Introduction: Neuromuscular autoimmune diseases, above all multiple sclerosis, have an increasing prevalence today. They develop with nonspecific symptoms, progress, have consequences on the functioning of the whole organism and are a major cause of disability. Case Report:A70-year old woman with difficulty in walking, cramps and numbness of the limbs seek medical help. The MRI of the brain and the cervical segment shows demyelination changes, typical of the multiple sclerosis, but due to the nonspecific clinical picture and age, the tests are directed to infectious agents, vasculitis. Later, because of swelling of extremities diagnosed the autoimmune polymyositis, but for the treatment is poorly reacted. Conclusion: Due to contradictory findings and a limited number of diagnostic procedures, multiple sclerosis are difficult to diagnose, remains undetectable, progresses and is often fatal, especially in the elderly.

Introduction: Hypersensitivity pneumonitis is a complex pulmonary syndrome mediated by the immune system and caused by inhalation of antigens to which the patient has been previously sensitized. From the clinical point of view hypersensitivity pneumonitis can be divided into acute/subacute, and chronic phenotypes. It is characterized by an insidious onset of cough, dyspnea, fatigue, and weight loss that develop over several weeks to a few months. Case report: A 52-year-old patient came in February 2017 with high temperature, chest tightness, dyspnea, persistent cough, hemoptysis and weight loss of more than 6 kilograms. Radiography and computerized tomography showed poorly defined small diffuse centrilobular bilateral nodules. Inspiratory crackles were detected by physical examination. Routine laboratory tests were regular. Bronchoalveolar lavage fluid analysis and lung biopsies by video-assisted thoracoscopic surgery indicated the presence of diffuse lymphocytic infiltrates and giant cells with non-necrotizing granulomas and cellular bronchiolitis. Hypersensitivity pneumonitis diagnosed. She was given 35 mg deflazacort, bronchodilators to widen the airways and etamsilat pills. We did not identify the causative agents, including home, workplace and recreational environmental factors.Conclusion: Making the correct diagnosis has critical therapeutic and prognostic implications. Patients with hypersensitivity pneumonitis should be referred to expert centers, as the overlap with other forms of interstitial lung disease may be deceiving. The mainstay in managing this illness is to avoid the causative antigen, though complete removal is not always possible.

A case of a patient is shown, who was admitted for neurological exploration, with clinical manifestations of the cerebrovascular accident in the posterior circulation (TIA V-B vascularisation). In accordance with diagnostic protocol, an endocranial CT was performed. The results of the brain CT indicated an existence of an alteration in the right pontocerebellar angle area, which was subsequently diagnosed as a n. vestibularis schwannoma in an NMR examination. After a neurosurgical deliberation, the patient was treated with a gamma knife. After this surgery, which was done in a local anesthesia, the patient's condition was well and he was discharged. Control examinations have shown minor difficulties during the stimulation of the left ear auditive structures. Control examinations involving NMR showed no signs of recidivate focal findings.

Migratory erythema is the most common manifestation of the first (early) phase of Lyme borreliosis. It is defined as the spreding rash or redness at the site of the tick bite. Although the occurrence of migratory erythema indicates the presence of local infection with pathogenic strains of bacteria from Borrelia burgdorferi sensu lato complex, the exact mechanism by which spirochetes conductspreading in human skin has not been elucidated. This paper will review the literature, initially related to tick-pathogen-host interaction, after which the most common theories of the development of specific morphology of migratory erythema will be presented, as well as differential diagnostic problems that may arise from infection with other pathogens or the development of various allergic and autoimmune conditions.

Introduction: Obesity is one of the seven leading risk factors for the occurrence of the most common non infectious diseases. An epidemic model of the obesity prevalence increase is also present in the student population. To identify an overweight person, who has an increased relative risk status and who did not develope clinically manifested cardiometabolic disorders is a critical moment for the effective obesity prevention and treatment program. Objective: To determine the prevalence and status of relative risk of developing overweight related diseases among students at the University of Pristina-Kosovska Mitrovica. AUTORI SAŽETAK ENGLISH ORIGINALNI RADOVI Uvod: Gojaznost je svrstana među sedam vodećih faktora rizika za nastanak najčešćih nezaraznih bolesti. Epidemijski model povećanja prevalencije gojaznosti prisutan je i kod studentske populacije. Prepoznavanje osobe sa prekomernom težinom koja je u statusu povećanog relativnog rizika a kod koje se još uvek nisu razvili klinički manifestni kardiometabolički poremećaji je poslednji trenutak za efikasan program prevencije i lečenja gojaznosti. Cilj rada: Odrediti prevalenciju i status relativnog rizika od razvoja bolesti povezanih sa prekomernom uhranjenosti među studentima Univerziteta u Prištini-Kosovska Mitrovica. Metode rada: Procena stepena relativnog rizika od razvoja bolesti povezanih sa prekomernom uhranjenosti rađena je na osnovu izmerenog indeksa telesne mase (BMI-Body mass index), obima struka (WC-Waist circumference) i kombinovano BMI sa WC. Rezultati: U ispitivanju je učestvovalo ukupno 1686 studenta (44,4% muškog pola i 55,6% ženskog pola). Srednje vrednosti telesne težine, BMI i WC bile su ispod vrednosti korišćenih tačaka preseka. Status povećanog relativnog rizika od pridruženih bolesti je imalo: prema BMI-20,2% studenata (27,8% muškaraca i 14,1% žena); prema WC-12,6% (12,2% muškaraca i 12,9% žena) i prema BMI sa WC-20,2% (27,8% muškaraca i 14,1% žena). Postoji značajna razlika u stopi prevalencije koji su u statusu visokog i veoma visokog nivoa rizika u zavisnosti od metode procene (samo prema BMI i prema BMI sa WC). Zaključak: Utvrđena je visoka stopa prevalencije predgojaznosti i gojaznosti, opšte i abdominalne među studentima Univerziteta u Prištini-Kosovska Mitrovica. Oni se mogu svrstati u grupu studenata sa statusom povećanog relativnog rizika od nastanka i razvoja bolesti povezanih sa prekomernom uhranjenosti. Savetovalište za ishranu i dijetetiku u okviru Studentskog centra prema njima mora intenzivirati mere prevencije i eventualnog lečenja gojaznosti.

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: Thyroid nodules are defined as limited changes in the thyroid structure. A smaller number of thyroid nodules are palpable, only 10% in women and 2% in males. The prevalence of non-imperfect nodules visualized by ultrasound exploration of the structure of the neck (thyroid incidents) is 50%. Not malignant nodes can be found in people with thyroid hyperplasia, inflammatory and autoimmune thyroid diseases, granulomas, hemorrhagic or colloid cysts. Follicular carcinomas include follicular (papillary, follicular, anaplastic and insular carcinoma) and parafollicular carcinoma (medullary carcinoma). Case report:Apatient born in 1965 appears in a family medicine clinic for heart palpitations, malaise, and mood swings. Due to right-sided vetriculomegaly, diffuse reductive changes of the brain parenchyma, sensorimotor neuropathy of the right median nerve, sensory neuropathy of the right ulnaris and radial nerve, depression and arterial hypertension, it is under the supervision of a neurologist, physiatrist, psychiatrist and cardiologist. Physical examination reveals an enlarged, squamous thyroid gland, an ultrasonographically heterogeneous calcified malignantly suspected nodule in the lower poleleft lobe, 18x15 mm in size. The patient is referred to the Department of Nuclear Medicine where an FNAB is done indicating the presence of malignant cells. At the decision of the Oncology Consulium, a total thyroidectomy is performed at the Thoracic Surgery Clinic, followed by radioiodine therapy (131-I). The histopathological findings are: carcinoma papillare lobblateralis sinistri glandulae thyreoideae gradus II-classic type, T1N0. After 24 months, the patient without signs of relapse of malignancy. Conclusion: Educating family medicine physicians in the field of thyroid ultrasound diagnostics and incorporating it into everyday practice would allow significant advances in the diagnostic evaluation of thyroid nodules at the primary care level.