Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease of unknown etiology, which most commonly affects men, smokers, aged from 20 to 40. It is diagnosed by histological analysis of material obtained by lung biopsy, with immunohistochemical proving of Langerhans cells. The aim of this research is to determine pathohistological characteristics of PLCH and analyzing demographic, clinical and radiological parameters. Retrospective analysis of medical data for 13 patients, proven for PLCH at Institute for Pulmonary diseases of Vojvodina in period of fifteen years. PLCH was found at 9 (69.3%) women and at 4 (30.7%) men, average age 34.7 years. Main clinical symptoms were cough (76.9%) and chest pain (61.5%). Out of 13 patients, 11 (84.6%) were smokers. In most cases PLCH histologically corresponded to the cellular phase of the disease (46.1%), proliferative phase was present at 5 (38.4%), and the fibrotic phase at 2 (15.5%) patients. Immunohistochemically, Langerhans’ cells were positive for presence of CD1a and S-100 antigens in all 13 of analyzed cases, while CD68 antigen was positive in 6 patients. In 6 patients (46.2%) there was disease regression, and at 7 (53.8%) patients the disease progressed despite the applied therapy. In our research, PHLC was more common in younger females, smokers with cough and chest pain. At most of the patients, histologically disease was in the cellular phase. Langerhans cells were positive to presence of CD1a and S100 antigens in all 13 patients. At more than half of the patients the disease progresses despite the applied therapy.

Implementation of IMRT offers possibility to escalate radiation therapy dose without increased acute and late toxicity. The aim of this study is to compare acute and late genitourinary and gastrointestinal toxicity in patients treated with IMRT and 3DCRT technique. This study included 35 patients in study group A treated with IMRT technique, and 35 patients in study group B treated with 3DCRT technique. Patients were selected and referred to radical radiotherapy treatment prostate cancer. Acute genitourinary and gastrointestinal toxicity was evaluated during radiotherapy treatment according to recommendation of RTOG group. Late gastrointestinal and genitourinary toxicity was evaluated during regular control exams after radical radiotherapy treatment for six months. Based on the results χ2 test there was no statistical significant difference (p>0,05) between study group A i B in terms of acute gastrointestinal and genitourinary despite escalated radiotherapy dose in study group B treated with IMRT technique. Based on the results χ2 test there was no statistical significant difference (p>0, 05) between study group A i B in terms of late gastrointestinal and genitourinary toxicity. Intensity modulated radiation therapy is optimal technique in the radical treatment prostate cancer. This technique allows clinical benefit compared with 3D conformal radiotherapy-escalation of radiotherapy dose without increased toxicity in patients treated with IMRT technique.

As a consequence of significant development of neurosciences several different scientific fields as neuroeducation, neuroesthetics, nerotheology, neuromarketing etc. had been established. Neuroeconomics is interdisciplinary scientific field that has aim to explain neurological mechanisms of decision making process, mental ability of consideration of several possible alternatives, and ability to follow certain direction of action. Neuroeconomics is based on research methods, techniques and models that are overtaken from neurosciences, but also from cognitive and social psychology, as well as from experimental and behavioral economics. In practical sense, neuroeconomics is mainly involved in situations in which humans are not behaving according to rational model, but rather according to innate and adapted schemes of behavior and due to their strong emotional reaction. In this way, knowledge from the scientific fields of neurology and neurosciences that are obtained mainly by usage of neuroimaging, are used in example to investigate market or to determine functioning of employees in critical situations. This kind of practical approach opens several ethical and legal dilemmas..

Karcinom dojke je najčešća maligna neoplazmu u žena, čini oko 25% svih svih malignih bolesti i 15% svih smrtnih slučajeva, u ženskoj populaciji. Cilj našeg rada je ispitivanje učestalosti karcinoma dojke u pirotskom okrugu u periodu od 1998-2017 godine. Za ispitivanje smo koristili histopatološke izveštaje Službe za patologiju Opšte bolnice u Pirotu. Istraživanjem je obuhvaćeno 573 pacijenta operisana od karcinoma dojke u periodu od 1998-2017god. Analizirani su broj obolelih,vreme nastanka bolesti, starosno doba pacijenta u vreme dijagnoze, pol i histopatološki tip tumora. Za ispitivanje statističke značajnosti između grupa korišćen je Studentov t test. Karcinom dojke je verifikovan u 558 (97.38%) žena i u 15 muškaraca (2.62%). Prosečna starost žena sa karcinomom dojke u vreme dijagnoze je 62 god, a prosečna starost obolelih muškaraca je 64 godine Najveća učestalost karcinoma dojke zabeležena je u 2017 godini, pri čemu je zapažen statistički značajan porast broja obolelih od 2007 do 2017 godine. U radu se diskutuje o mogućim patogenetskim faktorima koji su uticali na signifikantan porast incidence karcinoma dojke u pirotskom okrugu.

Strano telo u disajnim putevima predstavlja životno ugrožavajuće stanje i zahteva urgentnu evaluaciju i lečenje. Prepoznavanje kliničke slike gušenja, anestezija i uklanjanje stranog tela u dečijem uzrastu predstavljaju veliki izazov za dečijeg anesteziologa i otorinolaringologa. U slučaju organskih stranih tela iritacija, inflamacija i bubrenje mogu dodatno komplikovati situaciju. Najuži deo disajnih puteva u deteta je subglotis i rigidni bronhoskop iritira ovo područje što može uzrokovati postoperativnu opstrukciju disajnog puta. Prikazujemo slučaj 13 mesečnog deteta koje je aspiriralo strano telo u levi bronh, kliničku sliku, preoperativnu pripremu, tehniku anestezije, tok rigidne bronhoskopije, kao i probleme sa kojima smo se susretali do izlečenja deteta.

Kadmijum (Cd) je mekan srebtrnasto-beli metal, jedan od 126 prioritetnih zagađivača, a svrstan je i u grupu humanih karcinogena I kategorije.Cilj rada je mikromorfološko i funkcionalno ispitivanje endokrinog pankreasa pacova hronično tretiranih kadmijumom. Za istraživanje su korišćeni beli Wistar pacovi ženskog pola, starosti 35-37 dana, težine 120-140 g.Ukupno je bilo 22 životinje koje su podeljene na kontrolnu (n=11) i eksperimentalnu grupu (n=11). Eksperimentalna grupa je svakodnevno tretirana sa 15mg/kg CdCl2 rastvorenog u pijaćoj vodi. Kontrolna grupa nije bila podvrgnuta nikakvom tretmanu. Svi pacovi su čuvani u kontrolisanim laboratorijskim uslovima. Posle tri meseca, sve životinje su žrtvovane. Tkivo pankreasa je rutinski obrađeno i kalupljeno u parafi n. Na 4μm presecima su primenjene HE i imunohistohemijska ABC metoda sa antitelima na: chromogranin A, insulin,glucagon,somatostatin, pankreasni polipeptid, i peptid YY. U životinja eksperimentalne grupe su nađene guste, hiperplastične B ćelije koje zaposedaju skoro čitavu površinu insule. Prisutna je i hiperplazija A ćelija sa izraženom funkcionalnom aktivnošću. Osim po obodu hiperplastičnih insula, pojedinačne A ćelije se nalaze i u acinusima u kojima je njihova aktivnost znatno povećana. Zapažen je povećan mitotski indeks i odsustvo citoplazmatskih produžetka D ćelija. Izražena je hiperplazija PP ćelija, sa znacima kako morfološkog tako i funkcionalnog polimorfi zma. Prisustvo PP ćelija je evidentirano i u hiperplastičnom i displastičnom epitelu većih duktusa. Samo u životinja eksperimentalne grupe smo našli ćelije koje sekretuju peptid YY. Ove ćelije imaju identičnu topografi ju kao i A ćelije, ali je njihov broj znatno manji. Hronično izlaganje kadmijumu remeti strukturu i funkciju endokrinog pankreasa.Sve pankreasne endokrine ćelije su pogođene.

Atipične ciste bubrega klasifikovane kaoBosniak III ili IV sususpektne na malignitet ali je u nekimslučajevima teško uspostaviti pravu dijagnozu uprkos savremenim radiološkim metodama i predložiti odgovarajući terapijski pristup. Evaluiramo slučaj komplikovane hemoragične bubrežne ciste kod 73 –godina starog pacijenta. Pacijent je primljen u našu bolnicu na dalju evaluaciju zbog nespecifičnih bolova u leđima i trbuhu i zbog hroničnih urinarnih infekcija. Ultrazvukom su verifikovane bilateralne ciste bubrega od kojih neke sa gustim sadržajem. Nakon CT pregleda jedna od tih cista je klasifikovana kao Bosniak II F, zbog diskretne opacifikacije zida ciste u jednom segmentu, dok je MR nalaz ukazao na suspektnu malignu leziju, pri čemu je opisana restrikcija difuzije intraluminalno, što ukazuje na prisustvo solidnog dela, te je pacijent nefrektomisan. Patohistološki pregled je verifikovao inflamiranu hemoragičnu cistu bez prisustva malignih ćelija. Atipična cista bubrega može odgovarati komplikovanoj cisti sa infekcijom ili krvarenjem, ali takođe i cističnom tumoru. Radiološki pregled često nije dovoljan za jasnu diferencijaciju. Lažno negativne biopsije kod cističnih promena su vrlo izvesne i često je neophodno izvršiti hiruršku intervenciju za preciznu dijagnozu.

Moebius syndrome is rare and complex disorder which due to clinical expression poses a great challenge for pediatric anesthesiologist. The most significant problem for anesthesia, due to craniofacial malformations, is difficulties to provide a safe airway. The need for anesthesia is imposed sometime in the age of the newborn and later in childhood because of necessary diagnostic and surgical procedures. We present the case of a two-month old infant with Moebius syndrome, potential anesthetic implications, as well as the safe application of the caudal block as an anesthetics technique for operations of Achilles tendons and correction of congenital deformities of both feet.

Investing in the health of mother and child during pregnancy and postpartum reduces inequality of achieving health care. Maternal and child health indicates health of the population, society as a whole and the effectiveness of health care. Since people in our area knows little and doesn’t talk about the postpartum depression, we tried to identify information how many maternal knows about the postpartum depression, mood disorder, which basis is not only biological, but also the psycho-social nature. Furthermore, we examined the relationship between being informed about postpartum depression and sociodemographic characteristicss and the level of the self-esteem.Instruments used in the study were a questionnaire on sociodemographic characteristics and Rosenberg’s self-esteem scale.The results of our study show that 68% of women don’t know what is postpartum depression, and that the knowledge of postpartum depression is associated with women’s education and employment. Correlation of being informed about postpartum depression and selfesteem is not determined.On the basis of these results, we believe that it is necessary that the institutions, experts from different areas and the future mothers learn more about postpartum depression, symptoms, treatment, causes and possible risks because the concern about the health of mothers and babies has to be primary concern of healthy society.

The incidence of diabetes is on a boom in the world. Coronary heart disease is the most common macrovascular complications of diabetes. Strict control of blood glucose levels contribute to the betterment of the patient and reduce the cost of treatment. The aim is to show the influence and significance of diabetes in the five-year outcomes in patients who underwent percutaneous coronary intervention Initially in the study included 800 patients who underwent percutaneous coronary angioplasty index. After the indexing procedure clinical monitoring is completed for 720 patients (90%) whose data after the completion of the follow-up period subjected to statistical analysis, which included descriptive statistics, a mutual comparison of the examined groups were used methods for testing the significance of differences numeric-factor analysis of variance (ANOVA) student’s t test, rank sum test (Mann-Whitney U test) hi-square test. They were monitored and analyzed the parameters of cardiac status obtained on outpatient examinations, and data obtained by telephone contact with the patient. Patients involved in the study had a very good glycoregulation, therefore there were no statistically significant differences in the five-year outcomes after percutaneous coronary intervention. The study showed approximately equal distribution of the sexes patients who are suffering from diabetes, those with diabetes mellitus type 1 patients with type 2 diabetes. There is no significance in survival, no matter what the patient is suffering from diabetes, has no significance because of the small number of deaths. It is similar to myocardial infarction, no statistically significant differences between patients with diabetes and patients who do not suffer from diabetes in terms of myocardial infarction.