Aktuelna metoda za uklanjanje dobroćudnih lezija glasnica na našem odeljenju je mikrolaringoskopija u opštoj endotrahealnoj anesteziji. Ova tehnika obezbeđuje odlično uveličanje pomoću operacionog mikroskopa i omogućava hirurgu da istovremeno operiše sa obe ruke. Ipak, u nekim slučajevima se kao alternativa može koristiti i indirektna laringoskopska hirurgija u lokalnoj epimukoznoj anesteziji. U ovom članku ćemo napraviti kratak istorijski osvrt na proceduru, indikacije i opis same hirurške tehnike, kao i njene prednosti i ograničenja. Imajući u vidu da ova tehnika nije široko prihvaćena od strane otorinolaringologa, autor će navesti i neka lična zapažanja u vezi sa ovom relativno jednostavnom tehnikom.

Prostate cancer is the second most common cause of cancer mortality in men population. Multifactorial etiology, unpredictable course and outcome of the disease put survival determining factors of disease in the spotlight. One of new survival prognostic factors is Charlson Comorbidity Index – CCI. We presented basic characteristics of CCI, literature review regarding the CCI, as well as advantages and disadvantages of this index. CCI represents optimal balance between ease of use and prognostic capabilities. CCI value significantly contributes to better assessment of the long-term survival and the selection of appropriate cancer therapy.

The objective of this study is to obtain data on the incidence of scabies in the city of Podgorica, the observed ten-year period (2006 to 2015) and its incidence in relation to age and gender. The second objective was to find out whether the incidence is declining to the observed period.Scabies is contagious, worldwide disease, sporadically or in epidemic form. For the creation of this parasitosis, importance is given to the socioeconomic status, living conditions, sexual promiscuity, the development of resistant populations of the parasite. In developed countries, the incidence shows a cyclical fluctuation, with long, calm intervals, while in developing countries the incidence is constantly high. The disease is spread by close physical contact, often spreading within families and it is subject to mandatory reporting. In this paper, we used the official data of the Institute for Public Health in Podgorica, which included all clinical cases reported for the ten years, a total of 1,141 people, which are classified according to age and sex, for each year. Scabies as parasitism has been reported in the highest percentage among the younger population, aged 0-20 years, more common among males. The largest number of patients is registered in 2012.

Caecal diverticulosis is a rare cause of ileocoecal pain in western population. It represents 3.6% of all colonic diverticular disease. Signs and symptoms of this disease may mimic acute appendicitis and it is found in one in every 300 appendicectomies. Giving its low incindence the correct diagnosis is usually intraoperative. Eighty-three years old male presented to the surgical admission unit with a two days long history of pain in ileocaecal region. The pain started suddenly, it was constant and worsened on cough and excertion. He was afebrile, denied nausea and vomiting, changes in bowel movements and urination. The abdomen was not distended, it was soft and tender in low right quadrant, without organomegaly. Renal sucussion was negative. There were no signs of hernias. There were traces of normal stool on the rectal examination. Blood tests revealed an elevated total leukocyte count with granulocytosis and elevated parametrs of inflamation. A provisional diagnosis of acute appendicitis was made. Taking into consideration the atypical presentation we decided to do the multislice computed tomography (MSCT) of the abdomen. It revealed a heterogenous soft tissue mass in the area of right hemicolon infiltrating the surrounding fat tissue. The patient was operated on the same day. The procedure revealed a normal looking appendix and caecal diverticulum with an inflamed wall with localized perforation. We performed a right hemicolectomy. The postoperative course was uneventful and the patient made a full recovery. Caecal diverticulosis, although a rare disease in the westwrn world should be taken into consideration in patients with pain in right lower quadrant of the abdomen. The management of this disease should be individual, depending on patient's health status and the stage of disease in the moment of diagnosis. Management of patients with confirmed caecal diverticulitis can be conservative or surgical. Surgical treatment include diverticulectomy, ileocaecal resection and right hemicolectomy.

Retroperitoneal sarcomas are mesodermic origin and include less than 1% of all malignant tumors. The most frequent histological type of sarcoma are liposarcomas. Most commonly they are located in lower extremitetes while intraabdominal findigs are rare. Early diagnosis is quite challenging because the first symptoms occur only in advanced stages of disease. The gold standard for diagnosing is MSCT. The therapeutic approach is surgical by combining radiation therapy in case of recurrence and excision was not comletly. The chemotherapy is still controversial, and most authors consider that it is not adequate way of treatment. Seventy years old woman was admitted to the department of surgery because of the pain located in theleft half of the abdomen. It lasts for 3 monthsand in recent times became stronger and accompanied by nausea. Stooll and urin were regular . Physical examination revealed painfully formation. Velaues of blood examples were within normal range. US and MSCT of the abdomen were made before operation. MSCT showed retroperitoneal TU formation size 52x35cm. The findings were confirmed during the operation. Tumor weight was 9250g. Histopathological examination showed that it was a low-grade myxoid liposarcoma. One year after surgery, there was a recurrence. The first symptoms of abdominal liposarcoma manifests only in advanced stages of the disease. Radical surgical excision first choice in treatment. If the excsion lines could not be clear radiotherapy should be added.

Breast cancer is a serious health problem. It is the most common cancer in women. The aim of this study was to estimate the concordance between ER, PR receptor and HER-2 immunohistochemistry assessment scores in pared CNB (core needle biopsy) and surgical specimens. Histological grade, oestrogen receptor (ER) status, progesterone receptor (PR) status, and human epidermal growth factor receptor-2 (HER2) status were evaluated in a blinded fashion in CNB and in surgical excision specimens. Absolute concordance rate between core needle biopsies and surgical specimens for histological grade was 50% with κ value (0,15) for ER 92% with κ value (0,79), PR 88% with κ value (0,73) and for HER2 96% with κ value (0,91). CNB can provide reliable information in evaluation of ER, PR and HER2 status in an invasive breast carcinoma.

Tumors of the gallbladder are rare. Adenomas of the gallbladder is mostly occur as papillary or tubular. Tubular adenomas of the gallbladder occur in middleaged and old people, and it is extremely rare in children. We present 61 year old woman in whom during an ultrasound examination of the abdomen for pain that lasts a long time discovered a chronic inflammation of the gallbladder and slightly polypoid tumor of the gallbladder. Cholecystectomy was performed based on ultrasonographic findings of polyps in the gallbladder. Macroscopic and microscopic established that it is a tubular adenoma type with intestinal epithelial dysplasia, which clearly indicates that it is adenoma with reliable signs of precancer Finding intraoperative cholangiography was normal, and the postoperative course was uneventful.

The aim of this paper is to present the incidence of placental abruption and placenta previa at GAO General Hospital N. Pazar like to stress the importance of bleeding in the second trimestreu pregnancy. A retrospective study was conducted at the department of gynecology and obstetrics, ZC Novi Pazar January 2008 December 2012th As the basis of the data, the history and the findings from the protocol konzervtaivno treated surgically and we pacijenata. Analizirali incidence of bleeding compared to the total number of births, maternal age, parity and gestation. During the period of 2008-2012, there were 186 abruption (1.72 %) and 34 placenta previa (0.31%). Within a given period, there were 10778 delivery of which 220 bleeding or 2.03 %. The incidence of placenta previa and ab.placente compared to 84.5% abruption and placenta previa 15.5%. The age of pregnant women who develop bleeding: the highest percentage of bleeding at the age of 26- 31god (43.6%) than in the group of 19-25 years. 82.63 % and the lowest in the group under 18 (3.18) and above 35 years of age (11.3%). Maternal parity. primipara i 92 (41.88%), second child 49 (22.27 %) , third child i 46 (20.91%), fourth child 28 (12.72%). Gestational age at which it contacted the bleeding; 8 to 27 ng (3,645), 28-34 ng 30 (13.63 %) 0.35 to 37 ng 41 (18.64 %), and 37 ng 141 (64%). Method of delivery; caesarean 117 abruption (62%) vaginal delivery 69 (38%). Placenta previa; cesarean section 28 (82.3 %) and 6 vaginal (17.6 %). Any bleeding in the second half of pregnancy should be taken seriously. Prolong pregnancy as possible. You need to pay attention to risk factors: hypertension, gestational diabetes, smoking, previous cesarean section, and in this sense preventive effect on pregnant women.

Colorectal cancer (CRC) is an important social and medical problem. Complete recovery can be achieved only if the disease is diagnosed in the early stages, most common by screening methods. Studies have shown that screening methods reduce the incidence and mortality of colorectal cancer. The methods for colorectal screening can be divided into tests that allow the detection of cancer (fecal occult blood test and fecal DNA test) and morphological tests that allow diagnosis of cancer or adenomatous polyps (flexible sigmoidoscopy, colonoscopy, double contrast barium enema, CT colography ). In people with average risk of disease, screening begins at 50 years and performed on one of the following: fecal occult blood test (every year), flexible sigmoidoscopy (every 5 years), colonoscopy (every 10 years), double contrast barium enema (every 5 years) or CT colography (every 5 years). Colonoscopy is the preferred method, and is used as a confirmatory method, if the any other methods was positive.

Mnogi autori odnedavno dovode uvezu postojanje elemenata metaboličkog sindroma(MetSy) kod bolesnika sa subkliničkim hipotiredizmom(SH).Cilj:U ovoj studiji preseka smo prikazali elemente MetSy kod novodijagnosktikovanih bolesnica sa SH ipokušali da utvrdimo njihovu povezanost. Istraživanje je obuhvatilo 70 ispitanica, 50 ispitanica sa novootrkivenim SH, i 20 eutiroidnih kontrola. Grupa bolesnica je prema vrednostima glikemije i posle OGTT testa podeljena na dve grupe, bolesnice koje imaju SH , a bez Diabetes mellitusa tip2 (DMT2), i bolesnice koje imaju i SH i DMT2. Kalkulacije su urađene pomoću EXCEL i Med Calc (verzija 9.3.8.0) programa,i pomoću programa SPSS-verzija 17. Dobili smo sledeće rezultate: Bolesnice su značajno starije u odnosu na kontrolnu grupu, imaju više vrednosti za obim struka(OS) i BMI (Index telesne mase ), značajnoveći procenat osoba sa hipertenzijom (62%) i DMT2 (36%),od toga 14% novootkrivenih sa DMT2, dok u kontrolnoj grupi nije bilo DM. Vrednosti glukoze i HbA1c su više u grupi bolesnica u odnosu na kontrolnu grupu, a nema razlike u insulinemiji i HOMA. Očekivano su vrednosti TSH i Anti TPO-At više, a koncentracije FT4 značajno niže kod ispitanica sa SH u odnosu na kontrolnu grupu.Utvrđeno je da postoji korelacija između koncentracije glukoze i TSH u grupi bolesnica,ali ne i u kontrolnoj grupi.Prevalenca MetSy je 25 % kod kontrola i 62 % kod bolesnica. S obzirom na rezultat naše studije preporučuje se odredjivanje glikemije kod svakog bolesnika kod koga je utvrđen SH,i obrnuto,određivanje tiroidnog statusa kod osoba sa DMT2. Takođe se preporučuje lečenje SH po utvrđenim kriterijumima, jer zajedno sa MetSy imaju veći rizik za razvoj kardiovaskularnog događaja.