Using the HEART score in patients with chest pain in the emergency department of Kosovo as an important triage criterion for treatment and hospitalization.

Despite being a frequent presenting complaint in emergency rooms, chest pain's clinical therapy varies greatly. Our objectives were to identify the traits of people who complain of chest pain and to analyze the value of the HEART (history, electrocardiogram, age, risk factors, and initial troponin) score index for risk assessment. Depending on how bad it is, each abnormality can be given a score of zero, one, or two points. These five factors add up to the HEART score. Methods: Clinical information on 269 individuals with chest pain admitted to the Emergency Room was reviewed: January 2022 until January 2023. A prospective registry was used to record information about patients with nontraumatic chest discomfort who were admitted from the emergency department. Results: Over a 12-month period, patients admitted in emergency department were classified through HEART score. From them 101 patients (37%) belong to the age group older than or equal to 65 years, 134 patients (50%) belong to the age group 45-65 years, and 34 patients (13%) belong to the age group younger than or equal to 45 years. Strong positive correlation between troponin level (HEART score) and hospitalization, also p value 0.043 is typically considered to be statistically significant. According to HEART score classification 43 cases (60%) from the group with 7-10 (high risk) were hospitalized. According to anamnesis (history) on cardiovascular disease in relation to hospitalization, then 48 cases hospitalized (67%) belong to the classification 1-moderately suspicious and 21 cases hospitalized (29%) belong to the classification 2-highly suspicious classification. Conclusion: The HEART score can be used for triage since it is a simple, rapid, and accurate predictor of outcome in patients with chest pain. A medium risk group included about half of the patients who reported chest pain to an emergency room. Hospitalization and troponin level had a strong positive link (HEART score), with a p value of 0.043.

Modes of presentation of reactive arthritis based on the affected joints.

INTRODUCTION: Reactive arthritis is an autoimmune condition that occurs as a reaction against an infection site elsewhere in the body. Reactive arthritis affects mostly young ages, mainly group age 20-40 y.o., mostly males with ratio 2:1 against females, sometimes 3:1, and even 14:1. The purpose of the study was to observe the mode of illness presentation based on the number of affected joints. MATERIAL AND METHODS: During the 01.03.2012 - 01.03.2014 in the Clinic for Rheumatology and O.S.I.R. "Vendenisi - AL" in Besiana have been examined, elaborated and hospitalized 100 patients with reactive arthritis, out of them 66 males and 34 females. Patients underwent necessary laboratory, hematological, biochemical, and immunological examinations. Subsequently each affected joint has been examined based on the propedeutics rules (inspection, palpation and assessment of the level of motility), as well as x ray examination. RESULTS: From 100 examined patients 66% were males and 34% females respectively. 11% of them were in the 10-20y.o. group age, 30% belonged to group age 21-30 y.o., 24% of patients to 31-40 y.o. group age, 30% to 41-50 y.o. group age, and 5% of patients to the group age over the 51 year old. Regarding the affected articulations and modes of illness presentation, we've obtained the following results: Knee was affected in 64.7% female and 52,12% male patients respectively, T/C joint in 50% female and 57.57% male patients, MTPH joint in 41.11% female and 48.48% male patients respectively, and R/C joint in 44.11% female and 48.48% male patients respectively. Oligoarticular type is seen in 73% male and 70% female patients. Monoarticular type is seen in 14% male and 13% female patients, and poliarticular type is seen in 10% male and 14% female patients respectively. Results from our study have revealed that: reactive arthritis is more frequent in males than females in ratio 2:1 in the infections of urogenital infection, 3:1 in nasopharyngeal infections, and similar in infections of enteral origin. CONCLUSION: Reactive arthritis mostly attacks young ages 20-40 y.o., while over the age of 50 and below the age of 20 is rarely seen. First reactive arthritis attack in males occurs earlier than in females. Most affected joints are: knee, talocrural joint, metatarsophalangeal (MTPH) joint, radiocarpal (R/C) joint, and proximal interphalanteal (PIPH) joint. Oligoarticular mode of illness presentation is 2.5 more frequent than mono and poliarticular mode of illness presentation.