Modern aspects of social development brings new concerns that contribute to obesity, as a direct result of the overall abundance. Almost that there is declarative consistent view that obesity, according to its frequency, a global epidemic of the new millennium and that is because of the effect on the overall health of the necessary complementary multidisciplinary approach, because its prevention can prevent and significantly reduce the mortality rate. Technological development, automation in the food production, reduced participation of manual labor and a sedentary lifestyle, obesity causes an increase not only in highly industrialized, but in the less developed countries. Obesity is a direct temptations of modern civilization and a major challenge for a community where food is plentiful. This fact increases the responsibility of each individual and placed before him the obligation to recognize the causes of obesity, so that, by changing their behavior, could reduce the burden involved with obesity.

Transposition veins, in some cases when there is no adequate superficial veins, preferred is model of the vascular access. This approach may be acceptable version vascular access where is not possible to create other shapes. But basilic vein transposition is time consuming and technically challenging procedure with significant perioperative morbidity. Complication rate for basilic vein transposition remains high at 47-71%. We report a patient who underwent transposition basilic vein, and its anastomosis with radial artery, in which developed the digital hypoperfusion ischemic syndrome.

Oštećena tolerancija glukoze,pojam poznat kao predijabetes , predstavlja stepenicu ispred razvoja dijabetes mellitusa tip 2 i može se javiti i deceniju pre manifestnog oblika dijabetesa i sve je češći u mlađoj populaciji. Cilj rada bio je da utvrdi uticaj fizicke neaktivnosti na pojavu predijabatesa i dijabetes mellitusa tip 2. Obrađeno je 80 bolesnika u endokrinološkoj ambulanti Interne klinike KBC Priština-Gračanica, u Lapljem Selu.Ispitanici su anketirani uputnikom iz vodiča Nacionalnog programa za prevenciju dijabetesa tip 2 Republike Srbije. Svim ispitanicima su odrađene polne, demografske i antropometrijske karakteristike kao istepen intolerancije glukoze. Od 80 pacijenata, 33 (41,25%) su muškog pola, a 47 (58,75%) su ženskog pola. Nema statističke značajnosti Hi² testa raspodele ispitanika prema familijarnoj anamnezi (=0,007, p>0,05). Fizička neaktivnost je registrovna u 16 ispitanika (20%), a ostalih 64 ispitanika je fizički aktivno. Normalna glikemija natašte u fizički neaktivnih ispitanika je bila u 56,25% (9), a glikemiju veću od 7 mmol/l je imalo 18,75% ispitanika. Pozitivan OGTT nalaz kod fizički neaktivnih ispitanika je potvrđen u 62,5% , a pozitivan OGTT nalaz kod fizički aktivnih je registrovan u samo 5 ispitanika (11,36%). Ispitanici sa rizikom za nastanak dijabetesa tip 2 (skor 12 i više) u 60% su bili fizički neaktivni. Umerena fizička aktivnost uz korekciju telesne mase ,može znatno da „odloži“ nastanak dijabetes mellitus-a tip 2.

Različita oboljenja pluća se na radiogramu grudnog koša mogu manifestovati u obliku solitarnih perifernih kružnih plućnih promena. U najvećem procentu radi se o tumorima pluća i to najčešće o karcinomu bronha perifernog tipa. Po učestalosti zatim dolaze tuberkulozne, bakterijske, gljivične, parazitne, infekcijske lezije kao i metastaze na plućima. Ostala oboljenja su zastupljena u znatno manjem procentu. Ovakve periferne plućne lezije su uglavnom asimptomatske i otkrivaju se slučajno. Veličine su 3-6 cm u prečniku. Lokalizovane su u desnom plućnom krilu, apikalno znatno češće, u odnosu na levo plućno krilo. Kod tuberkuloznih lezija u 50 % slučajeva prisutne su kalcifikacije, a najčešće su zastupljeni tuberkulomi. Periferne solitarne plućne lezije mogu pričinjavati značajan dijagnostički problem što iziskuje primenu mnogih dopunskih metoda ispitivanja do konačne dijagnoze i primene adekvatnog lečenja.

Aterogeneza je postepen proces koji započinje u ranom životnom periodu, odvija se lagano, decenijama i može biti prepoznat tek kada se razviju infarkt srca, mozga ili periferna vaskularna bolest. Cilj istraživanja bio je da se utvrdi učestalost i zastupljenost faktora aterogeneze kod pacijenata sa moždanim infarktima u graničnoj supratentorijalnoj arterijskoj distribuciji. Istraživanje je sprovedeno u sedmogodišnem periodu, kod 30 bolesnika, kao prospektivna studija. Kao faktori aterogeneze definsisani su pacijenti sa kardiovaskularnim oboljenjima, dijabetes mellitusom i pušači, a kod svih ispitanika verifikovana je koncentracija holesterola. U grupi ispitanika sa infarktom moždanog tkiva u prednjim partijama, u odnosu na bolesnike sa moždanim infarktom u zadnjim partijama, utvrđen je statistički značajno veći broj bolesnika sa kardiovaskularnim bolestima (p=0,025). Grupa pacijenata kod kojih je utvrđen infarkt moždanog tkiva u prednjim partijama imaju značajno veći broj bolesnika sa diabetes mellitusom (p=0,023), veći broj pušača (p=0,021), a utvrđena je i statistički značajno veća koncentracija holesterola (p<0,0001). Pacijenti sa prednjim moždanim infarktom imaju statistički značajno veći aterogeni potencijal.

U radu je prikazana žena starosti 86 godina kojoj je ehodoplerkardiografskim pregledom postavljena dijagnoza restriktivne kardiomiopatije i dijastolne srčane slabosti zbog prezentovane enormne biatrijalne dilatacije, nedilatirajućih i nehipertrofičnih komora i normalne sistolne funkcije. Zbog starosnog doba nije realizovana endomiokardna biopsija, a prioritetni terapijski cilj je usmeren ka smanjenju Nyha funkcionalne klase.

Cutaneus melanoma is the most malignant tumor of the skin. Melanoma arises from the malignant transformation of melanocytes at the dermal-epidermal junction or from the nevomelanocytes of atypical melanocytic nevi, that become invasive and metastasize after various time intervals. Dermoscopy is a noninvasive diagnostic technique in dermato- venereology that includes the inspection of the lesion with a handheld dermoscope. Dermoscopy enables the evaluation of the specific morphological structures of the skin that are not visible to the naked eye.therefore, it links clinical dermatology and dermatopathology. The major goal is to differentiate pigmented lesions into melanocytic and nonmelanocytic lesions, and make further differentiations within each group. Furthermore, it is essential to distinguish melanoma from other me- lanocytic and nonmelanocytic skin lesions, and to diagnose melanoma and amelanotic melanoma in their early stages. Der- moscopic follow up includes long-term and short-term monitoring, and is an essential diagnostic technique in the manage- ment of pigmented skin lesions.

Acute instable atherosclerotic plate in the basis of the pathophysiology of the acute coronary syndrome and it is divided on two big groups: a) acute coronary syndrome without ST elevation (NONSTEMI) and b) myocardial infarction with ST elevation (STEMI). Clopidogrel belongs to the group of antiaggregation drugs which inhibit ADP receptors and on that way prevent platelets aggregation. The clinical confirmation of the clopidogrel efficiency is confirmed trough 4 big clinical studies: CAPRIE, CURE, COMMIT/CCS 2 and CLARITY-TIMI 28 studies. In CAPRIE study, clopidogrel showed moderate but significant advantage comparing to aspirin in prevention of the secondary ischemic cerebrovascular stroke and myocardial infarction. The results of CURE study showed that doubled combined therapy with clopidogrel and aspirin brought the reduction of the relative risk of cardiovacular events with patients with acute coronary syndrome without ST elevation. The results of this study showed that the group of patients which received clopidogrel beside aspirin and thrombolytic therapy it came to the reduction of the occluded arteries. In COMMIT were also involved the patients with the acute myocardial infarction with ST elevation. Total number of lethal cases of the repeated myocardial infarctions or acute brain stroke was smaller in a group which was receiving clopidogrel beside thrombolytic therapy and aspirine in comparison with the placebo group. The results of CLARITY and COMMIT studies gave us recommendation that patients with acute myocardial infarction with ST elevation which have thrombolytic therapy or percutaneous coronary intervention should receive clopidogrel as well.

In clinical hyperkalemia, correlation between plasma K and the ECG is less reliable. A tall, peaked, symmetrical T wave with a narrow base, the so-called "tented" T wave is the earlinest ECG abnormality, usually best seen in leads II, III, V2, V3, and V4. The tented appearance and the narrow base are probably more characteristic of hyperkalemia than is the amplitude of the T wave. A decrease in amplitude of the R wave, appearance of a prominent S wave, widening of the QRS complex, depression of the ST segment evolve as plasma K approaches 8-9m Eq/liter. With hyperkaliemia, depression of intraventricular conduction is characteristically diffuse and results in prolongation of both the initial and terminal parts of the QRS complex. The resulting pattern may resemble RBBB, LBBB, left anterior or posterior divisional block, or a combination of the four.

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.