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.

The existence of left ventricular hypertrophy is an independent prognostic factor for cardiovascular morbidity and mortality. Heterogenous factors lead to left myocardial hypertrophy. The most frequently factors are: arterial hypertension, valvular heart disease (aortic stenosis and insufficiency, mitral insufficiency), hypertrophic myocardiopathy, left myocardial hypertrophy after myocardial infarction... For making the diagnosis of left ventricular myocardial hypertrophy used electrocardiography („voltage“ and „repolarization“ criteria) and echocardiography. Echocardiography is the gold standard for diagnosis of left ventricular myocardial hypertrophy. Left ventricular mass was estimated by the modified formula 3 3 using measurements obtained in accordance with the Penn convention: MLK = 1,04 (LDDd+PWDd+IVSDd) - (LVDd) - 13,6 Where LDDd is diastolic left ventricular internal dimension, IVSDd is diastolic ventricular septal thickness and PWDd 2 is diastolic posterior left ventricular wall thickness in diastole. LV mass indexed by body surface area (g/m ). By Penn con2 2 vention left ventricular hypertrophy criteria were ≥134 g/m for men and ≥110 g/m for women.

A characteristic hemodynamic pattern has observed in patients with right ventricular infarction, with frequently accompanies inferior left ventricular infarction or rarely occurs in isolated form. The electrocardiogram may provide the first clue that right ventricular involvement is present in the patient with inferior wall myocardial infarction. Most patients with right ventricular infarction have ST- segment elevation in lead V4R (right precordial lead in V4 position). ST segment elevation of 0,1mV or more in anyone or in combination of leads V4R, V5R, and V6R in patients with the clinical picture of acute myocardial infarction (MI) is highly sensitive and specific for the diagnosis of right ventricular MI.

Background: Cardiovascular disease is the predominant cause of morbidity and mortality in hemodialysis patients. Left ventricular hypertrophy is a major cardiovascular risk factor in hemodialysis patients.The present study was aimed at assessing the prevalence of left ventricular hypertrophy by doppler echocardiography in hemodialysis patients. Methods: We studied 20 patients on maintenance hemodialysis in Dialysis Centre in Kosovska Mitrovioca. LV mass was measured by both Doppler echocardiography. Left ventricular mass was estimated by the modified formula using measure2 ments obtained in accordance with the Penn convention. Left ventricular mass was divided by body surface area in m to obtain the left ventricular mass index. Results:This clinical observation study involved 20 patients (9 males and 11 females) with end-stage renal diseases undergoing maintenance hemodialysis with a mean age of 55,26 years, mean time on dialysis was 38,74 months. Main causes for developing chronic renal failure was arterials hypertension and polycystic kidney. Arterial hypertension (60%), diabetes mellitus (20%) and hyperholesterolemia (10%), were the most frequent risk factors for cardiovascular disease among the dialysis patients. Left ventricular hypertrophy were detected in 14 (70%) patients. Mean left ventricular mass wass 153,62g/m2 (males), and 142,71 g/m2 (females). To conclude, the present study shows that hemodialysis patients have higher left ventricular mass and higher prevalence of left ventricular hypertrophy.

Conclusion about efficacious of some medication can be given based on reducing morbidity and mortality in patients treated with that medication.. Aim of this work was to estimate intrahospital mortality in patients with acute myocardial infarction (AMI), role of myocardial reinfarction in that and side effects of medications in patients who were different treated in initial phase of AMI, based on what they were separated in three different therapeutic groups: group treated with thrombolytic therapy, group treated with beta-blockers and group treated with nitrates. It was shown that intrahospital mortality is highest in patients treated with nitrates but there was not significant difference between thera-peutic groups in frequency of myocardial reinfarction while frequency of complications and side effects were in range as in others similar studies.

Cardiac dysrrhythmias can be found in patient with no signs of ischemic cardiac disease but supraventricular and ventricular arrhythmias can be developed in cardiac hypertrophy. In this work we have examined frequency of cardiac dysrrhythmias in patients with hypertension and with or without hypertrophy of left ventricule (LVH). Investigation was accomplished on 80 patients with high blood pressure. In all 80 patients, basic on ECHO signs we define LVH, and by using of Holter monitoring we analised dysrrhythmias. Basic on ECHO signs we have 2 groups of patients: I.group ECHO (+) LV, and II group ECHO (-) LVH, in each 40 patients. Holter monitoring have 37 patients [22 mans (59,45%) and 15 women (40,54%)]. Hypertensive patients with LVH, who hade dysrrhythmia, have middle value IMLV 155,3 ± 27,21; аgе 56,42 ± 6,04; duration of hypertension 11,73 ±10,05; and EF% 55,2 ± 3,77. In patients with Holter monitoring 16 ( 43,32%) have dysrrhythmias type II, IIIa, IIIb and IV Lowny degree, (12) 34,43% from 43,32% have LVH. Salves VES are registrated only in group hypertension patients with ECHO(+) 5,4%. By using Mann Whitney statistic test for presents of dysrrhythmias in 2 groups of patients (ECHO LVH and ECHO without LVH), we found statistics significants (p = 0,049). In IMLV 60-110 g/m² 8,82% patients have dysrrhythmia, IMLV 151-200 g/m² dysrrhythmias are registrated in 40%; and 50% patients have dysrrhythmias in IMLV> 200g/m². In group hypertensive patients with LVH dysrrhythmias are registrated in group with ecscentric LVH 35,1%

Heart insufficiency is frequent and important complication of acute myocardial infarction (AMI). Aim of this work was to estimate frequency, haevyness and course of heart insufficiency in patients with AMI who were different treated in initial phase of AMI, based on what they were separated in three different therapeutic groups: group treated with thrombolytic therapy, group treated with beta-blockers and group treated with nitrates. It was shown that time of admission and condition of patient in moment of admission is the key factor for choise of therapy but using of therapy making less frequency and heavyness of heart insufficiency while for cases with most difficult forms of insufficiency of heart as a pump thrombolytic therapy is practically only posible choice

Diabetes mellitus with one`s chronical complications is the cause of the large percent morbidites and mortality, among the population. With regard to a lot of people who have diabetes mellitus tip 2 (WHO-over 170.000.000 peoples), adequate therapy is very important. By this stady, we wont to show positive consequence new therapy for medication diabetes mellitus typ 2, chiefly application tiazolidinedion in therapy. Handlend 25 patientis with diabetes mellitus typ 2 during 3-mounth observed. Patients were divide in II groups forms on basic of the kind therapy. At the end of 3-mounth, derived results (decrease HbA1c from 7.9%±1.24% to 6.99±0.89%; data value fasting glycemia from 8.99mmol/l±2.08 mmol/l to 7.45±1.35 mmol/l, and value glycemia after meal 10.36 mmol/l±2.18 mmol/l to 8.18 mmol/l±1.31 mmol/l) indicate validity the introduction tiazolidinedion in therapy diabetes mellitus type 2.

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.

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.