The most common and basic reason for belowknee amputation is bad nutrition of disstalnih parts of extremities, destabilization of tissue and appearing of trophic demerits,which with second infection brings gangrene. Trauma is indicated as one of often causers for amputation extremities, and in a war-conditions has an epidemical character. The goal of our article is to show experience of KBC Zemun and studing the vitality of remainded part of leg after the below-knee amputation during the war trauma. This study included 78 amputated persons in the time from 1991 to 1995, who were treated on the surgical ward in KBC Zemun. A very high percent of amputation was below-knee amputations (53,8%). In the time of surgery recovery, in 21 case the patients have had an infection of the reminded part of the leg and their ischemia. In this cases the patient were surgical treated (antibiotics, flection and HBO). Of the totally number of after surgery complicated patients, 52,3 % patients after the therapy where improving and 47,6 % of them were reamputated (in most of cases was done because of infection of bones and soft tissues).

Pediatric population, particularly in neonatal age, because of their physiological characteristics (propensity to infection, anaemia and hypovolemia) are often candidates for supportive therapy with labile blood components and blood derivate. Good clinical assessment and laboratory testing are essential in identifying the primary disorder, in order to implement the optimal blood product, with an appropriate manner and in sufficient doses. New technological procedures in the preparation and processing of blood components, adherence to the principles of good manufacturing and laboratory practices, as well as permanent quality control of labile blood components, make transfusion with blood products safe and more efficient. In pediatric practice are now available the products obtained from whole blood units, which are concentrates of red cells, platelets, fresh frozen plasma and cryoprecipitate. All doses are adjusted to the body mass of the patients (small volume doses). According to our results, the most common reason for transfusion care for pediatric patients was anaemia. In spite the reason of hospitalisation (different diagnoses), during diagnostic procedures the diagnosis of anaemia was established. This condition required the supportive therapy with small volume concentrated erythrocytes. To avoid giving unnecessary blood products, it is necessary to comply with recommendations by national guidelines for the application of labile blood components. Multi-disciplinary approach should provide right time diagnosis of disorders and conditions with right time transfusion care. Because of that, treatment of paediatric patients was efficient and safe.

Diskus hernija je bolest međupršljenskog diska kičmenog stuba koja nastaje kao posledica prolapsa (hernijacije) i prodora želatinoznog jezgra međupršljenskog diska u međupršljenske otvore (lat. foramina intervertebrales) gde vrši pritisak na korenove spinalnih živaca, a ponekad i centralno u spinalni kanal i prostor u kome se nalaze kičmena moždina i kauda ekvina koje takođe komprimuje. Uzrok diskus hernije je često fizičko preopterećenje već postojećih oštećenja međupršljenskog diska, herniacija diska, reumatične i zapaljenjske bolesti, ali i bezuzročna koja nastaje bez uticaja ikakvih spoljnih uzroka. Simptomi diskus hernije su: jak bol, najčešće lokalizovan u leđima i udovima, iradijacija bola, ukočenost i ponekad paraliza. Lečenje je konzervativno, a kod težih slučajeva i operativno.

Poznat je uticaj aeropolutanata na pogoršanje astme kod dece. Cilj ovog rada je da se prikaže kako tipični aeropolutanti (čađ, TSP, NO2, SO2, NH3 i benzen) utiču na egzarcerbaciju akutnog napada astme. Praćeni su dnevni podaci koncentracija aeropolutanata i dnevni broj dece sa akutnim napadom astme za januar, februar, oktobar, novembar i decembar u 2009. i 2010. godine.Ostale mesece nismo uključili zbog povišenih koncentracija polena. Za navedeni period se za 117 dana prekoračenja GVI (granična vrednost imisije) aeropolutanata obratilo lekaru zbog akutnog napada astme 2675 dece ili dnevno 23, a za 185 dana bez prekoračenja GVI lekaru se obratilo 2839 dece ili dnevno 15. Ova razlika je visoko statistički značajna sto je potvrđeno χ2 testom i testom korelacije. Aeropolutanti kumulativno su značajno povezani sa egzarcebacijom akutnog napada astme kod dece, a samim tim i dovode do njenog pogoršanja.

The most common tumor in the cerebellopontine angle (CPA) are vestibular schwannomas and meningiomas. The purpose of this study is to present proportional representation according to gender and age, incidence of histological type, as well as relation between tumor magnitude, clinical symptoms and prognosis. A group of 38 patients with PCA expansion were examined and treated in time interval from 2006 until 2010 at clinical-hospital center “KBC Zemun – Belgrade”. Gender proportion was 22 female (57,1%) and 16 male (42,9%). Middle-aged patients (from 30 to 60 years) were predominant in age proportion 20(52,6%). The most frequent tumor in the study was vestibular schwannoma (63,1%) followed by meningioma (31,6%). The rest were various histological type tumors like cholestatoma, plexus papilloma, glioma etc. (5,3%). Tumor magnitude proportion showed that the most of the scwanoma (over 95%) were grades III and IV (according to Koss classification). The leading admission symptoms were: deferent degrees of hearing loss, cerebellar disorders and trigeminal lesions. The analysis of postoperative results for 38 patients have shown: mortality rate of 13,2%, complete lesion of facial nerve(39,4%), partial lesion(33,3%) and (27,3%) without lesion of facial nerve. Lesions of lower group of cranial nerves (IX, X and XI) had 3 patients (9%) and pyramid deficit had 6(17,3%) patients. This study showed that typical PCA vestibular schwannoma is predominantly in female and elder population presented. Recommended treatment is surgical (total or subtotal extirpation), followed by adjuvant therapy for elder patients. The most frequent causes of lethal outcome are infections and hematomas in tumor bed. The leading neurological deficit after tumor extirpation is total or partial lesion of facial nerve.

We reviewed our experience with retroperitoneal lymphadenectomy (RPLA) after multiple cisplatin-based chemotherapy regimens in nonseminomatous testicular tumors (NSTT) patients and specifically evaluated clinicopathologic and treatment trend in addition to potential predictors of survival. Fort-one patients with NSTT underwent their RPLA between 1982 and 2005 after ≥ 2 regimens of chemotherapy. Thirteen patients (32%) necessitate redo-RPLA, combined with nephrectomy in 6 patients. 13 extra-RP (ERP) resections were performed in 11 patients (27%), including pulmonary (7), neck (4) and liver (2) sites. Thirty patients (73%) are rendered free of disease and 26 (63%) obtained serologic remission. Nine patients who relapse, necessitated new salvage chemotherapy+surgery (3 teratoma, 6 vital carcinoma [VC]). Four of 9 relapsing patients (44%) are currently free of disease with redoRPLA. Alive, free of disease are 19 pts (46%) at median follow-up of 131 months. Study of RP pathology demonstrated the presence of fibrosis in 15%, teratoma in 39% and VC in 46%, with survival in 67%, 56% and 32%, respectively. Different histology occurred in 38% at redo-RPLA and in 64% at ERP resection in comparison to previous RP pathology. Univariate analysis of clinicopathologic parameters associated with VC at RPLA included RP masses ≥ 5 cm (p<0.05), elevated AFP (p<0.001) or HCG (p<0.05) and ERP resection (p<0.04). On univariate analysis survival was worse in patients with RP masses ≥ 5 cm (p<0.04), elevated AFP (p<0.05) or HCG (p<0.007), ERP resection (p<0.01) and VC (p<0.004). On multivariable analysis, a RP masses ≥ 5 cm (p<0.03) and VC (p<0.005) predicted a worse prognosis. Our data support the continued use of salvage RPLA in three separated groups of patients: 1. Patients who achieved a complete response (CR) to 2nd -line chemotherapy and have no radiologic evidence of disease should undergo RPLA; 2. Patients who achieved a partial response (PR) to chemotherapy should undergo RPLA with ERP surgery, as indicated; 3. Highly selected group of patients with residual masses and elevated serum tumor markers (STM), particularly AFP, after chemotherapy may be candidate for surgery.

Ultrasound examination of the fetal arches is important to highlight babies at greatest risk of perinatal collapse, those with ductus-dependent lesions. Diagnosis of those anomalies before discharge from home is difficult because the arterial duct is patent. Routine incorporation of the three vessel and tracheal view at screening is essential to better detect this important sub-group of babies with congenital heart disease in a timely manner.

Improved methods of early detection and modern therapeutic protocols for malignant diseases led to better survival and increased ratio of cured patients diagnosed for malignances. Cancer survivors are population with increased risk not only for recurrence of the disease but for new primaries and other chronic conditions. Life-style factors, such as nutrition, physical activity and weight management, play key role in preventing these risk factors. Patients in each phase of malignant disease have specific nutritional needs and location of the primary disease and therapeutic modalities additionally modify these needs.

U pedijatrijskoj praksi poslednjih godina uočena je povećana učestalost pleuralnih efuzija. Prema načinu nastanka pleuralne efuzije su podeljene na eksudate i transudate. U grupi eksudata najčešće se sreću parapneumonične efuzije i empijem. 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. Glavni bakterijski uzročnik pneumonija udruženih s izlivom je Streptococcus pneumoniae serotip 1. Kod 10% bolesnika ne dolazi do povlačenja pleuralne efuzije i pored konzervativnog lečenja. Tada sprovodimo standardizovan postupak prema smernicama BTS vodiča, sa algoritmom dijagnostičko-terapijskih mera. Signifikantna količina pleuralne tečnosti koja perzistira i kompromituje plućnu funkciju čini komplikovanu pleuralnu efuziju 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. Rana video-asistirana torakoskopija u kombinaciji sa fibrinoliticima verovatno će u budućnosti biti metoda izbora.