Congenital simple hepatic cysts are extremely rare, and are usually asymptomatic. The therapeutic approach for simple liver cysts is still subject of debate. We present a case of a giant liver cyst removed with minimally invasive laparoscopic approach in a 68 years old women presented with rapid weight loss.

Zemun hospital, the present-day Clinical Hospital Zemun-Belgrade, was founded in 1784, is the oldest hospital in the Serbia. For over two centuries, it blazed the trial and still pioneers in the application of numerous advanced medical achievements and knowledge in this region.

The development of Zemun Hospital in the 19th century was followed by better work conditions and an increasing number of patients. The arrival of doctor Vojislav Subotić to the hospital and his work were key moments in the general improvement of the hospital. Since 1887, the hospital was administered by a society known as „Sisters of Charity of Saint Vincent De Paul“. By the end of 1891, they had constructed a new hospital building.

The purpose of this study was to evaluate the spectrum of the Waldeyer’s ring tumor pathology. Waldeyer’s ring is a ringed arrangement of lymphoid tissue that surrounds nasopharynx and oropharynx. It consists of a pharyngeal tonsil, two tubal tonsils, two palatinal tonsils in the oropharynx, and lingual tonsil. The tonsils are made of heterogeneous tissues, therefore inside the tonsils proliferations could be neoplastic or reactive nature. The participants in our retrospective research were one thousand one hundred thirty patients with histopathology report of tumors of the Waldeyer’s ring. Seven hundred eleven where male and four hundred nineteen were female. The research was conducted at the Clinic for Otorhinolaryngology and Maxillofacial Surgery of the Clinical Center of Serbia from January 1, 2007 to December 31, 2017. The collected data was analyzed by descriptive and analytical statistic methods. It was found that the highest percent of participants developed reactive follicular hyperplasia (51,2%), 25.9% percent squamocellular carcinoma, 8.4% undifferentiated non keratinizing nasopharyngeal carcinoma, and 8.0% nonHodgkin lymphoma. The most malignant tumors were found among male participants over 60 years of age. The majority of malignant tumors grew in oropharynx. The most common tumor was squamous cell carcinoma.

The aim of the study was to investigate the degree of exposure to the health risk of the user by using a medical prescription reading goggles, which are classified as low risk, and whether the data from the package leaflet are correctly applied. Medical devices are instruments, apparatus, materials and other products intended to be used for humans and which do not achieve its basic purpose on the basis of pharmacological, immunological or metabolic activity, but are used alone or in combination, including the software required for proper use. Depending on the categories to which they belong, medical devices have greater or lesser risk of adverse health effects on patients. Medical devices are classified to classes according to the degree of risk for the user ranging from low risk to high risk. Research was conducted in retail stores: pharmacies, optical stores and facilities for selling consumer goods. The survey questionnaire methodology collected data on habits of customers - users of diopter reading glasses. The survey was conducted among the masters of pharmacies, opticians and retailers in the period from March to June 2019. Twenty-five facilities were included in the survey in the area of Tuzla, Sarajevo and Zenica.Statistical data processing was done in Microsoft Excel. Study showed that 35% of the respondents answered that patients visited ophthalmologists and brought medical report with needed corrective diopter, while significantly larger number of respondents – 65% answered that patients didn’t visit ophthalmologists and didn’t have a medical report with needed corrective diopter. Research has shown that 73.75% of patients don’t read the instructions for use, while only 26.25% of patients read instructions for use.

The aim of this case report was to review the therapeutic effect of therapeutic plasma exchange in the treatment of retrobulbar neuritis in relation to its side effects, in the absence of the desired therapeutic response to previously applied immunomodulatory therapy, as a justification of therapeutic plasma exchange in the treatment of patients suffering from central nervous system demyelinating diseases. Optic neuritis is an inflammatory optic nerve lesion that may lead to partial or complete loss of vision. Therapeutic plasma exchange was performed on the SPECTRA OPTIA apheresis apparatus, according to a predefined disease diagnosis (RN), which according to the 2016 AFSA criteria belongs to the III category of disease in which apheresis is accepted as the second line of treatment. Three procedures were analyzed and an average of 5050ml of blood was processed. In conclusion, this therapeutic method is absolutely justified, with the appropriate prior preparation of the patient.

Adult intussusception caused by inverted Meckel diverticulum is infrequent but important clinical entity, presenting with nonspecific symptoms. It may be observed in any age. We report a 26-year-old male patient with intussusception, who was examined several times for abdominal pain accompanied with nausea and vomiting. Basic diagnostics were inconclusive, so the patient was discharged each time with conservative therapy. After the last episode, CT scan showed suspicious intussusception, so the patient was admitted to general surgery ward. The next day there was a complete regression of all difficulties, and he was free of them in the month ahead. Finally, NMR enterography verified the presence of intussusception, and the operative procedure was performed. At laparotomy, ileo-ileal double intussusception was observed and the affected segment was resected with T-T anastomosis. Histopathological examination demonstrated an inverted Meckel diverticulum, measuring 8cm, with ectopic gastric antral type mucosa and ectopic pancreatic tissue. Postoperatively, the patient made an uneventful recovery.

The effect of hyperbaric oxygenation on the treatment of ischemic ulcers on patients with diabetic angiopathy is known, but the effect of HBO t (hyperbaric oxygen therapy) on diabetic claudicates is less known, i.e. to those that havethe second stage of peripheral vascular disease (without ulceration). In this study, we tried to point out the impact of hyperbaric oxygen (HBO) on the development of collateral arteries, i.e. the process of arteriogenesis, and consequently the symptom of claudication. 30 subjects in total were included in the case-control study. Inclusion criteria were: diagnosis of diabetes mellitus for at least five years, as well as Doppler-verified distal angiopathy. The respondents were randomly divided into two groups. The control group (n = 15) was treated by standard methods only.The respondents in the experimental group received 20 HBOTs each in a single-chamber hyperbaric chamber for 70 minutes at a pressure of 2.0 ATA. In this regard the assumptions of the arteriogenic effect of hyperbaric oxygenation, the eventual development of new arterial collaterals it was monitored by Doppler. after 20 HBO treatments and at the follow-up, 3 months after HBO therapy. It was observed that there was a statistically highly significant difference before treatment, in the number of registered functional small blood vessels of the lower leg and three months later, and after 20 HBO sessions, both on the left and the right leg, within the experimental group. There was observed also a highly statistically significant difference in the number of newly formed blood vessels on experimental patients in comparison with the patients from the control group. Our study shows that HBO therapy has a positive effect on the development of collateral blood vessels of the legs and that it may find application in the treatment of patients with diabetes mellitus with angiopathy and claudication disorders. Our study shows that HBO therapy has a positive effect on the development of collateral blood vessels of the legs and that it may find application in the treatment of patients with diabetes mellitus with angiopathy and claudication disorders.

The liver is an organ with many indispensable functions in the body. Liver diseases can be caused by numerous ethiological factors, and are divided into two basic groups, according to an anatomical substrate which is primarily affected – on hepatocellular (parenchymal) and billiard diseases. Approximately 10% of patients with liver disease require a surgical procedure (not including a liver transplant) in the last 2 years of life. Because of its reserves and regenerative abilities, the liver can suffer a great deal of damage before the clinical manifestations of its own dysfunction, which is a challenge for the pre-operative assessment of its condition. The goal of preoperative screening is to determine the presence of preexisting liver disease without the need for extensive or invasive testing. Routine testing of liver function has a low prediction value. The post-operative outcome depends on the nature and severity of the existing liver disease, as well as the type of the operation. It is often necessary to treat complications of severe liver damage, such as coagulopathy, thrombocytopenia, ascites, kidney failure, encephalopathy and malnutrition. Predisposition for infections of patients with cirrhosis requires prophilactic use of antibiotics. Induction of anesthesia, bleeding during surgery, hypoxia, hypotension, the use of vasoactive drugs, and even positioning of patients and surgical techniques can reduce intraoperative and perioperative delivery of oxygen in liver and increase the risk of hepatic dysfunction. Pharmacokinetic parameters of anesthetic agents, muscle relaxants, painkillers and sedatives may be altered in connection with plasma proteins, detoxification in liver etc.. The postoperative liver dysfunction depends on surgical trauma, ischemia during surgery or loss of hepatocite mass, and it can be divided into three groups – hepatocelulcular, cholesterol and mixed liver dysfunction. Posthepatectomy liver failure is one of the most serious complications after the liver resection and is a post-operative deterioration of liver capability to maintain its main functions. In recent years, liver function support systems have been developed. Molecular recirculation system with absorption (MARS), modified fractional plasma separations and adsorption (Prometheus) and bioartifical liver and extracorporal device for assistence of liver activity. Extensive clinical studies are needed to prove the effectiveness of these artefical systems for temporary replacement of the edible functions to its recovery or to transplantation.

Colorectal cancer, as one of the leading oncological causes of disease worldwide, is a major challenge in terms of treatment and patient access. Technological advances have made it possible to apply a minimally invasive laparoscopic surgical technique that has proven superior to open surgery. In order to optimize treatment, reduce mortality and morbidity, a perioperative strategy has been developed summarized in the principles of ERAS protocol (Enhanced Recovery After Surgery). The basic postulates of the ERAS protocol include prehabilitation, comorbidity control, prevention of postoperative nausea and vomiting, minimally invasive surgical method, multimodal analgesia, achieving euvolemia, prevention of hypothermia and early mobilization of the patient. The principles of the ERAS protocol are based on evidence to support safety, applicability and effectiveness, however, there are not yet enough studies to examine the long-term benefits of their implementation. The implementation of the ERAS protocol at KBC “Dr Dragisa Misovic -Dedinje” is not complete, but there is significant compliance with the guidelines of the 2018 ERAS Association, which has reduced inpatient stays and the number of postoperative complications. Although there is ample evidence to support the safety and effectiveness of this treatment approach, a multimodal strategy poses a major challenge to traditional surgical doctrine, making its implementation slow and incomplete in practice.