Za postavljanje dijagnoze sepse, najpouzdanije je određivanje PSP u kombinaciji sa drugim markerima sistemske infekcije. Pojedinačno merenje je često bez značaja, tako da je kontinuirano merenje u vremenu, sa trendovima pada ili porasta nivoa markera sistemske infekcije, daleko informativnije. Nivo PSP značajno zavisi od GFR. Kod obolelih od ABI, PSP je solidan pokazatelj sistemske infekcije do težih i prologiranih stadijuma ABI. Kod obolelih od HBI, tumačenje vrednosti PSP je veoma spekulativno, te postoji potreba za definisanjem novihcut-off vrednosti za PSP kod ovih bolesnika. Kod oblelih pod tretmanom HD, pokazan je različit klirens PSP sa različitim dijaliznim membranama. Svakako, nivo PSP se po HD vraća na pređašnji nivo, koji je inače povišen.

The aim of this paper is to analyze the method of term and preterm deliveries of twin pregnancies and vitality of twins at birth. The development of two fetuses in the uterine cavity at the same time is considered a twin pregnancy. Today, due to more often examination and proper treatment, 50% of twin pregnancies end in preterm delivery. We used retrospective study to analyze the delivery method and vitality of twins born term and preterm at Gynecology and Obstetrics Department of General hospital Novi Pazar in the five-year period, from 2009 to 2013. There were 10.489 deliveries in the said five-year period. Out of this number, 118 pregnancies were twin pregnancies and they amount to 1.12% of all deliveries which is in line with world’s standards. About 73% of deliveries were term and 27% were preterm twin deliveries. The analysis of twin vitality showed that first-born twins at both term and preterm deliveries are more vital and in better condition. Second-born twins are generally born with lower Apgar score. Due to liberalization for caesarean section indication, a great number of twin deliveries end in caesarean section. 

Head gunshot injures are usually fatal. Elderly patients may have survived penetrating head injuries, since old bullets with lower velocity produce much less damage to brain tissue. We report a case of elderly male patient with mild head injury due to accidentally fall. Patient died a few hours after admission to Emergency Department. Autopsy finding showed one strayed projectile in the posterior horn of left lateral ventricle and one in the soft tissue of right VIII intercostal space. Later we obtained information that patient suffered multiple gunshot wounds about 35 years earlier. However, the cause of death was deterioration of long-term and severe hypertensive and atherosclerotic heart disease.

In this manuscript we report one pediatric surgeon’s experience in childhood inguinal hernia repair. From 2005 to 2008, 402 children with inguinal hernias were operated on by one surgeon. A retrospective survey of their charts was carried out to evaluate the demographics and clinical aspects of these patients. The ages ranged from 20 days to 16 years with a maleto-female ratio of 2.5:1. 64.9% right, 27.1% left, and 7.9% bilateral hernias. Hydroceles were present in 6.2% assosiated hernias. Incarceration occurred in 8.7% of children. An opposite-side hernia developed in 5.7%. 5.3 percent of patients with a hernia repair on the right side later developed a hernia on the left side, and 8.2% of patients with a hernia repair on the left side later developed one on the right side. 4.5 percent of all male patients in this series and 8.6% of female patients developed an opposite-side hernia. While overall recurrence rate was 1.2%, our recurrence rate was 0.25%. There was a 0.24% wound infection rate, and 1 (0.24%) testicle was atrophic at followup. In this study, in the recurrence of childhood hernia, the general surgeon’s intervention was the prominent cause. It is suggested by the study that inguinal hernias on the contralateral side becomes symptomatic within the first six months following initial operation.Therefor, close observation is needed in that time.

The current practice for removal of benign vocal fold lesions is microlaryngoscopy under general anaesthesia. The technique provides excellent magnification with use of operating microscope and enables the surgeon to work with both hands at the same time. However, in certain cases the technique of indirect laryngoscopic surgery under local epimucous anaesthesia can be used as an alternative. In this article we will give the brief historic perspective of the procedure, indications and technical description, as well as its advantages and limitations. Given the fact that technique is not widely accepted by otolaryngologists, the author will also share some personal remarks on this relatively simple procedure.

Za postavljanje dijagnoze sepse, najpouzdanije je određivanje PSP u kombinaciji sa drugim markerima sistemske infekcije. Pojedinačno merenje je često bez značaja, tako da je kontinuirano merenje u vremenu, sa trendovima pada ili porasta nivoa markera sistemske infekcije, daleko informativnije. Nivo PSP značajno zavisi od GFR. Kod obolelih od ABI, PSP je solidan pokazatelj sistemske infekcije do težih i prologiranih stadijuma ABI. Kod obolelih od HBI, tumačenje vrednosti PSP je veoma spekulativno, te postoji potreba za definisanjem novihcut-off vrednosti za PSP kod ovih bolesnika. Kod oblelih pod tretmanom HD, pokazan je različit klirens PSP sa različitim dijaliznim membranama. Svakako, nivo PSP se po HD vraća na pređašnji nivo, koji je inače povišen.

In this manuscript we report one pediatric surgeon’s experience in childhood inguinal hernia repair. From 2005 to 2008, 402 children with inguinal hernias were operated on by one surgeon. A retrospective survey of their charts was carried out to evaluate the demographics and clinical aspects of these patients. The ages ranged from 20 days to 16 years with a maleto-female ratio of 2.5:1. 64.9% right, 27.1% left, and 7.9% bilateral hernias. Hydroceles were present in 6.2% assosiated hernias. Incarceration occurred in 8.7% of children. An opposite-side hernia developed in 5.7%. 5.3 percent of patients with a hernia repair on the right side later developed a hernia on the left side, and 8.2% of patients with a hernia repair on the left side later developed one on the right side. 4.5 percent of all male patients in this series and 8.6% of female patients developed an opposite-side hernia. While overall recurrence rate was 1.2%, our recurrence rate was 0.25%. There was a 0.24% wound infection rate, and 1 (0.24%) testicle was atrophic at followup. In this study, in the recurrence of childhood hernia, the general surgeon’s intervention was the prominent cause. It is suggested by the study that inguinal hernias on the contralateral side becomes symptomatic within the first six months following initial operation.Therefor, close observation is needed in that time.

Implementation of IMRT with 4DCT simulation offers possibility to correlate the respiratory movements and position of tumor volume during radiotherapy treatment. The aim of this study is to quantify movements of primary tumor during IMRT treatment in three axes-Z-superoinferiorSI, X-mediolateral ML, Y -anteroposterior AP.This study included 15 patients with lung carcinomareferred to radical radiotherapy. Contouring of GTV was done in the phases FB- GTV FB, phase 0-GTV0, phase 50- GTV 50, and phase MIP-GTV MIP. Comparison was done with GTV FB as basic value. Evaluation was done in three axis-SI, AP, ML. The movements of GTV in relation to X axis were in the range 0.02-0.47 cm, in relation to Y axis in the range from 0.01-0.56 cm, and according to the Z axis in the range of 0.00-0.79 cm. Based on the results of t-test there was a statistically significant difference (p<0.05) related to X axis between the upper and lower lobe. There was no statistically significant difference (p>0.05) between the upper, lower and middle lobes related to Y and Z axis. The test results which were obtained after the 4D CT simulation and planning of IMRT treatment show the importance of high-quality and precise radiation therapy treatment.

Stvaranje aneurizme leve komore je komplikacija koja može nastati kao posledica infarkta miokarda. Najčešće zahvata apikalni ili anterolateralni zid leve komore (85%) i prati okluziju prednje descedentne grane leve koronarne arterije. Zid prave aneurizme sadrži endokard, epikard i fibrozno ožiljno tkivo. Funkcionalno može biti akinetičan i diskinetičan. Ukoliko kod pacijenta postoje simptomi, kao što su srčana slabost, anginozni bolovi ili komorske aritmije, indikovana je elektivna operacija. Od operativnih tehnika najčešće se koristi Dorova procedura. Od materijala najčešće se koristi politetrafluoroetilen ili perikardno tkivo. Njihova mana je podlžznost kalcifikaciji i retrakciji. Cormatrix je tkivni pač sastavljen od decelularizovane submukoze svinjskog tankog creva. Bogat je kolagenom, glikozaminoglikanima i faktorima rasta. Eksperimentalne studije, sprovođene na životinjama pokazale su da implantacija ekstracelularnog matriksa u područije infarkta srca dovodi do pojave kontraktilnih elemenata, kao i do promene u prirodnom formiranju ožiljnog tkiva

U okviru ovog rada prikazan je slučaj bolesnika sa komplikovanim akutnim dislipidemijskim pankreatitisom u čijem je zbrinjavanju učestvovao tim, koji su činili endokrinolozi, gastroenterolozi i transfuziolozi. Dislipidemija, prevashodno tip IV dislipidemije, predstavlja čest uzrok nastanka akutnog pankreatitisa u populaciji mladih ljudi, posebno u slučajevima nezadovoljavajuće komplijanse (neredovno uzimanje preporučenih fibrata i nepridržavanje higijensko-dijetetskog režima). Tretman akutnog pankreatitisa se nezavisno od etiologije, zbog težine stanja, kompleksnosti lečenja i monitoringa bolesnika, sprovodi u Jedinicama intenzivnog lečenja. U slučajevima kada je dislipidemija uzrok akutnog pankreatitisa, često se u sklopu akutnog zbrinjavanja sprovodi i terapijska izmena plazme, kojom se brzo i značajno koriguju nivoi lipida, prevashodno triglicerida. Terapijska izmena plazme zahteva aktivnost transfuzioloških ekipa, koje su u manjim centrima, često nedostupne.