Prezentujemo slučaj obolele od akromegalije, sa prisutnim kožnim visuljcima na vratu i aksilama, kod koje su kolonoskopski detektovani brojni polipi kolona. Akromegalija je hronična endokrinopatija, najčešće uzrokovana adenomom hipofize koji sekretuje hormon rasta (somatotropinom). Povezanost akromegalije sa nastankom neoplazija još uvek je stvar debate i pored brojnih in vitro i in vivo dokaza. Ipak, maligniteti su na trećem mestu uzroka smrti u obolelih od akromegalije. Najučestalije neoplazije se detektuju u kolonu. Prisustvo izvesnih kliničkih znakova (npr. kožnih visuljaka), može ukazati kliničaru na postojanje prevage proliferativnoneoplastične IGF1 aktivnosti (npr. u kolonu). Sa tim u vezi, dužnost kliničara je da preduzme odgovarajuće dijagnostičke procedure u cilju detekcije neoplazija.

Društveni položaj žene u Srbiji u prvim decenijama XX veka oblikovali su patrijarhalno uređeni porodični i društveni odnosi kao i tradicionalni moral.Opasnost za život i zdravlje žene predstavljali su porođaji koji su se dešavali u kući a posebno ilegalni pobačaji koji su obavljani bez prisustva lekara, vršeni od lica koja nisu bila stručna, pa čak i u poodmakloj trudnoći. Ne higijenske prilike u Srbiji bile su glavni uzrok smrti porodilja i novorođenčadi kako na porođaju, tako i u prvim mesecima života. Pri tom, podaci pokazuju da je smrtnost porodilja i dece na rođenju na selu bila viša nego u gradu. U prvim godinama posle Drugog svetskog rata jedan od značajnih indikatora položaja žene u Srbiji se odnosi na dostignut nivo zdravstvene zaštite žene, trudnice, majke i dece. Zdravstveno prosvećivanje žena biilo je vezano za zdravstvenu zaštitu i borbu protiv, posledica neznanja i loših higijenskih navika u zaostalim i patrijarhalnim sredinama.U prvim posleratnim godinama posebna pažnja bila je usmerena na zdravstveno prosvećivanje žena na selu. Liberalizacija namernog prekida trudnoće odvijala se od početka 60-ih godina, da bi pravo čoveka da slobodno odlučuje o rađanju svoje dece, kao pravo garantovano Ustavom, bilo uspostavljeno 1974. godine. U poslednjoj deceniji XX veka u Srbiji je došlo do pogoršanja položaja žena-porodilja i majki čemu je doprinela višegodišnja ekonomska kriza u Srbiji.

Ovim radom obrađuje se deo problema ehinokokoze CNS-a koji se odnosi na spinalnu lokalizaciju oboljenja. Ističu se podaci o lečenim slučajevima u Neurohirurškoj Klinici u Beogradu, Specijalnoj bolnici “Vaso Čuković” u Risnu i Neurohirurškoj službi KBC Zemun. Kada je reč o kliničkoj slici detaljno se ističu: klinička slika kompresije medule spinalis, klinička slika sa udruženom spinalnom i viscelarnom ehinokokozom, klinička slika radikularne, odnosno periradikularne kompresije. Navedene su detaljno specifičnosti ovog oboljenja i teškoće pri postavljanju diferencijalne dijagnoze. Posebno se govori o mogućnostima ultrazvučne i kompjuterizovane tomografije pri postavljanju dijagnoze. Navedena je medikamentozna terapija u kombinaciji sa hirurškim zahvatom, kao i mogućnost supstitucije delova razorenog kičmenog pršljena sa Palakosom uz analizu dostupnog materijala

We compared the safety and efficacy of transurethral vapor resection (TUVRP) and transvesical prostatectomy (TVP) for prostate > 50 ml in retrospective study. Ninety patients with urodynamic obstruction and prostate volume (PV) in range between 50 and 100 ml were analyzed according to the mode of operative treatment (TUVRP vs. TVP). Patients were assessed preoperatively and followed-up at 3 and 12 months postoperatively. All patients underwent general and urological standard evaluation before surgery, including urine analysis, urine culture, blood samples tests, with determination of PSA, DRE, abdominal and minor pelvis ultrasound (US), transrectal ultrasound (TRUS), maximal flow rate (Qmax), postvoid residual urine(PVR), and self assessment by International Prostate Symptom Score (IPSS) and Quality of Life Score (QoLS). Urethrocystoscopy was obligatory done before TUVRP. TRUS-guided biopsies of the prostate were performed in patients with PSA > 4 ng/ml, abnormal DRE, and/or suspicious echogenicity on TRUS. IPSS, QoLS, Qmax and PVR were obtained at each follow-up. Of 90 patients eligible to participate, 69 patients completed 12 months of follow-up (TUVRP, n=35; TVP, n=36). TUVRP procedure was not faster than TVP procedure (P=0.41); 43.6% and 84.8% of prostatic tissues were resected after TUVRP and TVP, respectively (P<0.001). In TVP group, IPSS, QoLS, Qmax and PVR volume were significantly better than those in TUVRP group at 3 and 12 months of followup. At 12 months postoperatively, IPSS improved 62.7% and 87.9% (P<0.001), QolS decrease by 41.9% and 71.9% (P<0.001), mean Qmax increased by 6.3 ml/s (102.0%) and 11.4 ml/s (230.2%) (P=0.001) and mean PVR volume decreased by 65.4 ml (70.5%) and 71.2 ml (88.6%) (P=0.001) in TUVRP and TVP group, respectively. Two TUVRP patients developed urethral stricture and 1 bladder neck sclerosis postoperatively, requiring internal urethrotomy and TUIP, respectively. TVP may be more effective and safer than TUVRP for benign prostatic hyperplasia (BPH) patients whose PV is > 50 ml.

The aim of the paper was to describe and compare means of deliveries after assisted conception and after spontaneous conception. The rapid spread of assisted reproductive technology (ART) is part of development of modern society. Study is retrospective, descriptive and analytical. Data were collected out of medical charts of patients of Hospital for gynecology and obstetrics CHC Zvezdara, who have delivered babies in this institution after using methods of ART during the years 2001 till 2011. There were 190 ART patients, age ranging from 21 to 56 years, on average 35.6 (± 4.7) years. Majority (94.6%) of women were primiparous, without previous miscarriages. The most frequently used method of ART is IVF/ET (94.8%, of which ICSI was performed in 6.53%). 42.1% of pregnancies were achieved after second attempt of IVF/ET. Pregnancies delivered vaginally lasted on average 38,7±1,2 week of gestation. Majority of premature infants (overall incidence of preamaturety was 20,2%) were born by urgent cesarean section. There were 5 extremely premature infants (2,17%). There was 17,4% of twin pregnancies, and almost all of them (92,5%) we delivered by cesarean section. Average birth weight was 3160g (± 600), and average body length on birth was 51cm (± 3). The most vital infants were born spontaneously (wirh mean Apgar score in the 5th minute of 9,08). During our first ART pregnancy experiences we performed no vaginal deliveries. Further on, evident decreasing trend of cesarean section made place for vaginal deliveries. This ratio in study population slowely approaches to the general population ratio, and for now it is 40:60 (vaginal:cesarean delivery). Current experiencies encourage us to deal with ART pregnanices, as if they were spontaniously achieved, and to deliver them respecting obsteric indications.

Nakon oružanih sukoba koji su se devedesetih godina XX veka odvijali na teritoriji bivše SFR Jugoslavije, poseban izazov predstavlja identifikacija žrtava rata. U radu je dat detaljan opis procesa identifikacije ekshumiranih posmrtnih ostataka. Jedan od ciljeva rada predstavlja i poređenje rezultata analize DNK i klasičnih forenzičkih metoda identifikacije. Ovaj rad se odnosi na identifikaciju posmrtnih ostataka koji su ekshumirani na Kosovu i Metohiji u periodu od 2001-2011. godine, a koji pripadaju Srbima i drugim nealbanskim nacionalnim zajednicama (Crnogorci, Bošnjaci, Romi, Goranci i dr.) i u znatno manjem broju Albancima, koji su takođe stradali u ratnom i posleratnom periodu. Ekshumacija i identifikacija posmrtnih ostataka otpočela je još tokom oružanog sukoba, nastavljena je velikim intenzitetom neposredno po uspostavljanju UN administracije u pokrajini, a od kraja 2001. godine među identifikovanim žrtvama dominiraju osobe nealbanskog porekla – Srbi, Crnogorci, Romi i dr. Iskustva ovog procesa kao i iskustva drugih država pokazuju da postoji potreba za organizovanjem odgovarajuće službe za identifikaciju posmrtnih ostataka nepoznatog identiteta u Srbiji, da bi se na efikasan način moglo reagovati u slučaju velikih nesreća.

The millions of patients at risk of developing dementia may be identified at an early stage of disease at the primary health care. The aim of our study was to perform screening for dementia in patients older than 65 years.Clinical instrument that we used in the screening of dementia patients was the Montreal cognitive assessment: Serbian version. The investigation involved forty patients older than 65 years who were tested for the existence of cognitive impairment. The results were processed by a computer program for statistical analysis (SPSS, version 20), using the Student’s t-test and linear correlation. Of all respondents, in 80% causes was registered cognitive disorder and with age were deteriorated test results. Our results suggest the efficiency and simplicity of screening programs on dementia, which could be implemented in daily practice.

According to the relevant investigations during past decade there is a great increase of malignant skin tumors. By this research we tried to investigate this hypothesis in domestic population and present complicated reconstructive procedure. In this research were included 591 patients with melanomas and carcinomas of head and neck, who were surgically treated at our clinic from 2000. to 2010. Results of this research showed that 50 patients had melanoma and 541 carcinomas of skin. We have found that men are four times more affected by skin facial carcinomas than women. 62% patients with squamous cell carcinoma, who were primary surgically treated, survived more than 5 years. On other hand, 85% patients with basal cell carcinomas survived more than 5 years.

We investigated whether finasteride given before transurethral vapor resection (TUVRP) treatment has an impact on intra- and postoperative bleeding. Forty-two patients with diagnosis of benign prostatic hyperplasia (BPH) who had prostate volume (PV) > 30 mL underwent TUVRP: group A (n=21) received preoperatively finasteride 5 mg per day for median time of 7 months and group B (n=21) no finasteride. Preoperative evaluation include assessment of International Prostatic Symptom score (IPSS), Quality of Life (QoL), PV, maximum flow rate (Qmax) and postvoid residual (PVR). Patients mean age was 71.4± 2.1 vs 69.8 vs ± 3.4 years, respectively. Median PV was 55.5 ±21.2 vs 57.1 ±28.8 mL, respectively. Twenty-two (52%) patients had complete retention (29% vs 76%) (p<0.001). At baseline mean IPSS, QoL, Qmax and PVR were 18.1±5.9 vs 19.8±5.04, 3.3±1.7 vs 3.3±1.7, 8.1±4.4 vs 6.9±1.6 mL/s, and 146±106.9 vs 151.6±112.1 mL, respectively. The mean operation time was 59±16.8 vs 64±19.2 min, mean volume of irrigation fluid intraoperatively was 14.1±7.01 vs 15.2±8.1 L and postoperatively 7.0±2.1 vs 8.1 ±1.3 L, respectively. Mean blood loss was 312±85.9 vs 425±68.5 mL, respectively. The mean weight of resected tissue was 31.3±5.8 vs 30.75±8.4 gr, respectively. Mean duration of postoperative irrigation was 6.1 ± 4.7 vs 6.2 ±5.1 h, respectively. Thirty-six (85.7%) patients were discharged within 12 h postoperatively and the catheter is removed on 2.0±0.5 vs 2.5 ± 0.6 days, respectively. No patients received blood transfusion postoperatively. At 3 months postoperatively IPSS was 6.7±4.2 vs 5.2 ±2.01 (p<0.001), QoL 1.1±0.9 vs 1.1±0.7, Qmax 18.1±10.3 vs 17.5±8.1 mL/s (p<0.01) and PVR 41±46.1 vs 45±51.3 mL (p<0.05). The present study failed to demonstrate that preoperative treatment of BPH with finasteride did not have significant impact of perioperative bleeding at TUVRP.

Sposobnost organizma da zaustavi krvarenje iz oštećenog krvnog suda je neophoda za preživljavanje pacijenta.Isto tako,veliki uticaj ima i sposobnost organizma u regulisanju različitih procesa u koagulaciji krvi,čime
se može sprečiti nastanak tromboza i mogućih fatalnih posledica. U zdravom organizmu postoji ravnoteža
prokoagulantnih i antikoagulantnih faktora hemostaze i pod normalnim okolnostima sistem funkcioniše u korist prevage antikoagulacije Hirurške procedure u tretmanu bolesti ginekološkh organa nose veliki rizik za
nastanak dubokih venskih tromboza , imajući u vidu anatomske odnose u maloj karlici i bogatu vaskularizaciju obturatornih i ilijačnih jama.Standarna terapijska doza heparina niske molekulske mase (LMWH) sa ciljem prevencije nastanka venskih tromboza, a u slučajevima blagog i umerenog rizika je 3.000-5.000U/24
h.U svim slučajevima visokog rizika, doza niskomolekulskog heparina se može udvostručiti . Veća sklonost
ka nastanku dubokih venskih tromboza u svakoj hirurškoj proceduri u maloj karlici naročito kod ženske populacije, stavlja primenu heparina niske molekulske mase kao primarni cilj u prevenciji eventualne tromboembolijske bolesti.