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.

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: Diabetes mellitus is a metabolic disorder syndrome with the presence of hyperglycemia, which is in turn caused by reduced insulin secretion, reduced biological effect of insulin, or both. It is certainly one of the most common endocrinological diseases of the modern way of life. Diabetes mellitus is a problem for every society. It is a chronic illness that people of all ages suffer from, regardless of their sex. It is believed that there is a "World Epidemic of Diabetes". Diabetes mellitus, with its chronic complications, is the cause of a significant percentage of morbidity and mortality among the population. In 2011, Serbia was among the countries with high rates of of death from diabetes. Case outline: Male, a longtime diabetic and former smoker. The mother was a longtime diabetic and hypertonic. Conclusion: Chronic complications of diabetes represent a major medical, social and economic problem and significantly impair the quality of life of the patient. Screening for the detection of persons at risk of developing diabetic foot is performed at the primary level of health care by mandatory examination at least once a year. Patient education is of particular importance. The patient should be alerted to the reduced protective sensibility (thermal, mechanical and chemical agents), the need for daily foot inspection, adequate foot hygiene, including skin and nails, and wearing appropriate footwear.

Najčešći nemelanomski maligni tumori kože epidermnog porekla su bazocelularni (BCK) i planocelularni ili spinocelularni (PCK) kože. Nastaju na fotoeksponiranim delovima kože i u 90% slučajeva su povezani sa oštećenjima kože nastalim dugotrajnom izlaganju UV zracima, kod osoba svetle puti i strarijeg životnog doba. Cilj ovog rada bio je ispitivanje kliničko morfoloških i histopatoloških karakteristika obe vrste nemelanomskih karcinoma kože i prekanceroznih promena na koži. Urađena je jednogodišnja epidemiološka analiza najznačajnijih parametara. Od ukupno 50 pacijenata PCK je dijagnostikovan kod 46%, BCK kod (32%), i prekanceroze kod 22%. PCK je češći kod muškaraca 52,8%. Prekanceroze lezije prisutne su kod oba pola podjednako. Muški pol je predominatan za nemelanomske karcinome kože .Od ukupnog broja 72% je muškog pola. Prosečna životna dob kod oba pola iznosi 67.22. Najmlađa osoba imala je 41. godinu dok je najstariji pacijent imao 93 godina. Lice je najčešće zahvaćena regija sa 73,9%. Najučestaliji histološki gradus za PCK je gradus I (60,9%) Interesantno je da je PCK kod žena najčešće bio lokalizovan na leđima 28,6% dok kod muškaraca nismo imali ni jedan slučaj lokalizacije na leđima. Mešovita (43,8%) i nodularna forma(37,5%) su najučestalije u grupi BCK-kože dok je superficijalna tek na trećem mestu(18,8%). Zapaljenski eksudat mononuklearnog tipa bio je prisutan kod svih oblika NMTK i to kao umeren (72%) i izražen(28%). Uspešnost hirurške ekcizije merila se pozitivnim linijama resekcije koje su kod BCK bile kod tri pacijenta(6%)a kod PCK u 6 pacijenata (12%).

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.

INTRODUCTION: Stress at work is a major problem in the modern world in many areas of work, especially in health care. Occupational burnout of nurses represents a serious problem, not only for themselves. It also affects the quality of the health services provided to patients. OBJECTIVE is to examine the connection between occupational stress and occupational burnout among nurses working in public health institutions. METHODS: An examination was carried out to determine aconnection between occupational burnout and occupational stress among nurses working in the hospital, at the departments of surgery, gynecology and emergency. For the evaluation of professional burnout among nurses, the Maslach Burnout Inventory, MBI-HSS pattern, was used, and Matteson and Ivancevich Questionnaire was used to assess occupational stress. Statistical data processing was done by the SPSS 17 software.RESULTS A total of 60 examinees were included in the study, 20 of them from the Surgery, Gynecology and Emergency department. Of these, 51 (81.7%) arefemale and 9 (18.3%) are male. The average age of nurses is 41.45 years, from which 40.9on Surgery; 41.8 on Emergency; 41.65 on Gynecology, and the average years of serviceare 17.91. Descriptive statistics for the examined variables are shown and it can be seen that there is a low level of occupational stress, i.e. the result is below 21.In the occupational burnout variable, respondents show the medium level of emotional exhaustion (M=24.05), low level depersonalization (M=3.83) and low level of lack of professional achievement subscale (M=38.71). The test results confirm the first hypothesis (H1) that with the increaseof occupational stress levels, the level of occupational burnout among nurses also increases.Occupational stress correlates with occupational burnout (r=0.529, p<0.01), i.e. nurses who have higher results of occupational stress, have more occupational burnout results also. The results of the tests involving correlations between occupational burnout and occupational stress dimensions show that with the increase of occupational stress the dimension of emotional exhaustion also increases (r=0.493, p<0.01), that there is no significant correlation between occupational stress and the dimension of depersonalization, and that the dimension of occupational stress and the dimension of individual realization have significant connection (r=0.393, p=0.01). The results show that there is no statistically significant difference between departments when it comes to occupational burnout, i.e. nurses working in Surgery do not have higher results of occupational burnout than nurses working in Gynecology and Emergency F(0.679) p>0.05, and that there is no statistically significant difference between the departments in terms of occupational stress, i.e. nurses working in Surgery do not have higher occupational stress results than ones working in Gynecology and Emergency department F(0.722) p>0.05. The results do not show significant differences in the level of occupational burnout and occupational stress in relation to nurses' age and years of service. DISCUSSION AND CONCLUSION: The results of the study show that with increased occupationalstressoccupational burnout also increases and that nurses have low levels of occupationalstress, low depresonization, low level of lack of personal achievement and a medium level of emotional exhaustion. There were no significant differences in occupationalburnout and occupationalstress between nurses working in surgery, gynecology and emergency departments. No significant differences in occupationalburnout and occupationalstress were found in relation to the age and years of service of nurses working in the departments of surgery, gynecology and emergency.

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.

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.

Introduction: Hernia is a defect of the continuity of the normal musculoaponeurotic and fascicular abdominal wall, which allows the release of any tissue, except those that normally pass through the apertures on the abdominal wall. Aim: The aim of the paper is to show the frequency of pathological changes in the inguinal region, their timely diagnosis and treatment, in order to avoid the severe consequences of their complications. Material and methods: For this study two-year material of the Surgical Clinical Hospital Clinical Hospital Priština in Gracanica was used, where we analyzed 102 patients who were operated in this center due to pathological changes in the inguinal region. Results: Male males are represented by 91 (89.22%), and female sex with 11 (10.78%) cases. Hernia was recorded in 86 (84.31%) and testicular retention in 16 (15.69%) patients. Femoral hernia in children is extremely rare and occurs in about 0.2% of all hernias of childhood. The femoral hernias on the left with faded and gangrenous left adnex were found in a baby only three months old, where adnectomy was done. Primary hernias was 84 (97.63%) of the patients, while we recorded recurrent hernias in two (2.33%) patients. With one child, we did a recurrent retention of testicles, which was done for a year in another institution. Postoperative complications were reported in one (0.98%) patients, where there was an infection of the wound. Conclusion: In modern surgical practice, it tends to diagnose the hernia at an early stage of development, which facilitates intervention and provides a better postoperative outcome. Incarceration represents a serious complication of all hernias, so timely and accurate diagnosis is needed to take adequate surgical intervention.

Oxidative stress plays an important role in development of ulcer lessions of the rats exposed to indomethacin induced stress. It has been suggested that endogenous opioids releassed during the stress may attenuate gastric ulcer lesions. The aim of this study was to investigate effects of morpine on development of ulcer lessions, pathohistological alterations and antioxidative status in stomach of the rats exposed to indomethacin induced stress. Research was performed on adult, male Wistar rats weighting 200-230 g. Indomethacin stress was induced by intragastric administration of indomethacin at a dose of 20 mg/kg b.w. 6 hours before sacrificing. Morphine was applied intraperitoneally, in the doses of 10 mg/kg b.w. 15 minutes before indomethacin induced stress. The size of lesions in the form of petechiae and erosion, is expressed as the total surface of changes (mm2), i.e. ulcer index (UI). The pathohistological samples were analyzed by Leica DML S2 light microscope, and specific changes were photodocumented with Canon Power Shot S70 digital camera. In the homogenate of the stomach, the activity of catalase (CAT), glutathione peroxidase (GSHPx), glutathione reductase (GR) and xanthine oxidase (XOD) were measured, as well as the reduced glutathione content (GSH) and the lipid peroxidation intensity (Lpx). Morphine significantly reduced the ulcer index (UI) in animals exposed to indomethacin stress and the presence of large amounts of mucus in the stomach mucosal was established histopathologically. The use of morphine in the pretreatmant of indomethacin induced stress statistically significantly reduced the activity of all enzymes in the stomach compared to the control group, and this activity of catalase (CAT), glutathione peroxidase (GSHPx) and glutathione reductase (GR ), xanthine oxidase (XOD),as well as the lipid peroxidation intensity (Lpx), while the reduced glutathione content remained unchanged. Gastroprotective morphine activity in animals exposed to indomethacin induced stress is most likely a consequence of the strengthening of cytoprotective mechanisms rather than antioxidant action.