Subtrochanteric fractures these days are about one quarter of all femur fractures. Mostly, they occur with the elderly which demand certain speed when it comes to operation procedures and quick verticalisation. These are fractures that extend from the distal part of the small trochanter and about 5 cm distally. A 88 year old patient underwent surgery in our hospital because of the fracture of the femur, sustained in a fall. On the basis of anesthesiology overview it was concluded that there is a very high risk. Stabilization of the fracture with self-locking wedge was done. Not in this or in other cases is not necessary to achieve perfect anatomical reposition, axle and length of the extremities are enough. This is achieved with the stabilization of the proximal and distal screws. Method of administration justifies its use for the most critical moments in the surgical treatment of the elderly population: the speed of execution and minimal approach.

Cilj rada je da pokažemo metode dijagnostike, terapiju i uspešnost lečenja infertiliteta u manjim sredinama. Retrospektivnom studijom analizirali smo dijagnostiku, terapiju i uspešnost lečenja infertiliteta u periodu od 2002-2006. godine. Pratili smo kupno 94 para sa problemom infertiliteta. Kod 30 parova problem dijagnostike i lečenja infertiliteta nije ozbiljno shvaćen, tako da su u startu bili osuđeni na neuspeh. Preostala 64 para su aktivno učestvovala u dijagnostici i lečenju tako da je studija zasnovana na njima. Analizirajući anovulaciju, odnosno stimulaciju ovulacije, kod 64 pacijentkine pratili smo: uspešnost stimulacije ovulacije, trudnoće i njihov ishod, nadzor ovulacije folikulometrijom i određivanjem progesterona 20 dc, komplikacije - hiperstimulirajući ovarijalni sindrom,prosečnu starost pacijentkinja, vrstu i trajanje infertiliteta,dužinu stimulacije, prisustvo bakterija u cervikalnom kanalu, nalaz HSG, hormonski status, ishod urađenih laparoskopija, spermogram muževa i mesto lečenja infertiliteta. Uzroci steriliteta kod ispitivanih pacijentkinja su poremećaji ovulacije, oštećenje jajovoda, bakterije u cervikalnom brisu, muški faktor, godine starosti. Poremećaji ovulacije su uzroci infertiliteta u oko 30-40% slučajeva. Stimulacijom ovulacije kod 73% pacijentkinja je došlo do trudnoće a kod 62% pacijentkinja je trudnoća završena uspešno.

Skin antisepsis prior to invasive procedures, hand hygiene performed by health care workers, sterilization and disinfection of medical devices and environmental surfaces are the most important measures used to control nosocomial infections. Hand hygiene is the cheapest and most effective measure. Hand rubbing with an alcohol-based hand rub is recommended for the routine decontamination of hands. Hand washing with soap and water should be employed when hands are visibly soiled, and when exposure to Clostridium difficile infection is suspected or proven. Most alcohol based hand rubs are based on isopropanol, ethanol or npropanol. The WHO published guidance recommend 20–30 seconds for routine hand rubbing. There are no recommendations stating that antimicrobial soaps are more effective than plain soaps. It is recommended to use alcohol-containing preparatory agents for skin preparation prior surgery, injections, incisions and punctures. Neutral pH detergent solutions are commonly used for cleaning equipment and instruments. Data did not clearly demonstrate that enzymatic cleaners are more effective than non-enzymatic cleaners. High level disinfection is safe procedure only if adequate products are properly used. There are no any special products for multidrug resistant bacteria.

The biological potential of teratoma remains unpredictable, therefore identifying its presence in the retroperitoneum remains important. We evaluated patients undergoing post-chemothe rapy retroperitoneal lymphadenectomy (PC-RPLA) for nonseminomatous testicular tumors (NSTT), to determine predictors of teratomatous elements in the retroperitoneum. We identified 161 patients from 1982 to 2005 who underwent PC-RPLA for metastatic NSTT. Multiple clinical and pathological variables were reviewed from out RPLA database. Of the 161 patients in our series, 112 (70%) received only induction chemotherapy and 49 (30%) required 2nd line chemotherapy. Studies of retroperitoneal pathology demonstrated the presence of fibrosis in 44 (27%), teratoma in 82 (51%) and vital carcinoma in 35(22%).Among 82 patients (51%) with finding of teratomatous elements at PC-RPLA, we revealed the presence ofmature teratoma in 85%, immature teratoma in 12% and teratoma with malignant transformation in 3%. Of the 99 patients (61%) with teratomatous elements in the primary NSTT, 61 (62%) had teratoma at PC-RPLA. Even in the absence of teratoma in the primary NSTT, teratoma was present in the retroperitoneum in 21 of 62 patients (32%)(p<0.0001). All patients had normal values of serum tumor markers (STM) at PC-RPLA. Post-chemotherapy retroperitoneal residual mass measuring <2 cm, from 2.1-5.0 cm and > 5 cm in diameter occured in 30%, 52% and 55%, respectively. By multivariate analysis , teratoma in the orchiectomy specimen (p<0.005), relative change in nodal size before and after chemotherapy (p<0.005), and no requirement for 2nd line chemotherapy (p=0.33) were independent predictors for the presence of the teratoma in the retroperitoneum. Teratoma remains a common histologic finding in the retroperitoneal lymph nodes following chemotherapy. We have identified several pre-RPLA variables that predict the finding of teratoma in the retroperitoneum for men treated with chemotherapy for metastatic NSTT.

Karcinom mokraćne bešike predstavlja načešći malignitet urinarnog trakta. Primarni standardni tretman tumora mokraćne bešike je transuretralna resekcija (TUR), ali procenat recidiva kod pacijenata tretiranih samo TUR-om je do 70%, a procenat progresije tumora tj, invazije u mišićni sloj je oko 30%, a to su pacijenti kojima je indikovano radikalno operativno lečenje. Intravezikalna instalacija bacillus Calmette-Guerin (BCG) nakon TUR tumora mokraćne bešike predstavlja dokazano najefikasnije pomoćno sredstvo u lečenju i profilaksi površinskih karcinoma mokraćne bešike. Cilj našeg rada je poređenje ishoda lečenja pacijenata podvrgnutih TUR sa pacijentima lečenim kombinovanom terapijom koja obuhvata sprovođenje imunoterapije intravezikalnom instalacijom BCG nakon TUR. Rezltati prikazani u radu predstavljaju izvod rezultata prospektivno-retrospektivne studije koja se od januara 2013. godine sprovodi na odeljenju Urologije KBC Zemun.

Hair loss in children hospitalized for malignant diseases treatment is most visible manifestation that dramatically influences their later selfconfidence. Further, this could strongly affect possible development of psychic crisis. Scientific researches on motivational aspects of involvement for provision of non-formal categories of support to patients with malignant diseases are infrequent. Therefore, this topic should be more investigated in future. Humanitarian initiative “Kilometer of hair”, as unique philanthropic activity at territory of Serbia in year 2015, had as an aim to collect hair for preparation of wigs for children treated for malignant diseases. The main question in our study was definition of key motives for hair donation. We classified three main groups of motives. Altruism was detected as motivation in almost one-half of all interviewed subjects. Second group included almost one third of all subjects and their main motivation for hair donation was empathy. The smallest percentage of hair donors was motivated with some kind of public approval and welcome from society. We believe that further research in this area could give some directives for program planning of further improvement of social awareness for psychosocial support to children with malignant diseases.

Jednojajčani blizanci su multidisciplinarni fenomen, čudo fetalne biologije, medicinski reproduktivni izazov, najbliža i najtrajnija biološka veza. Cilj istraživanja je komaparativna analiza fiziološkog mirovanja mandibule kod jednojajčanih blizanaca. Ovo longitudinalno oralno-epidemiološko istraživanje, izvršeno je na randomizovanom uzorku od 30 parova jednojajčanih blizanaca, podjednake polne zastupljenosti i hronološke starosne dobi od 20 do 40 godina. Na osnovu statističkih parametara vrednovan je položaj fiziološkog mirovanja i obavljena komparativna analiza, odnosno određen stepen intraparske sličnosti i razlika, među članovima istog para i određen stepen interparske sličnosti i razlika, kod članova različitih parova monozigotnih blizanaca. Vrednovanjem poređenja položaja fiziološkog mirovanja,kod jdnojajčanih blizanaca, t-testom nije utvrđena statistički značajna razlika za fiziološko mirovanje, u predelu prednjih zuba. Konkordantnost odnosno usaglašenost konačnih ioshoda je dokazana među članovima istog i različitih parova. Razlika nije uočena, ni odnosu na pol. Komparacijom vrednosti položaja fiziološkog mirovanja, nije utvrđena statistički značajna intraparska ni interparska razlika, među članovima istih i različitih MZ blizanačkih parova.

Mucinous aenocarcinoma is one of the least common variant of prostate cancer. The prognosis of this variant of prostate cancer remains controversial. We report the case of 67-year old men with severe lower urinary tract symptoms (LUTS), bladder outlet obstruction (BOO), and sense of urinary retention. The serum level of prostate specific antigen (PSA) was 10.4ng/mL. Prostate was large (56mL), hard, lobulated, with extraprostatic extension and infiltration of surrounding structures, unsuitable for radical operative treatment. The patient demonstrated poor response to complete androgen blockade (CAB) (bilateral orchiectomy, steroidal antiandrogen) after 6 months of treatment with minimal decline of PSA (7.1ng/mL) and progressive growth of the primary tumor (110mL). The patient is submitted to antiandrogen withdrawal consisted of simultaneous addition of ketoconazole with hydrocortison substitution, resulting in normalisation of PSA (<1.0ng/mL) and diminution of prostate volume (PV) (63 mL) after 2 months, followed by adjunctive radiotherapy. Ketoconazole in reduced doses was stopped 6 months after completion of radiotherapy with PSA level < 0.002ng/mL and PV 16mL. The patient is alive with no evidence of disease more than 9 years after diagnosis of primary tumor. This case demonstrated modest hormonal sensitivity of mucinous adenocarcinoma of the prostate, whereas ketoconazole combined with radiotherapy, resulted in long term survival.

Razlike u polu su pronađene u mnogim oboljenjima srca, kod moždanog udara i tumora.Razlike u poluu depresiji kod pacijenata satumorommozga su retko istraživane. Cilj rada Cilj ovog rada je bio da se utvrdi odnos između ispoljene depresivne epizode i pola kod pacijenata sa tumorom mozga. Metode rada Podaci se sastoje od 115 pacijenata sa primarnim tumorommozga, 61 muškaraca i 54 žena. Depresija pacijenata je procenjena Hamiltonov skalom depresivnosti (HADS). Nivo depresije kod žena je bila veća u odnosu namuškarce. Nije bilo statistički značajne razlike između muške i ženske grupe, iako je depresija češća kod žena. Naši podaci su slični kao i većina rezultata iz epidemioloških studija koje pokazuju da je depresija češća kod žena.Dalje studije su potrebne da pronađu konekciju između biološkog uzroka tumora mozga i depresije. Razlike u polu pomažu nam da razumemo prirodu neuropsihijatrijskih poremećaja, koje će nam pomoći da pronađemo specifične tretmane i strategije prevencije.

Trisomy 13 (Sy Patau) is a clinically severe entity. 85% of the patients do not survive beyond one year, and most children die before completing six months of age. We report a female child, 30 day old, white, the third child of a non-consanguineous couple, who presented trisomy 13. The child was born at term, from a vaginal delivery, weighing 3200 g. The second day of life the development of respiratory distress translated ino KBC Kragujevac (release list no.29623). The initial clinical examination detected shisis primariy and secunday palate, ASD, stenosis rami AP, polidactily pedis dextri, microcornea and microftalmia. After 27 days of hospitalization in KBC Kragujevac, transferred to the Institute for mother and child New Belgrade, where he died after three days of receipt. During hospitalization blood samples were taken for determination of kariotip. Parents are advised that in case of subsequent pregnancies occur in the genetic counseling of the Institute for prenatal diagnosis.