Introduction: In over of 99% cases of cervical cancer its appearing is preceded by persistent cervical epithelium infection caused by high-risk oncogenic types of human papillomavirus (HPV). The aim of the study was to examine the distribution of high-risk oncogenic HPV types compared to patohistological diagnoses of cervical diseases in women. Materials and methods: The study included 56 women with suspected premalignant and malignant cervical lesions, due to suspected colposcopic and cytological findings (Papanicolaou test). The HPV typing by "in situ" hybridization method on high-risk HPV types 16, 18, 31 and 33 was performed in all patients from cervical smear as well as cervical biopsy. Histological findings of cervical biopsy was a "gold standard" in the analysis of materials. Results: Histologically detected premalignant or malignant changes of the cervix were found at 34 (60.7%) of all 56 examined women: 17 of them had LSIL, 13 of them had HSIL, while 4 had squamous cell carcinoma. A positive HPV test had a 47 (84%) of them with a prove of the presence of one or more types of HPV. The most common type of virus was HPV 16 and it was detected in 27 (48.2%) women, followed by HPV 31 that was detected in 26 (46.4%) women, HPV 18 in 18 (32.1%) of women and HPV 33 in 4 (7.1%) women. The infection caused by oncogenic type HPV16 was significantly more frequent in patients with HSIL and cervical cancer (p<0,001), while the infection caused by oncogenic type HPV 31 was significantly more frequent in patients with LSIL and cervicitis (p=0,003). The distribution of HPV 18 and HPV 33 types was not statistically significantly different in patients with different histological findings (HPV 18, p = 0.41; HPV 33, p = 1.0). Conclusion: Based on our results we can conclude that there is a good correlation of HPV infection with pre-malignant cervical lesions and cervical cancer. The incidence of HPV type 16 infection increased with severity of cervical lesions and it is usually detected high-risk oncogenic type virus in women with severe cervical lesions type like HSIL and cancer are. HPV 31 is the most common high-risk type of HPV of mild type lesions, like LSIL and cervicitis are. We believe that women infected by high-risk oncogenic HPV types, although without histologically diagnose of cervical lesion, should be more frequent controle by colposcopy and cytology (Papanicolaou) test, because of possible disease progression to a more advanced level.

Stopa incidence cervikalnog karcinoma u Srbiji je među najvišima u Evropi i iznosi 23,8 na 100000. Papanicolau test, dopunjen kolposkopijom i histologijom, osnovna je metoda sekundarne prevencije cervikalnog karcinoma. Cilj rada je bio ispitati histološko-citološku korelaciju i pouzdanost Papanicolau testa u detekciji cervikalnih lezija. Analizirani su cervikalni razmazi (Papanicolau test) kod 3868 žena. Suspektne nalaze imalo je 190 žena i kod njih je urađena cervikalna biopsija. Kod 77 žena detektovane su premaligne ili maligne promene na cerviksu. LSIL (CIN1) je imalo 43(22,6%), HSIL(CIN2/3) 25(13,2%), a planocelularni karcinom 9 (4,7%) žena. Između histološkog i citološkog nalaza ispitanica postoji statistički značajna pozitivna povezanost (Spearman r=0,829, p<0,001). Najviše ocene dijagnostičkih performansi Papanicolau testa u diskriminaciji LSIL-a(CIN1), HSIL-a(CIN2/3) i planocelularnog karcinoma od cervicitisa su za citološki nalaz ASCH (PA IIIa) (Sp=90,6%, a Sn=100% za Ca planocellulare, Sn=96% za HSIL i Sn=86% za LSIL). U diskriminaciji HSIL-a od LSIL-a najbolja diskriminativnost postiže se za nalaz LSIL (PAIIIb) Papanicolau testa (Sn=72,0%, Sp=67,4%), a u diskriminaciji Ca planocellulare od LSIL najbolja diskriminativnost postiže se za nalaz HSIL (PA IIIb/IV) Papanicolau testa (Sn=77.8%, Sp=97.7%). Na osnovu naših rezultata možemo zaključiti da postoji pozitivna histološko-citološka korelacija nalaza i da je Papanicolau test pouzdaniji u detekciji težih premalignih promena. Citološke dijagnoze ASCH (PAIIIa) i LSIL (PAIIIb) mogu pouzdano ukazati na postojanje premalignih cervikalnih lezija kod žena, pa pacijentkinje sa tim nalazima treba češće kontrolisati i lečiti.

Increased mortality rate for patients with mental disorders and their shorter lifespan compared to the general public is stated by numerous authors. Services on the Clinic for mental disorders “Dr Laza Lazarević” were reorganized, by introducing intensive care units – level two, i.e. contemporary intensive care of patients was introduced, only without life support. Primary objective of the research was to determine if the introduction of intensive care to the Clinic led to a statistically significant change in the number of fatal outcomes of hospitalized patients. The research was designed as a cross-sectional study and it included 62 patients that have died while being hospitalized at the Clinic for mental disorders “Dr Laza Lazarević” in Belgrade, in 2011 and 2012. Data were collected by retrospective insight in the histories of illnesses and treatment protocols of the Clinic and institutes for pathology and forensic medicine of the Faculty of Medicine in Belgrade. Obtained data were statistically analysed with Student’s T-test and ANOVA test, with a significance level of 0.05. Statistically significant difference was determined in fatalities in 2011 compared to 2012 with p = 0.007, and there were significantly less fatalities in 2012. Statistically significant difference in frequency of fatal outcomes when comparing 2011 to 2012 was determined only when comparing the ward of previous intensive care on one side with the newly established psychiatric intensive care units – level two on the other. High level of significance was determined with p = 0.005. New organizational concept introduced in 2012 has led to more efficient twenty-four-hour care and monitoring of hospitalized patients, suppression of accompanying somatic illnesses which altogether led to a significant reduction of fatal outcomes.

 Atrial arrhythmias are an often and common problem in patients with arterial hypertension. Some recent studies have shown that the electrical pulse delay estimated by echocardiography is prolonged in patients with paroxysmal atrial fibrillation compared to healthy persons. To assess the electromechanical function of the left atrium in patients with various degrees of hypertension compared to healthy persons. The study has included 103 patients with artery hypertension, who were divided into four groups according to the degree of arterial hypertension and 46 healthy persons as a control. The volumes of the left atrium were measured by echocardiography using the disk, active and passive emptying volumes of left atrium and the fractions were calculated. Electrical delay within the left atrium and between the two atria were measured using the tissue Doppler. The values of passive left atrial emptying fraction were highest in patients in the control group and in patients with prehypertension they have significantly declined with the increased degree of hypertension (12.8 vs 12.6 vs 11.2 vs .10.2 vs 9.9%, p˂0.001). The values of the active emptying fractions left atrium were higher in patients in the control group and with prehypertension threy have significantly declined as increased degree of arterial hypertension (28 vs 23 vs 40 vs 40 vs 39%). Electrical delay within the left atrium was significantly lower in patients in the control group and it has been significantly increased as a growing belonging to a group with higher levels of arterial hypertension (6 ... 9 ... 15 ... 23 ... 31 ms, p˂0.001). Patients with prehypertension had significantly higher values of electrical delays within the left atrium compared to the patients in the control group. Electrical delay between the two atria grew significantly as a growing belonging to the group with a higher degree of hypertension (15.6 ... 25.3 ... 35.2 ... 50.2 ... 67.4ms, p˂0.001). The study showed that even patients with regulated arterial hypertension have disturbed electromechanical function of the left atrium. Electrical delay in the atrium between the two atria is extended to the increasing degree of arterial hypertension, which can be explained by the higher risk for atrial arrhythmias in these patients.

Dijagram toka studije predstavlja sastavni deo usklađenih standarda o izveštavanju (CONSORT). Preporučuje se njegova primena u izveštavanju ogleda sa klaster randomizacijom. Cilj rada je da se predstavi učestalost korišćenja dijagrama toka u klaster randomizovanim studijama u skladu sa standardima o izveštavanju. Urađeno je pretraživanje Medline-a i za analizu izdvojeno 474 studija sa klaster randomizacijom. Studije su pregledane u cilju otkrivanja upotrebe grafičkog prikaza, primene standarda o izveštavanju i vremena publikovanja studije. U zavisnosti od trajanja, studije su podeljene na one koje su prikazale završena istraživanja i one čije je izvođenje još uvek u toku. Učestalost dijagrama toka je bila statistički značajno veća u studijama koje su se pridržavale standarda (86,2%) u odnosu na studije koje nisu koristile CONSORT smernice (71,4%), i u studijama koje su prikazale završena istraživanja (81,2 %) u odnosu na studije koje su predstavljale pilot projekte (54,3%). Primena CONSORT-a je zabeležena u 145 (31%) literaturnih jedinica. Broj klaster randomizovanih studija dobijenih pretraživanjem MEDLINE-a niskom cluster randomized trial [ti] i cluster randomised trial [ti] i primena CONSORT-a u izveštajima klaster randomizovanih studija linearno rastu tokom vremena (p<0,001). Učestalost primene dijagrama toka je veća u izveštajima klaster randomizovanih studija koji su rađeni u skladu sa standardima o izveštavanju.

Meta-analiza je kvantitativna statistička analiza koja se koristi za sintezu i sumiranje rezultata istraživanja više studija. Da li su studije kvalitativno dovoljno slične da se kombinuju i da li postoji publikaciona pristrasnost? Grafički prikazi su moćno sredstvo koje može dati odgovor na ova pitanja. Cilj rada jeste da se predstavi učestalost korišćenja grafičkih tehnika za prikaz rezultat u meta-analizama opservacionih studija. Urađeno je pretraživanje Medline i izdvojeno je 473 meta-analiza studija slučaj-kontrola i kohortnih studija. Studije su pregledane u cilju otkrivanja upotrebe grafičkog prikaza i vrste grafikona, broja studija koje su obuhvaćene meta analizom i vremena objavljivanja date meta-anlize. Za analizu primarnih podataka korišćene su deskriptivne statističke metode i analitičke metode- hi kvadrat test. Kriterijum za statističku značajnost je bio p<0,05. 82% studija koje su uključene u analizu za prikaz rezutata su koristile forest plot. Kod meta-analiza sa manje od 30 opservacionih studija, 60% studija je koristilo forest plot a sa povećanjem broja studija njegova primena se smanjuje na 49%. Upotreba funnel plota sa povećanjem broja uključenih studija beleži porast primene sa 20% na 29%. Grafički prikazi u studijama objavljenim posle 2000. godine su statistički značajno učestaliji, p< 0,05. Učestalost korišćenja potvrđuje značaj grafičkih tehnika u meta-analizi i važno je ukazati na informacije koje su sadržane u grafikonima.

In our work we analyzed utilisation of antibiotics for systemic use at the Surgical Clinic of the Clinical Hospital Centre - Pristina in Gracanica in 2007. and 2008. Data on antibiotic utilization were delivered on the basis of drug dispensing records from the Central Hospital Pharmacy during the two-years period. Antibiotics were distributed inside the ATC/DDD system in accordance with WHO guidelines. Quantitative antibiotics' utilisation was expressed as number of defined daily doses per 100 patient-days (DDDs/100 PD). Overall use of antibiotics in 2007 was 123.37 DDDs/100 PD, and 125.09 DDDs /100 PD in 2008. Three most utilized antibiotics in 2007. were cefuroxime 24.26 DDDs/100 PD (19.66 % of total antibiotics' use), ceftriaxone 16.65 DDDs/100 PD (13.49 %), and cephalexin 15.78 DDDs/100 PD (12.79 %). In 2008. the most utilized were ceftriaxone 23.23 DDDs/100 PD (18.57 %), cefuroxime 22.53 DDDs/100 PD (18.01 %), and co-trimoxazole 19,55 DDDs/100 PD (15.63 %). Qualitative and quantitative part of the consumed antibiotics was mainly in accordance with the results of similar researches in our country.

In diabetics fungal skin infections are reported to be related to greatly disturbed metabolism. In order to get better insight into the association between diabetes mellitus and fungal skin infections, we started our study with the aim to assess the effect of metabolic regulation on the incidence of fungal skin infections is diabetics. The obtained results of our study show that in patient with metabolically poorly regulated primary disease i.e. diabetes the incidence of the fungal skin infections is highest (36.0%), its incidence is lower in patients with metabolically satisfactorily regulated diabetes (29.5%) and lowest in those with well regulated diabetes (18.8%), witch is statistically significant difference (p=0.045).

Topiramate is the new antiepileptic drug, which is related with high efficiency in the reduction seazures, and also whit high prevalention of cognitive adverse events. Purpose of study is to define the relationship between efficiency topiramate in control of epileptic seizure and the apperance of cognitive adverse events. In the prospective stady we followed 40 adult patients with refractory epilepsy, which treatment took place on the Institute of neurology Clinical center of Serbia. The efficacy of treatment was estimated as the ratio of the total number of seizures during the last two months before the introduction of topiramate (on basic antiepileptic therapy) and during the last two months on stable (200mg/day) dose of topiramate.All patients are neuropsychological tested twice. First time before the start of therapy with topiramate, and next time two months after the achieving of stable dose. We used neuropsychological tests for evaluation attention, concentration, visual and verbal memory, speech, executive functions, divergent opinion and visual construction abilities. Patients with good success of topiramate in control of the seizures had worse scores on cognitive measurements than patients in whom topiramate was not demonstrated efficacy in treating epileptic seizures. Our findings indicate that the appearance of cognitive adverse events of topiramate possible in patients with reduction of seizure after the introduction of drug. This suggests that the same mechanism topiramat achieve a positive therapeutic effect and adverse effect on cognition in people with epilepsy.

Patients with epilepsy more often than healthy individual have cognitive disorders, what may be the result of different factors, among which significant place occupy the treatment with antiepileptic drugs. Topiramate is the new antiepileptic drug, which is related with high efficiency in the reduction seazures, and also whit high prevalention of cognitive adverse events. Purpose of our study is to clarify the role of depression in developing cognitive adverse events during therapy with topiramate in patients with refractory epilepsy. In the prospective stady we followed 40 adult patients with refractory epilepsy, which treatement took place on the Institute of neurology Clinical center of Serbia. All patients are neuropsychological tested twice. First time before the start of therapy with topiramate on basic antiepileptic therapy, and next time two months after the achieving of stable dose of 200mg/day. We used neuropsychological tests for evaluation attention, concentration, visual and verbal memory, speech, executive functions, divergent opinion and visual construction abilities. For estimate degree of depression we used Hamilton's scale of depression. Patients with the depressive manifestation had lower scores on cognitive tests in comparition to patients without the depression, before and after introductions topiramate. More the score of depression was larger, the scores of neuropsychological tests have been worse. Depression has bad influence on the cognitive functioning and her presence in the patients with epilepsy increases the risk from development of cognitive adverse events of topiramate.