Although there is generally world trend in decreasing of number of smokers, expecially in developed part of world, smoking cigarettes still have large importance in morbidity and mortality of modern human population. Taking anamnestics data about smoking habit instruct anaesthesiologist to apply special strategy in general anaesthesia for a reason of possible complications provoked bby a chronic influence of nicotin and other tobbaco ingredients on different organs. In this article we wanted to examine influence of chronic tobbaco smoke exposing on arterial oxygen saturation SaO2 during and short period after general anaesthesia. Research was evaluated on patients in Emergency Center of Clinical Center of Serbia. Patients were divided in two groups (ASAI and II): group I smokers (n=40) and group II nosmokers (n=40). Our investigation has shown no statistical significant difference on SaO2 during general anaesthesia between two experimental groups. Immediately after general anaesthesia and extubation in postoperative period SaO2 dicreases (p<0.001) during transport from operating room to recovery room in both groups of patients,but the level of hypoxemia was significantly higher in smokers group. In this study we demonstrated that tobbaco smoking corellate with postoperative decrease of SaO2 after general anaesthesia, proposing an additional oxygen therapy in early postoperative period.

The Early Warning Score is a simple physiological scoring system that can be calculated at the patient's bedside, using parameters which are mesured in the majority of unwell patients. Patients suffering in-hospital cardiac arrest often have abnormal clinical observations documented prior to the arrest. Study objestives:This study assesses wheather these patients have less favourable outcome following in-hospital cardiac arrest. Matherials and the methods:For the present study, the patients' hospital charts were reviewed to identify possible abnormal observations within 8 h prior to the arrest. Results: From the total of 100 patients who sufferd in-hospital cardiac arrest, 64 patients had documentation of vital signs and 9 patients had no documentation of vital signs. Of the patients with documented vital signs 27 (29,7%) had normal vital signs and 64 (70,3%) had abnormal observations. Among these 64 patients the distribution was as follows: 17 patients (13,1%) had respiatory rate below 8 or over 20 per min, 40 (30,8%) had puls rate below 40 or over 140 beats per min, 20 patients (15,4%) had systolic arterial blood pressure below 90 or over 200 mmHg, 5 (3,7%) had temperature (˚C) below 36,1 or over 37,9 ˚C, 20 (15,4%) had oxygen saturation below 90%, 14 (10,8%) had decrease in consciousness and 14 (10,8%) had urine output below 50 ml/2hours). Compared with patients whose EWS were 0-2 (ОR 1,2; 95% CI: 0,935-1,507) patients with EWS 3 or more were 6,5 times more likely to die in first 24 hours (OR: 7,8; 95% CI: 1,205-50,205). Conclusions:Patients with documented clinically abnormal observations prior to in-hospital cardiac arrest have a worse outcome than those without. The main implication of these is that these patients need to be identified in time thereby possibly avoiding arrest. This can also be used when assessing the prognosis of in-hospital patients after achieved ROSC.

Diabetic retinopathy, particularly diabetic maculopathy, are leading cause of visual loss in the world.Purpose: to estimate type of diabetic maculopathy in patients with diabetic retinopathy. Method: hospital based study. 118 patients with diabetic retinopathy underwent complete ophthalmologic examination ( mean age 58,1 years, male 78, female 40; 7% were diabetes type 1 patients; 46% had nonproliferative diabetic retinopathy (NPDR) and 54% had proliferative diabetic retinopathy (PDR). Results: 88 patients (74% of all) had diabetic maculopathy. The most common type of diabetic maculopathy was diffuse (60% of all patients ), afterward focal (33% patients) ischemic maculopathy (both with PDR) had two patients (3%) and five patients had mixtus (7%) . Conclusions: diffuse diabetic maculopathy is the most common type of maculopathy both in NPDR and PDR

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

Haemodialysis, as a drastic medical procedure, needs a modern technology for performing of qualitative depurative process. Trying to imitate a function of healthy kidneys, it provides survival without one vital organ. The aim of the study was a qualitative estimation by comparing laboratory and clinical parameters of one-year haemodialysis treatment with different dialysis methods. In all patients treated with chronicle haemodialysis in Dialysis Centre in Kosovaska Mitrovica, we performed a set of laboratory analyses, recorded hepatotrophic viruses and determined a quality of haemodialysis by the degree of urea elimination. There are 16 patients on chronicle haemodialysis, 11 female (68,75%) and 5 male (31,25); mean age, 52,46±16,89 years, mean time on dialysis was 58±51,835. An increase of hemoglobin concentration was correlated with bicarbonate heamodialysis initiation. (61,692±19,405 vs. 75.466±13,814; p=0,038). Cholesterol (5,32±1,522 vs. 4,34± 1,006; p=0,0481) and inorganic phosphorus (1,427±0,2327 vs. 1,692±0,260; p=0,0056) are biochemical factors that are in a reverse correlation with bicarbonate haemodialysis in our patients. The degree of urea elimination as a measure for haemodialysis adequacy was statistically significant indicator of an adequate dialysis and was correlated with bicarbonate haemodialysis initiation (t=8,571; df=1; p=0,0389)

In this work we have examined echocardiographic characteristics of left ventricle in patients with acute myocardial infarction (AMI). We used prospective study, during 12 months, and we followed 55 patients with diagnosed non Q AMI. All patients were hospitalized in the Coronary unit. Results: 55 consecutive (40 males middle age 55,4±8,7 and 15 females middle age 57,4±10,3) had non Q AMI. Value of ejection fraction: after 4.day - 50,4±6,2% ,2.weeks - 54,6±5,8%, 4. weeks - 59,3±5,4%. Value of ejection fraction in patients with thrombolytic therapy: 61,6±6,8% vs. 57,3±6,6% p> 0,05;Value of left ventricle fractional shortening: 28,8±2,5% (in patients with thrombolytic therapy 30,3±4,8% vs.27,2±5,9%) Value of end2 2 2 - diastolic volume: after 4.day- 62,5±5,3 ml/m , 2.weeks - 63,1±5,4 ml/m , 4. weeks - 64,4±5,8 ml/m (in patients with throm 2 2 2 bolytic therapy 60,5±9,2 ml/m vs. 67,4±8,4 ml/m ) Value of endsistolic volume: after 4. day - 26,2±2,1 ml/m , 2.weeks2 2 26,8±2,3 ml/m , 4. weeks - 27,6±2,2 ml/m (in patients with thrombolytic therapy 25,6±2,8 ml/m2 vs. 31,7±3,1 ml/m2 p> 0,05). During the in-hospital follow up period, 2(3,6%) patients and during the post-hospital follow up period, 1 (1,9%) patients with non Q AMI had lethal outcome.

Pruritus is one of the commonest symptoms of dermatologic appearances in uraemic syndrome and it occurs in 90% of patients on dialysis with different etiology and pathophysiology. The aim of the study was to estimate the frequency of uraemic pruritus and the comparison with clinical and biochemical parameters in 124 patients treated by chronicle haemodialysis at Department of Haemodialysis, Urology and Nephrology Clinic, Clinical Center “Kragujevac”. The routine laboratory analyzes were carried out in examined patients and the concentration of parathyroid hormone was determined. The study was based on data from history of disease and  questionnaire carried out in all patients. Of 124 patients, 65,3% were male and 34,7% were female, mean age of 55,98±12,94 years; the mean time on HD was 55,5 ±50,4 months. 46,8% of examined patients had symptoms of uraemic pruritus. Uraemic syndrome and uraemic complications, manifested by the concentration of urea, 21,57±7,56 vs. 22,93±5,754; p=0,05 and time on dialysis, 67,27±60,07 vs. 43,64±36,84; p=0,02, are the significant parameters of uraemic pruritus. Serum concentration of iron 15,16±8,03 vs. 11,73±6,21; p=0,05 and UIBC 25,12±10,6 vs. 30,45±9,86; p=0,04, as well as hyperglycemia 6,16±2,516 vs. 6,82±2,872; p=0,02 are significantly correlated with uraemic pruritus. There was a statistically significant difference in albumin concentration 35,84±9,09 vs. 37,72± 3,105; p=0,05 but our results were reverse to the data in literature where the reported albumin level was higher in patients with uraemic pruritus. 27,6% of examined patients had itching of all the body what is in correlation with literature. Between the patients with localized itching and patients with generalized itching, there are statistical significance in following: number of erythrocytes 2,4±0,96 vs. 2,7±0,6; p=0,02, concentration of hemoglobin 78,53±31,44 vs. 89,36±19,81; p=0,05, hematocrit 0,23±0,089 vs. 0,26±0,057; p=0,02 and TIBC 29,45±12,01 vs. 34±4,86; p=0,02, as well as concentration of glycemia 5,38±2,52 vs. 6,42±2,12; p=0,01.

Diabetes mellitus is the most frequently chronical disease.In the relation on the degree of affection populations (over 150 000 000 peoples), was able speak about pandemic of this illnesses. In the orgin of insulin-indipendent diabetes mellitus, the primary role has the insuline resistence. Date from literature gives the evidence that the metformin is a drug for insuline resitence. Behaind the rest, has been proved that metformin, decrease risk factors for beginning complications this illnesses

The retrospective study included all patients treated at Clinical Centre in Kragujevac, who needed an acute HD treatment due to vital endangerment, during 2003. The objective of this study was to demonstrate our experiences in treating these patients using central venous catheter. The results of this study show that femoral catheters are dominant (over 95%), with slight using of jugular and subclavial catheters (5%), in spite of the recommendation of the American Association for Renal Diseases to use femoral catheters only for patients supposed to be in hospital during the interval of 5 days. The
frequency of infections in our study (16,6%), coincides with the data of the American Association for Nosocomial Infections (NNIS)[1] (17,8% catheter infections). Gram-positive bacterium from Staphylococci group are the most frequent cause of catheter infections also in our patients