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: 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.

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: 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.

Bronchiolitis is an acute viral disease of lower respitatory pathways in children under 2 years of age. It is manifested by coughing, whistling and refusing food intake. The most common cause of bronchiolitis is a respiratory syncytial virus. Vitamin D is a steroid hormone which is synthesized in the skin after sun exposure or food intake. With discovery of Vitamin D receptors and hydroxylated enzymes in immune cells, a potential role for Vitamin D in maintaining immune homeostasis was seen. It has been established that Vitamin D induces a change of the antimicrobial polypeptide, cathelicidin, which has both antibacterial and antiviral roles.

The emergence of brain infarction depends to a great extent on the status of collateral blood circulation and is associated with hemodynamic instability. This kind of brain infarction is usually found in border vascular zones. Infarction of borderline fields arises between vascular territories ACA and ACM or between ACM and ACP, deep paraventricular infarcts in internal border zones, wound or triangular cortical infarcts, as well as major infarctions involving the entire irrigated territory of ACM.

Introduction: The role of oxidative stres in patients with Meniere disease (MD), is still unresearched.

The aim: The aim was to compare serum levels of total and direct bilirubin, albumins, uric acid and creatinine as antioxidative status parameters in patients with MD with healthy controls, and patients with multiple sclerosis (MS).

Methods: We divided patients in three groups - 85 MD patients, 75 healthy controls (HC) and 72 MS patients. Patients with
MD were divided into groups according to sex, age at the time of the disease onset, and number of attacs per year. Severity
of clinical presentation during the attack was assessed by Vertigo Symptom Scale.

Results: The serum levels of all parameters were significantly lower in MD and MS group compared to the healthy control
group (p<0.05). Regarding severity of clinical presentation we found strong correlation (p<0.001) which indicates lower
antioxidant status in patients with severe clinical presentation.

Conclusion: The results of our research showed significantly lower values of all investigated parameters in MD group
related to the healthy controls, which could suggest a potential role of oxidative process in MD patophysiology. 

Introduction: Stomach cancer is the second in mortality and the fourth most frequent of all cancers in the world. In the recent decades, the number of patients with Signet ring cell carcinoma type has been growing. Unknown etiology with proven risk factors such as smoked and salted foods, smoking, metabolic syndrome, alcohol abuse and Helicobacter pylori infection. Five-year span survival is 20%-40%.

Case outline: Patient, 70 years old, in good health, came to the GP, because of pain she had been feeling in the lower back area for a couple of months. Sometimes she wakes up because of the pain below the chest. Belch, acid, lost three kilograms. Didn't pay any attention to the problem because earlier, due to severe osteoporosis, she had obtained a compression fracture of two vertebrae. Occult bleeding negative. Laboratory normal. Tenderness on palpation of epigastrium, the tumor mass is not palpable. Addressed immediate to esophagogastroduodenoscopy. Diagnosis: Ulcer ventriculi, region antrum. Histopathological findings: Gastric Adenocarcinoma, diffuse type, Signet ring cell. Computed tomography showed locoregional lymphadenopathy so responsible Consilium decided radical surgery and chemotherapy. Despite being treated, the patient pass away two years after the onset of the illness.

Conclusion: Primary health care workers have a big responsibility, because of nonspecific symptoms, in detection of gastric cancer. Good evaluation of patients who should be referred for esophagogastroduodenoscopy is essential. The doctor should keep in mind in the further course of treatment early postoperative complications, Dumping syndrome, appears ventral anastomosis, subocclusive disorders, gallbladders calculus formation, educate patients about nutrition, vitamins, monitor vitamin B12 and iron because patients are prone to vitamin deficiency and pernicious anemia. Psychological support for patients and their families is also very significant, through a concrete doctor-patient relationship. 

Introduction The testing of stressors and the impact of stress on health and work ability of electricians working in workplaces with a special health risk is very important.

OBJECTIVE is to examine the impact of occupational stress on the ability of electricians to work.

METHODS The research was designed as a cross sectional study and covered 108 respondents, classified into two groups: electricians (52) and control group (56) made up of administrative workers. The survey included the following: Questionnaire on basic sociodemographic indicators of respondents, IRS Questionnaire, Work Ability Index (WAI) Questionnaire, General Health Questionnsire (GHQ), Copenhagen Burnout Inventory (CBI) and Occupational Stress Assessment Questionnaire. Data analysis was performed with SPSS.

RESULTS The frequency of different categories of WAI score is uniform between the tested groups (p = 0.155). Work ability is poor in 11.5%, moderate in 25%, good in 26.90% and excellent in 36.5% of electricians. The frequency of different categories of WAI score is aligned between the tested groups (p = 0.155). By analyzing all components of IRS score, it was found that there is a statistically significant difference in the components between the electricians and the  control group: requirements (p <0.001) and work role (p <0.001); GHQ is higher in electricians, but no statistically significant difference was found (p = 0.082); CBI is statistically significantly higher in electricians (p <0.001) and WAI score is statistically significantly higher in electricians (p = 0.039). In the overall population, the 10 strongest stressors were ranked and statistically significant difference in all stressors (p <0.001) between the electrician and the control group was shown. The values of the stressors are equal in relation to WAI score categories. In the electricians, the strongest stressors are: night work (4.60), hazards (4.58), shift work (4.54), working overtime (4.46), time limit for individual tasks (4.44), fear of injuries (4.42), pressure of time limits for execution of tasks (4.23), work overload (4.22), inadequate work space (4.18) and daily unforeseen situations (4.10). Average value of all stressors among electricians is 2.87 ± 1.10 (Min 1.10, Max 4.60). In the tested population, 14 different stressors have higher values than the average value of all stressors. In the control group, the average value of all stressors is 1.84 ± 0.33 (Min. 1.17, Max 2.69). Correlation analysis has shown that there is a correlation of age with shift work (r = 0.130, p = 0.013) and working overtime (r = -0.220, p <0.001). URS is statistically significantly related to the time limit for individual tasks (r = 0.149, p = 0.005) and pressure of time limits for execution of tasks (r = 0.125, p = 0.017). ERS is statistically significantly related to night work (r = 0.169, p = 0.001), shift work (r = 0.160, p = 0.002), time limit for execution of tasks (r = 0.203, p <0.001) pressure of time limits for execution of tasks (r = 0.194, p <0.001), work overload (r = 0.128, p = 0.017) and inadequate work space (r = 0.122, p = 0.022). The subjective assessment of work ability in relation to physical (p = 0.010) and psychological requirements (p <0.001) is statistically significantly lower in electricians compared to control group. DISCUSSION By analyzing all components of IRS score, it is found that there is a statistically significant difference between the electricians and the control group in the requirements and the working role components. In the overall population, the top 10 stressors were ranked and it was shown that there was a statistically significant difference in all stressors between the electricians and the control group. The average value of all stressors in the electricians is high and a large number (14) of different stressors have higher values than the average value of all the stressors. The subjective assessment of work ability in relation to physical and mental requirements is statistically significantly worse in electricians than in control group. More than half of electricians went on sick leave (mostly short leaves) during the previous year.

CONCLUSION Occupational stress significantly affects work ability of electricians. Values of WAI score are statistically significantly higher in electricians, and values of stressors are equal in relation to WAI score categories. Correlation analysis has shown there is a correlation between age, URS and ERS with individual stressors. 

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.