Savremeni akcenti u tretmanu varikocele. Postići “minimalnu invazivnost” tretmana, odrediti broj trudnoća nakon operacije i ustanoviti vremenski period od operatvnog zahvata do začeća kod partnerki. Selektovana grupa muškaraca pomoću uroloških kriterijuma za infertilni par, tretiranih subingvinalnom ligaturom spermatične venepampiniformnog pleksusa. Tretirali smo 26 subfertilnih muškaraca kombinacijom subingvinalne ligature spermatične vene ili pampiniformnog pleksusa i medikalmentozne terapije.U desetogodišnjem periodu, registrovali smo 16 trudnoća (61,5%) partnerki naših pacijenata. Smatramo da je subingvinalna ligatura spermatične vene minimalno invazivan i isplativ početni tretman “infertilnih parova”.

Among all ALS procedures, effective airway management is vital in the treatment of critically ill patients. The aim of this study was to evaluate the impact of pre-hospital endotracheal intubation and early defibrillation on outcome of cardiac arrest (CA) patients. We examined 200 patients suffering from out-of-hospital cardiac arrest (OHCA) in a prospective cohort study in a two years period. We determined survival from CA to discharge from hospital and the factors associated with survival. We calculated the time intervals until shock decisions were made. Shock decisions were verified according to EKG downloads. 52% of patients were intubated in the field, survival to discharge from hospital was significantly higher among patients who were intubated in the field. Survival rates in patients with VF/VT was 9.7% compared to patients with asystole/PEA (1.6%). 66.7% of patients were given the shock after 4 minutes. Low survival to hospital discharge may be due to low number of CA patients who were intubated in the field and long "interval to shock delivery" (there are no AED). Existing literature shows that the first minutes are a critical time frame for successful resuscitation and this is an argument towards the introduction of AEDs used by bystanders.

We treated 15 subfertile men with varicocele with combination of subinguinal ligature of spermatic vein or plexus pampiniformis and medicaments. In a five-year period , we registered 5 pregnancies (30%) in female partners of our patients. We consider subinguinal ligature of spermatic vein as minimally invasive and cost-effective initial treatment of "infertile couples".

Scientific researches considering the effects of glucagon on cardiovascular system show that glucagon has a certain cardiostimulative potential. The fact that glucagon accomplishes its cardiostimulative effects by activating its own, highly specific glucagonic receptors is of most importance. That's the reason why we've wanted to give more details about the effects that glucagon has on cardiovascular system in terms of having more precise image of its effects on hemodynamics and changes which can be seen on electrocardiogram. The experiment included six dogs treated with intravenous glucagon injection. Electrocardiograph and hemodynamic parameters (middle arterial pressure, central venous pressure and heart st nd rd th th th th th frequency) have been recorded in 1 , 2 , 3 , 5 , 10 , 20 , 30 and 40 minute. Electrocardiograph and heart frequency have been recorded by continuous monitoring. Middle arterial pressure has been recorded through catheter placed into a. femoralis while central venous pressure has been recorded through central venous catheter placed into v. femoralis. Having received the intravenous injection, glucagon shows extremely positive chronotropic effect, followed by ephemeral increase of middle arterial pressure, while central venous pressure has a significant decrease. Having received intravenous injection, P-R, Q-Tand T-Pinterval have been significantly shorten.

The most important characteristic of calcium channels is a selective regulation of a slow incoming current of calcium into the tissue cells with tendency of a slow growth of the action potential. Such tissues include smooth muscles of the blood vessels, cardiocities and hearth noduses (AVand SAnode). Different calcium antagonists have different influences on the mentioned tissues, because they also have different chemical components. Verapamil, Nifedipin and Diltiazem have the most common usage. Verapamil is a product of papaverine, nifedipin is a product of dehydroperidine while diltiazem is a product of benzodiazepine. Their common characteristic is blocking the calcium channels which cause blood vessels vasodilatation, negative inotropic and negative chronotropic influence. By blocking calcium to enter through channels spores of miofibrile smooth muscles, calcium antagonists are reducing the amount of available calcium for contraction, which causes vasodilatation. One of the best-known and the commonest calcium antagonist is verapamil. In electrophysiological terms, it inhibits action potential of the heart noduses (especially AV node), where the most important thing for depolarisation, is a slow entrance of calcium. By extending the refractory period of SA node, it reduces the frequency of impulse generation (heart frequency), while by extending the refractory period of AVnode, it slows down the work of chambers in cases of flater and atrium fibrillation. Taking into consideration the fact that verapamil shows cardiodepresive effects, the aim of our work is to study closely its effects on electrocardiogram and hemodynamic parameters. The experiment was conducted on six adult, healthy dogs which were, after 10 minutes 0,9% NaCl infusion, treated with i.v. bolus verapamil injections on every 5 minutes until the appearance of intoxication signs, which causes bradycardia, heart rhythm disorder and the fall of arterial blood pressure. The average verapamil dose was 4 mg per kilogram. After i.v. verapamil administration, heart frequency and middle arterial pressure have a significant fall, while central venous pressure has a significant rise. Larger verapamil doses nd rd can significantly extend T-P and P-R interval with the appearance of AV-block (2 and 3 grade), while the Q-T interval doesn't show any significant change.

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.

Important facts about recombinant human factor VIIa have been mentioned, also about the renal cell carcinoma. Case report: Male, aged 69, with infiltrative renal cell carcinoma, underwent radical nephrectomy using Hasagawa`s approach. Extirpated tumor had 35 cm in diameter. During the surgery, patient suffered a cardiac arrest with 3500 ml blood loss. After operation, he lost 2100 ml more blood. Despite of active blood supstitutions with intensive surgical attempts in order of haemostasis, bleeding did not stop untill the application of rFVIIa (300 I. U.). Patient survives and recovers completelly. Conclusion: RFVIIa is very succesful in controling of massive surgical bleeding, possibly associated with paraneoplastic syndrome.

Glucagon is polypeptide hormone derived from pancreas which in addition to its metabolic actions has also certain cardiovascular stimulatory effects. We've explored the effects of glucagon on hemodynamic variables (mean arterial pressure, heart rate and central venous pressure) and on catecholamine level and the electrolite level in the kanine sera. It was estimated that glucagon expressed the positive chronotropic effect and significantly lowers the central venous pressure while inconsiderably inceases mean arterial blood pressure. It also leads to transient (short-lasting) hipokaliemia and nonsignificant hipocalcemia. As the result of the action of the glucagone, the serum adrenaline concentrations were significantly increased while the serum noradrenaline concentratios were significantly decreased

It is known that the intoxication with heavy metals and pesticides is most often unmedical poisoning. In contrast to other heavy metals, for example: mercury, lead, cadmium and zinc, toxic copper activity and the mechanism of its effect are not known enough and they are not yet explained. Because of that, the aim of this work was ( with acute dog intoxication with copper sulfate ) to contribute to better clearing of biochemical mechanism as a result of copper toxical effect and to make analysis of its tissue distribution. Researching was done on adult dogs, both sexes, different races and body mass of 14- 20 kg, who were given a 10% water solution of copper sulfate in the dosage of 33mg/b.m. divided into 5 equal doses. The analysis of biochemical blood structure took the following things: total proteins, albumins, globulins, total lipids, chole2+ sterol, glucoze, transaminase (AST,ALT), catalase, peroxidase, vitamin C, proteine SH, the contretation of Cu in the serum 2+ and the content of Cu in the tissues. The results are presented in the charts and graphic presentation. All these changes can be the important directions in an biological monitoring as a biochemical indication of copper pollution in the surroundings.

Scientific research of effects of glucagon on the cardiovascular system have shown that glucagon has some
cardiostimulatory potential. The very interesting fact is that glucagon shows its cardiostimulatory effects by activating its
own, higly specific glucagonic receptors. That is way we wanted to research not only the effects of glucagon on the C.V.S.
but also its effects during the depression of the C.V.S. with high dosses of beta blocators (presolol) expecting a good
hemodinamic response. The experiment has been performed on two groups of 6 dogs. The first group of animal was treated
with i.v. bolus injections of glucagon and other group with presolol (15 mg/kg b.w.) i.v., and after that with i.v. bolus
injection of glucagon. Hemodinamic variables (mean arterial pressure, central venal pressure and hearth frequency) were
registred at the 1-st, 2-nd, 3-rd, 10-th, 20-th, 30-th and 40-th minute. The hearth frequency was registred by continous
monitoring, mean arterial pressure was registred with cateter in the arterial femoralis, while the central venal pressure was
registred over central venal cateter in v. femoralis. After the i.v. bolus injection glukagon shows higly positive effects,
followed by short-term increase of the mean arterial pressure, while the c.v.p. considerably falls. During the administration
of presolol the hearth frequency and mean arterial pressure fall considerably and progressively, while the c.v.p. rises
considerably. Glucagon, in conditions of c.v.s. depresion by high doses of presolol (15 mg /kg b.w.) considerably increases
hearth frequency and mean arterial pressure, while the c.v.p. falls considerably.