Arterial hypertension is a major risk factor for increased morbidity and mortality from cardiovascular, cerebrovascular and renal disease, and it is shown that it has its roots in childhood. There is an obvious trend in the incidence of hypertension in the pediatric population, which follows the increase in the prevalence of obesity in this population. The de¿ nition of hypertension has undergone signi¿ cant changes over the past few decades. According to the modern de¿ nition, normal systolic and diastolic blood pressure in children above 90 percentile speci¿ c for age and gender. Given the great importance of the disease, both in medical and in the broader social context, it is necessary to establish clear diagnostic criteria and treatment protocols, and effective programs for prevention and early diagnosis of hypertension in children.

Study objective was to test the relationship between maternal body mass index (BMI) and fetal abdominal subcutaneous fat tissue (ASCT) measured by ultrasound. The total number of pregnant women enrolled in the prospective study was 280. For all participants BMI was determined. Study participants underwent ultrasound exam at 32nd week of gestation and ASCT was measured. Positive correlation has been found between ASCT and maternal BMI (p<0.01, r=0.1612). The study showed that intrauterine growth and development is partially regulated by the maternal BMI.

Diabetes mellitus (DM) and maternal obesity are in parallel related with adverse maternal and neonatal outcomes. Examination of the combined association of these common metabolic problems with pregnancy outcomes is an important question. Objective of our study was to determine associations of diabetes mellitus and obesity with adverse delivery outcomes. The primary outcome measures were duration of labor, mode of delivery, Apgar scores in 1st and 5th minute, obstetric interventions and maternal injuries at births. Women with DM were more likely to have Cesarean Section (p < 0.01) and less likely to have had an episiotomy and perineal repair than women without DM (all p < 0.05). Connections between DM and obesity with other adverse outcomes of labor have not been found.

The aim of this paper is to show our results in the treatment of femur neck fractures in patients on hemodialysis. The femur neck fractures are more common in patients on hemodialysis than in patients without chronic renal failure. From the year 2000. to 2012, in the Traumatologic center of the CHC Zemun, 12 patients in terminal renal failure with femur neck fractures, were treated. The postoperative rehabilitation, occurence of complications and survival rates were followed. The operative treatment of femur neck fractures by implantation of endoprosthesis in patients with chronic renal failure, although followed by frequent complications, gives the patient a chance to return to normal activity.

Dobrovoljno davalaštvo (DDK) je jedini način za obezbeđivanje kontinuirane zalihe ovog jedinstvenog leka. Stoga je neophodno motivisati i informisati stanovištvo o pozitivnim efektima donatorstva krvi, a u cilju da se regrutuju novi i zadržavanja postojećih DDK. Cilj ovog rada bio je ispitivanje načina informisanosti, motiva i prepreka za dobrovoljno davanje krvi, kao i razloga za ponovno davalaštvo. Ispitivanje je obuhvatilo 65 DDK koji su popunjavali upitnik u Službi za transfuziju krvi KBC Zemun- Beograd. Pitanja su se odnosila na strukturne podatke (pol, starosna dob, obrazovanje), znanje i informisanost o davalaštvu, kao i na motaviciju i prepreke u vezi budućeg dobrovoljnog davanja krvi. Statistička obrada je obuhvatila standardne metode deskriptivne statistike kao i grafičke prikaze. Dobijeni rezultati su pokazali da je većina ispitanika za dobrovoljno davanje krvi saznalo od porodice i prijatelja (40.6%). Namensko davanje krvi je u većini slučajeva (33.8%) bio prvi kontakt sa davalaštvom. Čak 66.5% DDK se tokom procedure davanja krvi oseća odlično, međutim 7.7% kao prepreku u davanju krvi bira ubod igle. Njih 73.9% se odlučilo da će nastaviti redovno da daruje krv, a kao glavni razlog su uglavnom navodili altruizam (33.8%). Među onima koji bi krv darovali možda povremeno (26.1%), glavni motiv je bio slučaj da krv zatreba nekome iz bliskog okruženja (12.3%). Na osnovnu ispitivanja, može se reći da je u našoj lokalnoj zajednici dobrovoljno davalaštvo krvi zasnovano na altruizmu. Ipak, u cilju okupljanja većeg broja potencijalnih DDK i zarad zadržavanja postojećih, neophodna je stalna motivacija i promocija davalaštva kao jedinstvne karike zdravstvenog sistema u koje je uključeno celokupno stanovništvo.

The psychological impact of developing gestational diabetes mellitus (GDM) has been investigated widely in both children and adults. Although these studies suggest that person who develop GDM is at risk for emotional/ psychological distress, this finding is not universal. The aim of our study was to look at the state of anxiety in the group of pregnant women with well controlled GDM class A1 patients at 36 weeks of gestation and to compare it with the healthy controls at the same gestational age in population of pregnant women in Belgrade, Serbia. The study was carried on in 48 pregnant women with GDM and 80 healthy controls. The anxiety state of the two groups was evaluated with Hamilton Anxiety Scale (HAMA). The incidence rate of anxiety in the pregnant women with GDM were 27.03% (13/48), and in the healthy pregnant women 13.75% (11/80). The incidence rate of anxiety in pregnant women with GDM was higher significantly than control group, and there were significant difference in total score and its factorial score of HAMA in the two groups. The incidence rate of anxiety in the pregnant women with GDM is higher, and anxiety is the dangerous factor of GDM. Psychological state in pregnant woman, especially in pregnant women with GDM must be noticed, and psychological counseling and psychological therapy may be carried on as early as possible.

Cilj rada: utvrđivanje učestalosti uzročnika nekomplikovanih i komplikovanih infekcija urinarnog trakta novorođenčadi rođene u terminu kao i utvrđivanje eventualnih prediktornih faktora povezanih sa prisustvom najčešćih uzročnika u uzorcima urina. Metod: Retrospektivna studija obuhvatila je terminsku novorođenčad hospitalizovanu na Univerzitetskoj dečijoj klinici zbog urinarnih infekcija u periodu od deset godina. Podaci su prikupljeni iz raspoložive medicinske dokumentacije. Rezultati: Od 4261 hospitalizovanih novorođenčadi u periodu od deset godina, 286 (6.7%) primljeno je na odeljenje zbog infekcije urinarnog trakta. Komplikovane urinarne infekcije dijagnostikovane su kod 61 (21.3%) ispitanika a nekomplikovane kod 225 (78.7%). Kao vodeći uzročnici nekomplikovanih infekcija urinarnog trakta među neonatusima izdvojili su se coli (60.8%), Klebsiella (13.3%) i Enterococcus (4.9%). Pomenuta tri uzročnika najčešće su izolovani i u uzorcima urina kod komplikovanih infekcija (Escherishia coli 52.5%, Klebsiella 23.0% i Enterococcus 11.5%). Rezultati su ukazali da je veća starost neonatusa na prijemu povezana sa većom šansom da je uzročnik Escherichia coli (OR=1.06, 95% IP:1.02-1.11), dok su ženski pol i znaci komplikovane urinarne infekcije protektivni faktori (OR=0.27, 95% IP:0.14-0.49, odnosno OR=0.38, 95% IP:0.19 – 0.74). Sa druge strane ženski pol je faktor rizika za razvoj urinarne infekcije izazvane bakterijama Klebsiella (OR=2.75, 95% IP:1.44- 5.26) i Enterococcus (OR=3.05, 955 IP:1.33 – 6.97). Dodatni faktor rizika za infekciju urinarnih puteva novorođenčadi izazvanu Enterococcus je i komplikovanost infekcije (OR=2.61, 95% IP:1.10 – 6.20). Zaključak: Podaci dobijeni u istraživanju mogu biti od koristi pri odluci o izboru antibiotika u ranoj fazi lečenja urinarnih infekcija terminske novorođenčadi. Poželjna su dalja istraživanja o profilu rezistencije vodećih uzročnika urinarnih infekcija novorođenčadi na antibiotike.

Preeclampsia complicates about 5% of all pregnancies worldwide. It is a major cause of maternal, fetal and neonatal morbidity and mortality. The aim of this systematic review was to study the literature on the predictive potential of screening for preeclampsia based on serum markers and uterine artery Doppler velocity waveform assessment. First-trimester uterine artery Doppler can identify over half of women who will develop preeclampsia. Detection rates may be increased by a combination with maternal serum markers. In screening for early preeclampsia, the detection rate for a 10% falsepositive rate was 96.3% for a combination of maternal factors, soluble endoglin, placental growth factor and uterine artery lowest Pulsatility Index. First trimester placental protein 13 predicts preeclampsia in women at increased a priori risk and predicts early-onset better than late-onset disease. The Fetal Medicine Foundation has released in 2009 the new software to allow calculation of risks for preeclampsia and gestational hypertension. Uterine artery Doppler velocimetry in combination with some biochemical markers seems to be an effective first-trimester screening tool for preeclampsia and in particular early-onset preeclampsia.

The aim of our study was to determine whether there is a relationship of flow through arteriovenous fistula and adequacy of dialysis in patients treated with repeated hemodialysis. The study included 37 patients who were on the program of repeated hemodialysis for more than three months. Patients were divided into two groups according to the flow through the arteriovenous fistula. For each patient, the observed parameters were recorded at baseline and after six months. In both phases of the study, more patients who had reduced flow through the fistula had inadequate dialysis but none of these differences reached statistical significance. The frequency of abnormal values of laboratory parameters was higher in patients who had reduced flow through the fistula, but these differences were not significant in the first phase of the study. Between the two phases of the study in patients with adequate flow through the fistula, there was a reduction in the frequency of pathological values of laboratory parameters, and in the group of the patients with reduced flow rate the frequences remained the same or increased, so that in the second phase of the study the incidence of hypocalcemia was significantly higher in patients with low flow. Satisfactory flow through the vascular access is important, but not decisive factor for good dialysis adequacy and must be viewed within the context of other clinical and laboratory parameters.

Gestational diabetes mellitus and maternal overweight and obesity are associated with increased risk for adverse maternal and perinatal outcomes, such as fetal overgrowth. Although most studies addressing the effects of maternal BMI on adverse outcomes include women with GDM, a little is known about associations between maternal BMI and fetal metabolic status evaluated by ultrasonography means. One of the ultrasound parameter of glycemic controlis the measurement of fetal liver length. Prospective study of 385 women with monofetal pregnancies and established risk for GDM underwent mid-trimester ultrasound exam, during which fetal liver length were measured. After exam, body mass index (BMI) was determined for each patient. Each participant underwent 100 g fasting oral glucose challenge test (oGTT) in order to confirm or to exclude diagnosis of GDM. There was a statistically highly significant positive correlation between the BMI and fetal liver length for the entire sample (N=385; p<0.001; R=+0.55) as well in the sample of GDM patients (N=96; p<0.001; R=+0.58) and controls (N=289; p<0.001; R=+0.33). Maternal BMI has impact on fetal liver length assessed by ultrasound exam. This influence is even higher in GDM.