Introduction: This study highlights the importance of transitioning to a modern approach to outpatient surgery, analyzing the safety and feasibility of this treatment model in patients undergoing hemithyroidectomy or total thyroidectomy, with a focus on postoperative complications.

Materials and Methods: Data were collected from the medical records of 626 patients over a five-year period, from 2011 to 2015, at the Surgery Clinic of the "Dr Dragiša Mišović – Dedinje" in Belgrade. This period allowed for a reliable analysis of the safety and feasibility of outpatientthyroid surgery.

Results: A total of 97 hemithyroidectomies and 529 total thyroidectomies were performed. The average age of hemithyroidectomy patients was 51.24 years, and for total thyroidectomy patients, it was 54.88 years. The most common substrates were benign tumors (over 50%) for hemithyroidectomies and multinodular goiters (almost 50%) for total thyroidectomies. The average hospital stay was 1 day for hemithyroidectomies and 1.48 days for total thyroidectomies. Complications included postoperative bleeding (0.57%), subcutaneous hematoma (1.32%), subcutaneous seroma (2.08%), temporary hypocalcemia or hypoparathyroidism (18.9%), permanent hypocalcemia or hypoparathyroidism (0.76%), temporary vocal cord paralysis (2.65%), permanent vocal cord paralysis (1.89%), bilateral vocal cord paralysis (0.19%), and mortality (0%).

Conclusion: The study confirmed the feasibility and safety of outpatient thyroid surgery, with minimal complications and short hospital stays, especially for hemithyroidectomy, but careful postoperative monitoring is required for patients undergoing total thyroidectomy. 

Introduction: Paraneoplastic pemphigus is an autoimmune bullous and erosive mucocutaneous syndrome associated with malignancy. First of all, it is associated with lymphoproliferative disorders, but also with solid tumors.

Case report: We present a 73-year-old female patient who developed polymorphic lesions on the skin and mucous membranes after treatment of nonHodgkin's lymphoma. Disseminated pale erythematous macules, exudative papules and plaques, papulovesicles, pustules, targetoid lesions and bullae are present on the skin, mostly with a flaccid roof, some with a hypopyon. Oral mucosal changes included erosions and ulcerations covered by fibrin deposits. Histopathological examination of several biopsies revealed the presence of interface dermatitis, eosinophils, necrotic keratinocytes, as well as intraepidermal cracks with acantholytic cells, dominated by eosinophils. Direct immunofluorescence microscopy of the perilesional skin showed fluorescent intraepidermal reticular IgG deposits, as well as segmental linear IgG deposits along the basement membrane zone. Indirect immunofluorescence microscopy revealed circulating IgG autoantibodies binding to monkey esophagus and rat bladder at a titer of 1:320. Initially, he was treated with systemic corticosteroid therapy, then, in consultation with a hematologist, rituximab therapy was indicated (375 mg/m2, 4 doses once a week). The patient died after the 2nd dose of rituximab.

Conclusion: Considering the different clinical, histopathological and immunological features, paraneoplastic pemphigus presents a challenge for the clinician. Knowledge of different clinical presentations, as well as individualization of therapy with a multidisciplinary approach, are of crucial importance. 

Introduction/Objective

The objective of this study was to examine the relationship between use of psychoactive substances among University students and diagnosed somatic or mental disorders.

Methods

The cross-sectional study was conducted in a population of 2,000 students of the Belgrade University. Four faculties (Medicine, Geography, Economics, Electrical Engineering) from which the students participating in this research were chosen by the method of random choice (by computer listing), conducted in the period April - June 2010.

Results

We observed that are more numerous students who used psychoactive substances among students with diagnosed somatic illnesses compared to those without them. Statistical significance was found among students who used tobacco (p=0.027), alcohol (p=0.002), sedatives (p<0.001) and cannabis (p=0.021). Mental disorders are also connected to use of psychoactive substances. The statistical significance was achieved for all psychoactive substances except for alcohol.

Conclusion

Use of psychoactive substances is an important issue among University students with diagnosed somatic or mental disorder. Therefore, it is essential to recognize the symptoms and consequences of such behavior, and above all and connection thereof, the importance of prevention which may enhance better solution-seeking via proper education.

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.

Introduction: Nummular headache is a type of primary headache of chronic character, with a large number of described varieties in the clinical picture, and therefore the differential diagnostic consideration must include a large number of disorders related to changes in epicranial structures. Certain dermatological disorders can also include pain in a limited area of the scalp with itching, burning or burning sensation, such as Lichen Planopilaris. Case report: This is a report of a patient who was initially diagnosed with Lichen planopilaris, but after determining the parameters of the distinction and the necessary additional diagnostic procedures, a diagnosis of Nummular headache was made. Conclusion: In this presentation, we have presented another important differential diagnostic item and we believe that the work is a small contribution to everyday practice, but also to further research.

In clinical practice, involuntary hospitalization in psychiatry is a procedure that patients with severe mental disorders are subject to due to the inability to make rational treatment decisions.. The prevalence of involuntary hospitalizations varies widely within and between countries. Involuntary admission to a hospital for psychiatric treatment can be life-saving and may be considered beneficial to some people in the long run. However, the experience of involuntary treatment can be traumatic, intimidating, stigmatizing, and lead to long-term avoidance of mental health services and an increased risk of rehospitalization. In this paper, we have considered the risk factors for involuntary hospitalizations and their frequency in the region and Europe.

The ageing process is characterized by numerous changes in the body that negatively affect the health, lifestyle and diet of the elderly. An adequate and balanced diet plays a vital role in the quality of life of the elderly, including physical, mental and social health. Physiological decline in food intake in the elderly is a risk factor for certain micronutrient deficiencies such as osteoporosis, anaemia and decreased immunity. To prevent these public health diseases, it is suggested to promote the intake of foods of animal origin (offal, meat) to prevent iron and vitamin B group deficiency. An adequate intake of anthocyanidins, fruits and vegetables with blue-purple pigments is recommended for the prevention of anaemia. Adequate intake is also important, i.e. intake of at least two portions of dairy products per day and fish products per week in combination with physical activity can provide adequate intake of calcium and vitamin D for the prevention of osteoporosis. The intake of fresh or minimally processed foods has played a significant role in ensuring an adequate intake of vitamin C, which, in addition to improving iron absorption and preventing anaemia, also affects the proper functioning of the immune system. For the same reason, it is recommended to take vitamin A from offals or beta-carotene from yellow-brown and orange fruits and vegetables. In general, appropriate nutritional interventions can be effective and financially effective forms of preventing and treating micronutrient deficits, thus improving the overall quality of life of the elderly

IIntroduction: Fractures of the lower leg are frequent fractures of long bones that are of great importance in traumatology. The role of external fixation (SF) as a type of surgical treatment is significant and widely applied. There are 3 methods of using SF to treat tibial fractures: SF as primary and definitive treatment, SF combined with internal fixation, and conversion of SF to internal fixation. Objective: To show the possibilities of SF as a definitive way of treating lower leg fractures. Methods: In our paper, we analyzed 254 lower leg fractures treated with SF according to Mitković M20, which were treated at the Department of Orthopedics and Traumatology of CHC Kosovska Mitrovica. This series included 172 men or 68% of the total number of patients, and 83 or 32% women. Results: The average age of patients treated with this method is between the third and fourth decades of life. Falling on the leg with twisting of the table or the entire lower part of the leg is the most common type and cause of injuries in 69%. A closed lower leg fracture was diagnosed in 220 patients (A AO 59.%, B AO 26% and C AO 15%). Adequate position of the bone fragments was achieved by the closed reposition method in 190 (%), the average healing time was 18.4 weeks. In 93% of patients, we achieved bone union. Conclusion: The simple placement technique, the simplicity of the instrumentation, the wide range of indications where SF can be used, have led to the fact that it is a type of surgical treatment of great importance for lower leg fractures in small areas.

Supracondylar fractures are the most common elbow injuries in children and are associated with prolonged morbidity due to possible complications that can lead to deformity. The decision on the treatment method is made based on Gartland's classification (I, II, III and IV types) and the treatment can be non-operative (I and II type) and operative (III and IV type). When it comes to the percutaneous method, the main dilemma for its implementation is related to pinning from the medial side of the elbow because there is a high possibility of injury to the n. ulnaris which, according to data from the literature, occurs in some 15% of cases. The aim of treatment is pain relief and maintenance of the patient's functional status. The case presented in this paper represents a patient with whom the clinician is most likely to encounter and shows the clinical assessment of the patient's condition, the way of deciding on the treatment method and the outcome of the treatment undertaken. Agirl, 8 years old, was injured when she fell while playing. At the Department of Orthopedic Surgery and Traumatology, Clinical Hospital Center Kosovska Mitrovica, the patient was clinically and radiographically examined, and the injury was defined as a supracondylar fracture type III according to Gartland. After adequate preoperative preparation under general anesthesia, without the use of a drape - Turniquet, with the use of a C-bow, repositioning is performed and after obtaining a satisfactory position of the fragments, they are fixed percutaneously with 3 Kirschner needles, two medially and one laterally. The patient was discharged 3 days after admission with controls performed for 7 days. The Kirschner pins were removed on the 5th week after the operation and physical treatment was started, after which the movements of flexion and extension as well as pronation and supination were fully restored. Similar results are found in the literature. This information can be helpful in advising parents about what to expect after their child's injury. Also, they represent evidence of good clinical practice for orthopedic doctors and physiotherapists.

Introduction: Ellis-van Creveld syndrome is a rare genetic disorder characterized by short limb dwarfism, additional fingers and/or toes (polydactyly), abnormal development of fingernails and, in over half of the cases, congenital heart defects. Motor development and intelligence are normal. This disorder is inherited as an autosomal recessive condition. Some boys with this condition have been described with undescended testicles (cryptorchidism) or an abnormally located opening of the urine canal in the penis (epispadias). Abnormalities in the chest wall, spine and respiratory system have also been reported. Case report: The boy, aged two (2) years and eight (8) months, lives with parents and two brothers, in good living conditions. From the perinatal anamnesis, we can see that it is the third child from the third monitored pregnancy, delivered naturally at 39.gestational weeks, with normal birth parameters (3980/51/36), Apgar score 9. Immediately after birth, has been spotted complete postaxial polydactyly on both hands and postaxial poly-syndactyly (3,4,5,6) on the left foot, and ultrasound of the hips in early infancy indicated their unusual morphology and delayed bone maturation, which led to further medical investigation and treatment. Conclusion: Ellis-van Creveld syndrome is an extremely rare disease (this is the first registered case in our country). On the basis of this case, we want to express the importance of early diagnosis in order to improve the prognosis of the disease, and necessity of careful monitoring of these patients.