Listeriosis is an acute infectious disease of the zoonosis, caused by a microorganism Listeria monocytogenes, aerobic or anaerobic microorganism conditionally. The patient had received no department of neurology the clinical picture of hypertensive encephalopathy. Subsequently, the resulting figures are an indication that the sample fluid in isolation L. monocytogenes, the patient is treated with an appropriate antibiotic therapy with a positive outcome. Through illustrate our case quickly progressive neuroinfection we wanted to emphasize the importance of recognizing this now rare and easy to overlook entity, characteristically frequent interventions aging population, newborns, or people who are generally immunocompromised.

We are showing this event aimed to highlight the potential for gastroschisis at older mothers over 40 years and not only mothers younger population.The patient M. M, born in 1965, married in 41.years life diagnosed with uterine fibroids two. Three months after her marriage comes naturally to pregnancy. Sonographic findings: One fetus, pelvic presentation, amniotic fluid is optimal in the neck visibly thickened (accentuated nuchal traslucencija), BPD 25 mm, AC 84 mm, 14 mm FL, heart (-) NG / KL 15.2, NG / ultrasound 14.0, the placenta is embedded in the front wall of the uterus contraction. After careful observation in the area of insertion of the umbilical cord can be observed intestinal convolutions freely floating in the amniotic fluid. Grav.ml III IV.HBD ½-15 / 16.FMU. Anomalies foeti obs. Gastroshizis obs. Uterus myomatosus. Consultative decided to terminate the pregnancy GAO HC Novi Pazar. Ekstrahovana Bed, underwent explorative curettage and administered terapija.Fetus a whole with the umbilical cord and placenta sent to PH review. For three weeks the PH finding confirmed gastroschisis and miltipne anomalies. The paper describes the case female patient 41 years old, first pregnancy, in which the early second trimester of fetal gastroschisis diagnosed with absence of fetal heart rate. Pregnancy is consultative decision interrupted without complications.

Renocelularni karcinom (RCC) je najčešći maligni tumor bubrega kod odraslih. Čini oko 3% adultnih maligniteta i 90-95% neoplazmi bubrežnog porekla. Renocelularni karcinom može biti asimtomatski tokom najvećeg dela svoje evolucije a klasična trijada koja obuhvata lumbalni bol, hematuriju i lumbalnu masu je neuobičajena. RCC se karakteriše čestom pojavom paraneoplastičnog sindroma. Muškarac starosti 46 godina se žalio na uporan kašalj koji je trajao oko godinu dana. Negirao je druge tegobe i nije uzimao blokatore angiotenzin konvertujućeg enzima. Fizikalni nalaz po sistemima je bio u granicama normale. Rezultati laboratorijskih analiza su ukazali na ubrzanu sedimentaciju (SE 92 mm/1.h), leukocitozu i sideropenijsku anemiju (hemoglobin 103 g/L, serumsko gvožđe 4.3 μmol/l). Radiografija srca i pluća i spirometrija su bili uredni. Test na okultno krvarenje u stolici je bio negativan a vrednosti tumor markera su bile u referentnim granicama. Ultrazvuk abdomena je pokazao postojanje tumorske mase duž desnog bubrega. Kompjuterizovana tomografija abdomena je potvrdila postojanje tumorske mase veličine 93x72 mm duž celog desnog bubrega bez znakova invazije okolnih organa. Postavljena je radna dijagnoza renocelularnog karcinoma i izvršena je otvorena desna radikalna nefrektomija. Postoperativni tok je protekao uredno uporni kašalj je nestao 2 dana nakon operacije sa brzim poboljšanjem anemije i normalizacijom SE a uporni kašalj je nestao 2 dana nakon operacije. Tri meseca nakon operacije pacijent nije imao nikakve tegobe niti je bilo znakova rekurencije tumora. Veoma je važno imati u vidu čitav spektar simptoma i znakova kojima se renocelularni karcinom može prezentovati.

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.

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.

Spinalna mišićna atrofija (SMA) je autozomno recesivna neuromišćna bolest koju odlikuje progresivna denervacija skeletnih mišića usled propadanja alfa-motoneurona i sledstvena pojava hipotonije, mišićne slabosti, atrofije. Cilj rada je da se pokaže potencijalni uticaj broja kopija SMN2 na razvoj jednog od tri tipa SMA. Ispitivanjem je obuhvaćeno 74 pacijenta oba pola sa kliničkom dijagnozom SMA i to 44 (59.4%) ženskog pola i 30 (40.5%) muškog pola. Pacijenti su klasifikovani u određenu kategoriju SMA (tip 1, 2 ili 3). Glavni kriterijum za klasifikaciju bio je mogućnost samostalnog sedenja/hodanja. Dijagnozu SMA tip 1 imalo je 8 (11.3%) pacijenata, SMA tip 2 27 (38%), dok je SMA tip 3 imalo 36 (50.7%). Homozigotna delecije gena SMN1 bila je zastupljena kod 72/74 (97.2%) pacijenta, dok je kod preostalih detektovana jedna kopija ezgona 7 i 8 SMN1 gena (heterozigotni status), u kombinaciji sa tačkastom mutacijom na drugom alelu. Broj kopija SMN2 gena je bio statistički značajno niži kod SMA tip 1 pacijenta nego kod SMA tip 2 i tip 3 pacijenata (p<0.001). Broj kopija gena SMN2 je u korelaciji sa težinom kliničke slike SMA, što se može koristiti kao jedan od prognostičkih parametara kod ovog obolenja.

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.

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.

Schwannomas are benign sheat tumors composed of Schwann cells, which are covering peripheral nervs. Althought schwannomas can be found in any localisation, retroperitoneal scheannomas are extremly rare. Multiple schwannomas (neurilemomas) can be part of neurofibromatosis type II, as well as schwannomatosis. Depending on tumor localization, disease symptoms differ. We present a patient with multiple spinal as well as peripheral schwannomas as a part of schwannomatosis. Patient was successfully operated in cooperation between general surgeon and neurosurgeon.