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.

The most significant prostate diseases (PD) are benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia
(PIN) and prostate cancer (PC). Generally, all PD are rare before the age of 50 with growing number of patients, primarily
with BHP, with each next decade, but about decade later the highest number of PIN and PC began to report. The aim of this
paper is to examine some of clinical, biochemical and histopathological characteristics of BPH, PIN and PC. Our sample
consisted of 169 men. Statisticaly the most common PD was BPH-77.5%, and the rarest PIN-8.3% (p<0.001). The average age of patients was 70.6±7.5 years (51-89) with no significant differences between diagnosis (p=0.415). PIN and PC are more often found in people from urban areas (p=0.004). In the central prostate area BPH is significantly higher in 88.5% (p<0.001). Peripheral parts are significantly more common places of PIN and PC (p<0.001). Median serum PSA values is statistically highest in PC-87.2 ng/ml (12.7-372.5), (p<0,001), especially those with predominantly peripheral parts localization. Gleason score is an important prognostic factor, with average value at PC is 7.32±1.4 (5-10), with a significantly higher values for diffuse PC. BPH is the most common, and PIN rarest PD. All diseases have occurred in people older than 50 years. Usually, BPH is in central and PIN and PC in peripheral prostate parts. PSA values were highest at PC, which is a prove of its importance in malignancy early detection.

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:Although placement of the central venous catheter is a routine procedure carried out by anesthesiologists, it
carries a certain risk of complications. One of the complications is malposition, or inadequate catheter position.

Case report: We present a case of the patient who was admitted to an intensive care unit due to head injury and blood
vomiting. The central venous catheter was inserted through the right internal jugular vein. Due to haemodynamic instability and the need for fluid and blood infusion, a chest x-ray examination was not immediately performed to evaluate the position of the catheter. After the patient was stabilized, the test was performed and revealed that the tip of the catheter was not located in the superior vena cava but in the right subclavian vein.

Conclusion: This case has shown that the misplacement of the central venous catheter tip is not unusual. Once in the venous system, even when it is not located in the superior vena cava, it can be used for initial fluid replacement and drug administration, and after the patient is stabilized, the repositioning or placement of a new catheter should be considered. 

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. 

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.