The aim of this study is to examine how the introduction of medical therapy for symptomatic benign prostatic hyperplasia (BPH) might have changed the indications, patient characteristics and outcome in men undergoing transurethral resection of the prostate (TURP) over two decades (1991.- 2011.). All patients who underwent TURP for symptomatic BPH at our institutions in 1991. (before the introduction of medical therapy for BPH), 2001. (when medical therapy was becoming an important therapy for BPH) and 2011. (when medical therapy was the first line therapy for BPH), were reviewed. We assessed the total number of TURPs, indications for surgery, patient age, health status, weight of resected tissue, and pre and post-operative events/ complications. Our institutions provided primary urological care for 989, 1815 and 2162 men > 50 years of age in 1991., 2001. and 2011., respectively. There was a 60% decrease of TURPs from 1991. to 2011. with a slight increase in number in 2001. Failure of medical therapy was not an indication in 37% and 88% of patients in 2001. and 2011., respectively. There was a substantial rise in the percentage of men at risk presenting with acute or chronic retention (AUR and CUR) at the time of their TURPs ( from 23% in 1991. to 55% in 2001. and from 14% in 1991. to 38% in 2011. for AUR and CUR, respectively) (P<0.05). There was also rise in the percentage of patients presenting with preoperative hydronephrosis (2% in 1991., 13% in 2001. and 6% in 2011.) (P<0.05) and gradual decrease of UTI before TURP overtime (14%, 10% and 12%, respectively).The mean operative time was lower in 2011., compared with either of the two previous cohorts (P<0.05), postoperative stays decreased (from 4.1 days in 1991. to 2.7 days in 2001. and 2.1 days in 2011.)(P<0.05), but the number of patients discharged with catheter increase over two decades (from 3.5% in 1991 to 4.8% in 2001., and to 8.8% in 2011.)(P<0.05). The postoperative complications of our three cohorts differed significantly (14% in 1991., 6.4% in 2001. and 20.6% in 2011.)(P<0.05). The increasing use of medical therapy as a first line treatment for BPH has resulted in a dramatic decrease in TURPs which, in turn, has been associated with an apparent increase in risk of poor pre- and postoperative outcomes seems to be related to earlier catheter removal and hospital discharge, although a causal relationship cannot be established. The present study covering the last two decades would suggest that we are not delaying surgery for patients who will eventually require it. We are now selecting the appropriate patients for TURP, rather than using TURP as our only means of BPH therapy as we did two decades ago.

The balance between analytical (low) and clinical (high) sensitivity is crucial for the specificity of a routine HPV test as limited specificity will be harmful due to unnecessary treatment of healthy women. Up to now HPV diagnostics is mainly based on DNA detection for which target and signal amplification methods are available. PCR techniques can be divided into type-specific and consensus PCRs. Due to its high clinical sensitivity and its relatively high specificity the HC2 test is still regarded as the gold standard in routine HPV testing. It hybridizes 13 (near) full-length stabilized RNA probes of high-risk HPV types to denatured target DNA followed by detection via antibodies and chemiluminescence. To avoid costly validation studies for each new HPV test standards for evaluation have been defined. Recently several new HPV detection assays have been commercialized. They all show promising data in first published studies but still await full validation according to the criteria mentioned above. Among them only the cobas HPV test has already been fully validated for use in triage and as adjunct to cytology. HPV 16 and 18 confer a much higher risk for development of a CIN 2+ compared to the other HPV high-risk types. It is therefore appropriate to test for these HPV types independently. Apart from that testing for individual HPV types is of very limited clinical value up to now.HPV RNA testing is a promising option with potentially higher specificity. As a first system, the APTIMA test has now received an FDA approval.

U radu je obrađen jedanaestogodišnji period obolelih i umrlih pacijenata od akutnog infarkta miokarda (AIM) u populaciji Kosovske Mitrovice od 2001-2011 godine. Retrospektivno su obrađeni podaci o pacijentima koji su hospitalizovani na internom odeljenju Zdravstvenog centra u Kosovskoj Mitrovici tačnije u koronarnoj jedinici za period od 2001-2011 godine.Obrađeni su pacijenti uzrasnih grupa od 20- 70 godine.Za napred navedeni period hospitalizovano je ukupno 1380 pacijenta koji su lečeni od akutnog infarkta miokarda. Od ukupnog broja obolelih 894 ili 64,7% su muškarci a 486 ili 35,3% su žene. Stopa obolelih od akutnog infarkta miokarda je 1,9:1 u korist muškaraca. Registrovano je 142 fatalna ishoda 10,3% dok je 1238 bilo nefatalnih infarkta ili 89,7%.

Koža vulve se razlikuje od koze drugih regija po različitoj bakterijskoj flori I uslovima trenja. Dermatološke bolesti vulvarne kože i mukoze se dele u dve grupe. Prvu grupu čine dermatoze slične ekstravulvarnim dermatozama, a drugu čine dermatoze koje zahvataju predominantno vulvarnu regiju. Spečificne dermatoze vulve su kontaktni dermatitis, lichen planus, lichen sclerosus. Infektivne bolesti vulve se mogu preneti direktnim kontaktom. Prepoznavanje tipičnih mikroskopskih karakteristika pomaze u dijagnostici scabiesa, herpes virusne infekcije i molluscum contagiosuma. Humani papilloma virusi (HPV) su epiteliotropni virusi i mogu uzrokovati premalgnu i malignu transformatciju epitelnih ćelija. Sledeći kriterijumi kao što su virusne promene, klinički parametri i mikroskopski nalaz upućuju na postojanje dva puta u karcinogenezi skvamoznog karcinoma vulve i to HPV-zavisni put udružen sa Vulvarnom intraepitelialnom neoplazijom/VIN/ klasičnog tipa i ne -HPV sa VIN diferentovanog (simlex) tipa često udruženim sa lichen sclerosusom i/ili vulvarnom hiperplazijom.Invazivni planocelularni karcinom je najčešći karcinom vulve. Procena prognostičkih faktora je neophodna komponenta patohistoloskog izveštaja. Visoki gradus tumora, vaskularna invazija, veće dimenzije tumora i dubina invazije zaslužuju imunohistohemijsku analizu limfnih čvorova radi nalazenja metastaskih ćelija karcinoma. Extramamarna Pagetova bolest je retka. Može biti primarnog kožnog porekla ili udružena sa nekožnim tumorima gastrointestinalnog ili porekla mokraćne bešike. Imunohistohemijskla analiza je važna za odredjivanje primarnog porekla tumora.

Gestational trophoblastic disease (GTD) is a term used for a group of pregnancy-related tumours, overwhelmingly affecting women of childbearing age. These tumours are rare, and they appear when trophoblastic cells start to grow out of control. In these conditions production of beta subunit of human chorionic gonadotropin (hCG) is evident. Hydatidiform moles, partial or complete, are in most cases benign featured by villous hydrps, scalloping effect, hyperplastic trophoblastic pseudoinclusions and syncytiotrophoblastic sprouts. Invasive mole is an aggressive trophoblastic lesion with myometrial and/or vascular invasion. Choriocarcinoma, placental site trophoblastic tumor and epitheloid trophoblastic tumor are clearly malignant tumors with proliferation of intermediate trophoblast, with metastatic potential. Tumor-like trophoblastic conditions are placental site nodul and exaggerated placental site wich are proliferative lesions and reactive processes and are not considered as true tumor lesions.In all of these conditions vaginal bleeding is the most common symptom followed by elevation of serum beta hCG. GTD has to be confirmed histologically with extensive sampling of the material. Follow up is necessary in all women with GTD and it is rutinley done by measurment of serum levels of hCG. Since GTDs are proliferative conditions of diferent trophoblastic tisues, pathologists should be well histologicly educated about normal pregnancy stages and its abnormalities in order of adeqate diagnosing these rare conditions.

The presence of free fluid in the pleural space can be a sign of many pathological processes. Some of them may be of inflammatory or hemodynamic origin but others are caused by a malignant neoplasm spreading either in the pleural cavity or from distant site. The importance of establishing the origin of the cells in the pleural fliud lies not only in the fact that a correct diagnosis leads to a correct therapy, but it also is essential in the staging of a malignant tumor. The aims of this study were to evaluate the frequency of various types of pleural effusion and to discuss the value of reactive atypia of mesothelial cells in longstanding effusions. The introduction of a third cathegory of pleural effusion called reactive, would be helpful to the general pathologists to avoid making false-positive diagnosis in the presence of atypical reactive mesothelial cells or missing the diagnosis of a malignant effusion in case when malignant cells are scarse or look like an activated mesothelial cell. In this study, a total of 157 patients from the thoracic department of the General Hospital in Kruševac were examined. Of this number, 33 patients or 21% had the so-called reactive type of pleural effusion. In the everyday practice, one in five patients could be expected to have reactive mesothelial atypia, which may be quite confusing in inexperienced hands.

The present study was performed to establish the socioepidemiological caracteristics (mean age, male to female ratio), the prevalence of various histological types of meningiomas in the groups of primary and recidivant tumors as well as Cathepsin D immunoexpression. We analysed 50 patients with primary and recidivant intracranial and intraspinal meningiomas who underwent surgery in KBC Zemun during the year 2004, with a two years follow-up. All surgical specimen were evaluated for histologic type of tumor and representative slides were immunostained with the anti-Cathepsin D antibody. In both primary and recidivant meningioma groups the number of mitosis, as factor tumor agressivness, was counted on 10 and 20 HPF and those results were statistically analyzed. A considerable difference was found when the number of mitosis and the histologic tumor grade have been compared with the Cathepsin D immunoexpression. The result lead to conlusion that the immunopositivity of Cathepsin D decreases with higher mitosis count and higher tumor grade.

Parapneumonična efuzija kod dece definiše se obično kao nakupljanje pleuralne tečnosti u toku akutne bakterijske pneumonije, a ređe u sklopu virusne pneumonije i tuberkuloznog pleuritisa. Empijem označava prisustvo purulentnog sadržaja u pleuralnom prostoru. Pleuralna infekcija je kontinuum, ali klasično postoji podela u tri stadijuma: eksudativni, fibropurulentni i organizovani. Glavni bakterijski uzročnici su Pneumococcus, Streptococcus pyogenes i Staphylococcus aureus. Postoje dve kliničke prezentacije parapneumonične efuzije. Kada sumnjamo na pleuralni izliv, sprovodi se standardizovan terapijsko-dijagnostički postupak prema smernicama BTS vodiča. Ukoliko perzistira signifikantna količina pleuralne tečnosti i dođe do kompromitovanja plućne funkcije, tada govorimo o komplikovanoj parapneumoničnoj efuziji i indikovana je torakalna drenaža. Pri pojavi septacija i lokulacija u pleuralnom prostoru, neophodna je intrapleuralna instilacija fibrinolitika. Primena Streptokinaze je bezbedna, efikasna, smanjuje potrebu za hirurškim lečenjem i zajedno sa ostalim terapijskim merama dovodi do kompletnog oporavka deteta.

Prenatal diagnosis of congenital heart disease is crucial to optimal obstetric and neonatal care. In utero identification of heart anomalies allows a variety of treatment options to be considered, including delivery at an appropriate facility, termination of pregnancy, and in some cases in utero therapy. Specific indications and risks have been classified and patients considered at high risk have been offered detailed fetal echocardiography, commonly at a center with appropriate expertise and facilities. However, most children are born to mothers who have no known risk features during pregnancy. Screening in the low-risk population has been reported to have lower accuracy rates then in high-risk population. The most common indication for performing a fetal echocardiogram is a prior family history of congenital heart disease. A number of drugs have been implicated as causes of various malformations, including heart anomalies. Therefore, their use during pregnancy is considered as indication for echocardiography. Several maternal conditions also carry an inherited risk to the fetus and their presence is also indication for this diagnostic procedure. The incidence of congenital heart disease is increased fivefold among infants of diabetic mothers, whereas phenylketonuria has reported risk of 12 to 16%. Chromosomal anomalies, extracardiac malformations and monozigotic twins are also indications for fetal echocardiography.