Introduction: Ebstein anomaly, a congenital heart defect characterized by a morphological and functional abnormality of the tricuspid valvula while moving the mouth of the tricuspid valvula towards the apex of the right chamber. Case report: A patient aged 39 years on the Department of Surgery was admitted under the image of an acute abdomen and the need for emergency surgical treatment. Routine preoperative preparation, laboratory treatment, examination of internist and examination of anesthesiologist on the part of the part was carried out. He has a history of occasional breathing problems during respiratory infection, a smoker. Clinical status, other than primary problems, is orderly. Operational treatment passed neatly, on the fourth postoperative day the patient complained of suffocation, lack of air and chest pain, translated into intensive care monitored (spo2 87% f about 110/min TA 90/60), blood gas analysis done and laboratory treatment (fibrinogen, D dimer) due to suspected pulmonary thromboembolia consulted cardiologist, dilation of the right atrium seen by ultrasound. Discussion: Non-cardiac surgeries in patients with pre-existing congenital heart defects are high-risk surgeries with increased mobility and mortality in the perioperative period. In accordance with the accompanying pathoanatomical and pathophysiological changes that define the congenital heart defect, a detailed plan must be made - anesthesiological management for each patient separately. Hemodynamic and respiratory stability with avoidance of hypoxia and paradoxical arrhythmias are the basic postulates in patients with Ebstein's anomaly.

Prostate cancer (CP) is the most common malignancy in men in America, while it is the second most common in Europe. It is responsible for about 10% of cancer deaths in the same population. It is clinically manifested in various forms, from slow-growing to aggressive forms with pronounced metastatic potential. Diagnosis is made by a well-defined algorithm, which begins with the determination of serum prostate specific antigen values and ends with prostate biopsy as the "gold standard". Pathohistological diagnostic criterias are based on architectural, cytoplasmic, nuclear and characteristics of intraluminal structures, as well as periacinar cleftings, which are deffined as helpfull diagnostic criteria of undoubted importance. Prognostic and predictive parameters are classified into three categories. Some of them are an integral part of routine pathohistologicat report, while others are considered as the diagnostic process progresses. Modern knowledge introduces biomarkers into the everyday practice of personalized medicine, especially when is necessary to treat prostate cancer patients.

Introduction: The process of recording a patient includes a procedure with several separate segments during work that together provide the imaging to be obtained for adequate radiological analysis. Throughout the process, it is possible to experience errors that create artifacts on X-rays which ultimately results in an inadequate recording that is not for valid analysis. Aim: Determine the total number of radiological films that are not for valid analysis. Sort out and analyze errors in radiographs according to the work process. Provide recommendations for improving the quality in the process of recording the patient. Material and methods: A prospective study was conducted at the Radiology Clinic of the Clinical Hospital Center Pristina-Gracanica, for two calendar years. All films that are not for valid analysis were considered. The radiological procedure of patient imaging was broken down into logical segments so that possible errors could be observed. We have summarized the causes of the artifacts in five appropriate groups (errors made by the recording technique, during the acquisition of the image, caused by the object of recording, during the processing of films in an automated machine and improper handling of films). Results: The total amount of used X-ray films is 32600 pieces, of which 242 (0.74%) were errors and artifacts. The most common format of a film with an error or artifact was 30x40 cm. A frequency of errors according to the cause of the occurrence is classified into appropriate groups. The largest number was in a group 1 - 155 (64.04%), in a group 2 - 3 (1.24%), in a group 3 - 13 (5.37%), in a group 4 - 67 (27.69%), and in a group 5 - 4 (1.66%). Conclusion: In the proper systematization of all observed errors and artifacts of X-ray film, it allows us to realise the place of error during the whole process of recording and processing of the film. We hereby wish to propose their elimination and improve the quality of the radiology department.

Introduction: Health education, as one of the important aspects of preventive dentistry, plays an important role in promoting good oral health. The aim of this study was to determine and define the influence of parents' knowledge about the effects of oral hygiene, proper nutrition and fluoride prophylaxis on oral heath in early childhood. Methods: The survey was conducted in four pedagogical-education institution on Kosovo and Metohia, Serbia. The study included 403 parents of children, aged between 3-6 years. Parents were asked to fill a questionnaire about oral hygiene, nutrition and fluoride prophylaxis. Results: Parents from urban (64.8%) and parents from rural (63.5%) areas were informed that the teeth should be brushed at least twice a day. Only 3.4% parents from urban and 3% parents from rural were informed how often should a child toothbrush be changed. Awareness about nutrition showed that parents from rural areas were better informed than parents from urban areas. Parents from urban (31.4%) and rural (31.7%) areas belived that tooth decay may be caused by prolonged breastfeeding. Awareness about fluoride prophylaxis in preventive and pediatric dentistry was poor. Conclusion: The study showed that parents knowledge about the impact of oral hygiene, nutrition and fluoride on the oral health in early childhood is not good.

Introduction. Jarisch-Herxheimer reaction implies trembling, headache, temperature, rash, meningitis, respiratory problems, liver, kidney and heart dysfunction during antibiotic treatment of Lyme disease. Case outline. A 47-year-old patient in May 2016 had circular redness on the thigh, fatigue, myalgia, nausea and headache. Borrelia Burgdorferi IgM antibodies were positive. She took doxycycline 200 mg/day, four weeks. Western blot IgM and IgG were positive as well. Retreated with Azithromycin, 500 mg/day, three weeks. Next year, there was a sleep and memory disorder, fatigue, dizziness, right leg paresthesia and burning in the soles, muscle weakness, decreased sensitivity and right foot hyperreflexia. Electromyography showed axonal degeneration of the peroneus and the tibialis. Pleocytosis (5 leucocytes/mm³) and intrathecal IgG were found. Magnetic resonance of the head in order. Neuroborreliosis was diagnosed and treatment included ceftriaxone, 2 grams/day, three weeks. After the second dose, trembling, myalgia, headache, nausea, flushed nose, dizziness and nausea started. Temperature 37.8°C. No changes on the skin. The antibiotic was not interrupted, symptomatic therapy was administered, and after two days the symptoms stopped. Neurological disorders have not completely disappeared. Titre antibodies still present. Conclusion. Jarisch-Herxheimer reaction occurs in 7.0-30.0% of patients treated for Lyme disease. Causes are multifactorial. Spirochetes release toxins, hypersensitivity is present, phagocytes destroy agents, complements and cytokines are activated. It is often not recognized. Tremor, fever, myalgia and skin rashes are present before the antibiotic, and the worsening is attributed to the underlying disease or allergy. Doctors should expect it during the treatment of spirochete-related diseases and provide appropriate care.

Objective: In the available literature data, there is not much information about problems of patients with end stage kidney disease in relation to oral health. Our objective was to show the importance of oral diseases for patients on hemodialysis. Data sources: In this review article, the sources of data are review articles and scientific articles in the English language published in MEDLINE database. The choice of studies was based on keywords: Chronic kidney disease, Hemodialysis, Oral health, Periodontal diseases. Results: It is assumed that almost 90% patients with chronic kidney disease manifest some symptoms of oral disease. Therefore, it is important to determine the impact of periodontal disease on the progression of kidney failure in these individuals, to evaluate inflammatory parameters in this patient population, to assess the degree of bone loss and periodontal disease index, to determine the presence of bacterial strains, paradontopathy of gingival fluid and antibody titers, to examine correlations of proinflammatory cytokines in the gingival sulcus and serum, as well as to determine the relationship between periodontal tissue and inflammatory mediators. Periodontal diseases can increase the possibility of developing chronic kidney disease by 1.5 to 2 times. These oral diseases include gingival hyperplasia, periodontitis, xerostomia, unpleasant breath, changes in the oral mucosa, malignancies, oral infections, dental abnormalities and bone lesions. Conclusion: This requires serious cooperation between nephrologists and dentists to make proper communication possible, in order to provide quality dental care for this growing patient population in accordance with new treatment strategies.

Uvod: Primarni medijastinalni B krupnoćelijski limfom je redak, visoko agresivan oblik non Hodgkinovog limfoma i javlja se u 5-7 % svih difuznih velikoćelijskih B limfoma i 2% svih non Hodgkinovih limfoma. Vodi poreklo od medularnih ćelija timusa i ima sopstvenu histogenezu. Tipično obolevaju mlade žene u trećoj i četvrtoj dekadi života. Sindrom gornje šuplje vene je prisutan u više od 50% slučajeva, sa otokom lica, ruku, dubokim venskim trombozama, dispnejom, disfagijom, bolom u grudima, glavoboljom i kašljem. Dijagnoza se postavlja patohistološkom i imunohistohemjskom analizom hirurškog bioptata dobijenog medijastinoskopijom. Blagovremena terapija ciklusima monoklonskih antitela i polihemioterapijom omogućava stabilan relaps bolesti. Prikaz bolesnika: Pacijentkinja, stara 37 godina, javlja se prvi put na pregled kod svog izabranog lekara jer je već u nekoliko navrata posećivala Službu hitne medicinske pomoći zbog kašlja, osećaja da je nešto davi, nedostatka vazduha, pritiska i bolova u glavi kao i otečenosti vrata i lica. Započeta detaljna dijagnostika. Radiološki utvrđen tumor medijastinuma, kompjuterizovana tomografija potvrdila i poslata na referentni Institut gde je videoasistiranom torakoskopskom hirurgijom i patohistološkom analizom dijagnostikovan PMBCL CSII AM+. Ordinirano šest ciklusa rituksimab, ciklofosfamid, doksorubicin, vinkristin i prednizolon terapijskog protokola koje je podnela sa očekivanim neželjenim dejstvima. Kontrolna pozitronska emisiona tomografija utvrdila da se tumorska masa u potpunosti povukla. U remisiji je dve godine, dobro se oseća i javlja se na redovne kontrolne preglede. Zaključak: Na izabranom lekaru je velika odgovornost u prepoznavanju ranih simptoma maligne bolesti što ubrzava postavljanje konačne dijagnoze i blagovremeni početak lečenja.

Introduction: Asphyxiation by aspiration- inhalation of foreign bodies is a form of violent mechanical asphyxia and can occur at any age, most commonly in children and the elderly. In children up to third age choking is a significant cause of morbidity and mortality. Mortality due to aspiration of foreign bodies is higher in children because of the relatively narrow airways and less developed protective mechanisms. The size, type, shape and place of obstruction with foreign body leads to the diversity of clinical picture.

Case report. We present the case of a 15 month-old girl, who was found by her mother in her house in a village, lying down, cyanotic, collapsed, without breathing. Autopsy showed that the cause of death was acute respiratory obstruction with impacted grains of corn in two places, on the larynx entrance and in the right bronchus.

Conclusion. The diagnosis of death by asphyxiation due to aspiration of foreign bodies is set at autopsy, when the place of airway occlusion is found. If a foreign body was removed during providing assistance, the diagnosis would be made based on medical records or history data of persons who were provided assistance. In cases of sudden deaths of young children, in order to clarify pathophysiological mechanism and mode of death in each case, a pathologist should always keep in mind the possibility of aspiration of foreign bodies, and in accordance with this, carefully apply appropriate autopsy techniques to locate the place of obstruction, with special regard to local finding in airways.