The aim of the work is to examine the relationship between the clinical and pathological characteristics of colorectal cancer and indicators of disease progression. The examined group consisted of operative biopsies of colorectal carcinoma (n=75), and the control group (n=75) consisted of biopsies of adjacent non-tumor tissue of the colon from the operative preparation submitted to the Pathology Centre of the Clinical Center of Montenegro. After routine histopathological processing, classic Hematoxylin-Eosin and immunohistochemical ABC method with anti-Ki67 antibodies were applied to the 4 μm sections. The histological grade of the tumor is significantly related to the proliferation index, while the pT status depends on the invasion of lymphatic vessels, metastases in the lymph nodes and the Astler-Coller stage. Metastases in lymph nodes are highly significantly associated with invasion of lymphatic vessels and Astler-Coller tumor stage. Distant metastases are significantly related to blood vessel invasion, perineural invasion and Astler_Coller stage. The histological grade of the tumor, lymphovascular and perineural invasion, the presence of metastases in the lymph nodes, distant metastases and the Astler-Coller stage depend on the proliferative index of the tumor cells. Ki67 expression is a good marker of colorectal cancer progression due to its high sensitivity and specificity.

The aim of the survey conducted at the Galen Farm Pharmacy in Belgrade is to analyze the impact of the COVID-19 infection on the mental health of the population aged 30-50. The end of 2019 marked the beginning of the COVID-19 (Coronavirus disease 2019) pandemic from China, which affected more than 214 countries and territories around the world. Preventive strategies play a major role in reducing the spread of the virus. The advent of vaccines slows down the transmission of the virus and alleviates the symptoms of the disease. The ongoing pandemic poses a serious threat to human health and the global economy and has resulted in enormous stress on health care systems worldwide, and mental and physical health are equally important components of overall health. 104 respondents, users of the services of the “Galen Farm” Pharmacy in Belgrade, were included in the research. An original questionnaire of 15 questions was created, and the research was anonymous. The DASS-21 scale (The Depression, Anxiety and Stress Scale-21 Items) was used in the research. For the largest number of respondents, the pandemic affected their quality of life, while a smaller number of respondents estimated that the pandemic had no effect. The largest number of respondents were positive for the virus, while twice as many respondents were not positive. More than half of the respondents were in mandatory isolation. The largest number of respondents reported that someone close to them was positive for the virus. The largest number of respondents had no the experience of the death of a close person. In order to gain insight into the impact of the COVID-19 infection on the mental health of the respondents, the answers of the respondents on the DASS-21 scale were processed in more detail. The respondents more often report experiencing stress symptoms during the past period. Medical workers have statistically significantly higher scores on average, on the individual scales of the DASS questionnaire, compared to non-medical workers, and this also applies to people who have had someone close to them die due to COVID-19. The obtained results are partially consistent with previous research. During the outbreak of any infectious disease, the psychological reactions of individuals play an important role in the spread of the disease, as well as in the frequency of emotional distress and social disturbances during and after the outbreak of a pandemic.

Kompjuterizovana kolonografija (KT), poznata i kao virtuelna kolonoskopija je neinvazivna radiološka dijagnostička metoda koja omogućava evaluaciju celog kolona sa ciljem otkrivanja kolorektalnih tumora i klinički značajnih adenomatoznih polipa. U suštini, KT kolonografija predstavlja modifikovani KT pregled kod pacijenta nakon neophodne pripreme creva gde se zatim dobijene slike tumače korišćenjem naprednih tehnika 2D i 3D prikaza1 . Karcinom debelog creva je jedna od najčešćih malignih bolesti kod oba pola i to je drugi je po redu vodeći uzrok smrti zbog malignih bolesti u razvijenim zemljama1 . Skrining i rano otkrivanje raka creva je značajna karika u prevenciji. Konvencionalna kolonoskopija je zlatni standard u dijagnostici i skrning kolorektalnog karcinoma3 .

Kako se kolonoskopija radi pod kontrolom oka, mogu se jasno videti sve, pa i najdiskretnije promene na debelom crevu: zapaljenski procesi, krvarenja, divertikulumi, polipi, benigni i maligni tumori. Virtuelna kolonografija, poznata kao virtuelna kolonoskopija je manje invazivna procedura i radi se pomoću KT skenera, koji propušta rentgenske zrake kroz pacijentov abdomen. Virtuelna kolonoskopija, može da otkrije više neočekivanih tumora od obične kolonoskopije, uključujući i one koji se nalaze van debelog creva. Ova tehnika je mnogo manje invazivna nego standardna kolonoskopija, za koju je obično potrebna anestezija dok lekar vrši pregled debelog creva kolonoskopom tj. savitljivim endoskopskim aparatom4,5.

Osim pogleda na unutrašnjost debelog creva, virtuelna kolonoskopija pregleda celi abdomen i karlicu, te je ovim putem moguće otkriti i tumore izvan debelog creva. Ipak, u praksi se češće koristi standardna, optička kolonoskopija koja je izuzetno pouzdana dijagnostička metoda. Kompjuterizovana tomografska kolonografija ili “virtuelna kolonoskopija” je metod u kojem se koristi tomografska 2D ili 3D slika kolona u cilju ispitivanja strukturnih promena zida creva, intraluminalnih promena ili promena koje sa spoljašnje strane pritiskaju zid creva. Prednost ove metode je što ne zahteva sedaciju, ne nosi rizik od perforacije i zahteva nekoliko minuta za pregled4 . Virtuelna kolonoskopija uz pomoć kompjuterizovane tomografije (KT) ili magnetne rezonance (MR) omogućava dvodimenzionalnu ili trodimenzionalnu sliku debelog creva od najnižeg dela rektuma, pa sve do donjeg kraja tankog creva te ih prikazuje na ekranu. 2D i 3D slike u KT kolonografiji treba da se dopunjuju. 3D interpretacija je korisna za otkrivanje polipa, posebno onih na preklopima zida creva. Sa druge strane, 2D interpretacija pomaže da se potvrdi da li je lezija identifikovana na 3D slici pravi polip ili samo lipoma, adhezivni izmet ili istaknuti nabor. Virtuelna kolonoskopija je manje invazivna od uobičajene optičke kolonoskopije6 .

The aim of the study was to determine the epidemiological and demographic distribution of patients (age, sex), number of treated children by months, distribution by type of hemophilia, presence of comorbidities, clinical manifestations of hemophilia and severity of hemophilia in relation to age of patients treated for hemophilia. for examination and treatment of hematological and oncological diseases, Institute of Maternal and Child Health “Dr. Vukan Cupic” in the period from January 1, 2020 to December 31, 2020. Hemophilia mainly occurs in the male population and is inherited through the X chromosome (X-linked inheritance). An indirect descriptive method (analysis of medical documentation) was used in the research. Patient disease protocols and case histories were used as a research tool. In relation to age, almost half of the patients (43%) were of school age (age from 7 to 15 years), and in relation to gender, 81% were boys. In relation to the type of hemophilia, most patients had Hemophilia type A was diagnosed in 17 (81%) while Christmas disease (Christmas disease) as it is also called hemophilia type B, hemophilia C (Rosenthal syndrome) and the so-called . von Willebrand’s disease were significantly less common. The most common symptom was bleeding in the joints in 15 patients (71%), and other symptoms such as bleeding into the muscles, hematuria and bleeding in the gastrointestinal tract were less common. The nurse must be specially educated and trained to work with patients with hemophilia.

The aim of the research was to determine the profile of employed nurses involved in the care of patients receiving chemotherapy and to assess the level of specific education for this type of care. Specialized education, preparation and training are required for oncology nurses who administer chemotherapy and other dangerous anti-cancer drugs to ensure a safe level of care. An observational survey of the survey type was applied, and the results were presented by descriptive statistical methods. The study sample consisted of 20 respondents, nurses and technicians from the Institute of Oncology and Radiology in Belgrade. The research was conducted in the period from May 1 to 20, 2019, at the Institute of Oncology and Radiology in Belgrade. The profile of nurses in our study was that most nurses are traditionally female, with an average age of 36-55 with a high school diploma. Nurses have sufficient knowledge about malignant diseases (65%), 80% are well aware of the side effects of chemotherapy, 55% of nurses provide psychological support to patients with malignant diseases, and 75% assess pain in patients. A slightly higher percentage of 65% of nurses who devote enough time to acquainting patients with their disease and the purpose of treatment. Half of the respondents go to trainings regularly. Based on the results of the research, we can conclude that most nurses have sufficient knowledge about malignant diseases, but the number of those who need additional education is not negligible, to which additional attention must be paid.

Tumor nije moguće apsolutno korektno definisati. Tumori se prepoznaju po jednom parametru, a to je abnormalni rast ćelija, tako da se one razlikuju od normalnih ćelija po tome što više ne reaguju na normalne mehanizme kontrole rasta. Tumori se karakterišu stalnom, patološkom i autonomnom proliferacijom ćelija. Po biološkim karakteristikama dele se u dve velike grupe: benigni i maligni tumori. Maligni tumori rastu brzo, vrše razaranje okolnog tkiva i ukoliko se na vreme ne otkriju i ne leče, dovode do smrti. Najveći broj karcinoma nastaje spontano, kao odgovor na nepoznati stimulus, ali za nekolicinu su odgovorni sledeći faktori: hemijski ili fizički karcinogeni agensi, virusi, nasledna predispozicija, hormonski poremećaji i dugotrajne hronične bolesti. Maligni tumori mogu da budu dobro, srednje ili loše diferentovani. Ukoliko su građeni od nediferentovanih ćelija, grupišu se u anaplastične tumore. Maligni tumori rastu brzo, uz infiltraciju, invaziju i destrukciju okolnog tkiva. Nemaju kapsulu, nisu jasno ograničeni i retko se odstranjuju u potpunosti. Pored metastaziranja, invazivnost je druga najvažnija karakteristika malignih tumora. Postoje tri osnovna pristupa lečenju malignih tumora: hirurška ekscizija, zračenje i hemioterapija, a uloga pojedinačnih pristupa zavisi od tipa i stadijuma razvoja tumora1 .

Medicinske sestre i tehničari koji rade sa pacijentima obolelim od malignih tumora vrše procenu stanja pacijenta, edukaciju, menadžment simptoma i negu pacijenta. Onkološki pacijent spada u grupu pacijenata kojima bi trebali pristupati samo kvalitetno edukovani medicinski radnici2,3.

U radu je analizirana uloga medicinske sestre i tehničara u pripremi citostatske terapije, kao i klinički problemi i intervencije sa kojima se susreću i obavljaju medicinske sestre i tehničari prilikom lečenja onkoloških pacijenata.

The aim of this paper is to point out the importance of drugs and their impact on quality of life. Quality of life is a wide multidimensional concept that usually includes, in addition to objective parameters, a subjective assessment of both positive and negative aspects of life. Quality of life is not easy to fully define and therefore there are no clearly defined universally accepted parameters for its assessment. Drugs have a task to prolong the life expectancy of sick people, reduce working ability limitation and total medical costs. The most important standards which drugs must meet are: quality, efficiency and safety. Quantification of objective and subjective parameters of quality of life before and after drug therapy is important for assessing its effect. For this purpose, in addition to generic, “disease-specific questionnaires” are used. Although some of these questionnaires have been used for decades, they primarily give priority to determining objective indicators that are much easier to quantify than subjective ones. Individual understanding of quality of life depends of: social factors (as family and environment in which the patient lives), historical, geographical and cultural factors, age, religion, emotional and intellectual personality traits, physical constitution, health status and profession. Examining the impact of drugs on quality of life and creating precise evaluation criteria are imperatives and challenge for modern pharmacotherapy, as they will facilitate making the right decision about the choice and therapy protocol. The pharmaceutical industry plays an important role in these studies because modern drugs have the task of improving both health and quality of life.

We present a case of cerebral vasculitis and suspicious retinal vasculitis of a thirty-five- year old, HIV-negative woman. Toxocara canis is a ubiquitous parasite found worldwide. She can only complete lifecycle in dogs, and humans are accidental hosts. Among the neurological and neuropsychological disturbances produced by Toxocara infection, in humans, the most representative are meningitis, encephalitis, myelitis and cerebral vasculitis. Predominant symptoms were trembling and tingling in the left side of the body, tremor of the hands and weakness of the extremities, more to the left, fever and visual disturbance. MR imaging of the brain showed obliterative endarteritis to the left. Visual acuity was impaired, the optic nerve was swollen and macula was thickened. Antibodies to Toxocara canis were detected by ELISA test. Antiparasitic therapy with corticosteroids has led to the reduction of symptoms and clinical findings.

Mitral valve prolapse is the most common cause of primary mitral regurgitation. Arrhythmic mitral valve prolapse is a special entity that is characterised by ventricular arrhythmia and increased risk for sudden cardiac death. We present a 48-year old patient that was referred to our Department of Cardiology for elective invasive coronary angiography because of significant number of premature ventricular contractions observed on 24h-ECG ambulatory monitoring. Echocardiography and cardiac MRI revealed signs of arrhythmic mitral valve prolapse.

U poslednje dve godine pandemija izazvana COVID-19 infekcijom predstavlja najveći izazov sa kojim se suočavaju zdravstveni sistemi širom sveta. Ova bolest donela je ozbiljne promene u načinu rada zdravstvenih ustanova, a promenjeni su i prioriteti različitih medicinskih i hirurških intervencija, između ostalih i u domenu urologije.

U ovom radu prikazujemo uticaj COVID-19 pandemije na rad Službe za urologiju Kliničko bolničkog centra Zemun. Pored analize rada urologa u COVID-19 sistemu dat je i kratak pregled uticaja COVID-19 pandemije na različite, najčešće urološke bolesti, pre svega u odnosu na stepen hitnosti lečenja uroloških bolesti. Potom je dat osvrt uticaja COVID-19 infekcije na bubrežni sistem. Deo rada posvećen je uticaju pandemije na rad mladih lekara, odnosno pre svega specijalista urologije.