Chronic obstructive pulmonary disease (COPD) significantly reduces quality of life and is one of the main causes of chronic morbidity and mortality worldwide. Acute exacerbation of COPD (AECOPD) is a life-threatening condition that causes rapid deterioration of respiratory symptoms (worsening of dyspnea, cough and/or abundant sputum production) requiring urgent treatment. This review article examines the evidence underlying supplemental oxygen therapy and ventilator support during exacerbations of COPD. In the introduction, we discuss the epidemiology and pathophysiology of hypercapnic respiratory failure, and then we explain that the key to achieving appropriate levels of oxygenation is using controlled low-flow oxygen therapy. In patients with risk of hypercapnia a target oxygen saturation (SaO ) range of 88%–92% 2 is now generally accepted unless hypercapnia is disproved by gas analysis of arterial blood. However, if the partial pressure of carbon dioxide in arterial blood (PaCO ) is normal, oxygen therapy may target the usual saturation range of 94%–98%. 2 Many COPD patients may have a lower stable SaO , such that chasing this target (94%-98%) is not usually necessary unless 2 the patient is unwell. Further, we review current recommendations for ventilatory support in patients with AEHOBP. Noninvasive ventilation has assumed an important role in managing patients with acute respiratory failure. The use of invasive ventilation is the last remaining option, associated with a poor outcome.

Introduction: Dementia is a clinical diagnosis based on deficits of intellectual function, usually memory. Primarily neurodegenerative diseases are characterized by progressive neuronal damages and its synapsis. Early-onset Alzheimer disease 18 occurs in someone younger than 65. FDG-PET/CTis a quantitative tomographic technique also calleda biomarker of neuronal activity.

Case outline: A female of 54, mother, 12 years of education, an accountant, was sent to FDG-PET/CT brain scan because of loss of memory, social withdrawal, apathy, behavior changes, troubles with paying bills, speaking difficulties with no structural imaging abnormalities. PET scan reviled glucose hypometabolism in parietal lobes, left posterior cingulum, parietotemporal regions, the left parietooccipital region, left insula and temporal lobes. A male of 43, father, army corporal, 12 years of education, was sent to metabolic hybrid imaging because suspected dementia. He expressed progressive behavior decline, in a year time. The patient wasn't cooperative, could not concentrate and confabulated a lot. Forgetfulness, decline in voluntary dynamics and apathy dominated the clinical presentation. Structural imaging showed supratentorial, right precentral gyri solitary lesion and cortical bilateral hypocampal atrophy. FDG scan reviled distinctively diminished glucose metabolism posteriorly in parietal and temporal lobes, both posterior cingulum. SPM analysis confirmed the visually observed pattern of hypometabolism in both patients.

Conclusion: Depression is an important consideration in the differential diagnosis of AD. Early detection of AD through molecular imaging techniques will assist the choice of medications to slow the progression of the disease and optimize patient care.

Hypoglycemia is defined asplasma glucose level sufficiently low to result in neurological damage. In the new-born age, the incidence of hypoglycemia ranges from 0.4-11.4%. Etiologically, low levels of plasma glucose can result from the hormonal or metabolic disorders; high doses of insulin, drug poisoning, liver disease or systemic disorders. The most common cause of severe and permanent hypoglycemia in the neonatal age group is congenital hyperinsulinism - the result of pancreatic cells hyperplasia and/or adenoma. Between two and five years of age, the most common form of hypoglycemic state is ketotic hypoglycemia of childhood, caused by limited amount of substrate. Diagnostic criteria include biochemical confirmation of low of glucose and/or high insulin levels, blood hormone testing (epinephrine, cortisol, growth hormone, glucagon levels), as well as metabolic screeningfor gluconeogenesis, glycogenolysis, and lipolysis disorders and disarrangements of fatty acid oxidation. Therapy is directed towards the substrate supplementation and the application of medications and fuels aiming atrapid attainment of normoglycemia (fruit juices, parenterally applied glucose and dextrose, glucagone, corticosteroid therapy); diazoxide and somatostatin therapy is indicated for patients with hyperinsulinemia.

Introduction: Clinical features of the ischemic neurovascular syndromes is constant and dependable from vascular territory of the affected blood vessel. Best examples are sensory and motor hemisyndromes and vision disturbances. Aim: To define motor, sensory and visual disturbances’ in patients with ischemic stroke in the border zone of the middle cerebral artery. Material and methods: Border zone ischemic stroke diagnosis was based on clinical and neurological examination and confirmed with brain computerized tomography. Estimation of the symptoms was obtained by history, and degree of functional (neurological) deficit was estimated based on NIH-NINDS scale. Results: In total 30 patients were included in the study, 12 (40%) were females 47-79 years of age (±62.3 years) and 18 (60%) males 43-79 years of age (± 58.7 years). Neurological features were clearly different based on the side of the infarct. In the group with (ACA+ACM) + (ACM+ACM) infarct localization hemiparesis is significantly more frequent. In the group with ACM+ACP infarct localization homonymous hemianopia is significantly more frequent. Initial symptom of the reversible loss of consciousness in duration of several minutes was observed in 14 (46.6%) patients. Focal seizures (clonic seizures of the face, arm and leg) were detected in 4 (13.3%) patients (all with infarcts in the anterior border zone ACA-ACM). Headache was rare manifestation seen in 5 (16.6%) patients with 4 having posterior border zone infarcts. Conclusion: Supratentorial border zone infarcts have high specificity in clinical manifestations. The implicates therapeutical approaches which are prone to specific procedures.

Introduction: The intracranial part of the optic nerve is perfused by the upper hypophyseal and ophthalmic arteries. Standard anatomical textbooks have not dealt with the vasculature of this clinicaly important part of the central nervous system. Objective: To study morphological characteristics of perioptical arterial vascularization of the intracranial part of optic nerve. Material and methods: The study was conducted on 18 whole brains of both sexes (11 male and 7 female), from the age of 51-78 years, with no signs of changes in the structures of the central nervous system. The vasculature of the optic nerves was microdissected and examined under the stereoscopic microscope after injecting their arteries with a 10% mixture of India ink and gelatin, and fixation in a 5% solution of formalin. Results: Intracranial segment of the optic nerve was richly supplied, from both, the ventral and the dorsal side, strictly with penetrating branches which come from the pial arterial network originating from the internal carotid artery and the superior hypophyseal artery for the ventral nervous surface, and from the anterior cerebral artery for the dorsal nervous surface. Conclusion: In accordance with the objective, and based on the obtained results, we confirmed that intracranial segment of the optic nerve has a rich and very delicate vascular network.

Introduction: Radiological diagnostics is the dominant diagnostic discipline in medicine. The level of technical equipment of radiological departments directly affects many aspects of importance for the diagnosis of a large number of pathological conditions and, therefore, the progress in the treatment of patients. Aim: The research analyzes the existing situation in radiological cabinets on the territory of AP Kosovo and Metohija. Particularly important elements will be analyzed for the functioning of the radiology service. An analysis of the obtained results gives recommendations in order to improve radiological diagnostics. Metods: A survey was conducted to obtain relevant data. A questionnaire consisting of segments containing basic elements for determining patients' accessibility criteria, equipping the cabinet with equipment and employing professional staff was designed. This formulated questionnaire was sent to radiological departments in health institutions on the territory of AP of Kosovo and Metohija, which are part of the Ministry of Health of the Republic of Serbia. Results: The highest percentage of radiological equipment is represented in KBC Kos. Mitrovica and KBC Pristina-Gračanica, a total of 54%. The percentage of medical staff is at KBC Kos Mitrovica radiologist 50%, work technician 36%. This is followed by KBC Prishtina-Gračanica with 25% radiologists and 27% of radiological therapists. Conclusion: The basics of radiological diagnosis are conventional x-ray techniques. Tertiary health care does not adequately possess radiological high-tech modes of computerized tomography and magnetic resonance. Staff training is required in order to re-establish existing knowledge and skills development that are followed by the continuous professional development of technology applied in radiological practice.

Introduction: patients undergoing hemodialysis has numerous ophthalmological complications. Aim: To explore if the dry eye disease incidence, in patients undergoing hemodialysis, exists and if its frequency is greater compared to the healthy subjects. Methods: A total of 126 patients undergoing hemodialysis as well as 23 healthy subjects underwent complete ophthalmological examinations. The dry eye disease tests were performed in the patients undergoing hemodialysis: Schirmer test, Tears Break Up Time (TBUT) test and “Red eye syndrome”. Results: Comparing findings of dry eye disease parameters in patients undergoing hemodialysis vs. healthy subjects findings were the following: Schirmer’s test results 52,78% vs. 36,36%, (χ2 = 4,02, p=0,0448, p<0,05) and “Red eye syndrome” 38,10% vs 19,05% ( χ2 = 5,69, p=0,0170, p<0,05), while the TBUT test has shown pathological results in 38.89% of undergoing hemodialysis patients. Conclusions: Dry eye disease is significantly more frequent in patients undergoing hemodialysis than in healthy subjects.

Introduction: Dental related oral mucosal lesions are most often complications of wearing removable dentures. Painful lesions treatment beside removing ethiologyical factor is symptomatic therapy. Recent investigations of ozone have reported that ozone can induce the wound healing. Case raport: A patient with three ulcerative lesions subsequently developed as a result of wearing implant retained overdenture were included in the study. Each lesion recived conventional care whereas tested lesion recived topical gaseous ozone therapy additionaly. Ozone was applied directly on the musocal lessions for three times in 1 week (baseline-1.day-3.day). The basic result were changes in greatest dimension of every lesion from first treatment and at days 1 and 3. Conclusion: The current case report showed positive effect of gaseous ozone on accelerating the process of healing and pain reduction but future clinical studies are needed to confirm these findings.

Introduction. Radius fracture at typical site - fractura radii loco typico, is one of the most common fractures (more than 10% of all fractures). It is frequent in the fall on the palm of the hand. It happens at all ages. Objective. To examine the efficacy of electromagnetotherapy in the treatment of patients with radius fracture at typical site in order to reduce pain, swelling and increased mobility of injured tissue and reduce the possibility of complications. Material and methods. The study includes 100 patients with radius fracture at the typical site of which 55 women and 45 men, aged 20 to 70 years. The study included patients undergoing bone trauma treated conservatively by plaster immobilization, immediately after orthopedic treatment patients were treated with lowfrequency pulsed electrical magnetic fields produced by the machine MAGNEMED MT - 91 results. Pain in the wrist after physiotherapy treatment static isometric contractions and after the application of electromagnetic therapy was significantly more intense in the control group. Swelling in the wrist were significantly reduced in patients treated with electromagnetic fields. In all patients, after 20 applied electromagnetic field therapy achieved a significant increase in flexor and extensor muscle strength. Electromagnetotherapy is important in the prevention of complex regional pain syndrome.

Introduction: The presence of malignant altered axillary lymph nodes, and their timely detection is crucial for staging and prognosis of breast cancer. Echotomographic examinations are widely used technique, and represents one of the first tests of diagnostic modalities. Classic B mode, Doppler sonography, and MicroPure testing technique, allow a comprehensive assessment of the detailed morphology and internal structure of the nodes (number, location, size, shape, borders, echogenicity, edema of the surrounding soft-tissue, the presence of microcalcifications), and determination of their nature. Objective:The aim is to determine the role of echotomographic review the morphology, determining the nature and setting guidelines for diagnostic testing algorithm for malignant altered axillary lymph nodes. Materials and methods: This cross-sectional study included 212 echotomographic tested axillary lymph nodes in the Department of Radiological Diagnostics KBC "Dr Dragisa Mišović-Dedinje" in Belgrade, in the period from February 2016.do March 2017. All patients were examined in the supine position with arms in abduction, and external rotation. The following parameters: shape, size, and homogeneity of the echo-structure, edge, an auxiliary structures such as intranodal necrosis, edema and peripheral vascularization, as well as the presence of microcalcifications, using classical B mode, Doppler sonography and MicroPure technique. For all examinations we used Toshiba device, Aplio XG, 10MHz linear transducer. Results: Of a total of 212 tested nodule, histopathology was also verified 44 malignantly changed (21%), 4 of which the primary (9%) in a patient with Hodgkin's lymphoma, and secondary 40 (91%) in patients with breast cancer. Other nodes 168 (79%) were normal-reactive. The best performance in the echotomographic examinations are the criteria of: the shape (longitudinal cross-ratio <2) with a sensitivity of 86.9%, presence of microcalcifications with sensitivity of 83,7%, hilus (not clearly defined, and hypoechogenic) with sensitivity of 81.8%, the size (transverse diameter greater than 8mm), with a sensitivity of 79.2%, as well as echogenicity (hypo to anechogenic) with sensitivity of 73.1%. Conclusion: Echotomographic review is a useful imaging modality in evaluating the morphology and nature of axillary lymph nodes, but none echotomographic criterion in itself is not enough reliable in evaluating malignancy. Meticulousness when reviewing and examining all the criteria and modalities (B mode, Doppler, MicroPure) remain imperative in the diagnostic algorithm of tests axillary lymph nodes.