1Family medicine education center at Health Center Tuzla, Bosnia and Herzegovina 1University of Tuzla Faculty of medicine, Department of family medicine, Bosnia and Herzegovina 2Family medicine education center at Health Center Zenica, Bosnia and Herzegovina 3Family medicine education center at Health Center Mostar, Bosnia and Herzegovina Selective serotonin reuptake inhibitors and risk for gastrointestinal bleeding Едукативни чланци / Educational Articles

ABSTRACT Objectives: The aim of this study was to evaluate a frequency and clinical presentation of hypertension crises due to age, gender, duration and seriousness at Emergency Medical Service Department of the “Dr Mustafa Šehovic” Health Care Center Tuzla. Methods: The research was conducted in the period between November 2009 and April 2010 and involved 180 examinees of both genders, aging between 30 and 80 years of age with the diagnosis of arterial hypertension. The examinees were divided into two groups: control group consisting of examinees without hypertension crisis (95 examinees) and experimental group consisting of examinees with hypertensive crisis (85 examinees). Descriptive statistical methods were used in the statistical data processing. Results: The research results showed that there had been significantly more female examinees than the male ones (60% vs. 40%; p=0.007). The average age of male examinees was 55.83±11.06 years of age, and the average age of female examinees was 59.41±11.97 years of age. The hypertension crisis frequency was 47.22%, where the hypertensive urgencies were statistically significantly more present than the hypertensive emergencies (16.47%vs.83.53%; p<0.0001). The largest number of experimental group examinees (28.23%) belonged to the age group of 60 to 69 years of age; urgency 26.76% and emergency 35.71%. The largest number of examinees with hypertensive crisis (49.41%) appeared in the period between 6.00 p.m. and 11.59 p.m. The largest number of emergency group examinees (69.01%) had been treated for arterial hypertension for ten years, and the examinees from the emergency group (42.86%) had been treated for 10, 11 and 20 years. The average blood pressure value at the hypertensive crisis examinees was 204.82/126.58 mmHg. Conclusions: The frequency of hypertensive crises in the Emergency Medical Service Department is high and it reaches 47.22%. Hypertensive urgencies were significantly more present in terms of statistics than the hypertensive emergencies (83.53% vs. 16.47%; p<0.0001).

Introduction: Factors of cardiovascular risk (CVR) are often grouped in cases with diabetes mellitus (DM) with significant increasment of risk for CV disease . The aim of this research is to determine the frequency of CVR and and total CVR in cases with DM and to investigate connection of CRP of other factors of CVR in total cardiovascular risks. Material and methods: In 92 cases with DM weist values were taken as well as body mass index (BMI), blood pressure, sugar in blood, cholesterol, triglycerides, C reactive protein (CRP) and according to SCORE system the 10 year period of CVR were determined. Results: Out of 92 tested cases with age 55,22± 8,3 years, 63,05% were males and 36,95% were women, 81,5% were with values of sugar in blood >7mmol/l, 44,6% were with values of HbA1C>7% and 63,0% >6,5%. The value of cholesterol were >4,5mmol/l in 87%, triglycerides >1,7mmol/l in 78.3% of tested cases. 81,5% of tested cases were overweight and 49% with larger weight values. Average cardiovascular factor according to SCORE system was 3, 92± 3,7% with significant difference among sexes (M-4,86; W-2,32, p3mg/l) 52% of tested cases were with high cardiovascular risk. There is significant positive correlation between CRP and cholesterol level (p<0, 01), triglycerides, blood in sugar, HbA1c and upper values of blood pressure (p<0, 05). Significant correlation between CRP and total cardiovascular risk (p=0, 63) was not evident. Conclusion: Cases with diabetes mellitus have high level of non regulated cardiovascular risk factors. Even though there is significant correlation between CRP and and pressure values, sugar in blood, HbA1c, cholesterol, triglycerides, significant correlation between CRP and total cardiovascular risk in cases with diabetes mellitus is not evident.

Background. Transfusion therapy represents a rational model of therapy which is frequently used in neonatal period. Aim.to investigate predictive role of blood group, Rh factor and gestational age in transfusions reaction in neonates. Patients and methods. we evaluated 95 neonates gestational age between 28 and 42 weeks treated with blood components. All neonates were treated in the Unit of Neonatology at Department of Gynecology and Obstetrics at University Clinical Center Tuzla in the period of 01.01.2006.-31.12.2008. Results. During the period of investigation there were 12 526 born neonates gestational age from 28 to 42 weeks. Incidence of transfusion reaction was 0, 37%. The median of gestational age in the complete sample was 38 weeks, with interquartile range from 35 to 39 weeks, with 28 weeks minimum and 40 weeks maximum. The incidence of transfusion reaction in relation with the blood group was most evident in recipients in blood group type A, but there were no statistically significant differences in incidence of transfusion reactions between four blood groups (X2=6.352; df=3; p=0.097). There was no statistically significant difference in incidence of transfusion reaction according to the Rh factor (X2=0.755; df=1; p=0.385). Investigation of transfusion reaction according to the blood group and Rh factor showed no statistically significant difference (X2=8.063; df=7; p=0.327). The logistic regressional analyses showed that the gestational age is significant predictor of appearance of transfusion reaction (OR=0.867; %95 CI=0.756 do 0.993; p=0.04). Conclusion. Transfusion reactions in neonates are not rare. The blood group and Rh factor are not valid in prediction of transfusion reaction while the gestational age is good predictor in appearance of transfusion reaction.