Congenital heart disease is the most important cause of infant mortality. Abnormalities of the heart and great arteries are the most common congenital defects. Congenital heart disease is often fallow by extracardiac malformations. Many studies revailed positive impact of prenatal diagnosis and timelly treatment on pre-operative condition and outcome of surgery and long term prognosis. Neverthelles, structural cardiac anomalies were also among the most frequently missed abnormalities by prenatal ultrasonography at mid-trimester scan. The 4-chamber view has a Detection Rate of 6-50%, with a reasonable figure of 20% in community setting screening programs. The addition of the outflow determines a significant increase of the Detection Rate which, in most studies, ranges 20-40%. The three-vessel view allows to detect major abnormalities of the arches, the neck vessels and the thymus. The prenatal detection of specific types of congenital heart disease, such as Transposition of great arteries, Hypoplastic left heart syndrome, Tetralogy Fallot, seems to have a significant impact on survival, hospital stay and pre-operative conditions of the affected neonates. Hence, fetal cardiac screening is a must for all health professionals involved in prenatal diagnosis.

Tuberculous peritonitis is a specific inflammatory disease of the peritoneum, rare in developed countries, often in developing countries. Symptoms usually have a chronic character and appearance of ascites is often the initial symptom of the disease. Symptomatology may not be typical. It occurs most often anorexia, weight loss, abdominal pain and subfebrile temperature Presented 23-year-old patient, after elective surgery on the right inguinal hernia, when the changes in the peritoneum and omentum were observed and 2l of ascites were evacuated, was admitted to Hospital for emergency surgery, Clinical Centre of Serbia, Belgrade for further diagnostic and therapeutic treatment. The patient noted occasional mild abdominal pain, bloating, fatigue and general weakness. Chest radiography showed a small pleural effusion in the right and laminar athelectasis in the lower right lung field. On performed EHO and MSCT of the abdomen is visible easily enlarged liver, with a discrete dilation of intrahepatic bile ducts, gallbladder with calculuses. Portal and spleen vein dilated, enlarged spleen. Right subphrenic and interintestinally present clear liquid. Other findings in order. Exploratory laparotomy was perfomed. Histopathological examination, of the slices of the peritoneum, confirmed changes typical for tuberculous peritonitis.

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.

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.

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.

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.