Dijabetes melitus tip 2 je jedno od vodećíh hroničnih oboljenja u svetu pa i u našoj zemlji, koje predstavlja
značajan faktor rizika u nastanku kardiovaskularnog morbiditeta i mortaliteta. Cilj ovog istraživanja je ispitivanje koji
faktori rizika doprinose nastanku koronarne bolesti kod gojaznih pacijenata sa dijabetes melitusom tip 2. U studiju je
uključeno 82 gojazna pacijenta, od toga 52 sa dijabetes melitusom i 30 bez dijabetes melitusa, sa angiografski dokazanom koronarnom bolešću. Kod svih je sprovedeno kliničko ispitivanje, laboratorijske analize i ehokardiografski pregled. Na osnovu rezultata ispitivanja utvrdili smo da je distribucija faktora rizika kao što su arterijska hipertenzija,
porodično opterećenje koronarnom bolešću, pušenje, konzumacija alkohola bila istovetna u gojaznih pacijenata sa i
bez dijabetes melitusa. Ehokardiografki je nađena statistički značajno veća leva komora, niža ejekciona frakcija, veća
leva pretkomora i značajna mitralna regurgitacija u grupi sa dijabetesom. U grupi sa dijabetesom je takođe češće,
statistički značajno, bila prisutna višesudovna koronarna bolest. Uprkos malom uzorku može se zaključiti da je prisustvo dijabetes melitusa kod gojaznih pacijenata presudno u nastanku težih oblika koronarne bolesti. Težina se ispoljila kroz značajnije strukturne i funkcionalne promene leve komore i broj obolelih koronarnih arterija.  

Očuvana kontraktilna rezerva leve komore podrazumeva sposobnost hipokinetičnih segmenata miokarda da pod dejstvom različitih inotropnih stimulusa poprave svoju kontraktilnost. Utvrditi razlike u kliničkim karakteristikama kod pacijenata sa dilatacionom kardiomiopatijom u zavisnosti od očuvane kontraktilne rezerve leve komore. U studiju je uključeno uzastopnih 55 bolesnika sa idiopatskom dilatativnom kardiomiopatijom. Svim bolesnicima uključenim u studiju urađen je stres ehokardiografski test fizičkim opterećenjem po standardnom protokolu. Postojanje očuvane kontraktilne rezerve je određivano uz pomoć promene ejekcione frakcije leve komore. Prosečna starost ispitivanih bolesnika je bila 54,98 ± 9,84 godina, 49 (89,1%) je bilo muškog pola. Na osnovu promene ejekcione frakcije leve komore kao kriterijuma kontraktilne rezerve leve komore, očuvanu kontraktilnu rezervu je imalo 25 bolesnika (45,5%). Bolesnici bez očuvane kontraktilne rezerve leve komore znatno češće u anamnezi imaju zastupljenu arterijsku hipertenziju (46,7 vs. 20,0%, p=0,038). Nema značajne razlike u zastupljenosti ostalih faktora rizika. Pacijenti sa očuvanom kontraktilnom rezervom leve komore imaju manju dimenziju leve komore na kraju sistole (49,64 ± 7,26 vs. 55,27 ± 8,36 mm, p=0.011), manji indeks volumena leve komore na kraju dijastole (77,35 ± 26,41 vs. 94,59 ± 34,97 ml/m2, p=0,005) i na kraju sistole (59,31 ± 26,05 vs. 78,62 ± 34,42 ml/m2, p=0,002), veću ejekcionu frakciju leve komore (25,48 ± 8,32 vs. 18,33 ± 6,49%, p=0,002) i niži indeks pokreta zidova leve komore (2,23 ± 0,27 vs. 2,48 ± 0,27, p=0,002). Kod bolesnika sa očuvanom kontraktilnom rezervom leve komore nalazimo manju zastupljenost arterijske hipertenzije i morfološki i funkcionalno manje oštećenu levu komoru.

Gastrointestinal stromal tumors (GIST omi) are a heterogeneous group of mesenchymal tumors. Etiological factors that cause GIST ome are not clearly distinguished, characterized by remarkable diversity of the clinical, histopathological and genetic features. Mitotic activity, nuclear pleomorphism, degree of cellularity, nuclear-cytoplasmic ratio, tumor size, mucosal invasion, tumor ulceration and necrosis, are factors that determine the malignancy of these tumors. The most common location of these tumors of the stomach and small intestine, while very rare localization of the colon, esophagus and rectum. Despite the progress that has been made in the diagnosis and further diagnosis of intra - or postoperative. The aim of this report is to contribute to easier recognizing the symptoms, diagnosis and treatment of these tumors. It was a mixed tumor, epitheloid-spindle type cells, immunohistochemical analysis, we have a positive expression of CD 117 and CD 34.

Osteoporoza se definiše kao sistemski skeletni poremećaj sa smanjenom koštanom masom i mikroarhitekturalnim oštećenjem koštanog tkiva. Faktori rizika su pojave koje znatno menjaju očekivani apsolutni rizik, odnosno verovatnoću pojave bolesti u odredjenoj populaciji. Starenje i pušenje su najčešće navodjeni faktori rizika za razvoj osteoporoze. Cilj našeg rada bio je da utvrdi najčešće prisutne faktore rizika za nastanak osteoporoze. U našem istraživačkom radu je obradjeno ukupno 88 bolesnika koji su podeljeni u dve grupe prema broju popušenih cigareta i dužini pušačkog staža. Rezultati su pokazali da faktori rizika: loše životne navike (pušenje i uzimanje kafe), su značajno zastupljeni kod pacijenata obolelih od osteoporoze. Kako bi smo blagovremeno sproveli lečenje, zaključili smo na osnovu dobijenih rezultata, da je potrebno aktivno tragati za faktorima rizika odgovornim za nastanak osteoporoze.

Dijabetesna retinopatija je najčešća mikrovaskularna komplikacija šećerne bolesti i jedna je od vodećih uzroka slepila kod odraslih uzrasta 20-74 godina. Učestalost mikrovaskularnih komplikacija dijabetesa je jasno povezana sa trajanjem dijabetesa, kvalitetom metaboličke kontrole i sistolnim krvnim pritisakom. Cilj rada bio je da se utvrdi incidencija i odrede karakteristike faktora rizika za razvoj retinopatije kod bolesnika sa dijabetesom tip 2. Studija je obuhvatila 100 ispitanika sa dijabetes melitusom tip 2, prosečne starosti 61,95±3, 98 godina. Pacijenti su podeljeni u dve grupe: pacijenti sa dijabetesom tip 2, na terapiji oralnim antidijabeticima, činili su grupu I, pacijenti sa dijabetesom tip 2 na kombinovanoj terapiji činili su grupu II. Analizirali smo anamnestičke podatke, stil života i porodičnu istoriju, štetne navike pre svega pušenje. Od kliničkih karakteristika utvrđena je telesna masa, visina, obim struka, arterijski pritisak, urađene su standardne biohemijske analize. Dijagnoza dijabetesne retinopatije postavljena je na os- novu modifikovane Međunarodne klasifikacije retinopatija. Ispitanici studijske grupe II, imali su statistički značajno duže trajanje bolesti u odnosu na ispitanike kontrolne grupe (p<0,001). U odnosu na antropometrijske karakteristike, ispitivane grupe se statistički nisu razlikovale (ITM, 27,28±8,28kg/m2 vs 28,72±5,75 kg/m2; t-1,306, a p=0,197, obim struka 95,70±12,96cm vs 94,58±12,96cm). Srednje vrednosti sistolnog krvnog pritiska u studijskoj grupi II bile su 144,50±27,37 a dijastolnog 86,30±11,08 mmHg, a u grupi koja je bila na oralnim hipoglikemicima 137,00±27,37mmHg za sistolni a dijastolnog 83,11 ±10,08 mmHg, r-0,00, p=1,00, nije bilo statistički značajne razlike među grupama. Bolesnici studijske grupe II nisu imali značajno veće vrednosti holesterola (6,02±1,59 vs 5,73± 1,29mmol/L; p=0,501), LDL holesterola (3,75±1,35 vs 3,94±1,21mmol/L; p=0,55), HDL holesterola (1,14±0,61 vs 1,02±0,27mmol/L; p=0,005), glikemije (10,2±8,15 vs 9,2±1,4mmol/L; p=0,183), u odnosu na grupu I, dok su vrednosti triglicerida su bile značajno veće (2,49±2,03 vs 2,00±1,22mmol/L; p=0,01). Poređenjem vrednosti HbA1c, statistički značajna razlika nije ustanovljena (8,8% vs 7,8%; t-2,946, p=0,009). Faktori rizika za razvoj retinopatije kod pacijenata sa dijabetesom tip 2 bili su značajno zastupljeni u obe ispitivane grupe.

Diabetic retinopathy is the microangiopathy which procedures pre capillary arterioles, capillaries and post capillary venules. The length of disease and poor metabolic control, have the biggest impact on development and progression of DR. By the prospective study in Gracanica Health House, for the period time of six months, there were matched 50 patients with DM tip 2.Along of internal review, there were made ophthalmological review, and anthropometric and laboratory researches.

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).

Metformin is an anti-hyperglycemic agent used for the treatment of type 2 diabetes mellitus. Biguanides lower blood glucose levels primarily by decreasing the amount of glucose produced by the liver. Metformin also helps to lower blood glucose levels by making muscle tissue more sensitive to insulin so glucose can be absorbe. The purpose of the study was to establish the effect of metformin on insulin secretion in obese patients with newly diagnosed diabetes mellitus type 2. We included 40 patients with Type-2 Diabetes Mellitus, who were treated on Department for Internal Disease in Hospital King Milutin Laplje Selo. Patients included in the study were newly diagnosed with diabetes mellitus type 2, glycemia < 12 mmol/L, and hed the Body Mass Index >30 kg/m2. They were treated with metformin, 1000 mg/day. Insulin sensitivity was determined by HOMA IR, insulin secretion by HOMA, lipid status by spectrophotometry. After six months of treatment blood biochemistry tested again. BMI was also established. Metformin significantly lowered BMI (BMI before therapy 31.02 kg/m2, after treatment 28.7 kg/m2) (both p<0,001 vs baseline) waist circumference mean value 98±0.55 cm-93,12 cm. (p<0,001) During the therapy the glycaemia decreased from 11.7 mmol - 6,78 mmol/l, insulinemia mean value 20.141 mlU/l -13.691, HOMA IR elevated in all patients. Among the cholesterol fractions, most significant results were obtained in LDL cholesterol. Mean LDL cholesterol levels 4.51± 2.02 mmol/L. Mean cholesterol level 6.98±2.31 mmol/L. HDL levels -1.32 mmol/L. Serum triglycerides was (mean) 2.63±1.32mmol/L. After six months therapy Metformin produces beneficial changes in lipid states. Metformin may be the first therapeutic option in the diabetes mellitus type 2 with overweight or obesity. Metformin produces beneficial changes in glycemia control, and moderated in weight, lipids and insulinemia. 

Doppler ultrasound check-up significantly increases a possibility of initial functioning of arteriovenous fistula. The aim of the study was the preoperative evaluation of vascular system of the extremity for creation of arteriovenous fistula for haemodialysis. The examination was organized at Urology and Nephrology Clinic, Clinical Centre "Kragujevac". The examined subjects were 87 patients, 52 (59,8%) male and 35 (40,2%) female, mean age of 61±11,1 years. There were performed the routine biochemical analyses, demographical structure and clinical characteristics (type of anastomosis, fistula placement, arterial blood pressure, lumen size of the artery and vein, measured intraoperatively by Doppler technique). In 72,1% of patients with functioning fistula there was made a terminal-lateral anastomosis, compared to 57,7% of patients with initial non-functioning fistula, there was found a statistically significant difference between the groups p=0,008. Radiocephalic fistula was created in 62,3% of the examined patients with initial functioning , in patients with non-functioning, the distal fistula was created in 38,5% of the examined patients. Regarding the type of the fistula location there was obtained statistically significant difference; p=0,04. There was found a statistically significant difference between the group of patients with initial functioning of arteriovenous and the group without, concerning the intraoperatively measured lumen of the cephalic vein (2±0,29 vs. 2±0,38 mm); p=0,03 (2,1±0,5 vs. 1,8±0,4); p=0,0009. Statistical significance between the groups was also found in the lumen of the cephalic vein verified by the ultrasound (2,1±0,53 vs. 1,8±0,25 mm); p=0,038. Peak of the systolic speed of the radial, corelated to the group of patients with and the group without initial functioning fistula (50 ± 12,42 vs. 40 ± 6,9 cm/sec); (p=0,0026), has statistically significant value. By the correlation of the group of patients with initial functioning and the group of patients without initial functioning, regarding hemoglobin (97 ± 16,1 vs. 88 ± 18,3 g/l); p=0,006 and the level of urea (22,6 ± 12,7 vs. 23,9 ± 9,8); p=0,02, there was found a statistically significant difference. Color Doppler ultrasound has an important role in preoperative evaluation of blood vessels and it represents a meaningful predictive parameter of functioning of arteriovenous fistula. 

Epstein-Barrov virus (EBV) is a cause of heterophile antibody positive infectious mononucleosis (IM),which is characterized by fever, sore throat, limfadenopatiom and atypical limfocitozom. IM is mainly a self-limited disease. Complications of the central nervous system, hepatitis (which can be fulminant), (splenomegalia, obstruction of the upper respiratory tract with bacterial can sometimes be deadly.