The aim of the study was to determine the epidemiological and demographic distribution of patients (age, sex), number of treated children by months, distribution by type of hemophilia, presence of comorbidities, clinical manifestations of hemophilia and severity of hemophilia in relation to age of patients treated for hemophilia. for examination and treatment of hematological and oncological diseases, Institute of Maternal and Child Health “Dr. Vukan Cupic” in the period from January 1, 2020 to December 31, 2020. Hemophilia mainly occurs in the male population and is inherited through the X chromosome (X-linked inheritance). An indirect descriptive method (analysis of medical documentation) was used in the research. Patient disease protocols and case histories were used as a research tool. In relation to age, almost half of the patients (43%) were of school age (age from 7 to 15 years), and in relation to gender, 81% were boys. In relation to the type of hemophilia, most patients had Hemophilia type A was diagnosed in 17 (81%) while Christmas disease (Christmas disease) as it is also called hemophilia type B, hemophilia C (Rosenthal syndrome) and the so-called . von Willebrand’s disease were significantly less common. The most common symptom was bleeding in the joints in 15 patients (71%), and other symptoms such as bleeding into the muscles, hematuria and bleeding in the gastrointestinal tract were less common. The nurse must be specially educated and trained to work with patients with hemophilia.

The aim of the research was to determine the profile of employed nurses involved in the care of patients receiving chemotherapy and to assess the level of specific education for this type of care. Specialized education, preparation and training are required for oncology nurses who administer chemotherapy and other dangerous anti-cancer drugs to ensure a safe level of care. An observational survey of the survey type was applied, and the results were presented by descriptive statistical methods. The study sample consisted of 20 respondents, nurses and technicians from the Institute of Oncology and Radiology in Belgrade. The research was conducted in the period from May 1 to 20, 2019, at the Institute of Oncology and Radiology in Belgrade. The profile of nurses in our study was that most nurses are traditionally female, with an average age of 36-55 with a high school diploma. Nurses have sufficient knowledge about malignant diseases (65%), 80% are well aware of the side effects of chemotherapy, 55% of nurses provide psychological support to patients with malignant diseases, and 75% assess pain in patients. A slightly higher percentage of 65% of nurses who devote enough time to acquainting patients with their disease and the purpose of treatment. Half of the respondents go to trainings regularly. Based on the results of the research, we can conclude that most nurses have sufficient knowledge about malignant diseases, but the number of those who need additional education is not negligible, to which additional attention must be paid.

The aim of this study was to point out the importance of the work of a nurse in the early detection of persons at increased risk for the development of diabetes at the level of primary health care. DM is a global phenomenon and a major socio-economic and medical problem. The most important tests for the diagnosis of diabetes are the determination of HbA1c and the oral glucose tolerance test (OGTT). The paper conducted a study in the form of analysis of data on examinations performed on 330 patients in 2020 at the Health Center Veliko Gradiste during the implementation of the project “Knowledge to Health” which included screening for early detection of DM type 2 by determining HbA1c-glycosylated hemoglobin and oral glucose tolerance test. The total number of respondents in this study was 330 and the survey was conducted during 2020. The analysis of the study sample showed that more than 184 respondents (55.76%) were female. In relation to age, most respondents were in the age group over 65 (64.54%) years of age in both sexes. This indicates that age (and often associated diseases) is a significant risk factor for type 2 diabetes. Measurement and determination of HbA1c values in both men and women showed that high values were mostly found in people over 65 years of age. The glucose load test in 27 men (oral glucose tolerance test - OGTT test) showed that normal tolerance exists in 10 men over the age of 65, w h ile 3 men over the age of 65 have a high risk of developing diabetes. Diabetes mellitus was determined by a glucose load test in 4 women ove r the age of 65, then in 1 woman aged 55-64, as well as in 2 women aged 45-54. One of the basic tasks of nurses is to conduct health education work with patients, give advice for successf u l treatment and care, and if done properly, it c an reduce one of the most important public health problems of modern society.

Schwannoma is a slow-growing benign tumor of the peripheral nerve that frequently occurs in the region of the head, neck and spine. We present a 50-year-old male patient diagnosed and operated for schwannoma of the ulnar nerve in the distal part of the left forearm. In the case of a palpable limb mass, one of the possible diagnoses is schwannoma, and since operative technique is somewhat specific with tumor enucleation and internal neurolysis, it is crucial to preoperatively keep in mind schwannoma as a possible diagnosis.

Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy in the absence of abnormal cardiac loading conditions. Apical hypertrophic cardiomyopathy (Yamaguchi syndrome) is a relatively rare HCM phenotype. It is characterized by apical left ventricular hypertrophy, often with the absence of left ventricular outflow tract obstruction. In patients with HCM symptoms of angina are quite common, mostly due to microvascular dysfunction or oxygen supply demand mismatch. Here we present a case of apical hypertrophic cardiomyopathy with concomitant severe coronary artery disease.

In this paper, we describe the case of an adult male with a pulmonary valve blood cyst. Blood cysts are benign primary heart tumors, common in neonates, but very rare in adults, mostly asymptomatic, and detected incidentally. Ultrasound (transthoracic transephophageal echocardiography) is crucial in detecting lesion, with the help of other diagnostic methods (MRI, CT). Further treatment, conservative or surgical, depends on the effect of the cyst on heart function. Although the diagnosis of cardiac lesions using routine imaging is available, definitive diagnosis is possible only by pathohistological and immunohistochemical analysis of the surgical sample.

Tumor nije moguće apsolutno korektno definisati. Tumori se prepoznaju po jednom parametru, a to je abnormalni rast ćelija, tako da se one razlikuju od normalnih ćelija po tome što više ne reaguju na normalne mehanizme kontrole rasta. Tumori se karakterišu stalnom, patološkom i autonomnom proliferacijom ćelija. Po biološkim karakteristikama dele se u dve velike grupe: benigni i maligni tumori. Maligni tumori rastu brzo, vrše razaranje okolnog tkiva i ukoliko se na vreme ne otkriju i ne leče, dovode do smrti. Najveći broj karcinoma nastaje spontano, kao odgovor na nepoznati stimulus, ali za nekolicinu su odgovorni sledeći faktori: hemijski ili fizički karcinogeni agensi, virusi, nasledna predispozicija, hormonski poremećaji i dugotrajne hronične bolesti. Maligni tumori mogu da budu dobro, srednje ili loše diferentovani. Ukoliko su građeni od nediferentovanih ćelija, grupišu se u anaplastične tumore. Maligni tumori rastu brzo, uz infiltraciju, invaziju i destrukciju okolnog tkiva. Nemaju kapsulu, nisu jasno ograničeni i retko se odstranjuju u potpunosti. Pored metastaziranja, invazivnost je druga najvažnija karakteristika malignih tumora. Postoje tri osnovna pristupa lečenju malignih tumora: hirurška ekscizija, zračenje i hemioterapija, a uloga pojedinačnih pristupa zavisi od tipa i stadijuma razvoja tumora1 .

Medicinske sestre i tehničari koji rade sa pacijentima obolelim od malignih tumora vrše procenu stanja pacijenta, edukaciju, menadžment simptoma i negu pacijenta. Onkološki pacijent spada u grupu pacijenata kojima bi trebali pristupati samo kvalitetno edukovani medicinski radnici2,3.

U radu je analizirana uloga medicinske sestre i tehničara u pripremi citostatske terapije, kao i klinički problemi i intervencije sa kojima se susreću i obavljaju medicinske sestre i tehničari prilikom lečenja onkoloških pacijenata.

Skočni zglob je često izložen povređivanju zbog svoje statičke i dinamičke uloge. Uganuće skočnog zgloba je značajna mišićno-skeletna povreda, kako kod fizički aktivne tako i kod opšte populacije1 , dok prelom gornjeg skočnog zgloba prednjači u povredama koštano-zglobnog sistema2 . Kod velikog broja povređenih osoba (10% do 60%) zabeležena je funkcionalna nestabilnost kao rezidualni problem3 . Većina stručnjaka ukazuje da se nakon povrede skočnog zgloba, naročito uganuća, razvija hronična nestabilnost. Ovo stanje karakteriše osećaj nestabilnosti zgloba, sa periodičnim ponovnim uganućem4 , a često je prisutno ograničenje obima pokreta dorzifleksije, povezano sa sa bolom3 . Povreda skočnog zgloba može biti preduslov za razvoj sindroma vezanih za stopalo i potkolenicu, kao što su plantarna fasciopatija, sindrom iliotibijalne trake, patelofemoralni sindrom, sindrom medijalnog tibijalnog stresa5 . Pored toga, pojava posttraumatskog osteoartritisa skočnog zgloba pronađena je čak kod 78% osoba sa hroničnom nestabilnošću zgloba4 . Kod osoba kod kojih je došlo do pojave kalcifikacija javlja se niz strukturalnih i senzomotornih simptoma6 , usled čega opada nivo fizičke aktivnosti7 i kvalitet života8 .

Ultrazvučni pregled je prvi pregled pri sumnji na bolesti urogenitalnog sistema. Ima visoku dijagnostičku vrednost, ne koristi štetno jonizujuće zračenje i relativno je jeftin, a nedostatak je što zavisi od iskustva radiologa i kvaliteta uređaja. Bolesti bubrega čine veliku grupu oboljenja različitog uzroka, toka, kliničke slike i prognoze. Ova oboljenja najčešće su izazvana infekcijama, metaboličkim poremećajima, toksinima i drugim uzrocima, a manifestuju se kao upale bubrega (glomerulonefritis, pijelonefritis, nefrotski sindrom) i akutna, odnosno hronična smanjena funkcija bubrega (bubrežna insuficijencija).

Ultrazvuk je standardna dijagnostička metoda kod hroničnih bolesti bubrega. Omogućava prikaz parenhima i kolektornog sistema bubrega. Pored ultrazvučnog pregleda, razvijene su i druge dijagnostičke metode, kao što su intravenska urografija, magnetna kompjuterizovana tomografija i magnetna rezonanca, mešutim ultrazvučni pregled i dalje je prva i nezamenljiva dijagnostička procedura kod obojenja urogenitalnog sistema, odnosno bubrega pre svega.

Najčešće indikacije za ultrazvučni pregled bubrega su: bol u slabinama, palpabilne mase u slabinama, hematurija, abnormalni laboratorijski nalazi koji ukazuju na oboljenja urinarnog trakta, evaluacija veličine bubrega, evaluacija obstrukcije urinarnog trakta, trauma u lumbalnoj regiji, učestalo mokrenje, smanjenje klirensa urina, pečenje tokom mokrenja ili groznica, evaluacija transplantiranih bubrega, biopsija i interventne procedure, neurogena bešika i kod pacijenata koji u alergični na kontrastno sredstvo, a imaju smetnje koje nesumnjivo potiču od strane urotrakta.

Radi jasnog formulisanja patološkog nalaza od nalaza u fiziološkim granicama neophodno je poznavanje normalnog ultrazvučnog nalaza, ali i anatomskih varijeteta odnosno bubrežnih anomalija koje u suštini nisu patološki nalaz. Ovaj pregledni rad obuhvata opis ultrazvučne anatomije bubrega, tehnike ultrazvučnog pregleda bubrega kao i pregled najčešćih anatomskih varijeteta odnosno bubrežnih anomalija koje u suštini nisu patološki nalaz.