Sjögren'ssyndrom is autoimmune disorder where cells of immune system afack and destroy eccrine glands which produce tears and spit. We have a patients with following problems: dryness of the bucal lining and conjunctiva, dysphagia of solid food, paint in joints amd muscles, hand sensitivity to coldness.

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)

Diabetes is the most common cause of end-stage renal disease .in United States , Europa and Japan. Approximately 40% of patients with type 1 diabetes and 5-15% of patients with type 2 diabetes eventually develop end-stage renal disease. Risk factors for development of diabetic nephropathy include hyperglycemia, hypertension, positive family history of nephropathy and hypertension, and smoking. Key elements in the primary care of diabetes include glycemic control, blood pressure control, and screening for microalbuminuria. In general, the goal for glycemic control is a blood glucose level as close to normal (HbA C <7%) . Blood pressure control is at least as important as glucose control, especially after the onset of 1 renal damage, and blood pressure should be consistently <130/85. Screening for diabetic nephropathy involves monitoring at least yearly for urinary albumin excretion >30 mg per day. Microalbuminuria is defined as the urinary excretion of 30300 mg of albumin per day. Both glycemic control and rigorous control of blood pressure have significant impact on prevention and progression of diabetic nephropathy. Identification of patients with microalbuminuria selects a population of patients with increased mortality. Microalbuminuria screening should begin at the time of diagnosis. ACE inhibitors should be used when microalbuminuria is present regardless of the presence or absence of hypertension in type 1 diabetes and are widely.
used in normotensive patients with type 2 diabetes, as well.The effect of ACE inhibitors is probably not only via lowered
systemic blood pressure but also via direct effects on intraglomerular hemodynamics. 

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.

The aim of our work was to inquire characteristics of myocardial infarction in diabetic patients.We questioned
prospectively 441 patients, diagnosed with acute myocardial infarction. Diabetes mellitus (DM) was found in 31,3%
patients. Atrial fibrillation was found in 16,7% patients with DM and 7,3% on patients without DM(p<0,05).Ventricular
arrhythmias gr.III was found in 18,8% patients with DM and 15,8% on patients without DM (p>0,05), gr. IV 24,6% vs.
12,9% (p<0,05) and gr.V 18,1% vs.9,9% (p<0,05). Heart failure (NYHA I) was found in 10,9% patients with DM and
10,6% on patients without DM (p>0,05), heart failure NYHA II 13,8 vs.10,6% (p>0,05), heart failure NYHA III 14,5% vs.
5,6% (p<0,05) and heart failure NYHAIV 10,1 vs. 3,3% (p<0,05).Cardiogenic shock was found in 21,7% patients with DM
and 10,2% on patients without DM (p<0,05). QRS scor was found 8,3+-2,9 in patients with DM and 4,5+-1,5 on patients
without DM (p<0,05). In-hospital mortality was found 20,3% in patients with DM and 8,2% on patients without DM
(p<0,05). Post-hospital mortality was found 10,2% in patients wuth DM and 5,1% on patients without DM (p>0,05).
Myocardial infarction in patients with DM have difficulty clinical flow and higher mortality

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

Most frequent congenital malformations in human are congenital heart disease (30%). In this article we represented basic of their etiology, pathogenesis, diagnostic and new therapeutics possibilities. Also we represented three cases of congenital heart disease. These cases we considered as very interesting. First of all, in this article we try to emphasize some aspects of this problem, which is not well known, especially in our environment. This very rare congenital heart disease shows how much diagnostic procedure can be difficult and treatment hard or impossible besides big improvement, which has be done last decades. We must learn much more about congenital heart disease!

There are different reports regarding the characteristics of examined quality of life (QOL) in patients with combined coronary and valvular surgery. Objective was to compare the quality of life changes after isolated coronary and associated coronary and valvular surgery. From February to May 2002, we prospectively studied 243 consecutive patients, who underwent elective CABG. The Nottingham Health Profile Questionnaire part I (NHPpart I) was used as a model for QOL determination. NHPpart I contains 38 subjective statements divided into six sections: physical mobility (PM), social isolation (SI), emotional reaction (ER), energy (En), pain and sleep. The scores ranged from zero to 100, by adding the item weight, determined by Thurstone method of paired compares, to every positive answer. We distributed the questionnaire to all patients before and six months after CABG. Two hundred twenty six patients filled in the postoperative questionnaire. An isolated coronary heart disease was present in 218 patients (89.71%), and associated coronary and valvular disease in 25 patients (10.29%). Preoperatively, there is no difference in QOLamong the examined groups. After operation, quality of life was improved in 84.65% (171/202) of patients using coronary surgery and in 79.17% (19/24) of patients using combined (coronary and valvular) surgery. Quality of life was statistically improved in the first group of patients in all sections, and in the second group of patients in 4 sections (PM, En, pain and sleep) (p<0.05). There is no significant correlation between the quality of life changes after operation and the type of surgical procedure. By univariate and multivariate logistic regression, combined procedure distinguished as the independent predictor of QOL worsening in the ER section (p=0.012, OR=3.62, 95% CI 1.32-9.92). Six months after CABG quality of life was significant better in most of patients in both studied groups. Associated coronary and valvular surgical intervention distinguished as the independent predictor of quality of life worsening in the ER section.

Besides big improvement of diagnostic, therapeutic and preventive procedures vascular disease generally and vascular disease of brain remain of biggest importance in total morbidity and mortality. This examination included patients in Urgent Surgery Center “Simonida” Gracanica. In article is represent relationship between brain and heart dysfunctions and it is obvious that cerebral disturbances can cause heart disturbances and also it can be in opposite direction. Well, based on this is very important to make fast and correct orientation: CARDIOCEREBRAL or CEREBROCARDIALSYNDROME. In diagnostic procedure and therapeutic treatment is necessary cooperation between cardiologist and neurologist because in most of these cases we have cardiocerebral or cerebrocardial syndrome. Better treatment patients with brain stroke claim teamwork different specialist.