Introduction/Objective: A diagnosis of STEMI can be made for patients with persistent chest discomfort or other symptoms of ischemia and an ST-segment elevation in at least two adjoining ECG leads. The differential diagnosis of ST-segment elevation consists of 4 major conditions: myocardial infarction, pericarditis, early repolarization syndrome, secondary changes and other diagnoses, such as pulmonary embolism (PE). The dilemma is whether an ST-elevation always requires the PPCI protocol to be activated? The objective of this article is to acquaint medical doctors with other similar clinical presentations and the importance of making the right decision that directly affects the course of treatment and the outcome for the patient. Case report: An 84-year-old woman called the EMS hotline complaining of chest pain and breathing difficulty. She was found in aprone position on a flat surface, pale and covered in sweat, but without chest pain at the ti. She had had hip replacement surgery and was discharged from the hospital two days earlier. She was currently receiving 0.4ml of Fraxiparine daily. Her blood pressure was 90/60mmHg, heart rate 115 per minute, breathing frequency 20 breaths per minute, blood oxygen saturation 70%. Upon auscultation, her heart sounds were softer, breathing was normal with no wheezing or crackles. ECG: ST-segment elevation in leads II, III and avF and reciprocal ST-segment depression in leads I, avL and V2-V6 and an S1Q3T3 pattern. Conclusion: There are many articles describing cases where the PPCI protocol had been activated for patients with similar ECG findings and who had been subjected to emergency coronary angiography. Since the coronary angiography findings had been normal and they were transferred for further diagnostics. Coronary angiography per se will not harm these patients, but delaying adequate treatment for pulmonary embolism could have a lethal effect. This is why it is very important to record serial ECG tracings. Rapid regression of ECG findings and Q-wave regression favorises pulmonary embolism.

In out-of hospital settings (OHS), various Trauma Scores (TS) are useful as significant trauma outcome predictors. This study was to retrospectively calculate the RTS (Revised Trauma Score), MGAP (Mechanism of Injury, GAP-Glasgow Coma Score, Age, Arterial Pressure) and GAP values and then compare them as mortality predictors in OHS. A cross-sectional study was conducted on 286 trauma patients (TP) in OHS treated from 1^st to 31^st October 2020 and transported to the Clinical Center of Serbia (CCS). The data analysed came from medical reports filled out by the IEM Belgrade doctors and the discharge papers from the CCS. Clinical and demographic variables for all the subjects, as well as their GAP, MGAP, and RTS scores, were examined. Their AUC values were compared. While analysing the ability of the GAP, MGAP and RTS scores to predict in-hospital mortality, we found comparable values at 0.890 (GAP), 0.869 (MGAP) and 0.871 (RTS) by using the AUROC curve with high statistical significance (p< 0.001). MGAP has the highest sensitivity, and GAP has the highest specificity. No significant difference in the ability to predict mortality between these three scores. Clinical parameters and calculated TS for all TP classified according to whether the subjects survived (n=230; 80.5%) or died (n=46; 19.5%) after four weeks of treatment in the CCS were significantly statistically different in these two groups. GAP, MGAP and RTS scores are significant predictors of poor outcomes and mortality in TP. It was established that there is no difference in their predictive value.

Introduction: Right ventricular myocardial infarction (RVMI) occurs as a consequence of an acute right coronary artery occlusion proximal to the branches supplying the right ventricular free wall. It rarely occurs as an isolated entity but presents as a complication of approximately 50% inferior myocardial infarctions. It is clinically characterised by the triad of arterial hypotension, elevated jugular venous pressure, and an absence of pulmonary congestion. In this setting, vasodilator therapy is contraindicated, while prompt intravenous volume loading represents the cornerstone of initial management. Case Presentation: A 50-year-old male presented with an acute onset of bilateral shoulder pain, nausea, and diaphoresis. The initial 12-lead electrocardiogram demonstrated an inferior STEMI, with maximal ST-segment elevation in lead III, suggestive of right coronary artery involvement. In the presence of hypotension, jugular venous distension, and clear lung fields, right-sided precordial leads were obtained, revealing ST-segment elevation in leads V4R-V6R, consistent with right ventricular involvement (Erhardt's sign). A rapid intravenous bolus of 0.9% sodium chloride was administered, resulting in hemodynamic stabilisation. The patient was urgently transferred to the cardiac catheterisation laboratory under continuous electrocardiographic and hemodynamic monitoring for primary percutaneous coronary intervention. Conclusion: Right ventricular myocardial infarction is associated with an unfavourable prognosis and carries a significant risk of iatrogenic complications if not promptly recognised. Early identification of RVMI and timely initiation of appropriate therapy are essential, especially in the prehospital setting.

Epidermolysis bullosa (EB) is a hereditary multisystemic disease caused by genetic defects in the skin's structural proteins. Depending on the type of disease, symptoms vary from localised fragility and bullae to a widespread generalised form, including extracutaneous manifestations. In the most severe forms, EB causes death in the earliest period of life. The treatment of EB is complex and usually requires the involvement of several different specialists. Without curative therapy, treatment is oriented towards supportive care, symptom control, and preventing mild to severe complications. Vector gene therapy Vyjuvek (beremagene geperpavec), based on the herpes simplex virus type 1, is a new hope for treating wounds in patients older than six months who suffer from dystrophic forms of EB.

Short bowel syndrome (SBS) is the leading cause of chronic intestinal failure in adults and most commonly follows extensive small-bowel resection. The resulting loss of absorptive surface and regulatory feedback leads to a spectrum of malabsorption syndromes, ranging from compensated intestinal insufficiency to intestinal failure requiring long-term parenteral support. Clinical outcomes are determined more by postoperative anatomy than by residual length alone, particularly the presence of colon continuity and the preservation of the distal ileum and the ileocecal region. The pathophysiology of SBS integrates reduced absorptive capacity, accelerated transit, gastric hypersecretion, disordered bile acid handling, microbiome perturbation, and impaired enteroendocrine signalling. Intestinal adaptation, driven by luminal nutrients and trophic hormones such as GLP-2, can partially restore function over months to years, enabling stepwise reduction of parenteral support in selected patients. Modern care is centred on structured intestinal rehabilitation delivered by multidisciplinary teams, combining individualised fluid-electrolyte strategy, optimised oral/enteral nutrition, targeted pharmacotherapy to control secretion and motility, prevention and management of catheter-related complications, and selective reconstructive surgery. Disease-modifying therapy with GLP-2 analogues can reduce parenteral support requirements in SBS-associated intestinal failure, while transplantation remains reserved for refractory, life-threatening complications. This review summarises current concepts and evidence-based principles for diagnosis, phenotype stratification, rehabilitation, and long-term surveillance in adult SBS.

This study examined associations between self-rated health (SRH) and burnout dimensions among prehospital emergency physicians. This cross-sectional study included a convenience sample of 151 physicians from one emergency medical service in Belgrade, Serbia. Burnout was assessed using the Maslach Burnout Inventory–Human Services Survey and SRH using a single SF-36 general-health item. Ordinal models examined three ordered SRH categories (excellent/very good, good, and fair/poor), with burnout dimensions entered separately and jointly, adjusting for age, sex, professional qualification, and chronic disease. Binary sensitivity analyses compared fair/poor with excellent/very good/good health. Higher emotional exhaustion was associated with less favourable SRH in the separate adjusted ordinal model (OR per 10-point increase: 1.31; 95% CI 1.04–1.64). After mutual adjustment for burnout dimensions, the estimate remained similar but was less precise (OR 1.30; 95% CI 0.96–1.75). Evidence was also inconclusive in the adjusted binary analysis. Depersonalisation and reduced personal accomplishment showed no clear adjusted associations with SRH. Unadjusted associations of shift work and daily working hours with SRH were inconclusive. Emotional exhaustion may be associated with physicians’ perceived health, although the evidence varied across models. The cross-sectional design precludes conclusions about direction or causality; longitudinal studies are needed.