Introduction: Elastic fibers are constituents of the dermal extracellular matrix, determining the histoarchitecture of the
dermal connective tissue. Organization and density of elastic fibers change as skin ages. The aim of this paper was to determine the similarities and differences between the photo-aging and the physiological aging of skin by examining organization and quantifying the elastic fibers in the dermis during aging. The material included samples of photoexposed and photoprotected skin, obtained from 90 cadavers aged 0-82 years. The samples were classified into five age groups: newborns, young age, middle age, mature age and the oldest age. Skin samples were stained using the Halmi modification of Aldehyd fucshin staining method, as well as Alcian blue staining (the Spicer method). Volume density (VD) of the elastic fibers was measured using Image J program.

Results: In the skin of newborns and young age group (neck and abdomen) elastic fibers appeared to form a network structure. In the photoexposed skin of the mature age and the oldest group, elastic fibers showed tendency to fragment, while the elastic material exhibited tendency to accumulate. VD of elastic network in the skin of the neck in the middle, mature and the oldest age group was greater than VD of abdominal skin of the respective age groups (3.66±0.28%, 5.61±0.22%, 6.24±0.21% respectively). Age-related statistically significant increase in VD of the elastic network in the skin of the neck, as well as a statistically significant reduction of elastic network VD in the abdominal skin, has been observed (middle age - oldest).

Conclusion: Correlation of the organization and quantity of elastic fibers with age exhibits different pattern in photoexposed compared to photoprotected skin. A quantitative evaluation of the volume density of elastic fibers correlates with clinically visible signs of photo-aging, primarily with solar elastosis.

Introduction: Glaucoma diagnosis is based on consideration of several factors, such as increased intraocular pressure (IOP), damage to the optical disc, and associated visual field loss. Evaluation of the integrity of the corneal endothelium and monitoring of the corneal thickness is indispensable during the preoperative preparation for phacoemulsification. These data are of great importance for later treatment and monitoring of early and late postoperative complications.

Objective: The aim of this study was to determine the central corneal thickness immediately before and after cataract surgery in patients with primary glaucoma (open and closed angle), comparing them with patients who do not have diagnosed glaucoma. Materials and methods: A prospective study covered a total of 159 subjects who performed cataract surgery by the method of phacoemulsification with the implantation of the intraocular lens in the posterior chamber at the Clinic for Eye Diseases at the Clinical Center of Serbia in Belgrade in 2017 and 2018. Pre-operative patients are classified into two groups. The first group with a primary glaucoma consisted of 71 respondents, with an open angle 41 with glaucoma, and a closed angle glaucoma 30. The second group consisted of people who did not have a diagnosed glaucoma, 88 of them. The central corneal thickness was measured using an ultrasound pachymeter. The measurements were made before the operation, 24 hours, 10 and 30 days after the operation, trying to get all done at the same time of day.

Results: Between patients without glaucoma (BG), primary open-angle glaucoma (POAG) and primary glaucoma of closed angle (PACG), there is a statistically significant difference in median age (χ2 = 10.102; DF = 2; p = 0, 006). Among the observed groups there were statistically significant differences in the values measured preoperatively (χ2 = 10.265; DF = 2; p = 0.006). Among the observed groups, there was no statistically significant difference in the values measured in the first postoperative day (χ2 = 4.364; DF = 2; p = 0.099), nor in the 10th postoperative day (χ2 = 3.250; DF = 2; p = 0.197); 30 days after surgery (χ2 = 1.427; DF = 2; p = 0.490). In each of the groups individually, the appearance of oedema or a very statistically significant difference in the first and tenth postoperative day. Statistically significant difference was present 30 days after surgery, but far less compared to early postoperative period.

Conclusion: Based on the values obtained in this prospective study, we estimate that monitoring of corneal thickness has a mandatory place in the observation of patients after cataract surgery. We found that there is no difference in preoperative measurement only between groups without glaucoma and open angle glaucoma. Measurements performed in the first, tenth, thirtieth day do not differ in groups, but edema restitutin in the 30-th day was observed in all observed groups. 

Melanoma is the most aggressive skin cancer that has a tendency of early lymphatic and hematogenous metastasis. Surgical excision constitutes as a methods of treatment. Early diagnosis is the key to successful treatment of melanoma, which is primarily associated with Breslow and Clark grading. The aim of this study was to investigate these and other prognostic parameters such as the age, the gender and the anatomical distribution of melanoma, macroscopic and histological type of melanoma, the size and the remains of the tumor tissue at the surgical margins. We analysed biopsy material of Institute of Pathology, Faculty of Medicine in Pristina from 2004 to 2017. year. We found that melanoma were more common at older men (average age of 68.5 ± 14.6 years), most common location was back, head and neck, upper and lower extremities, where were frequent occurrence of metastasis (Clark IV). Larger tumors require a wider excision. The greatest incidence was nodular type melanoma and predominant histological were epitheloid type melanoma. Between the size of the tumor masses and the depth of invasion there were no statistically significant positive correlation, which leads to the conclusion that the Clark and Breslow can be used as prognostic factors because they are mutually comparable.

Introduction: Acute myocardial infarction is a common and urgent disease with potentially poor prognosis, so the examination of the quality of life of diseased and all factors that affect it are very important. Objective of the paper is to examine the impact of the characteristics of the health issues, thelength of time since the myocardial infarction as well as the comorbidity to the quality of life of diseased of myocardial infarction.

Methods: In order to assess the impact of acute myocardial infarction on the quality of life of diseased, a retrospectiveprospective study was conducted, designed as a cross sectional study. The followingwas used during the research: sociodemographic questionnaire, questionnaire for assessment of health status, comorbidity and characteristics of health issues of patients and Short Form 36 Health Survey, i.e. SF-36. Statistical analysis of data was made using the SPSS software statistical program.

Results: The study covered 175 subjects, of which 113 (64.6%) were male and 62 (35.4%) female. In relation to the time of diagnosis of AMI in 29.7% of subjects, the diagnosis was set in the last month, while in the remaining 70.3% it was diagnosed in the last year to a month. The highest number of respondents (68.6%) felt a strong pain before reporting to a healthinstitution for treatment, 63.4% of the respondents had cardiovascular comorbidity and the highest number of respondents (83.4%) has diagnosed arterial hypertension. Physical functioning (65.48: 81.42) (t = -6.841; p = 0.001), limitation due to physical health (51.44: 76.62) (t = -7.364; p = 0.001), the presence of bodily pains (35.88: 57.05) (t = - 7.943; p = 0.001), general health (59.04: 75.75) (t = -7.277; p = 0,001), vitality (52.78: 56.99) (t = -4.796; p = 0.001), social functioning (39.42: 63.31) (t = -7.099; p = 0.001), limitation due to emotional problems (33.97: 61.51) = -6.693; p = 0.001) and mental health (36.69: 53.97) (t = -7.714; p = 0.001) are domains in which there is a high statistically significant difference in mean values between groups of subjects compared to the time of diagnosis, whereby respondents which diagnosis was set in the last year to a month have statistically significantly better quality of health compared to those which diagnosis was set in the last month. When it comes to a common measure of physical health and mental health, a group of subjects diagnosed in the last year to a month also showed statistically significantly better results than respondents in whom AMI diagnosis was found in the last month (t = -4.152; p = 0.001; t = -7.147; p = 0.001).

Discussion: The quality of life related to health is significantly lower in subjects diagnosed with AMI in the last month compared to respondents who have been diagnosed in the last year to a month and between groups of subjects of different sexes there is no statistically significant difference in any of the quality life domains related to health. When it comes to the age of respondents, HRQOL is significantly higher in all domains of physical and mental health in the younger group of respondents.

Conclusion: Myocardial infarction affects the quality of life of the diseased,which is significantly better in the younger age group compared to the older respondents, and does not differ in relation to gender. The quality of life of patients with myocardial infarction differs in relation to the time since myocardial infarction and those diagnosed with AMIduring the reception to the hospital in the last month have significantly lower quality of life compared to subjects with AMI diagnosed in the last year to a month. The quality of life of patients with myocardial infarction is worse if the health issues are more expressed and there is comorbidity.

Introduction: Some psychosociodemographic and characteristics of pregnancy and childbirth have been associated with
the onset of postpartum depression in the literature.

Aim: To examine certain psychosociodemographic and characteristics of pregnancy and childbirth as potential risk factors
for the onset of postpartum depression in the early postpartum period. Material and Methods: The study involved 120 subjects, which included the use of the Edinburgh Postpartum Depression Scale and a sociodemographic questionnaire constructed for the purposes of this study, in the early postpartum period.

Results: Of the total 92 (76.7%) subjects were not depressed, while 28 (23.3%) had depression. The high risk of postpartum depression correlates with: postpartum weight gain, subjective experience of lack of freedom, fear that she would be abandoned (p <0.05), as well as having frequent quarrels, mentioning a divorce or divorce, and a temporary separation, poor relationship with the parents on both sides and poor general family atmosphere (p <0.001). A statistically significant risk of depression was also found in the group with complications during childbirth, unplanned pregnancy (p <0.001), as well as alcohol and cigarette consumption during pregnancy (p <0.05).

Conclusion: The risk of postpartum depression can be detected by applying the EPDS scale in the early postpartum period. Early detection of potential risk factors can significantly prevent the onset of postpartum depression and significantly affect the central psychological process in the postpartum period, which is related to the development of an emotional relationship between mother and child.

A case of a patient is shown, who was admitted for neurological exploration, with clinical manifestations of the cerebrovascular accident in the posterior circulation (TIA V-B vascularisation). In accordance with diagnostic protocol, an endocranial CT was performed. The results of the brain CT indicated an existence of an alteration in the right pontocerebellar angle area, which was subsequently diagnosed as a n. vestibularis schwannoma in an NMR examination. After a neurosurgical deliberation, the patient was treated with a gamma knife. After this surgery, which was done in a local anesthesia, the patient's condition was well and he was discharged. Control examinations have shown minor difficulties during the stimulation of the left ear auditive structures. Control examinations involving NMR showed no signs of recidivate focal findings.

Arachnoid cysts are cavities filled with liquor, usually localized on the floor of the middle cranial fossa. Clinically, they are usually asymptomaticand can sometimes be presented with increased intracranial pressure syndrome and epileptic seizures. We present a patient who, after a slight head injury in a accident develops an increased intracranial pressure syndrome followed by an epileptic seizure. Based on the clinical course and diagnostic processing, we want to draw attention doctors who are in a position to inspect these patients that apparently slight head injuries can be complicated and dangerous for the lives of the premorbid intracranial condition of the injured.

Introduction:Although placement of the central venous catheter is a routine procedure carried out by anesthesiologists, it
carries a certain risk of complications. One of the complications is malposition, or inadequate catheter position.

Case report: We present a case of the patient who was admitted to an intensive care unit due to head injury and blood
vomiting. The central venous catheter was inserted through the right internal jugular vein. Due to haemodynamic instability and the need for fluid and blood infusion, a chest x-ray examination was not immediately performed to evaluate the position of the catheter. After the patient was stabilized, the test was performed and revealed that the tip of the catheter was not located in the superior vena cava but in the right subclavian vein.

Conclusion: This case has shown that the misplacement of the central venous catheter tip is not unusual. Once in the venous system, even when it is not located in the superior vena cava, it can be used for initial fluid replacement and drug administration, and after the patient is stabilized, the repositioning or placement of a new catheter should be considered. 

Introduction: Stomach cancer is the second in mortality and the fourth most frequent of all cancers in the world. In the recent decades, the number of patients with Signet ring cell carcinoma type has been growing. Unknown etiology with proven risk factors such as smoked and salted foods, smoking, metabolic syndrome, alcohol abuse and Helicobacter pylori infection. Five-year span survival is 20%-40%.

Case outline: Patient, 70 years old, in good health, came to the GP, because of pain she had been feeling in the lower back area for a couple of months. Sometimes she wakes up because of the pain below the chest. Belch, acid, lost three kilograms. Didn't pay any attention to the problem because earlier, due to severe osteoporosis, she had obtained a compression fracture of two vertebrae. Occult bleeding negative. Laboratory normal. Tenderness on palpation of epigastrium, the tumor mass is not palpable. Addressed immediate to esophagogastroduodenoscopy. Diagnosis: Ulcer ventriculi, region antrum. Histopathological findings: Gastric Adenocarcinoma, diffuse type, Signet ring cell. Computed tomography showed locoregional lymphadenopathy so responsible Consilium decided radical surgery and chemotherapy. Despite being treated, the patient pass away two years after the onset of the illness.

Conclusion: Primary health care workers have a big responsibility, because of nonspecific symptoms, in detection of gastric cancer. Good evaluation of patients who should be referred for esophagogastroduodenoscopy is essential. The doctor should keep in mind in the further course of treatment early postoperative complications, Dumping syndrome, appears ventral anastomosis, subocclusive disorders, gallbladders calculus formation, educate patients about nutrition, vitamins, monitor vitamin B12 and iron because patients are prone to vitamin deficiency and pernicious anemia. Psychological support for patients and their families is also very significant, through a concrete doctor-patient relationship.