Who is the patient? Disclosure of information and consent in anesthesia and intensive care (informed consent).

Physicians have always strived to uphold all the ethical postulates of the medical profession in all aspects of the practice, however with the vast advances in science and technology, numerous ethical dilemmas regarding all aspects of life and ultimately death have emerged. Medical decisions however, are no longer in the sole jurisdiction of traditional Hippocratic medicine but are now deliberated and delivered by the patient and they are comprised of a number of additional determining aspects such as psychological, social, legal, religious, esthetic, administrative etc., which all together represent the complete best interest of the patient. This is the basic goal of the "Informed Consent". The widening of legal boundaries regarding professional liability may consequentially lead to a "defensive medicine" and a deterioration in the quality of healthcare. In the Republic of Croatia there a four types of liability and the hyperproduction of laws which regulate healthcare geometrically increase the hazards to which physicians are exposed to on a daily basis. When evaluating the Croatian informed consent for anesthesia, we can come to the conclusion that it is completely impractical and as such entirely unnecessary. Anesthesiologists should concentrate on an informed consent which would in brief explain all the necessary information a "reasonable" anesthesiologist would disclose to a "reasonable" patient so that a patient could undertake a diagnostic or therapeutic procedure unburdened and with complete confidence in the physicians who are involved in the treatment of the respective patient.

Clinical and patohistological factors affecting the 5 year survival rate in a population of Croatian women with invasive ductal breast carcinoma.

Breast carcinoma falls into a heterogeneous group of diseases which can be determined by various prognostic factors. The identification of clinical and histopathologic factors is of great value in predicting the progression of tumor growth and survival outcome. Due to a high degree of cell proliferation in breast tumors and high genetic instability of these tumors, as a consequence of defective DNA repair mechanisms, chemotherapy as a treatment option often renders very successful results. During our scientific study of the expression of genes responsible for mismatch repair of DNA in cells of invasive ductal carcinoma we also compared the patient survival rate with the major prognostic factors. This study included 108 patients who were surgically treated for invasive breast cancer at the Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital "Dubrava". The overall survival rate was compared to factors such as initial tumor stage, regional lymph node involvement and distant metastasis. The overall five year survival rate of our patients was 78.7%. Patients without the presence of distant metastasis, a lower rate of local lymph node involvement and a lower. tumor stage statistically had a longer overall survival period. It is important that physicians recognize the various clinico-pathohistological factors in patients with breast carcinoma. This study confirms that this prognostic factors determine the type of treatment required and most important, the patient overall survival period.

Peace test: is war sometimes a better solution? Survey of students of Zagreb and Mostar Schools of Medicine.

AIM: To investigate the differences among medical students from two medical schools, one in Zagreb, Croatia, and the other in Mostar, Bosnia and Herzegovina, in their affinity towards peaceful vs violent way of solving conflicts. METHODS: A total of 733 students from the Zagreb and 102 medical students from the Mostar University School of Medicine filled out an anonymous questionnaire during their enrollment into the next academic year. The questionnaire consisted of 10 Likert-type questions with 1-5 answer scale, which were designed to give an illustration of students' attitude towards war. The test score was calculated as the sum of all answers x 2+20. The total score ranged from minimum 40 to maximum 120 points, with a higher score indicating stronger inclination toward peaceful way of solving conflicts. RESULTS: There was no difference between the mean total scores of Zagreb and Mostar students (66-/+17 and 67-/+18, respectively; p=0.744). The mean score of female students was higher than that of male students (71-/+19 vs 63-/+16; p<0.001) for the whole sample as well as for Zagreb and Mostar samples separately (p<0.001 for both). The average score of 2.3-/+0.9 per question indicated that the students' choice was mostly undecided on war-prone activities. Younger students were more war-prone than older ones (p=0.008 for age, and p=0.024 and 0.013 for comparisons between students in earlier and later academic years). Students from cities that were affected by war but not severely damaged seemed less war-prone than students from cities that were either seriously damaged or not directly affected by war (p=0.032). CONCLUSION: Women, older students, and students from cities that were under war threat but not seriously damaged showed to be more morally engaged towards peace.