Reperfusion therapy remains the most effective treatment for patients suffering from acute coronary syndrome. The start time of reperfusion therapy is an important factor, and has a positive influence in reducing the number of days of hospitalisation, occurrences of readmi ssion, risk of reinfarction, and both short and long-term mortality. Several models of reperfusion therapy are available: thrombolytic treatment (pre-hospital or in-hospital), primary percutaneous coronary intervention (primary PCI [pPCI]), or a combination of both. PPCI is the preferred treatment (and should be administered as early as possible) in centres with experienced teams, especially for patients in cardiogenic shock, or those with contraindicated fibrinolytic (TL) therapies. Many randomised clinical trials have shown that pPCI is superior to TL in reducing mortality, reinfarction, and stroke. Our aim is to describe the easiest and quickest way of establishing the primary PCI network in Bosnia and Herzegovina. It is possible, by combining the efforts of both entities of Bosnia and Herzegovina, to establish a functional and effective PCI network, particularly since Bosnia and Herzegovina has become a participant in the Stent for Life initiative.

AIM This study was to evaluate the impact of the family socioeconomic status (SES) on health-related quality of life (HRQOL) in children with type 1 diabetes mellitus (T1DM). METHODS The cross-sectional study included 65 consecutive children T1DM between ages 5 and 18 years and their mothers. The control group was formed by random selection by matching each patient with one or two healthy control subjects. To evaluate generic HRQOL in children with T1DM we used the PedsQL™ 4.0 Generic Core Scales which include both a parent proxy-report and a child self-report with age-appropriate versions. To categorize the families' SES, the parents' education level and current employment were recorded and analyzed using the Hollingshed two-factor index of social position. None of the diabetic children in the sample came from families of upper social classes, so we categorized our diabetic children into the lower and middle social classes. RESULTS Physical health (P=0.02), social functioning (P=0.04), and school activities (P=0.0003) were lower in T1DM children with middle SES families than in controls from middle SES families. Parental reports revealed statistically significantly poorer HRQOL in children from low SES families in total scale score (P=0.005) and in terms of physical (P=0.0126), and psychosocial health (P=0.0246) as compared with the control group with lower SES. Also the parental proxy reports for middle scores of family SES were statistical significantly lower in the total score (P=0.0001), psychosocial health (P=0.0001), emotional functioning (P=0.0006), and school functioning (P=0.0001) compared with the middle group of the control. CONCLUSION The current findings suggest that low and middle SES of families in children with T1DM is associated with lower generic HRQOL as compared to control children with similar SES of families.

Coronary artery spasm is one of the well-known causes of anginal chest pain. We presented the case of prolonged spasm of the left anterior descending coronary artery which happened during coronary angiography leading to pulse less state and low blood pressure with syncope and appearing of ventricular fibrillation on ECG. During one hour of successful cardiopulmonary resuscitation, the patient had again normal pulse and blood pressure. Coronary angiography performed immediately after DC's showed normal coronary angiogram. After two days the patient left the hospital without brain disorders.

The primary objective of the study was to examine the relationship between generic and disease-specific HRQOL scores and metabolic control in children with Type 1 Diabetes Mellitus (T1DM). This cross-sectional study included 65 consecutive children between ages 5 and 18 years with T1DM. According to their values of glycosylated hemoglobin (HbA(1C)), the children were assigned to one of two groups. In Group 1 (N = 21) were the children with HbA(1C) values < 8% (good to moderate metabolic control) and Group 2 (N = 44) were children with > 8% (poor metabolic control). To evaluate generic and disease-specific HRQOL scores in children with T1DM in relation to metabolic control, we used the PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Diabetes Module. The patients in Group 1, by pediatric patient self-report and parent proxy-report, had statistically better disease-specific HRQOL scores on the diabetes symptoms, treatment barriers, treatment adherence and worry domains in comparison with Group 2. We also found significant correlations between the total generic HRQOL scores and HbA(1C) for both parent proxy-reports' Spearman's coefficient of rank correlation rho = -0.257; p = 0.0412 and pediatric patients' Spearman's coefficient of rank correlation rho = -0.269; p = 0.0313. The current findings suggest that poor glycemic control in children with T1DM is associated with lower generic and disease-specific HRQOL scores in developing and transitional countries.

The aim of this study was to assess the quality of life children after cardiac surgery for congenital heart disease (CHD) and to compare these results with healthy children. To assess the quality of life children after surgery for CHD we performed a cross-sectional study of 114 patients who were patients at the Department of Paediatrics in Tuzla, between the ages of 2 and 18 years, of both sexes, and with one of their parents. We used the "PedsQL 4.0 Generic Core Scales", with both child self-report and parent proxy-reports. By self assessment, the PedsQL total scores for quality of life were statistically significantly different between children after cardiac surgery for ages 13 to 18 years and healthy children, while by parent report PedsQL total scores were statistically significantly different between children after cardiac surgery for ages 5 to 7 years and healthy children. By self assessment, children after cardiac surgery for ages from 5 to 7 and 13 to 18 years reported that they have a statistically significantly lower quality of life in the segment school functioning compared to the healthy children. By parental assessment, children after cardiac surgery for ages 2 to 4, 5 to 7 and 8 to 12 years have a statistically significantly lower quality of life in the segments of physical and psychosocial health, emotional, social and school functioning. The results of our study indicate that children after cardiac surgery for CHD by self and parent assessment have a lower quality of life than healthy children.

Hypertrophic obstructive cardiomyopathy (HOCM) is a primary, usually familial and genetically fixed myocardial hypertrophy, with dynamic left ventricular outflow tract obstruction. An alternative to surgical myectomy in the treatment of severe, drug refractory, HOCM is percutaneous transluminal septal myocardial ablation (PTSMA). We report a case of 24 year old female patient who had the first septal myectomy but because of progression of her disease, the percutaneous treatment of hypertrophic obstructive cardiomyopathy was performed. A year after the PTSMA the patient was without of symptoms.

OBJECTIVE The aim of the study was to assess the impact of the family socioeconomic status (SES) on health related quality of life (HRQoL) in children operated on for congenital heart defects. PATIENTS AND METHODS The study included 114 children aged 1.6-18 (mean = 10.2 +/- 4.2) years (46.5% male and 53.5% female), followed up at University Department of Pediatrics in Tuzla after cardiac surgery, and one of their parents or caretakers. Of 114 children with congenital heart defects, 54.4% had anomalies with left-right shunt, 18.4% obstructive type anomalies and 27.2% complex anomalies. Control group consisted of 127 healthy age-matched subjects (age range 1.5-18, mean = 11.2 +/- 4.2 years; 49.6% male and 50.4% female). In this prospective study, we used PedsQL 4.0 Generic Core Scale to assess HRQoL of children operated on for congenital heart defects. This measurement includes both the parent proxy and child reports. The family SES was assessed by use of Hollingshead two factor index of social position. Statistical significance of differences between respondents and control group was determined by use of t-test and ANOVA with Bonferroni test. RESULTS The reports of children operated on for congenital heart defects yielded no statistically significant difference in their HRQoL according to family SES. Parental proxy reports showed medium scores for physical health and activity to be significantly lower in children from low SES families as compared with those from medium SES families. Scores on school activities also differed significantly between patients with low and higher family SES. Parental reports revealed statistically significantly poorer HRQoL in children from low SES families in terms of physical health and activity, psychosocial and emotional health and social activities scores, as compared with the control group with low SES. Children operated on for congenital heart defects from medium and high SES families also had statistically lower school activities in comparison to control group of children from medium or high SES families. CONCLUSION The results of HRQoL according to parental proxy report indicated low SES to influence various aspects of HRQoL in children operated on for congenital heart defects. This could be explained by the fact that the risk factors associated with low SES may directly or indirectly affect not only family HRQoL but also HRQoL of children operated on for congenital heart defects. Therefore, it appears necessary for the low SES families with a child suffering from chronic disease to receive help from wider community to solve the above mentioned problem.

Angina pectoris may be associated with normaln coronary arteries. Normal coronary arteries status is defined as absence of visible disease or the irregularity of lumen (less than 50%) as assessed visually on the interventional cardiologists. In our retrospective study among 1130 patients we have identified 181 patients with normal angiographic findings with various risk factors, as male sex, body mass index (BMI), lipid disorders, smoking, hypertension, diabetes mellitus type 2. The analysis results suggest that 56.3% patients of 181 verified normal coronary findings involve female patients with high BMI, unregulated hypertension and lipid disorders. In order to find real causes of chest pain, patients with normal coronary status need careful examination and treatment. The reduction of risk factors and adequate medications are important preconditions for the good quality of life in these patients.

In this study we analyzed patients glucose levels taken before and after coronary artery bypass surgery. The data are taken from University of Sarajevo Clinics Centre- medical documentation of Heart Center from January 1st, 2007 to October 31st, 2007. Therefore, the entire study is done retrospectively. The patients considered in this analysis were divided into three groups. The patients in the first group were treated with peroral antidiabetics. The second group included patients treated with insulin while the third group consisted of patients without diabetes and acted as control group. All the patients had increased BMI. In the first two groups glucose levels were elevated before the surgery. Data analysis showed that three patients from the first group changed from peroral antidiabetics to insulin during postoperative period, and they were dismissed from hospital with this therapy. In the control group, peroral antidiabetis were introduced in four patients. The study results show that all the three groups have had high glycaemia on the first postoperative day. This may be caused by a number of reasons: inadequate pre-operative antidiabetic therapy, the impact of stress during surgery, inadequate pre-operative treatment of glycaemia or avoidance of the proscribed therapy by patients themselves. Stress during operation and administration of several medications after operation may also cause increased insulin resistance and distort glycaemia control.