Thyroid hormones, thyroxine and triiodothyronine, affect the work of all organs and organ systems. Whether they are in excess or in deficit, they lead to significant disturbances in the homeostasis of the organism, changing first of all the metabolic processes and leading to significant clinical manifestations, primarily in the cardiovascular, but also in other organ systems. The imbalance of thyroid hormones also has oralmanifestations, which are often the reason why patients visit the dentist. However, what worries dentists the most is the possibility of acute decompensation of hyper or hypothyroidism, with the appearance of thyrotoxic storm or myxedema coma, which are life-threatening conditions. Therefore, a valid pre-procedural evaluation and preparation of patients with thyroid hormone function disorders for pre-planned dental interventions is of great importance. During dental procedures, it is necessary to adhere to recommendations regarding the choice of local anesthetics, hemostasis, drug interactions, the possibility of infection and minimizing stress, all in order to avoid acute decompensation of thyroid imbalance.

Sveži prelomi u ortopedskoj hirurgiji i traumatologiji, dovode do hemodinamske nestabilnosti celokupnog organizma. Kod otvorenih preloma, stepen
 hemodinamske nestabilnosti organizma je značajno veći. Prioritet u lečenju svežih preloma ima DAMAGE CONTROL IN ORTHOPEDIC (DCO). DCO je
 invazivna procedura koja ima ulogu kako u stabilizaciji preloma, tako i u kontroli krvarenja. Prelomi dugih kostiju kao i prelom karlice su apsolutna
 indikacija za DCO. Slobodno možemo reći da ova procedura prestavlja prioritet u lečenju svežih preloma. Procedura je individualizovana u zavisnosti
 od težine povrede kao i  hemodinamskog statusa povređenog pacijenta. U ortopedskoj hirurgiji i traumatologiji kao standardna procedura u DCO
 koristi se spoljašnji fiksator po Mitkoviću. Ortopedski hirurzi moraju biti jako prisebni i obazrivi kod pregledapacijenata sa politraumom i da
 prepoznaju tkzv. trougao smrti. Trougao smrti čine: acidoza, hipotermija i koagulopatija. Svaka karika je medjusobno povezana jedna sa drugom
 dovode do ireverzibilnih promena u organizmu što za posledicu ima smrtni ishod. DCO se sprovodi u tri faze: 1) podrazumeva kontrolu kvarenja,
 smanjenje kontaminacija bakterijama, kao i privremenu fiksaciju preloma. Sve ovo je neophodno uraditi u roku od 1-2h.; 2)  obuhvata stabilizaciju
 vitalnih parametara u JIN-e kao i reanimacija pacijenta ordiniranjem neophodne terapije, krvi i krvnih derivata.; 3) podrazumeva definitivna metoda
 lečenja u smislu nastavka lečenja preloma spoljasnjim fiksatorom ili konverzija u neku drugu metodu lečenja.

 Uvod: Kognitivni pojačivači (KP) poboljšavaju kognitivne funkcije putem neurotransmitera CNS-a. Čine raznorodnu grupu supstanci koje se
 svakodnevno uzimaju kao napici nalik kafi, biljni lekovi i dijetetski suplementi (“meki pojačivači”) ili lekovi koji se koriste u lečenju bolesti
 (nootropici). Upotreba i zloupotreba su česte u studentskoj populaciji sa brojnim etičkim pitanjima.  
Cilj: Utvrđivanje informisanosti studenata medicine, njihovih stavova o upotrebi i stepenu rizika od neželjenog delovanja KP, na osnovu pretpostavke
 da je upotreba ovih supstanci redovna.
 Materijal I metode: Studija preseka je sprovedena po tipu anonimnog anketnog istraživanja na Medicinskom fakultetu Priština sa privremenim
 sedištem u Kosovskoj Mitrovici. U ispitivanju su dobrovoljno učestvovali studenti medicine prve tri godine integrisanih studija koji nisu položili ispit iz
 predmeta Farmakologija sa toksikologijom. Upitnik je obuhvatio socio-demografske podatke, podatke o koncentraciji i navikama u učenju, stepen
 informisanosti, procenu upotrebe i procenu rizika korišćenja KP. Stratifikacija uzorka je izvršena prema polu studenata, a Likert-ova skala je poslužila
 za rangiranje stavova ispitanika.
 Rezultati: Od ukupnog broja anketiranih (n=249) u konačnu statističku analizu podataka uključeno je 169 anketnih upitnika (M 32,5 %, Ž 67,5%).
 Najviše studenata je bilo sa druge godine studija (40%), dok je najviše studentkinja bilo sa prve godine (48,2%). Uočena je statistički značajna razlika
 između ispitivanih grupa u odnosu na godinu studiranja (p=0,009).  Informacije o KP su novina za 40,2% ispitanika (M 49,1%, Ž 36%). Da je o njihovoj
 primeni dovoljno informisano smatra 23,7 % ispitanika (M 20%, Ž 25,4%). Postoji statistički značajna razlika u upotrebi internet baza za informisanje o
 KP (p<0,001).Najveći broj studenata (71,6%) koristi internet za informisanje o KP, pri čemu je korišćenje internet baza bilo statistički značajno veće
 kod žena u odnosu na muškarce (M 56,4 %,Ž 78,9 %; p=0,002). Više od polovine ispitanika (50,3%) koristi Mediately bazu kao pouzdanu bazu podataka o
 lekovima. Od ukupnog broja studenata 40,8% upotrebljava neki od navedenih KP (M 43,6%, Ž 39,5%). Najčešći razlozi za upotrebu kod obe grupe
 ispitanika su poboljšanje koncentracije (M 27,3%, Ž 28,9%) i uspešnije polaganje ispita (M 25,5%, Ž 15,8%). Oba pola najviše koriste ginko bilobu (M
 29,1%, Ž 32,5%) i metilksantine (M 29,1%, Ž 17,5%). Studenti znatno češće upotrebljavaju kreatin u odnosu na studentkinje (M 20%; Ž 2,6%; p=0,003).
 Obe grupe studenata su prema medijani i interkvartilnom opsegu (25-75%) uočenog rizika od neželjenih reakcija rangirale kokain (M 9,0; Ž 9,0),
 metamfetamin (M 8,0; Ž 8,0) i amfetamin (M 8,0; Ž 7,0) kao najopasnije, dok je ginko biloba procenjena kao najbezbedniji KP (M 3,0; Ž 3,0). 
Zaključak: Većina studenata nije dovoljno informisana o kognitivnim pojačivačima, iako ih koriste samoinicijativno, radi postizanja boljih rezultata na
 studijama. Neophodno je studente uputiti na adekvatne izvore informisanja i organizovati vannastavne tribine i predavanja o bezbednosti i efikasnosti
 KP pre upotrebe. U skladu sa trendovima u svetu, može se očekivati porast zloupotrebe nootropika na univerzitetima i u našoj zemlji. Smatramo da bi
 trebalo ponoviti ili organizovati slično ispitivanje kroz par godina, po mogućstvu u većem obimu.
 Ključne reči: kognitivni pojačivači, informisanost studenata, stavovi studenata

Uvod: Dispepsija je čest gastroenterološki sindrom koji značajno narušava kvalitet života. Infekcija bakterijom Helicobacter pylori (H. pylori) ključni
 je faktor u razvoju organske dispepsije, dok njena povezanost sa funkcionalnom dispepsijom ostaje predmet istraživanja.
 Cilj: Ispitati prevalenciju H. pylori infekcije kod pacijenata sa dispepsijom i njenu povezanost sa simptomima, endoskopskim nalazima i hematološkim
 parametrima
 Metode: Retrospektivna studija obuhvatila je 117 pacijenata sa dispepsijom pregledanih tokom 2023. godine na Internoj klinici KBC Priština-Gračanica
 u Lapljem Selu. Svi su podvrgnuti gornjoj gastrointestinalnoj endoskopiji i testiranju na H. pylori antigen u stolici. Analizirani su demografski podaci,
 simptomi, endoskopski i hematološki nalazi.
 Rezultati: H. pylori infekcija je potvrđena kod 63,25% pacijenata, bez značajne razlike između polova. Zabeležen je trend porasta prevalencije sa
 godinama, ali bez statističke značajnosti (p=0,060). Epigastrični bol (p=0,0068) i gorušica (p<0,0001) su bili značajno češći kod H. pylori pozitivnih
 pacijenata, dok su hronični gastritis (p=0,005) i duodenalni ulkus (p=0,029) bili dominantni endoskopski nalazi kod ove grupe. Značajno veći procenat
 H. pylori pozitivnih pacijenata imao je snižene vrednosti broja eritrocita i hemoglobina u odnosu na negativnu grupu (p<0,01). Prosečan hematokrit
 bio je niži u H. pylori pozitivnoj grupi (p=0,013), ali se nije značajno razlikovao od referentnih vrednosti.
 Zaključak: H. pylori infekcija je česta među pacijentima sa dispepsijom i povezana sa specifičnim simptomima, patološkim endoskopskim nalazima i
 hematološkim promenama. Testiranje na H. pylori je ključno u proceni dispepsije, dok H. pylori negativni pacijenti sa upornim simptomima zahtevaju
 dodatnu dijagnostiku.
 Ključne reči: Helicobacter pylori; dispepsija; simptomi; endoskopski nalaz; hematološki parametri

Background: People with diabetes more often experienced severe clinical forms of COVID-19. However, it has been hypothesized that certain antidiabetic drugs may be associated with better outcomes in COVID-19 patients. The aim of this study was to analyze whether the COVID-19 pandemic influenced the change in consumption of antidiabetic drugs in Serbia.

Methods: This descriptive analysis was carried out using publicly accessible data obtained from the official website of the Medicines and Medical Devices Agency of Serbia during the period 2006-2022. The joinpoint regression analysis was applied to investigate the dynamics of antidiabetic drugs utilization over time.

Results: In the Republic of Serbia, this study analyzed the use of 28 antidiabetic drugs between 2006 and 2022.The results showed that at the beginning of the COVID-19 pandemic, there was an increase in consumption of dulaglutide (starting from 2020) and a decrease in consumption of insulin detemir (starting from 2019), insulin lispro (combined) and insulin lispro (fast-acting) (starting from 2020).

Conclusion: Our study revealed significant changes in the usage of certain antidiabetic drugs, such as increased consumption of dulaglutide and decreased use of various insulin types. These changes reflect the evolving strategies in diabetes treatment to better support patients during this global health crisis.

Key words: antidiabetic drugs, impact of Covid-19, consumption, Serbia

Pulmonary hypertension (PH) is a hemodynamic condition characterized by a mean pulmonary artery pressure (mPAP) ≥ 25 mmHg at rest, pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg, and pulmonary vascular resistance (PVR) > 240 dyn·s·cm⁻⁵. The annual incidence of pulmonary arterial hypertension (PAH) is approximately 3–10 new cases per million adults. It is estimated that the prevalence of pulmonary hypertension in individuals over 65 years of age is around 10%.The aim of this study is to present the case of a female patient with progressive dyspnea in whom PAH remained undiagnosed for a prolonged period.A 74-year-old female patient, M.P., was hospitalized in the Coronary Care Unit of the Clinical Center in Kosovska Mitrovica due to symptoms of shortness of breath, choking, fatigue, leg swelling, and weakness. The admission ECG revealed: sinus rhythm, normal axis, high R wave in V2, ST depression, and negative T waves in leads II, III, aVF, and V4–V5. Echocardiography findings showed right ventricular enlargement (2.9 cm), pulmonary artery dilation (3.3 cm), 1–2+ pulmonary regurgitation, and 3+ tricuspid regurgitation, with a systolic pulmonary artery pressure (SPAP) of up to 126 mmHg. The right ventricle measured 5.3 cm in the 4Ch view, with a TAPSE of 1.8 cm. Right heart catheterization revealed the following pressures: PA 78/34/57 mmHg, RV 74/8/10 mmHg, RA 6/6/7 mmHg, CO 4.3 l/min, and LV 99/10/8 mmHg. Although primary pulmonary hypertension is predominantly a disease of younger individuals, it should also be considered in older patients presenting with progressive dyspnea in the absence of structural heart disease.

The metabolic syndrome (MS) is a clinical entity of substantial heterogeneity, represented by the combination of obesity (especially central obesity),insulin resistance, impaired glucose tolerance, atherogenic dyslipidemia (high triglyceride levels and low levels of HDL-cholesterol (HDL-C)), and hypertension. Childhood obesity has become more common as a result of urbanization, bad diets, and more sedentary lifestyles.

The incidence of metabolic syndrome is ten times higher in children with obesity, and a special risk factor is the presence of obesity in the pediatric population, the classification of metabolic syndrome is based on standards set by the International Diabetes Federation (IDF).

Our goal is to summarize the diagnostic procedure of metabolic syndrome as well as comorbidity based on conventional methods and modern imaging procedures by analyzing the published papers.

This article focuses on the sonographic axamination techique for evaluation of intracranial translucencies during the first trimester ultrasound scan. Appropriate knowledge of sonographic landmarks is the most important factor for evaluation normal as well as abnormal brain structure, and this examination may enable detection of open spina bifida and Arnold – Chiari anomaly at an early stage of fetal develpoment.

Introduction:

Diabetes insipidus (DI) is a disease that occurs due to inappropriate secretion of anti-diuretic hormone from the pituitary, or as a result of disorder in which the level of the kidneys cannot adequately respond to the secretion of this hormone. Also, it is known as central diabetes insipidus. The most common causes are head traumas, tumors of the hypothalamus and pituitary glands, inflammatory processes, histiocytosis, anomalies in the development of brain. It can appear in the form of familial diabetes insipidus or in certain syndromes (Wolfram syndrome). It is characterized by hypotonic polyuria higher than 3l/24h (which persists if even taking liquids stops), then by nocturia and compensatory polydipsia. Enuresis often occurs among children.

Case report:

A boy, aged 11, lives with his mother and brothers. Mother noticed that the boy was urinating frequently in last few months (diuresis 4.6 l/24h, and 3.25 l/24h). After two months, the boy developed double images and severe headaches, vomiting, inability to see, squinting in the right eye and headache in the back of the head. MNR of the endocranium indicates the presence of a tumor formation. The tumor was surgically removed, and the boy started with chemotherapy and radiotherapy. Due to persistent diabetes insipidus, the boy started using desmopressin-acetate - in tablet form. Active substance desmopressin - acts in the same way as the natural hormone vasopressin and regulates the kidney's ability to concentrate urine. The positive effect of taking the drug appeared after three weeks from the start of taking the therapy.

Conclusion:

Central (neurogenic) DI occurs as a result of a relative or absolute deficiency of antidiuretic hormone, which is responsible for the osmolality of body fluids. Based on this case, we want to show the importance of early diagnosis of the disease in order to improve the prognosis and the necessity of careful monitoring of these patients.

Objective:

To investigate correlation between ultrasonically calculated urinary bladder weight and lower urinary tract symptoms (LUTS).

Methods:

3D and 2D measurement of parameters necessary to determine bladder weight: Inner and outer radius of the bladder, in 10 male and 10 female patients with LUTS, with urinary bladder filled to at least 200 ml of urine volume.

Results:

Average urinary bladder weight in males was 53,8 g and in female patient was 45,2 g. We found no statistically significant difference between male and female patients, all with LUTS. We also found that patients in LUTS have hypertrophied bladder, which means that urinary bladder mass should be larger and results in an increase of blader weight and both inner and outer radius of the urinary bladder, that should be detected ultrasonographically, but not too much over of pre- determined variations of normal bladder weight.

Conclusion:

Estimation of urinary bladder weight should be considered as non-invasive approach to patients with LUTS. However, it is more plausible to measure only urinary bladder wall thickness ultrasonically than to calculate urinary bladder weight without built-in software.