Existence of stress at workplace leads to the occurrence of occupational burnout among miners. OBJECTIVE is testing of influence of stress on occupational burnout among miners. METHODS The research was designed as a cross-sectional study and covered 345 subjects, which were classified into three groups: two investigated groups, consisting of Miners A (142), Miners B (147) and Control group (56) consisting of administrative workers. The research was conducted in the Health Center ZveĆan, in the Medical Laboratory Service in ZveĆan and at the Institute of Occupational Medicine in Niš. The following questionnaires were used in the study: Questionnaire on basic sociodemographic indicators of respondents, Copenhagen Burnout Inventory (CBI), and Occupational stress assesment questionnaire. Data analysis was performed using the SPSS 16.0 software package. RESULTS The study of the presence of stressors in the workplace compared to the examined groups showed that a large number of stressors were evident, with the average value of all stressors at miners 2.60 ± 1.02, which is significantly above the average value of all stressors in the control group 1.85 ± 1.02. Above the total average of all stressors 2.60 ± 1.02, there is a large number of stressors. All stressors statistically significantly higher in miners compared to the control group (p <0.001) and the values of each individual stressor in the control group are below the average values of all stressors in miners (2.60 ± 1.02). High burnout level is present in 50.70% of Miners A, 46.90% of Miners B and 16.10% of Control group subjects. It was found that there is a statistically significant difference in the incidence of high burnout in relation to the investigated groups (p <0.001). DISCUSSION There is a large number of stressors among miners and their average value is significantly above the average value of all stressors in the control group. The stressors are both quantitatively and qualitatively different in relation to the control group. A large number of high-strength stressors significantly increases the probability of stress in both groups of miners and contributes to the occurrence of occupational burnout. There is a high exposure to stress among miners, and the impact of stress on occupational burnout has been proven in a large number of research in different professions. This was also confirmed in miners, among whom high exposure to stress led to high occupational burnout, which is statistically significant in relation to the control group. CONCLUSION The results of the study showed that there are a large number of stressors in the miner groups, that the average value of all stressors in miners is significantly above the average value of all stressors in the control group, that there are a large number of stressors that are in strength above the total average of all mining stressors and that all stressors are statistically significantly higher in miners than in the control group. The strongest stressors are most important for stress, and the presence of a large number of stressors above the total average of all stressors not only increases the probability of stress, but also proves a great deal of stress, but also contributes to the intense occurrence of occupational burnout. The results of the study have shown that high burnout is present in about 50% of miners in both mines and that there is a statistically significant difference in the incidence of high burnout in relation to the control group. Occupational stress affects occupational burnout among miners.

The presence of regional metastases of laryngeal cancer differs depending on the location of the tumor and has an influence on the overall survival. The aim of this work is to analyze the frequency and characteristics of regional metastases T1 and T2 of laryngeal carcinoma in relation to the primary tumor location, and their effect on the overall survival. A retrospective study, conducted in the period between 2002 and 2012, that analyzed 445 patients who were surgically treated for laryngeal cancer of T1 and T2 category. The first group consisted of 397 patients without regional metastases, while the second group consisted of 48 patients with regional metastases. A three-year survival is followed, as well as the testing of potential predictors of outcomes by methods of regression. Regional metastases were present in 3.1% of patients with glottic carcinoma of T1 and T2 category, while 43.5% of patients with T1 and T2 supraglottis carcinoma had regional metastases. In the group with regional metastases, there is no statistically significant difference in the occurrence of extracapsular extension in relation to the tumor location, p = 0.7027. The three-year survival rate of patients without regional metastasis is 93.95%, while the survival of patients with regional metastases is 68,75%, p = 0.000. The tumor location (95% CI -1.4716 to -0.0497, P = 0.0369), and the presence of regional metastases (95% CI -1.6300 to -0.0253, P = 0.0443), were identified as predictors of outcomes by multifactorial analysis. Regional metastases in T1 and T2 laryngeal cancer are more common in patients with supraglottic carcinoma. The presence of regional metastases significantly reduces the three-year overall survival.

Healthy nutrition in childhood is of major importance for maintenance of health in adults. Early detection of nutritional status impairments in children is directed toward prevention of chronic non-contageous diseases. Obesity in children is reported as the most important public health problem in pediatrics in developed countries. The aim of this study was to established the frequency of overweight and obesity, as well as blood pressure levels in population of 4-years aged children. This study enrolled 125 children aged 4 years. The survey was conducted during their regular systematic exams. Nutritional status was estimated from standard antrhropometric measurements. Data regarding nutritional habits, as well as physical activity were collected from parents, using questionnaire. 67,2% of childred were normaly nourished, 19,2% were overweight, 10,4% were obese, and 3.2% undernourished. Average values of body weight on birth were similar, regardless of nutritional status and gender, as well as actual BMIs o parents. Sedentary activities were the most frequent in overweight children of both gender, which is statisticaly significant when compared to normally nourished (2,61 # 1,36 h vs 1,91 # 0,98 h; p<0,05 for boys; 2,75 # 0,96 h vs 1,89 # 0,80 h; p<0,05 for girls). Significantly higher values of blood pressure were recorded in obese boys compared to normally nourished (systolic BP: 101,25#6,41 mm Hg, vs 96,36#4,86; p<0,05; dyastolic BP: 71,25#6,41 mm Hg, vs 66,14#4,81; p<0,05). Obese girls had significantly higher systolic BP compared to normally nourished: 103,33#5,77 mm Hg, vs 97,03#5,19; p<0,05. Obtained results indicate the relationship between obesity and higher blood pressure even in such young children, which is the major contribution of this study, considering the lack of investigations in similar populations, as well as the previously established fact that increased risk in childhood may predict the development of cardiovasculard diseases in adult life.

This case report describes the application of adhesively cemented restorations made out of related, although not identical types of ceramic materials in the treatment of inborn hypodontia of the lateral incisors, as well as the aesthetic imperfections of certain teeth in the whole smile. Considering the minimally invasive approach, and the preservation of natural tooth fibers, the restorations have shown to be acceptable both aesthetically and functionally, and have proven themselves as a safe and comfortable solution for patients.

Determination of preoperative prostate-specific antigen (PSA) value is primary procedure in diagnosis of different pathological prostate changes (prostate cancer-PC, prostatic intraepithelial neoplasia-PIN and benign prostatic hyperplasia-BPH), followed by digital rectal examination and prostate biopsy as gold standard. Disadvantage of high sensitivity and low specificity of PSA testing in diagnosis of PC is a problem in clinical practice. Aim was to determine the diagnostic performance of PSA in diagnosis of PC, PIN and BPH. The study included 100 patients divided into three groups: 70 with PC, 20 with a PIN and 10 with BPH. Patients with PIN and BPH were control group. Preoperative PSA values were determined by Tandem-R, The patients were divided into subgroups by baseline PSA level as follows: 4-10, 11-20, 21-30, 31-40 and> 40. The definitive histopathological diagnosis was made on routine hematoxylineosin slides. The area under the receiver operating characteristic curve (ROC), sensitivity-SE and specificity-SP of each PSA level were evaluated for PC. Preoperative serum PSA levels in patients with PC (median-35.82 ng/ml, min-6 ng/ml, max-960.40 ng/ml) were significantly higher than with PIN (median-9.15 ng/ml, min-3.16 ng/ml, max-27.61 ng/ml) and BPH (median-8.68 ng/ml, min0.80 ng/ml, max-31.20 ng/ml). The best diagnostic characteristics of the PSA are on limit value 10 ng/ml (AUC=0.781, SE=92.9%; SP=63.3%; p<0,0001). PSA is of great help in diagnosis of advanced and initial form of PC. The chance of PC diagnosis was greater than that for other pathological changes when PSA level was higher than 10 ng/ml.

Acute bleeding of the upper gastrointestinal tract is an urgent condition with high morbidity, and a significant mortality despite advanced diagnostics and therapy. The goal is to investigate the determinants of the severity of duodenal peptic ulcer bleeding. The research included 304 patients hospitalized for acute bleeding from the upper part of gastrointestinal tract in a five year period. They had been treated in the Clinical Hospital Center Bežanijska Kosa in Belgrade. The diagnosis was made via gastroduodenoscopy. Out of the 304 patients, 197 (65%) suffered from bleeding peptic ulcer. 144 (73,1%) patients suffered from bleeding duodenal ulcer, most frequently with bulbar localization 124/86 (12%); 78 (62,9%) with a duodenal bulb back wall lesion. 48 (35,1%) of the bleeding duodenal ulcers were in the Forrest Ib stage, in 68 (47,2%) patients the size of the ulcer lesion was between 1,1-2,0 cm. A statistically positive correlation was determined between the duodenal ulcer lesions and the intensity of the bleeding (p<0,005). With 68/79/86,1% patients treated endoscopically, haemostasis was successful, whereas in 13/19,1%, rebleeding was localized in 11/84,6% in the duodenum bulb bask wall.

Validity shows the degree of concurrence between the results received by an actual measuring and that of what an instrument is supposed to measure. There are three main types of validity: content validity, criterion-related validity and construct validity. Factor validity is a special approach to constructive validity, tested by statistical analysis called factor analysis. Hamilton rating scale for depression and Montgomery-Asberg depression scale are the most widely used psychiatric instruments. The aim was to carry out a systematic review of the literature on factor structure of psychiatric scales reported in different times during longitudinal studies. The units of analysis were published papers obtained by searching the two bibliographic databases: MEDLINE and PsycINFO. Factor validity of the HAMD scale was reported in 6 (0.09%) of 6590 studies which used this scale, whereas the factor validity of the MADRS scale was reported in 4 (0.2%) of 2051 studies which used the MADRS scale. The difference between the first and the last measuring in relation to values was not statistically significant: median of the number of extracted factors of the HAMD scale (p=0.371), median of total explained factor variance of the HAMD scale (p=0.250), median of variance explained by the first factor of the HAMD scale (p=0.125). Factor validity of the MADRS scale in repeated measuring also did not have statistically significant difference for the following values: median of the number of extracted factors of the MADRS scale (p=0.174), median of variance explained by the first factor of the MADRS scale (p=0.125). Coefficients of concurrent validity of the HAMD i MADRS depression scales show the trend of increase in longitudinal studies and their values are for about a third higher at the end of studies than in their beginning. Low frequency of reporting the data about reliability and validity of applied rating scales is the main problem in using the meta-analytical methods effectively to study changes in adequacy of measures in longitudinal studies.

Biliary pathology represents today one of the most common indication for surgery in abdominalnj surgery. Calculosis gallbladder is a serious pathological condition, that their frequency, severity and possible complications constitute a significant percentage of medical emergencies. Septic complications are the most important factor of morbidity and mortality in biliary surgery. In relation to the gender structure of M: F=160: 519 1 3.2 23.6%: 76.4% is female domination. The highest incidence of biliary diseases in this interval is 91 (13.4%) in 2006, and 75 (11.0%) of 2010 average incidence of 52 patients per year. The lowest incidence was 2002 g 6 (0.9%) patients. The youngest patient was females aged 12 years. The oldest patient who underwent surgery were female, with a 82 yr. The range is 82-12=70g. The average age of the patients was 51 years, with dominant females 76.4%. Cholecystitis chronice is present in 423 (62.3%), cholecystitis acuta 251 (37%). Cholelythiasa 666 98%. Acalculosa 13 (1.91%). Calculosis gallbladder was present in 666 (98.1%) cases. OP: Solitary holelithiasis, 149 (22.4%), multiple holelithiasis 517 (77.6%). The absence of cholelithiasis in biliary diseases was verified in 13 (1.91%) patients. Holecistit empyema was verified in 8 (1.18%) cases. The structure of the surgical findings shows that gallbladder represents the dominant place of infectious processes in the acute pathology of extrahepatic bile ducts. 436 (64.2%). Hydrops 47 (10.8%). Empyema 102 (23.4%). Acute complications related to the spread of infection from the gallbladder put the main biliary tree and free abdominal cavity were registered in 2 (0.46%). Abscessus subhepatis 11 (2.52%). Choledocholythiasis 6 (1.38%). Cholangitis ac 17 (3.9%). Neo vesicae felleae 7 (1.03%). From that polypus vesicae felleae 2 (0.4%), ca vesicae felleae 4 (0.59%). There hepatocholedoci 1 (1.15%). Meta and hepato 4 (0.59%). M: F = 2: second Icterus 8 (1.18%). The ratio of M: F = 7: 1. Incidenca baktibilije analyzed in the entire series was 57%. Microbiological analysis of samples identified teen bacterial species.

Injury of the deltoid ligament as a component of the lateral malleolus fractures is caused by the fact rotational forces during the support. The aim of this research is to examine the functional results of the patient who had undergone suture of the deltoid ligament and osteosynthesis of fracture of the lateral malleolus. In a retrospective study the analysis included a series of 45 patients.The diagnosis of rupture of the deltoid ligament is made based on physical findings islands and tenderness in the region of the deltoid ligament and roentgenographic confirmation width of the medial joint space > 4 mm. There is a high degree of correlation with the 25 (55.55%) patients between excellent functional outcomes of treatment calculated by Gregory[11] score and great roentgenographic findings by Konrath score[12]. The total clinical scores of subjective and objective clinical assessment by Gregory of a sample of patients, characterized by an excellent, even with the 40 (88.89%) patients. In the literature there is no agreement on the method of treatment of the deltoid ligament rupture associated with fractures of the lateral malleolus. Based on theoretical considerations, a number of authors advocate surgical treatment discontinued deltoid ligament. In our series, using suture of the deltoid ligament and osteosynthesis of the lateral malleolus, the best results are obtained with the PAB fracture, lower percentages of excellent results is with the SER fractures. The worst result was obtained with the PER type fracture. Anatomical and functional integrity of all parts of the talocrural joint that allows harmony of movement and stability is achieved with osteosynthesis of lateral malleolus and suture of the deltoid ligament.