezultat ISS s kritičnim kliničkim tijekom. Zaključeno je da eritropoetin može biti dobar pokazatelj ozbiljnosti povreda. Potrebno je daljnje istraživanje za određivanje graničnih vrijednosti eritropoetina koje su značajne za ozbiljnost povreda

Frequencies of mtDNA haplogroups in Southeastern Europe: Croatians, Bosnians and Herzegovinianas, Serbians, Macedonians and Macedonian Romani

Mitochondrial DNA polymorphisms were analyzed in of 1,610 randomly chosen adult men from 11 different regions from southeastern Europe (Croatians, Bosnians and Herzegovinians, Serbians, Macedonians and Macedonian Romani). MtDNA HVS-I region together with RFLP sites diagnostic for main Euroasian and African mtDNA haplogroups were typed to determine haplogroup frequency distribution. The most frequent haplogroup in studied populations was H with the exception of Macedonian Romani among whom the most frequent were South Asian (Indian) specific variants of haplogroup M. The multidimensional scaling plot showed two clusters of populations and two outliers (Macedonian Romani and the most distant from mainland Croatian island of Korčula). The first cluster was formed by populations from three Croatian islands (Hvar, Krk and Brač) and the second cluster was formed by Macedonians, Serbians, Croatians from mainland and coast, Herzegovinians, Bosnians, Slovenians, Poles and Russians. The present analysis does not address a precise evaluation of phylogenetic relations of studied populations although some conclusions about historical migrations could be noticed. More extended conclusions will be possible after deeper phylogenetic and statistical analyses

Frequencies of mtDNA Haplogroups in Southeastern Europe - Croatians, Bosnians and Herzegovinians, Serbians, Macedonians and Macedonian Romani

Mitochondrial DNA polymorphisms were analyzed in of 1,610 randomly chosen adult men from 11 different regions from southeastern Europe (Croatians, Bosnians and Herzegovinians, Serbians, Macedonians and Macedonian Romani). MtDNA HVS-I region together with RFLP sites diagnostic for main Euroasian and African mtDNA haplogroups were typed to determine haplogroup frequency distribution. The most frequent haplogroup in studied populations was H with the exception of Macedonian Romani among whom the most frequent were South Asian (Indian) specific variants of haplogroup M. The multidimensional scaling plot showed two clusters of populations and two outliers (Macedonian Romani and the most distant from mainland Croatian island of Korčula). The first cluster was formed by populations from three Croatian islands (Hvar, Krk and Brač) and the second cluster was formed by Macedonians, Serbians, Croatians from mainland and coast, Herzegovinians, Bosnians, Slovenians, Poles and Russians. The present analysis does not address a precise evaluation of phylogenetic relations of studied populations although some conclusions about historical migrations could be noticed. More extended conclusions will be possible after deeper phylogenetic and statistical analyses

Triage procedure in early hospital management of patients in emergency centres

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Bernard Organ Failure Score in estimation of most severe forms of acute pancreatitis

Introduction. Despite intensive research, efforts and clinical investigations on pathogenesis of acute pancreatitis (AP) and system morbidity during the illness onset, mortality is still very high in the group of severe forms. A significantly high number of patients show moderate, self-limited forms of illness, with a minimal degree of systemic or local complications, with full recovery. However, some of them have a severe form, followed by a high percent of morbidity and mortality, and system organ failure. The distinction between mild and severe forms of AP within 24-48 hours of hospital admission is very important for the treatment of these patients. The usage of multifactorial scoring systems holds a lot of promise, reaching reliability in the disease severity estimation of approximately 70-80%. Objective. The main purpose of this prospective study was to assess the correlation of the Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Bernard Organ Failure Score (BOFS) scoring systems in estimation of disease severity and outcome prediction. Methods. Sixty patients with AP participated in the study, all of them scored with the APACHE II and BOFS scores. The results were used for integration of laboratory and clinical parameters. Results. In our study, we had a highly significant correlation between the APACHE II and BOFS scores from the disease onset until the end of treatment. There was a highly significant correlation between these two scores and the serum C-reactive protein concentration level. Conclusion. The concept of the BOFS score has more advantages than the APACHE II score in the patients with severe forms of AP with organ dysfunction

Application of ultrasound diagnostics in cardiopulmonary resuscitation

Ultrasound is becoming increasingly available and incorporated into emergency medicine. Focused echocardiographic evaluation in resuscitation (FEER) is a training program available to emergency doctors in order to ensure adequate application of echocardiography in the cardiac arrest setting. The FEER protocol provides an algorithm, whereby a “quick view” can be provided in 10 seconds during minimal interruptions in chest compressions. Performing ultrasound in the cardiac arrest setting is challenging for emergency doctors. The International Liaison Committee on Resuscitation recommend the ‘quick look’ echocardiography view can be obtained during the 10-second pulse check, minimizing the disruption to cardiopulmonary resuscitation

Strengthening Emergency Care Systems to Mitigate Public Health Challenges Arising from Influxes of Individuals with Different Socio-Cultural Backgrounds to a Level One Emergency Center in South East Europe

Emergency center visits are mostly unscheduled, undifferentiated, and unpredictable. A standardized triage process is an opportunity to obtain real-time data that paints a picture of the variation in acuity found in emergency centers. This is particularly pertinent as the influx of people seeking asylum or in transit mostly present with emergency care needs or first seek help at an emergency center. Triage not only reduces the risk of missing or losing a patient that may be deteriorating in the waiting room but also enables a time-critical response in the emergency care service provision. As part of a joint emergency care system strengthening and patient safety initiative, the Serbian Ministry of Health in collaboration with the Centre of Excellence in Emergency Medicine (CEEM) introduced a standardized triage process at the Clinical Centre of Serbia (CCS). This paper describes four crucial stages that were considered for the integration of a standardized triage process into acute care pathways

Biometeorological phases influence pedestrian trauma

Introduction. Biometeorological circumstances have a big influence on all traffic participants, especially reflexes, moving coordination and perception ability. With a lower attention and drivers’ and pedestrians’ concentration, there was a larger amount of pedestrian trauma in certain biometeorological phases. Objective. The aim of this study was to establish the correlation between pedestrian trauma and biometeorological phases. Methods. The comparative analysis of everyday biometeorological phases for the city of Kragujevac determined by RHMI and the evidence of knocked-down pedestrians from the Kragujevac traffic police for the period 2003-2008. Results. There were 6,127 accidents, with 696 knocked pedestrians in 666 (10.87%) accidents. Most of them happened in 2003 (135), and the fewest in 2005 (90). Most accidents were during December (74), the fewest were in June (46). The fewest accidents were during 04-05-06 hour interval (by 2), most during 13-14 hours (61). There were 374 males and 349 females. Most of the males (by 60) were 0-10 and 11-20 years old, most of the females (74) were 11-20 years old. There were 443 pedestrians who suffered slight body injuries (112 were 11-20), 225 suffered heavy and 28 had lethal injuries (most over 70). As provokers, the pedestrians suffered because of improper crossing roads (185), while as a casualties, they suffered due to speeding of vechicles (285). Most accidents happened in biometeorological phases 4 (168) and 9 (151), the fewest in phase 10 (4). Conclussion. Statistical analysis shows a significant correlation between pedestrians’ accidents and biometeorological phases, when the most accidents occurred during penetrations of cold fronts, while there was a sudden switch of weather conditions from warm-dry to cold-wet weather