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.

We present a 21 years-old patient with congenital monorchism, diagnosed and emergency operated for testicular torsion. In combination, testicular torsion and monorchism represent an extremely rare finding. In any case of monorchism, testicular sparing surgery is one of the main goals, and that is why fast and accurate diagnosis is mandatory, since delayed diagnosis lead to loss of only gonade.

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.

The aim of our study was to determine the frequency of scoliosis operations in the period from September 1, 2018 to March 1, 2019. year at the Institute of Orthopedic Surgery “Banjica”, the distribution of patients by sex and age, the most common complications and physiological responses of patients in the postoperative course, as well as the importance of the participation of nurses in this process. Scoliosis is a deformity of the spine in the frontal plane. The role of the nurse in the preoperative and postoperative course is very demanding and defined by clear protocols. In our study, we found that the majority of patients were female 57 (71%), and that the largest number of respondents 55 (72%) were aged 11 to 13 years. The largest number of patients 57 (71%) did not have comorbidity. When analyzing the physiological response of patients, we determined on the basis of the Numerical Scale that the largest number of patients 75 (96%) had a need for opioid analgesics in the first 4 hours after surgery. In relation to the length of stay of patients in JIN, the largest number of patients 69 (86%) remained in JIN 24 hours after surgery. Based on our study, we believe that continuous medical education of nurses is necessary in acquiring the necessary skills for the care of patients who have undergone scoliosis surgery. The emphasis should be on communication skills with this, especially vulnerable, population.

Schwannoma is a slow-growing benign tumor of the peripheral nerve that frequently occurs in the region of the head, neck and spine. We present a 50-year-old male patient diagnosed and operated for schwannoma of the ulnar nerve in the distal part of the left forearm. In the case of a palpable limb mass, one of the possible diagnoses is schwannoma, and since operative technique is somewhat specific with tumor enucleation and internal neurolysis, it is crucial to preoperatively keep in mind schwannoma as a possible diagnosis.

Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy in the absence of abnormal cardiac loading conditions. Apical hypertrophic cardiomyopathy (Yamaguchi syndrome) is a relatively rare HCM phenotype. It is characterized by apical left ventricular hypertrophy, often with the absence of left ventricular outflow tract obstruction. In patients with HCM symptoms of angina are quite common, mostly due to microvascular dysfunction or oxygen supply demand mismatch. Here we present a case of apical hypertrophic cardiomyopathy with concomitant severe coronary artery disease.

In this paper, we describe the case of an adult male with a pulmonary valve blood cyst. Blood cysts are benign primary heart tumors, common in neonates, but very rare in adults, mostly asymptomatic, and detected incidentally. Ultrasound (transthoracic transephophageal echocardiography) is crucial in detecting lesion, with the help of other diagnostic methods (MRI, CT). Further treatment, conservative or surgical, depends on the effect of the cyst on heart function. Although the diagnosis of cardiac lesions using routine imaging is available, definitive diagnosis is possible only by pathohistological and immunohistochemical analysis of the surgical sample.

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.