Postoje kontroverze vezane za vreme, vrstu i metod skrininga gestacionog dijabetesa, kao i za populaciju trudnica koju treba podvrgnuti skriningu. Iako najšire primenjen, glucose chalenge test, kao i alternativne metode skrininga različitim glikemijskim vrednostima, ne pokazuju dovoljno visoku specifičnost. Zato se traže alternativne metode skrininga. Osim o kontroverzama skrininga, ovaj pregledni članak razmatra u

Pathological diagnosis of lymphoproliferative processes has been associated with a high error rate of 17- 35%, compared to a low diagnostic error incidence of 1-3% in general histopathology. In lymphoma diagnosis, one half of the diagnostic errors result in significant clinical consequences such as delayed or inappropriate therapy, unnecessary treatment, avoidable morbidity and compromised survival.1 Inherent pathological ambiguity of lymphoproliferative processes, interpretational subjectivity, unfamiliarity with diagnostic criteria and novel entities, lack of expert opinion, inappropriate laboratory support and poor clinico-pathological correlation are the main reasons behind most pitfalls in this subspecialty.

Hodgkin lymphoma (HL) accounts for approximately 15% to 30% of all malignant lymphomas. According to current diagnostic criteria, approximately 90% to 95% of HLs fall into the Classical Hodgkin lymphoma (CHL) category; the remaining cases are nodular lymphocyte-predominant subtype of Hodgkin’s lymphoma (NLPHL) which is recognized as a separate entity in the World Health Organization (WHO) classification1. WHO classification is based on the fact that there are clear and consistent histologic, epidemiologic, immunologic, and genetic differences between NLPHL and CHL. NLPHL is an indolent germinal center (GC) B-cell malignancy, that represents a nodular proliferation comprised of a minority of large neoplastic centroblasts with multilobated nuclei, the so-called popcorn or lymphocyte-predominant (LP) cells. Immunohistochemically LP cells are CD20+, PAX5+, BCL6+, EBV-LMP1-, CD30- and CD15-. Background inflammatory infiltrate represent mixture of small B and T lymphocytes1. This type of tumour is characterised clinically by a relatively indolent course and a very good response to standard therapy in cases with low stage disease. Unfortunately, the prognosis is unfavourable for advanced stages2. CHL is also a clonal, malignant lymphoproliferation originating from germinal center B cells3. CHL has a bimodal age curve in western countries, showing a peak at 15-35 years of age and a second peak later in life at 45-60 years1. A histopathologic diagnosis of CHL is based on the identification of diagnostic Reed-Sternberg (RS) cells in an appropriate inflammatory background of mixed infiltrate by histiocytes, small lymphocytes, eosinophils, neutrophils, plasma cells, fibroblasts and colagen. Based on characteristics of the reactive infiltrate and the specific features of neoplastic cells, cases may be subclassified into one of four subtypes: nodular sclerosis (NSCHL), lymphocyte-rich (LRCHL), mixed cellularity (MCCHL) and lymphocyte-depleted classical Hodgkin lymphoma (LDCHL)1,4. Although most cases can be diagnosed on the basis of morphology alone, diagnostic criteria include the characteristic immunophenotype of the neoplastic population. RS cells and variants express the CD30 and CD15 antigens in the majority of cases and lack the common leukocyte antigen CD455,6. The LMP-1 protein of EBV is expressed in approximately 25% to 50% of CHLs depending on the histologic subtype and patient age7. The staining is membranous and cytoplasmic, and usually most neoplastic cells are positive. Etiology of CHL is still questionable, but due to the unique epidemiologic and clinical features of the disease, an infectious cause has long been suspected. Currently, immunohistochemistry for the EBV latent membrane protein-1 (LMP-1) and nonradioactive in situ hybridization for EBV-encoded early RNAs (EBERs) are the methods of choice for the detection of EBV in routinely fixed, paraffin-embedded tissues8. Recent data suggest that the EBV status of tumour cells in classical HL could have prognostic significance for patients with this heterogenous disease9.

Preeclampsia is a pregnancy-specific syndrome of unknown etiology and represents multisystem disorder. It is characterized by the increased blood pressure, proteinuria, and edema. Preeclampsia is a great risk for both mother and fetus. Disturbances of the balance between the production of reactive oxygen species antioxidants status is considered to be one of the causes of various pathological conditions of the reproductive system, including preeclampsia. The main objective of this study is to determine the activities of superoxide-dismutase and catalase in peripheral blood erythrocytes of the pregnant women with preeclampsia and healthy pregnant women before delivery and umbilical cord blood erythrocytes of their babies immediately after the delivery. The results showed that the activity of superoxide dismutase in erythrocytes were statistically significantly lower in the group of patients with preeclampsia than in healthy pregnant women, as in the group of their babies compared to the babies of healthy pregnant women. Similarly, catalase activity was significantly lower in women with preeclampsia compared to the controls, as well as in erythrocytes of their babies compared to babies of healthy mothers. An observed difference in the antioxidant enzyme activities suggests a putative association between preeclampsia and decreased antioxidant status. Since the direct application of antioxidants did not give expected results of the data presented indicate the opportunity for the prevention of preeclampsia and alleviation of symptoms by dietary measures and life style changes in the population of pregnant women and women of childbearing age, directy targeting the enzymatic antioxidant system.

Pregledom literature utvrdili smo da su primarni tumori slezine u dece jako retrka pojava, a angiom slezine u dece ispod pet godina je jako redak. Mi prikazujemo redak slučaj angioma u donjem polu slezine u dečaka uzrasta pet godina.Detetu je tokom rutinskog ultrazvučno pregleda bubrega nađena masa koja je na CT okarakterisana kao tumor donjeg pola slezine zbog koga je dete operisano. Dete je praćeno dve godine po operaciji. Dijagnoza i opcije lečenja su široko razmatrane. Angiom slezine je redak tumor u odnosu na druge uzroke abdominalnih masa u dece. Konačna dijagnoza je postavljena histopatološkom i imunohistohemijskom analizom od strane dva patologa i glasi: angioma slezine. Primarni tumori slezine u dece se jako retki a naročito angiom. Parcijalna splenektomija ili parcijalna embolizacija slezine su metode izbora kad je moguće kod primarnih tumora slezine u dece.

Among 781 cases of adverse drug reactions reported in 2010 to the Medicines and medical devices agency of Serbia involving 546 suspected drugs, the greatest reporting frequency was found for contrast media used in radiological diagnosis and visualization. Most of the commercial contrast media may be classified to inorganic (barium sulfate) and organic (iodine contrast media – ionizing and non-ionizing, low-osmolar, high-osmolar and isoosmolar). Iso-osmolar and low-osmolar contrast media are the most frequently used at domestic market, mainly because of the most favorable safety profile and tolerability. As their alternative in patients with hypersensitivity reactions to the iodine contrast media, gadoliniumcontaining contrast agents can be administered. Overall the incidence of adverse effects is 5-15%, while the incidence of serious adverse reactions is 0.04 to 0.14%. By mechanism and predictability, adverse reactions are classified to idiosyncratic and non-idiosyncratic. In clinical practice, the most common adverse reactions are mild - extravasation, headache, limb oedema, nausea, vomiting, bronchospasm, bradycardia, etc. However, serious side effects are the most significant; though rare, these can be dangerous, such as nephropathy, anaphylactic shock, thrombosis, arrhythmias, angina attacks and myocardial infarction, serious thrombocytopenia, neurological episodes with subsequent permanent sequelae and/or fatal outcome. Special attention is devoted to the systematization of available contrast media, the classification of adverse reactions and measures for their prevention in individuals with risk factors identified from the available primary evidence of high methodological quality and clinical validity.

The aim of the present study is to prospectively investigate the presentation of germ cell testicular tumors (GCCTs) in terms of clinical stage (CS) or histology, as the incidence of this malignancy in increasing. Patients diagnosed with GCTTS between 1976 and 2005 were categorized into 3 period depending on date of diagnosis of GCTTs and presentation characteristics assessed. For purpose of analysis patients were assigned into 1 of 3 similar groups in term of duration (10 years) (1976-1985, 1986-1995, 1996-2005). These 3 periods were compared statistically to identify the possible changes in the presentation of GCTTs. Among 1935 patients, the number diagnosed in each period was 111 (6%), 695 (36%) and 1129 (58%), respectively. There was substantial rise in the percentage of patients with GCTTs during the period of 30 years, particularly in 3rd vs. 2nd and 1st decade (P<0.0001). Overall, 46% of patients were diagnosed with seminoma and 54% with nonseminoma. The greater proportion of the entire cohort of patients presented in CS I (65%). Also, seminoma and nonseminoma occurred more frequently in CS I (78% and 51%, respectively). The median (range) age of the whole cohort of patients was 34 (14-80) years. The median age for developing metastatic seminoma was 4 years more than in CS I disease (38 vs. 42 years, respectively), while the median age for the presentation of CS I and metastatic nonseminoma was identical (31 years). The proportion of seminoma increased significantly in time (40% vs 55%) and this was accompanied by a significant decrease of nonseminoma (60% vs. 45%)(P<0.001). The proportion of patients in CS I disease also increased significantly with time (45% vs. 77%), while the proportion of patients with metastatic disease decreased (55% vs. 23%)(P<0.001). There was a significant rise in proportion of patients with CS I seminoma (27% vs. 47%) (P<0.001) and nonseminoma (18% vs. 30%) (P<0.001), accompanied by a significant decrease in the proportion of patients presenting with metastatic nonseminoma (46% vs. 15%)(P<0.0001). However, the proportion of patients with metastatic seminoma remained largery unchanged (13% vs. 9%). The present study shows a progressive increase of GCTTs during the observation period of 30 years, with increase in the proportion of patients with GCTTs confined to the testis, as opposed to metastatic disease. The other finding is that there has been an increase in the proportion of patients presenting with seminoma rather than nonseminoma. The reason for this remain unclear and require further investigation.

The aim was to determine the incidence of fetal breech presentation at term, the factors that determine how the impact of labor and mode of delivery on neonatal outcome in pregnancies with a fetus in breech presentation pelvic presentation is a form of the longitudinal position of the fetus, which leads the pelvis and occurs in approximately 3% of pregnancies. Numerous studies have shown contradictory results regarding the optimal mode of delivery in breech presentation of fetus. A retrospective study at the Hospital of Gynecology and Obstetrics, University Hospital Zemun-Belgrade in the period 01.01.2009-31.12.2011 year. We analyzed data obtained from the delivery protocol, computer databases and annual reports.study involved 111 pregnant women in the forward singleton pregnancy (37-41 weeks gestation) with fetal pelvis. We analyzed and compared the group of patients who delivered their babies vaginally and the group of patients who delivered their babies by caesarean section (emergency and planned). Analyzed and compared the following parameters: maternal age, parity, gestational age tudnoće, premature rupture of membranes, weight and head circumference fetus at birth, Apgar score and neonatal complications. The data were analyzed by descriptive and analytical statistics. Results are presented tables and graphs. The study period was performed 4665 deliveries, with 111 deliveries in futures fetuses in breech presentation, which is 2.4%. Women delivered vaginally was 79(71%), emergency caesarean section 17(15%), a planned caesarean section 15(14%) pregnant women. The study showed a statistically significant difference in parity (C2=6.23 p<0, 05), with greater participation in the group of primiparas cesarean section, gestational age (t=5.23 p<0,01), weight and head circumference (t=4.37, t=2.47 p<0,01), premature rupture of membranes, (C2=7.72 p<0,01) and gender structure (C2=4.03 p<0,05). The most common indication for elective Caesarean section was prolonged pregnancy, and for an emergency cesarean section because of the delivery routes. There was no statistically significant difference in age of the mother t=1.08, p>0,05, the values of Apgar score in 5 minutes t=1.67 p>0,05, neurological changes p=0.292 and birth trauma, p=0.292 between two groups of neonates. The values of ul minute Apgar score were at the limits of statistical significance p=1.97 p≥0.05. Vaginal delivery in breech presentation, fetal, obstetric an acceptable range, while respecting the principles of good obstetric practice, there is no increase in neonatal morbidity.