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.

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.

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.

U poslednje dve godine pandemija izazvana COVID-19 infekcijom predstavlja najveći izazov sa kojim se suočavaju zdravstveni sistemi širom sveta. Ova bolest donela je ozbiljne promene u načinu rada zdravstvenih ustanova, a promenjeni su i prioriteti različitih medicinskih i hirurških intervencija, između ostalih i u domenu urologije.

U ovom radu prikazujemo uticaj COVID-19 pandemije na rad Službe za urologiju Kliničko bolničkog centra Zemun. Pored analize rada urologa u COVID-19 sistemu dat je i kratak pregled uticaja COVID-19 pandemije na različite, najčešće urološke bolesti, pre svega u odnosu na stepen hitnosti lečenja uroloških bolesti. Potom je dat osvrt uticaja COVID-19 infekcije na bubrežni sistem. Deo rada posvećen je uticaju pandemije na rad mladih lekara, odnosno pre svega specijalista urologije.

The aim of this paper is to determine the importance of the nurse in the assessment, prevention, treatment and education of patients with decubitus ulcers. The pressure on the thin layer of skin between the bone protrusions and the hard surface, which is higher than 25 mmHg, and which lasts longer than 2 hours, causes ischemia of local tissue (interruption of capillary circulation), and it eventually leads to permanent deterioration of soft tissue cells. Nursing care for patients with pressure ulcers or risk factors for the development of pressure ulcers is focused on all existing preventive measures that prevent, delay or slow down the onset of the disease. The initial assessment performed by the nurse must include a complete medical history, environmental assessment, and family assessment. The education of medical staff and patients must be an integral part of any preventive strategy against the development of pressure ulcers. The ultimate goal of education is to reduce the occurrence of pressure ulcers. In the research, we applied the survey method using the Questionnaire with 17 questions. We used the Norton scale to assess the risk of pressure ulcers. In a study of patients with pressure ulcers in our study, we concluded that the subjects were older, mostly over 70 years of age, and male was more prevalent. Other data (education, housing conditions, marital status, length of treatment and method of treatment, mobility, physical activity and mental status, risk factors and complications) of our study on 30 respondents agree with data from the world literature. In terms of satisfaction with health services and the work of nurses, respondents are mostly satisfied. The education of medical staff and patients must be an integral part of any preventive strategy against the development of pressure ulcers. The ultimate goal of education is to reduce the occurrence of pressure ulcers.

The aim of this study was to determine the importance of health care in the treatment of patients with gastrointestinal bleeding. Bleeding in the digestive tract is divided into bleeding from the upper and bleeding from the lower part of the digestive tract. Caring for patients with severe bleeding is a serious challenge. The role of the nurse and the way the patient approaches the patient in terms of care, but also recognizing the development of possible complications, is very important. Descriptive surveys were applied using a questionnaire as a research instrument. The study found that females are more represented than males, that the level of education is high and that most employees have been working for more than 5 years. The analysis of questionnaires from the second group of questions related to professional issues related to bleeding from the gastrointestinal tract showed that 80% (16) of respondents were thoroughly acquainted with the types of bleeding from the digestive tract, and that 70% (14) of respondents Bleeding from the digestive tract is influenced by hereditary and environmental factors, so that 65% of respondents know in detail and apply the nursing procedures used in cases of gastrointestinal bleeding. 95% answered that the nurse is obliged to fully recognize the symptoms of bleeding and possible complications, and that 60% of the respondents were fully acquainted with the procedures aimed at reducing pain in patients with gastrointestinal bleeding. All 100% of the respondents thought that the nurse was fully acquainted with the symptoms and signs of bleeding, with the procedures of diagnosis and treatment, as well as with dietary measures. 85% of respondents were aware of care measures related to reducing fear and insomnia in patients. 80% of the respondents thought that they had enough knowledge to provide care for patients with gastrointestinal bleeding, and 97% of the respondents thought that the patients were not enough, or not educated at all.

The aim of the study is to present the tasks of a nurse in educating mothers about the importance of breastfeeding. Breastfeeding is the best start to a baby’s life, because breast milk is the best food for a baby. Despite all the advantages and multiple positive effects of breastfeeding, a small percentage of breastfed children has been recorded in the world. For the purposes of this research, an indirect observational method was used - a survey. A questionnaire constructed for the purposes of this research was used as an instrument. Using the random sampling method, we included 30 postpartum mothers who underwent an education program. The research was conducted in the Health Center Podgorica, in the period from 01.07.-20.07.2021. years. According to the results of the research, 46.7% of mothers had enough information about the benefits of breastfeeding, and 46.66% of them had a problem with breastfeeding. The results show that 73.34% of respondents are educated about breastfeeding. Half of the mothers of 15 of them received the most information about natural nutrition from other mothers. 90% of mothers had a positive attitude about the importance of natural nutrition. Based on the conducted research, we can conclude that the engagement of the nurse in the issue of educating mothers about breastfeeding has improved the attitudes of mothers, but not to a sufficient extent. The results of the research show that mothers are not sufficiently educated about the importance of breastfeeding. Research shows that if mothers receive adequate information and support, they will be more willing to start and maintain breastfeeding for as long as possible. Existing studies indicate that women need effective support for breastfeeding,but many health professionals lack the necessary knowledge, attitudes and skills. The results of our study also show that it is necessary to improve the education of nurses in order to improve their skills and pass on important information to mothers about the importance and need for breastfeeding.

Kompjuterizovana kolonografija (KT), poznata i kao virtuelna kolonoskopija je neinvazivna radiološka dijagnostička metoda koja omogućava evaluaciju celog kolona sa ciljem otkrivanja kolorektalnih tumora i klinički značajnih adenomatoznih polipa. U suštini, KT kolonografija predstavlja modifikovani KT pregled kod pacijenta nakon neophodne pripreme creva gde se zatim dobijene slike tumače korišćenjem naprednih tehnika 2D i 3D prikaza1 . Karcinom debelog creva je jedna od najčešćih malignih bolesti kod oba pola i to je drugi je po redu vodeći uzrok smrti zbog malignih bolesti u razvijenim zemljama1 . Skrining i rano otkrivanje raka creva je značajna karika u prevenciji. Konvencionalna kolonoskopija je zlatni standard u dijagnostici i skrning kolorektalnog karcinoma3 .

Kako se kolonoskopija radi pod kontrolom oka, mogu se jasno videti sve, pa i najdiskretnije promene na debelom crevu: zapaljenski procesi, krvarenja, divertikulumi, polipi, benigni i maligni tumori. Virtuelna kolonografija, poznata kao virtuelna kolonoskopija je manje invazivna procedura i radi se pomoću KT skenera, koji propušta rentgenske zrake kroz pacijentov abdomen. Virtuelna kolonoskopija, može da otkrije više neočekivanih tumora od obične kolonoskopije, uključujući i one koji se nalaze van debelog creva. Ova tehnika je mnogo manje invazivna nego standardna kolonoskopija, za koju je obično potrebna anestezija dok lekar vrši pregled debelog creva kolonoskopom tj. savitljivim endoskopskim aparatom4,5.

Osim pogleda na unutrašnjost debelog creva, virtuelna kolonoskopija pregleda celi abdomen i karlicu, te je ovim putem moguće otkriti i tumore izvan debelog creva. Ipak, u praksi se češće koristi standardna, optička kolonoskopija koja je izuzetno pouzdana dijagnostička metoda. Kompjuterizovana tomografska kolonografija ili “virtuelna kolonoskopija” je metod u kojem se koristi tomografska 2D ili 3D slika kolona u cilju ispitivanja strukturnih promena zida creva, intraluminalnih promena ili promena koje sa spoljašnje strane pritiskaju zid creva. Prednost ove metode je što ne zahteva sedaciju, ne nosi rizik od perforacije i zahteva nekoliko minuta za pregled4 . Virtuelna kolonoskopija uz pomoć kompjuterizovane tomografije (KT) ili magnetne rezonance (MR) omogućava dvodimenzionalnu ili trodimenzionalnu sliku debelog creva od najnižeg dela rektuma, pa sve do donjeg kraja tankog creva te ih prikazuje na ekranu. 2D i 3D slike u KT kolonografiji treba da se dopunjuju. 3D interpretacija je korisna za otkrivanje polipa, posebno onih na preklopima zida creva. Sa druge strane, 2D interpretacija pomaže da se potvrdi da li je lezija identifikovana na 3D slici pravi polip ili samo lipoma, adhezivni izmet ili istaknuti nabor. Virtuelna kolonoskopija je manje invazivna od uobičajene optičke kolonoskopije6 .

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.