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.

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.

Maligni astrocitomi su najčešći primarni tumori mozga kod odraslih i čine 2% od ukupnog broja malignih tumora. Glioblastom multiforme (GBM ) je visoko specifičan za stariju populaciju dok je kod mlađih od 14 godina izuzetno redak. GBM je malo zastupljeniji kod muškog pola nego kod ženskog u odnosu 1,6. Ovom retrospektivnom studijom obuhvaćeno je 183 pacijenata sa dijagnozom tumora mozga, operativno lečenih na odeljenju neurohirurgije KBC Zemun. U grupi mikstnih glioma postoji veća učestalost u odnosu na ostale tumore, kao i veća zastupljenost kod muškog pola 57 (60,6%), u odnosu na žensku populaciju 37 (39,4%). U odnosu na histološki tip analizirani su slučajevi koji su operisani i reoperisani (dijagnoza potvrđena PH nalazom). Od ukupno 175 operisanih i reoperisanih 40 (23%) su astrocitomi, 35 (20%) oligodendrogliomi, 94 (53,3%) multiformni glioblastomi (mikstni gliomi), i 6 (3,3%) ependimomi. Tipična lokalizacija astrocitoma i multiformnih glioblastoma je unutar temporalnog lobusa. Oligodendrogliomi su najčešće bili smešteni u prednjoj trećini velikog mozga, sa upadljivo najčešćim zahvatanjem frontalnih regiona.

Tracking of anatomical and functional results obtained after non-surgical treatment of the distal radius including 51 patients. Tracking of the results was based upon Anatomical Score System and Gartland-Werley Score System. The final numerical results obtained through Anatomical Score were the following:excellent in 12 cases (23.52%), good in 30 cases (58.82%), satisfactory in 8 cases (15.68%), dissatisfactory in 1 case (1.96%). According to the Gartland-Werley Score System, the final results included: excellent in 19 cases (37.25%), good in 24 cases (47.00%), satisfactory in 7 cases (13.72%), dissatisfactory in 1 case (1.96%). This work also presents correlation between Residual Deformity score, Subjective Hardship score and Objective dysfunction, with the results obtained by Anatomical score and Gartland-Werley total score. The possibility of dissatisfactory results obtained by radiological screening followed by dissatisfactory outcome is described in literature; however, dissatisfactory screening results could be found in up to 31.7% of cases with satisfactory clinical findings. Our work records 15.7% of the latter cases. We might say that non-surgical treatment is not to be accepted as the only and exclusive approach to distal radius fracture. Thus, proper evaluation is mandatory.

The present study is performed to determine whether retroperitoneal lymphadenectomy (RPLA) perioperative mortality (PM) rates reported from center of excellence [Indiana University: 0% for primary and 0.8% for postchemotherapy (PC) RPLA] are applicable to institution at large. Between 1975 and 2005, 327 assessable patients with nonseminomatous testicular tumors (NSTT) were treated with RPLA: primary in 134 (41%) and PC-RPLA in 193 (59%) patients. The observed PM rates were stratified according to age, clinical stage (CS) and type of RPLA. The median age at RPLA was 28 years (range 16-54) : < 29 years in 194 (56.3%), 30-39 years in 90 (30.3%) and > 40 years in 44 (13.4%) patients. Of 327 RPLA patients, 81 (27.8%) were performed for localized (CS-I), 179 (54.7%) for regional (CS-II) and 57 (17.5%) for metastatic (CS-III) disease. Ten (3.1%) patients died during initial 90 days after RPLA: 1 patient from pulmonary embolism, 2 of chemotherapyrelated toxicity and 7 of progressive disease due to preoperative worse prognostic factors. Of the entire cohort 30, 60 and 90-day PM rate was 0.3%, 1.0% and 1.3%, respectively. PM rate increase with increasing age: < 39 years 0%, 30-39 years 5.0% and > 40 years 9.3% (x2 trend test, P=0.002). PM rate also increased with CS: 0% localized, 2.8% for regional and 8.8% for metastatic disease (x2 trend test, p<0.001). PM rate at primary and PC-RPLA was increased with CS: 0% localized, 2.8% for regional and 8.8% for metastatic disease (x2 trend test, p<0.001). PM rate at primary and PC-RPLA was 0.7% and 3.1% 9P<0.001). RPLA was associated with virtually no or low (2.8%) PM rate in patients with localized and regional disease, respectively. In contrast, the PM rate of 8.8% for patients with distant metastases and group > 40 years of age (9.3%) implies that RPLA for these patients should be performed at centers of excellence, with intent of reducing PM rate.

Cilj ove studije je procena rezultata lečenja pacijenata sa intermedijarnim i lošim rizikom po kriterijumima “International Germ Cell Cancer Collaborative Group” (IGCCCG) metastatskih neseminomskih tumora testisa (NSTT) pomoću hemioterapije i retroperitonealne limfadenektomije (RPLA). U periodu od 1982do 2005, 82 pacijenta sa metastatskim NSTT, klasificiranih kao intermedijarna (65) i loša (17) rizična grupa po IGCCCG kriterijumima, su imali posthemioterapijsku (PH)-RPLA za srednje praćenje od 95meseci. Srednji dijametar RP rezidualne mase (RM) je iznosio 3.0 cm, 15 (18.3%) pacijenata je imalo povišene vrednosti tumorskih markera u serumu (TMS) pre PH-RPLA. Dvadeset i sedam (32.9%) pacijenata je iziskivalo administraciju hemioterapije druge linije, a kod 75 (91.5%) RP RM je kompletno resecirana. Retroperitonealna histološka analiza je pokazala prisustvo fibroze kod 20 (26%), teratoma kod 36 (42%) i vitalnog karcinoma kod 26 (32%), sa preživljavanjem u 76%, 80% i 38%, respektivno. Pacijenti podvrgnuti drugoj hemioterapijskoj liniji su imali signifikantno veću učestalost vitalnog karcinoma na PHRPLA (49% prema 24%)(P<0.001). Pacijenti sa lošim rizikom NSTT nisu imali signifikantno veću verovatnoću progresije (47% prema 55%)(P=0.5) i gori ishod (53% prema 69%)(P=0.2) nego sa intermedijarnim rizikom. Analiza pacijenata koji su primali hemioterapiju prve linije pokazuje signifikantno veću verovatnoću slobode progresije (VSP) (66% prema 41%) i bolje preživljavanje (74% prema 48%)(P<0.01) posle PH-RPLA nego oni koji su primili hemioterapiju druge linije. Konstatovano je bolje preživljavanje kod pacijenata sa prvom prema drugoj liniji hemioterapije pre PH-RPLA u pogledu nalaza na RP histologiji kod fibroze (94% prema 20%), teratoma (88% prema55%) i vitalnog karcinoma (54% prema 23%)(P<0.001). Ukupno, 5-godišnja VSP i preživljavanja su iznosili 57%(95% IP, 50%-62%) i 69%(95% IP, 61%-77%). Multivarijantna analiza je pokazala da nepotpuna resekcija (P<0.001), veličina PH RM (P=0.01) i nalaz teratoma i vitalnog karcinoma (p<0.01) na PH-RPLA predstavljaju nezavisne prediktivne faktore za recidiv bolesti. Pacijenti sa uznapredovalim NSTT imaju dug vremenski interval do progresije kada se hemioterapija kombinuje sa resekcijom RM. Naši nalazi ukazuju da odgovor tumora na hemioterapiju u kombinaciji sa kompletnom resekcijom svih RM, predstavlja garanci

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.

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.

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).