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.

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.

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.

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.

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.

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.

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.

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.