Skočni zglob je često izložen povređivanju zbog svoje statičke i dinamičke uloge. Uganuće skočnog zgloba je značajna mišićno-skeletna povreda, kako kod fizički aktivne tako i kod opšte populacije1 , dok prelom gornjeg skočnog zgloba prednjači u povredama koštano-zglobnog sistema2 . Kod velikog broja povređenih osoba (10% do 60%) zabeležena je funkcionalna nestabilnost kao rezidualni problem3 . Većina stručnjaka ukazuje da se nakon povrede skočnog zgloba, naročito uganuća, razvija hronična nestabilnost. Ovo stanje karakteriše osećaj nestabilnosti zgloba, sa periodičnim ponovnim uganućem4 , a često je prisutno ograničenje obima pokreta dorzifleksije, povezano sa sa bolom3 . Povreda skočnog zgloba može biti preduslov za razvoj sindroma vezanih za stopalo i potkolenicu, kao što su plantarna fasciopatija, sindrom iliotibijalne trake, patelofemoralni sindrom, sindrom medijalnog tibijalnog stresa5 . Pored toga, pojava posttraumatskog osteoartritisa skočnog zgloba pronađena je čak kod 78% osoba sa hroničnom nestabilnošću zgloba4 . Kod osoba kod kojih je došlo do pojave kalcifikacija javlja se niz strukturalnih i senzomotornih simptoma6 , usled čega opada nivo fizičke aktivnosti7 i kvalitet života8 .

The aim of our work is to examine the impact of lifestyle on body mass index, as well as to examine the impact of sociodemographic lifestyle factors in school children. Prevalence of overfeeding and obese children, is rapidly increasing both in the world and in our country, so obesity is gaining pandemic size. The research was conducted as a retrospective study for the period from 2011 to 2015. The respondents consist of 700 primary school students aged 7 to 14 from the territory of the municipality of Pancevo. The body mass index (BMI) - calculated on the basis of percentiles - is defined as a dependent variable in this paper ranks, categorized into four groups, as an independent variable are defined sociodemographic characteristics and lifestyle of young people. The questionnaire was formed for the purposes of this research, and dimensionality the questionnaire was confirmed by exploratory factor analysis. Between groups with different indexes body weight, there is a statistically significant difference in eating habits, leisure habits time and performing physical activity. Eating habits, leisure habits and physical activity, they are important predictors of body mass index, while school success is a predictor of lifestyle ages 7 to 14 years.

We present the case of a young mother, 21 years old, who developed an intra-abdominal abscess 2 weeks after the caesarean section. Postpartum abscess after caesarean section is rare (≤1%), but potentially a very serious complication. It usually occurs as a consequence of inadequate or delayed treatment of postesectional endometritis. Risk factors are younger age, lower socioeconomic status, multiple vaginal examinations and length of caesarean section. The causes are anaerobic and Gram-negative bacteria. Clinical symptoms are variable, nonspecific and present as fever, abdominal and pelvic pain, signs of peritonitis, tachycardia, tachypnea, and generalized weakness. Complications include septicemia, fistula formation, multiorgan dysfunction, and even death. Ultrasound examination is the initial diagnostic method that can confirm the existence of a purulent collection. In case of diagnostic dilemmas, an urgent CT examination is indicated.

The aim of our work is to acquaint other fellow physicians with our experience in prescribing high doses of ALA to which there was only a therapeutic response in terms of significant reduction of neuropathic ailments in our patients. We continued the therapy for six months after the introduction, because the difficulties are still maintained, now in a very mild form. COVID-19 disease caused by the SARS-CoV-2 virus was first described in December 2019 in Wuhan, China, but has since spread rapidly globally. Although the number of cases and deaths has attracted a lot of media attention, less attention is paid to the long-term tribute taken by those who survived the disease Since the discovery, there have been more and more reports linking SARSCoV-2 infection to various nervous system disorders. These disorders can be broken down into processes that affect the brain and spinal cord that make up the central nervous system or CNS, as well as those that affect the peripheral nervous system or PNS. Every day we learn more about the spectrum of neuromuscular disorders that develop after COVID-19 disease. We present two patients with polyneuropathy after proven SARSCoV-2 virus infection, aged 37 and 45, without previous chronic diseases that may be associated with peripheral nerve damage. The dominant symptoms in both patients are weakness and unpleasant sensations in the hands and feet, fatigue and general weakness. Therapy with high doses of alpha-lipoic acid has led to a significant reduction in discomfort and improved quality of life of patients.

Medicinska sestra (tehničar) ima značajnu ulogu u lečenju i nezi pacijenata obolelih od malignih bolesti. Tokom primene radioterapije, medicinska sestra preduzima sve mere i postupke, realizuje intervencije u cilju pružanja adekvatne nege, duhovne i psihosocijalne podrške1 . Odnos između medicinske sestre i pacijenta treba da bude interaktivan i pun poverenja, a to je moguće postići pružanjem kvalitetne zdravstvene nege, što zahteva posedovanje praktičnih veština, ličnih kvaliteta i znanja. Takođe, medicinska sestra predstavlja važanu kariku u multidisciplinarnom timu. Ona najviše vremena provodi sa pacijentom i njegovom porodicom, najkompetentnija je u proceni pacijenta i njegovih simptoma2 . Takođe je najčešći prenosilac informacija između pacijenta i drugih članova tima, u tome mora biti konkretna i tačna.

Mnogi pacijenti se plaše zračenja, što čini pripremu pacijenta i njegove porodice još značajnijom. Sestre bi trebalo da daju informacije o koristima zračne terapije u lečenju raka, procesu planiranja zračenja, šemi zračenja, kao i o aktivnosti samog pacijenta u cilju preveniranja propratnih neželjenih efekata zračenja, u odnosu na svakog pojedinog pacijenta. Od naročitog je značaja posvetiti vreme razgovoru sa pacijentom, njegovom porodicom i pružiti podršku3 . Neophodno je da se zadovolje mere zaštite bazirane na principima vremena, udaljenosti i metalnih blokova. Zdravstveno osoblje treba da provede što manje vremena u blizini pacijenta, sa radioaktivnim izvorima, kao i njegovoj sobi, uz maksimalno korišćenje olovne zaštite. Stepen sporednih efekata zavisi od mnogih faktora, što uključuje volumen tkiva koji se zrači, ukupne dnevne doze zračenja, metode zračenja i određene individualne faktore4 . Akutna reakcija, na primer kod kože, dešava se tokom zračenja i uopšteno govoreći, povlači se za 2-4 nedelje po završetku kompletnog zračenja. Kasni sporedni efekti mogu da se pojave nekoliko meseci nakon kompletnog zračenja i mogu trajati duži vremenski period.

Acute coronary syndrome is common term for various clinical conditions such as unstable angina (UA), myocardial infarction without ST segment elevation (NSTEMI) and myocardial infarction with ST segment elevation (STEMI). ACS is one of the leading cause of morbidity and mortality worldwide. The most serious manifestation of this syndrome is STEMI. The main goal of treatment is rapid restoration of blood flow in the infarct related artery. This can be achieved either with conservative (thrombolysis) or invasive (primary or rescue percutaneous coronary intervention – pPCI or rPCI) approach. Based on the data from varoius registries, the rate of complications of these type of interventions is low and they can be safely performed in centers without on site cardiac surgery. The main goal of this paper is to assess in-hospital mortality as well as demographic, clinical and angiographic characteristics of patients with STEMI treated in cardiac catheteterisation lab in the Clinical Hospital Center Zemun during the first year of implementation of pPCI program. The study included 284 consecutive STEMI patients. Total in-hospital mortality was 4.9% and, depending of the severity of heart failure at admission (Killip/Kimball class), the highest mortality was in cardiogenic shock (54,5%). The most common intrahospital complications were complicated infections unrelated to the pPCI procedure (3.5%), vascular complications (2.8%) and early stent thrombosis (2.1%). No patient was reffered to emergency cardiac surgery due to unsuccesfull or complicated pPCI procedure. Our study showed that performing pPCI during the first year of the implementation of pPCI program in the center without on-site cardiac surgery support was safe end effective and resulted in low in-hospital mortality.

Thyroid nodules are among the most common thyroid diseases, with higher female gender prevalence. The crucial clinician’s diagnostic dilemma is to distinguish benign and malignant thyroid nodules. Benign nodules are far more common than malignant, while papillary thyroid carcinoma predominates among malignant nodules. There is no unique and completely accurate diagnostic test, method, or even biomarker that would indicate with great certainty the malignant nature of thyroid nodules. Most thyroid tumors developed due to changes in genes, where protein products regulate mitogen activated protein kinase/ extracellular signal-regulated kinases and protein kinase B/ phosphoinositide 3-kinase signaling pathways that stimulate proliferation and inhibit apoptosis of cells. Today, we know a certain number of point mutations and chromosome rearrangements present in malignant tumors, but their diagnostic usage is not significant yet. Phospholipids, free fatty acids, and nitric oxide are essential for the thyroid gland function. Thus, deranged levels of such parameters in serum and thyroid aspiration biopsy washout could have a prognostic impact on malignant thyroid diagnostics.

Reliable preoperative staging of cervical cancer is important to evaluate and compare the results of different therapeutic modalities, including, surgical treatment, chemotherapy and radiation therapy. The diagnostic reliability of preoperative staging of cervical cancer by cervical biopsy and endocervical curettage was evaluated by a retrospective diagnostic study. The results of this preoperative staging were compared with the stage of cancer set on the basis of histopathological examination of the samples. Only patients who were clinically staged as early (operable) to the disease stage were included in the study. Postoperative diagnosis in 98 patients was exocervical cancer, in 12 endocervical cancer in 5 it was H-SIL (CIN III), and in 4 patients it was chronic cervicitis. The diagnostic reliability of preoperative staging of cervical cancer by cervical biopsy and endocervical curettage was 76.9%. In order to reduce errors in the staging of cervical cancer, it is advised that it be performed in specialized cancer centers by an experienced oncology gynecologist.

Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy or in the first postpartum year. High hormons level (estrogen, progesteron and prolactin) during this specific period make structural changes, increase breast volume and density and make the diagnosis often very difficult. We present the case of 38 old women, who noted a painless breast mass during first month of breastfeeding.

This study aimed to evaluate the degree of involvement and infiltration of the pelvic lymph glands in endometrial cancer. The retrospective study included patients who were diagnosed with endometrial cancer after exploratory curettage, and who were then referred for surgical treatment with partial or total pelvic lymphadenectomy. We analyzed 99 patients who met the inclusion criteria. Pelvic lymphadenectomy is the treatment of choice in patients with medium and high risk endometrial cancer for disease recurrence. Given the importance of the evaluated issue, it is necessary to perform randomized studies to examine the therapeutic effect of pelvic and paraaortic lymphadenectomy, especially in patients at medium and high risk for recurrence of endometrial cancer.