Formation of vascular access in elderly and diabetic patients is burdened with many difficulties. The aim of this study was to determine the factors that older people and patients with diabetes mellitus defined as the population risk for the formation of arteriovenous fistula for hemodialysis. The study was organized as a retrospective study, a subject of interest in people older than 65 years of age and diabetes, which in four years because of the need for further treatment performed arteriovenous fistula. Analyzed the demographic structure of the patient, type of anastomosis, the use of central-venous catheters for hemodialysis, arterial blood pressure and size of the lumen of blood vessels used for anastomosis, intraoperative measured. From the laboratory analysis determined the routine hematological and biochemical parameters. In relation to the positioning of arteriovenous fistula (p=0.033), the placement of catheters for hemodialysis (p=0.0009), preventive form of vascular access (p=0.04) and values of systolic (p=0.0001) and diastolic (p=0.0001) arterial blood pressure, achieved a statistically significant difference. Patients with diabetic nephropathy, compared to the population of elderly, have a significantly higher number of leukocytes (7.5±2.61 vs. 8.5±3.24, p=0.03), fibrinogen level (5.57±2.39 vs. 6.8±1.71, p=0.036), glycemia (5.35±1.24 vs. 7.1±2.28, p<0.0001), cholesterol (3.77±1 , 03 vs. 4.5±1.71, p=0.001), triglycerides (1.59 ±0.62 vs. 1.86±0.76, p=0.009) and LDL-cholesterol (2.13±0.76 vs. 2.42±2.04, p=0.02). Total proteins (64±9.98 vs. 62 ±7.4, p=0.027) and albumin (36±34 vs. 9.55±5.49, p=0.037) were significantly lower values in diabetics. Characteristics of older diabetics and is characterized as a risk population of patients for the creation of arterio-fistula were timely creation and position of arterio fistula, the need for placement of central-venous catheters for hemodialysis and arterial blood pressure.

Doppler ultrasound check-up significantly increases a possibility of initial functioning of arteriovenous fistula. The aim of the study was the preoperative evaluation of vascular system of the extremity for creation of arteriovenous fistula for haemodialysis. The examination was organized at Urology and Nephrology Clinic, Clinical Centre "Kragujevac". The examined subjects were 87 patients, 52 (59,8%) male and 35 (40,2%) female, mean age of 61±11,1 years. There were performed the routine biochemical analyses, demographical structure and clinical characteristics (type of anastomosis, fistula placement, arterial blood pressure, lumen size of the artery and vein, measured intraoperatively by Doppler technique). In 72,1% of patients with functioning fistula there was made a terminal-lateral anastomosis, compared to 57,7% of patients with initial non-functioning fistula, there was found a statistically significant difference between the groups p=0,008. Radiocephalic fistula was created in 62,3% of the examined patients with initial functioning , in patients with non-functioning, the distal fistula was created in 38,5% of the examined patients. Regarding the type of the fistula location there was obtained statistically significant difference; p=0,04. There was found a statistically significant difference between the group of patients with initial functioning of arteriovenous and the group without, concerning the intraoperatively measured lumen of the cephalic vein (2±0,29 vs. 2±0,38 mm); p=0,03 (2,1±0,5 vs. 1,8±0,4); p=0,0009. Statistical significance between the groups was also found in the lumen of the cephalic vein verified by the ultrasound (2,1±0,53 vs. 1,8±0,25 mm); p=0,038. Peak of the systolic speed of the radial, corelated to the group of patients with and the group without initial functioning fistula (50 ± 12,42 vs. 40 ± 6,9 cm/sec); (p=0,0026), has statistically significant value. By the correlation of the group of patients with initial functioning and the group of patients without initial functioning, regarding hemoglobin (97 ± 16,1 vs. 88 ± 18,3 g/l); p=0,006 and the level of urea (22,6 ± 12,7 vs. 23,9 ± 9,8); p=0,02, there was found a statistically significant difference. Color Doppler ultrasound has an important role in preoperative evaluation of blood vessels and it represents a meaningful predictive parameter of functioning of arteriovenous fistula. 

Epstein-Barrov virus (EBV) is a cause of heterophile antibody positive infectious mononucleosis (IM),which is characterized by fever, sore throat, limfadenopatiom and atypical limfocitozom. IM is mainly a self-limited disease. Complications of the central nervous system, hepatitis (which can be fulminant), (splenomegalia, obstruction of the upper respiratory tract with bacterial can sometimes be deadly.

The existence of left ventricular hypertrophy is an independent prognostic factor for cardiovascular morbidity and mortality. Heterogenous factors lead to left myocardial hypertrophy. The most frequently factors are: arterial hypertension, valvular heart disease (aortic stenosis and insufficiency, mitral insufficiency), hypertrophic myocardiopathy, left myocardial hypertrophy after myocardial infarction... For making the diagnosis of left ventricular myocardial hypertrophy used electrocardiography („voltage“ and „repolarization“ criteria) and echocardiography. Echocardiography is the gold standard for diagnosis of left ventricular myocardial hypertrophy. Left ventricular mass was estimated by the modified formula 3 3 using measurements obtained in accordance with the Penn convention: MLK = 1,04 (LDDd+PWDd+IVSDd) - (LVDd) - 13,6 Where LDDd is diastolic left ventricular internal dimension, IVSDd is diastolic ventricular septal thickness and PWDd 2 is diastolic posterior left ventricular wall thickness in diastole. LV mass indexed by body surface area (g/m ). By Penn con2 2 vention left ventricular hypertrophy criteria were ≥134 g/m for men and ≥110 g/m for women.

Introduction: Approximately 15-23% of the general population have had urticarial rush during their lives. Goal: Examination of the urticarial frequency and urticarial etiopathogenesis among hospitalized patients. Sources and methodology: Retrospective analysis of the data extracted from patients' medical history at the Clinical Center of Kragujevac, Department for Dermatology and Venereology. Statistical methods used include proportional relations with tabular and graphical representation of the results gathered. Results: Out of 228 hospitalized patients in 2007, total of 28 (or 12.28%) were treated for Urticaria. The disease is more frequent among the following groups of patients: female population (total of 23, or 82.1%); people between 30 and 60 years of age (total of 15, or 53.6%); urban area population (total of 24, or 85.7%); patients with Dg. Urticaria acuta diagnosis (total of 19, or 67.8%); Dg. Oedema Quincke (total of 6, or 21, 4%); et people with cardiovascular diseases (total of 9, or 32.2%). The disease is more frequent in Spring, during the period April-June (11 patients, or 39.3%) with the greatest frequency in May (7 patients, or 25%). According to etiological samples the most prominent types of Urticaria among patients were: idiopathic (13 patients, or 46.4%), due to medications (5 patients, or 17.9%), nutritional origin (4 patients, or 14.3%), psychological factors (3 patients, or 10.7%). Considering complications, 6 patients (21.4%) had Quincke's Oedema, while 7 patients (25%) had allergic reactions to penicillin. Regarding outcome of the disease, total of 23 patients (82.1%) have been successfully cured. Discussion et Conclusion: The greatest number of serious urticarias with complications has been inducted by non-physical factors, mostly of immunological nature, while physically inducted urticaria have had less severe symptoms and required shorter time to cure. Nevertheless, exact causes for most types of urticaria are unknown, so continual research of causes, as well as courses, complications and treatments of this serious disease is necessary.

To show the most common causes of bacteriemia in hospitalized patients, as well as their sensitivity to antimicrobial agents. The research data were extracted from official reports produced by Microbiological Laboratory in Clinical Centre Kragujevac. Isolation and identification of the causes were performed with standard microbiological methodology. Sensitivity to antimicrobial medication was tested using disc diffusion. Interpretation and inhibition zones of antibiogram were done in accordance with guidelines of US Clinical and Laboratory Standards Institute (CLSI). A descriptive epidemiological approach was used in the research. The collected data were processed using the appropriate software application. Amongst the processed samples, a significant presence of Staphylococcus spp. was found (coagulase-negative 35,8% and coagulase positive 11,7%). Over 60% of Staphylococcus aureus isolates were resistant to meticillin. Enterococcus spp, isolated in 11,7% of all isolates, in more than 50% of cases was sensitive to ampicillin, with approximate isolate vancomycin sensitivity of 90%. The isolated Klebsiellà spp strains produced high degrees of Extended-Spectrum â-Lactamases (ESBL) and showed resistance to third-generation cephalosporins, aminoglycosides and ciprofloxacin, with 100% sensitivity to carbapenem. Pseudomonas spp and Acinetobacter spp were less represented (5.8% and 5.4%) but these neither pathogens were exempt to antimicrobial resistance.The research indicated that causes of hospital infections should be continuously monitored. 

It is known that arteriovenous fistula for hemodialysis has an unfavorable impact of dialysis patients but their exact role in the development of heart failure was not clear enough. The paper presents a patient who is on chronic hemodialysis program is nine years, in which there was a clear clinical symptoms and signs of heart weakness, probably aided by a pronounced flow through arteriovenous fistula. Left ventricular hypertrophy due to volume of arteriovenous fistula, is not the only reason for the emergence of global heart failure.

Background: Cardiovascular disease is the predominant cause of morbidity and mortality in hemodialysis patients. Left ventricular hypertrophy is a major cardiovascular risk factor in hemodialysis patients.The present study was aimed at assessing the prevalence of left ventricular hypertrophy by doppler echocardiography in hemodialysis patients. Methods: We studied 20 patients on maintenance hemodialysis in Dialysis Centre in Kosovska Mitrovioca. LV mass was measured by both Doppler echocardiography. Left ventricular mass was estimated by the modified formula using measure2 ments obtained in accordance with the Penn convention. Left ventricular mass was divided by body surface area in m to obtain the left ventricular mass index. Results:This clinical observation study involved 20 patients (9 males and 11 females) with end-stage renal diseases undergoing maintenance hemodialysis with a mean age of 55,26 years, mean time on dialysis was 38,74 months. Main causes for developing chronic renal failure was arterials hypertension and polycystic kidney. Arterial hypertension (60%), diabetes mellitus (20%) and hyperholesterolemia (10%), were the most frequent risk factors for cardiovascular disease among the dialysis patients. Left ventricular hypertrophy were detected in 14 (70%) patients. Mean left ventricular mass wass 153,62g/m2 (males), and 142,71 g/m2 (females). To conclude, the present study shows that hemodialysis patients have higher left ventricular mass and higher prevalence of left ventricular hypertrophy.

Diabetes mellitus with one`s chronical complications is the cause of the large percent morbidites and mortality, among the population. With regard to a lot of people who have diabetes mellitus tip 2 (WHO-over 170.000.000 peoples), adequate therapy is very important. By this stady, we wont to show positive consequence new therapy for medication diabetes mellitus typ 2, chiefly application tiazolidinedion in therapy. Handlend 25 patientis with diabetes mellitus typ 2 during 3-mounth observed. Patients were divide in II groups forms on basic of the kind therapy. At the end of 3-mounth, derived results (decrease HbA1c from 7.9%±1.24% to 6.99±0.89%; data value fasting glycemia from 8.99mmol/l±2.08 mmol/l to 7.45±1.35 mmol/l, and value glycemia after meal 10.36 mmol/l±2.18 mmol/l to 8.18 mmol/l±1.31 mmol/l) indicate validity the introduction tiazolidinedion in therapy diabetes mellitus type 2.

Eosinophilic Granuloma (EG) represent the most benign and localized form of the three Langerhans cell histiocytosis syndromes. In bone, it is a tumor-like proliferation Langerhans cells. Intraosseous EG lesions can be solitary or multifocal. EG accounts for 60-70 % of Langerhans cells histiocytosis cases. The authors are describle a 21 year-old men with Eosinophilic granuloma. The disease had a rarely course with disorders multiple lesions in bones