Acute instable atherosclerotic plate in the basis of the pathophysiology of the acute coronary syndrome and it is divided on two big groups: a) acute coronary syndrome without ST elevation (NONSTEMI) and b) myocardial infarction with ST elevation (STEMI). Clopidogrel belongs to the group of antiaggregation drugs which inhibit ADP receptors and on that way prevent platelets aggregation. The clinical confirmation of the clopidogrel efficiency is confirmed trough 4 big clinical studies: CAPRIE, CURE, COMMIT/CCS 2 and CLARITY-TIMI 28 studies. In CAPRIE study, clopidogrel showed moderate but significant advantage comparing to aspirin in prevention of the secondary ischemic cerebrovascular stroke and myocardial infarction. The results of CURE study showed that doubled combined therapy with clopidogrel and aspirin brought the reduction of the relative risk of cardiovacular events with patients with acute coronary syndrome without ST elevation. The results of this study showed that the group of patients which received clopidogrel beside aspirin and thrombolytic therapy it came to the reduction of the occluded arteries. In COMMIT were also involved the patients with the acute myocardial infarction with ST elevation. Total number of lethal cases of the repeated myocardial infarctions or acute brain stroke was smaller in a group which was receiving clopidogrel beside thrombolytic therapy and aspirine in comparison with the placebo group. The results of CLARITY and COMMIT studies gave us recommendation that patients with acute myocardial infarction with ST elevation which have thrombolytic therapy or percutaneous coronary intervention should receive clopidogrel as well.

Allergic disease are actual pathologic condition in medicine. From this diseases can get ill people of any age, both sex, and the number of patients with allergic diseases rapidly increase in countries of progressive world. This disease are wide - spread, with tendency of increase, and they can have fatal result in extreme cases. Because of high prevalence of morbidity and complications they have, allergic diseases are health problem. According to World allergic organization, more than 40 % of population in world will be atopic. In our environment this diseases are increasing, because of bad ecological condition from one side, and from the other side of genetic influence, and on the top of ladder are allergic diseases of respiratory system. The mayor key process in atopia is continuous and plentiful production of IgE antibody. 

In clinical hyperkalemia, correlation between plasma K and the ECG is less reliable. A tall, peaked, symmetrical T wave with a narrow base, the so-called "tented" T wave is the earlinest ECG abnormality, usually best seen in leads II, III, V2, V3, and V4. The tented appearance and the narrow base are probably more characteristic of hyperkalemia than is the amplitude of the T wave. A decrease in amplitude of the R wave, appearance of a prominent S wave, widening of the QRS complex, depression of the ST segment evolve as plasma K approaches 8-9m Eq/liter. With hyperkaliemia, depression of intraventricular conduction is characteristically diffuse and results in prolongation of both the initial and terminal parts of the QRS complex. The resulting pattern may resemble RBBB, LBBB, left anterior or posterior divisional block, or a combination of the four.

Chronic pulmonary heart (HPS) stands for presence of right ventricular hypertrophy with or without right ventricular failure, arising as a consequence of chronic bronchial diseases, lung, pulmonary artery, or severe deformation of the thoracic skeleton. Excludes the pulmonary hypertension as a result of heart disease of left cavities, and congenital heart disease. During the evolution of chronic pulmonary heart, distinguished three stages: a) uncomplicated pneumopathology, b) compensated chronic pulmonary heart and c) decompensated chronic pulmonary heart. Lung ventilation is the process of moving air from the external environment to the alveolar and back, and its ultimate aim is alveolar ventilation space. This process takes place through active action - inspirium and passive - expirium, which causes the lungs to the basic position of rest. The disorders of ventilation lung function can be obstructive and restrictive, and there are often mixed forms with predominantly obstructive or predominantly restrictive pulmonary function disorder. These disorders were particularly expressed in patients with chronic decompensated pulmonary heart, what indicates this work. We studied 40 patients and found low values of vital capacity (VC) and forced exspirium volume in the first second (FEV ), with normal values of 1 Tiffeneau index, which speaks to the fact that respondents with decompensated chronic pulmonary heart have mixed ventilation insufficienty, ìainly restricted type heavy degree. 

Doppler ultrasound check-up significantly increases a possibility of initial functioning of arteriovenous fistula. The aim of the study was the preoperative evaluation of vascular system of the extremity for creation of arteriovenous fistula for haemodialysis. The examination was organized at Urology and Nephrology Clinic, Clinical Centre "Kragujevac". The examined subjects were 87 patients, 52 (59,8%) male and 35 (40,2%) female, mean age of 61±11,1 years. There were performed the routine biochemical analyses, demographical structure and clinical characteristics (type of anastomosis, fistula placement, arterial blood pressure, lumen size of the artery and vein, measured intraoperatively by Doppler technique). In 72,1% of patients with functioning fistula there was made a terminal-lateral anastomosis, compared to 57,7% of patients with initial non-functioning fistula, there was found a statistically significant difference between the groups p=0,008. Radiocephalic fistula was created in 62,3% of the examined patients with initial functioning , in patients with non-functioning, the distal fistula was created in 38,5% of the examined patients. Regarding the type of the fistula location there was obtained statistically significant difference; p=0,04. There was found a statistically significant difference between the group of patients with initial functioning of arteriovenous and the group without, concerning the intraoperatively measured lumen of the cephalic vein (2±0,29 vs. 2±0,38 mm); p=0,03 (2,1±0,5 vs. 1,8±0,4); p=0,0009. Statistical significance between the groups was also found in the lumen of the cephalic vein verified by the ultrasound (2,1±0,53 vs. 1,8±0,25 mm); p=0,038. Peak of the systolic speed of the radial, corelated to the group of patients with and the group without initial functioning fistula (50 ± 12,42 vs. 40 ± 6,9 cm/sec); (p=0,0026), has statistically significant value. By the correlation of the group of patients with initial functioning and the group of patients without initial functioning, regarding hemoglobin (97 ± 16,1 vs. 88 ± 18,3 g/l); p=0,006 and the level of urea (22,6 ± 12,7 vs. 23,9 ± 9,8); p=0,02, there was found a statistically significant difference. Color Doppler ultrasound has an important role in preoperative evaluation of blood vessels and it represents a meaningful predictive parameter of functioning of arteriovenous fistula. 

The existence of left ventricular hypertrophy is an independent prognostic factor for cardiovascular morbidity and mortality. Heterogenous factors lead to left myocardial hypertrophy. The most frequently factors are: arterial hypertension, valvular heart disease (aortic stenosis and insufficiency, mitral insufficiency), hypertrophic myocardiopathy, left myocardial hypertrophy after myocardial infarction... For making the diagnosis of left ventricular myocardial hypertrophy used electrocardiography („voltage“ and „repolarization“ criteria) and echocardiography. Echocardiography is the gold standard for diagnosis of left ventricular myocardial hypertrophy. Left ventricular mass was estimated by the modified formula 3 3 using measurements obtained in accordance with the Penn convention: MLK = 1,04 (LDDd+PWDd+IVSDd) - (LVDd) - 13,6 Where LDDd is diastolic left ventricular internal dimension, IVSDd is diastolic ventricular septal thickness and PWDd 2 is diastolic posterior left ventricular wall thickness in diastole. LV mass indexed by body surface area (g/m ). By Penn con2 2 vention left ventricular hypertrophy criteria were ≥134 g/m for men and ≥110 g/m for women.

A characteristic hemodynamic pattern has observed in patients with right ventricular infarction, with frequently accompanies inferior left ventricular infarction or rarely occurs in isolated form. The electrocardiogram may provide the first clue that right ventricular involvement is present in the patient with inferior wall myocardial infarction. Most patients with right ventricular infarction have ST- segment elevation in lead V4R (right precordial lead in V4 position). ST segment elevation of 0,1mV or more in anyone or in combination of leads V4R, V5R, and V6R in patients with the clinical picture of acute myocardial infarction (MI) is highly sensitive and specific for the diagnosis of right ventricular MI.

Conclusion about efficacious of some medication can be given based on reducing morbidity and mortality in patients treated with that medication.. Aim of this work was to estimate intrahospital mortality in patients with acute myocardial infarction (AMI), role of myocardial reinfarction in that and side effects of medications in patients who were different treated in initial phase of AMI, based on what they were separated in three different therapeutic groups: group treated with thrombolytic therapy, group treated with beta-blockers and group treated with nitrates. It was shown that intrahospital mortality is highest in patients treated with nitrates but there was not significant difference between thera-peutic groups in frequency of myocardial reinfarction while frequency of complications and side effects were in range as in others similar studies.

Cardiac dysrrhythmias can be found in patient with no signs of ischemic cardiac disease but supraventricular and ventricular arrhythmias can be developed in cardiac hypertrophy. In this work we have examined frequency of cardiac dysrrhythmias in patients with hypertension and with or without hypertrophy of left ventricule (LVH). Investigation was accomplished on 80 patients with high blood pressure. In all 80 patients, basic on ECHO signs we define LVH, and by using of Holter monitoring we analised dysrrhythmias. Basic on ECHO signs we have 2 groups of patients: I.group ECHO (+) LV, and II group ECHO (-) LVH, in each 40 patients. Holter monitoring have 37 patients [22 mans (59,45%) and 15 women (40,54%)]. Hypertensive patients with LVH, who hade dysrrhythmia, have middle value IMLV 155,3 ± 27,21; аgе 56,42 ± 6,04; duration of hypertension 11,73 ±10,05; and EF% 55,2 ± 3,77. In patients with Holter monitoring 16 ( 43,32%) have dysrrhythmias type II, IIIa, IIIb and IV Lowny degree, (12) 34,43% from 43,32% have LVH. Salves VES are registrated only in group hypertension patients with ECHO(+) 5,4%. By using Mann Whitney statistic test for presents of dysrrhythmias in 2 groups of patients (ECHO LVH and ECHO without LVH), we found statistics significants (p = 0,049). In IMLV 60-110 g/m² 8,82% patients have dysrrhythmia, IMLV 151-200 g/m² dysrrhythmias are registrated in 40%; and 50% patients have dysrrhythmias in IMLV> 200g/m². In group hypertensive patients with LVH dysrrhythmias are registrated in group with ecscentric LVH 35,1%

Heart insufficiency is frequent and important complication of acute myocardial infarction (AMI). Aim of this work was to estimate frequency, haevyness and course of heart insufficiency in patients with AMI who were different treated in initial phase of AMI, based on what they were separated in three different therapeutic groups: group treated with thrombolytic therapy, group treated with beta-blockers and group treated with nitrates. It was shown that time of admission and condition of patient in moment of admission is the key factor for choise of therapy but using of therapy making less frequency and heavyness of heart insufficiency while for cases with most difficult forms of insufficiency of heart as a pump thrombolytic therapy is practically only posible choice