Karcinom grlića materice je ozbiljan javno zdravstveni problem kako u svetu tako i kod nas. Kontrola karcinoma grlića materice pored prevencije podrazumeva ranu dijagnostiku i lečenje, ali i preciznu registraciju i praćenje obolelih žena. Da bi bila obezbeđena dobra kontrola bolesti, svi ovi delovi sistema moraju funkcionisati paralelno. Cilj rada je sagledavanje osnovnih deskriptivno-epidemioloških karakteristika obolelih i umrlih žena od raka grlića materice u svetu, Evropi i Srbiji. Poseban osvrt i detaljan epidemiološki prikaz usmeren je na područje centralne Srbije za period od 1999. do 2011. godine. U radu je primenjen deskriptivno-epidemiološki metod. Kao izvor podataka korišćeni su podaci Globocan-a (softver za procenu opterećenja bolesti populacije, pokrenut od strane WHO), kao i podaci Registra za rak centralne Srbije za analizirani period. U svetu, broj novoobolelih slučajeva za 2012. g. je 527624 (standardizovana stopa incidencije je 14,0 na 100000 žena). U pogledu mortaliteta, za dotičnu godinu broj umrlih žena je 265653 (standardizovana stopa mortaliteta je 6,8 na 100000 žena). Od karcinoma grlića materice na svaka 2 minuta u svetu umre jedna žena (720 dnevno). U Evropi, ukupan broj novoobolelih žena za 2012. g. je 58348 (11,44 na 100000 žena). Ukupan broj umrlih žena je 24378 (3,75 na 100000 žena). U Srbiji, ukupan broj novoobolelih žena za 2012. g. je 1501 (23,8 na 100000 žena). Ukupan broj umrlih žena je 609 (7,7 na 100000 žena). Pozicija Srbije u Svetu u pogledu obolevanja je 62 (od 182. zemlje), dok je 84. u pogledu mortaliteta, što nas svrstava u gornju polovinu liste svih zemalja u svetu. Prema podacima Registara za rak za centralnu Srbiju, prosečna standardizovana stopa incidencije od 23,9/100000 žena i mortaliteta od 7,2/100000 za period 1999-2011. godine ukazuju na nepovoljnu epidemiološku situaciju ovog malignoma u centralnoj Srbiji. Mada se analizom pomenutog vremenskog intervala registruje blagi pad trenda obolevanja u centralnoj Srbiji (y=27,13-0,47x; p>0,05, otprilike jedan slučaj karcinoma grlića materice na 100000 žena manje za sledeće dve godine). Naprotiv, za isti analizirani period, beleži se porast umiranja (y=7,16+0,01x; p>0,05).

Najčešći maligni tumori kože epidermoidnog porekla su bazocelularni (BCK) i skvamocelularni (SCK) karcinom. U 90 % slučajeva nastaju na fotoeksponiranim delovima tela i direktno su povezani sa oštećenjima kože nastalim dugotrajnim izlaganjem UV zracima, obično kod osoba starijeg životnog doba i svetle puti. Od njihovih posledica godišnje u svetu umre 65000 ljudi. Najvažnija karika u sprečavanju nastanka ovih tumora jeste prevencija, dok njihovo rano prepoznavanje omogućava adekvatniji hirurški tretman sa poštedom okolnog tkiva. Osnovni cilj ovog rada je ispitivanje histopatoloških i kliničko-morfoloških karakteristika BCK i SCK kože glave. Analizom je obuhvaćeno 439 karcinoma (297 (67,7%) BCK, 126 (28,7 %) SCK i 16 (3,6%) BCK+SCK), među kojima je preko 60% dijagnostikovano kod muškaraca, najčešće u sedmoj i osmoj deceniji života, sa najvećom učestalošću BCK na nosu, odnosno na koži gornje polovine kože lica i SCK na usnama, odnosno na koži donje polovine kože lica. Svi karcinomi kože glave bili su češći na desnoj strani. Klinički i morfološki, najveći broj BCK manifestovao se ulceroznim oblikom prosečne veličine 1,2cm i mešanim histološkim tipom, a SCK vegetantnim oblikom prosečne veličine 1,55cm i histološki gradusom I. Najveći broj BCK i SCK bio je odstranjen u celini, za razliku od kombinacije ova dva tumora u kojima je u većini slučajeva bila neophodna i naknadna hirurška intervencija.

Primary angle-closure glaucoma (PACG) is highly prevalent in Asian countries, compared with primary open-angle glaucoma (POAG), which is reported predominant disease among Whites and that is the reason for paucity of reports about central corneal thickness (CCT) and corneal curvature (CC) in eyes with PACG in Europe. To determine central corneal thickness, corneal curvature and refractive error in patients with primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG). A total of 288 patients were enrolled into this study; 132 patients with PACG (mean age of 73 ± 7 years) compared with 156 patients with POAG (mean age of 70 ±7 years). The data was collected from all PACG patients who underwent Laser peripheral iridotomy at the Clinic for Eye Diseases, Clinical Center of Serbia in Belgrade between January 2012 and October 2012 and controls with POAG examined in the same period. Data from the right eye was used for analysis. In PACG/POAG mean CCT was 549±38/547±35 µm (p=0.353) and mean radius of corneal curvature (Cr) was 7.92±0.22/7.75±0.29 mm (p=0.003). There was no statistically significant correlation between IOP and mean Cr in PACG (p=0.244 ) and POAG ( p=0.637) while it was in POAG group with refractive error (p=0.005) and CCT (p<0.001). We found that CCT in PACG and POAG group were in normal range and there was no diference between them. Our results showed that the eyes with PACG had the flatter corneas than eyes with POAG and were hyperopic.

Cardiovascular complications are the major cause of mortality and morbidity in children with end-stage renal disease who are treated with chronic hemodialysis Arterial hypertension is a major cardiovascular risk factors in this population. The aim is that children who are on HD displays the prevalence of hypertension, to check arterial pressure before and after HD and displays the correlation with the left ventricle mass (LVM). Method: The study in 20 patients on chronic HD and 20 healthy control group children, blood pressure was measured by sphygmomanometer before and after HD. Also echocardiography were measured left ventricular mass before and after HD and track the correlation of these two parameters. Results: The prevalence of hypertension in children on HD is 62% for significant different compared to the control group (p <0.001) .. TA values of systolic and diastolic significantly lower after HD. (P <0.05). After HD TA values were significantly higher than the value of TA (p <0.05) in healthy children. The prevalence of LVH was 60% in children on HD and statistically be statistically highe then to the control group (p <0.001). The correlation between LVH and increased TA was linear but was not statistically significant in either group of patients. In conclusion: The fact that hypertension does not correlate significantly with left ventricular mass suggests that the increase in LVM except high blood pressure and affect other cardiovascular risk factors.

Savremeni akcenti u tretmanu varikocele. Postići “minimalnu invazivnost” tretmana, odrediti broj trudnoća nakon operacije i ustanoviti vremenski period od operatvnog zahvata do začeća kod partnerki. Selektovana grupa muškaraca pomoću uroloških kriterijuma za infertilni par, tretiranih subingvinalnom ligaturom spermatične venepampiniformnog pleksusa. Tretirali smo 26 subfertilnih muškaraca kombinacijom subingvinalne ligature spermatične vene ili pampiniformnog pleksusa i medikalmentozne terapije.U desetogodišnjem periodu, registrovali smo 16 trudnoća (61,5%) partnerki naših pacijenata. Smatramo da je subingvinalna ligatura spermatične vene minimalno invazivan i isplativ početni tretman “infertilnih parova”.

Twin to twin transfusion syndrome (TTTTS) accounts for approximately 10% of monochorionic twin pregnancies and, if left untreated, is associated with high morbidity and mortality rate. A net transfusion of blood flow from one fetus (donor twin) to the other (recipient twin) via placental vascular anastomoses has been supposed as the major etiology of TTTTS. The donor twin becomes hypovolemic and oliguria, oligohydramnios, and a variable degree of growth restriction develop, whereas the recipient twin manifests polyuria, polyhydramnios, and hydrops in response to hypervolemia. TTTTS can be treated by either serial amniocentesis or selective fetoscopic laser coagulation of the communicating vessels. The rationale for removal of large volumes of amniotic fluid is to prevent preterm delivery secondary to polyhydramnios and to improve fetal circulation by reducing pressure on the chorionic plate. On the other hand, the goal of laser therapy is to occlude vascular anastomoses, thereby interrupting intertwin blood exchange. Although laser treatment is associated with increased survival rate and reduced neurologic complications, compared with amnioreduction, it requires highly specialized centers, whereas serial amniocentesis has the advantage of being performed worldwide. Therefore, the optimal treatment for pregnancies complicated with TTTTS is still controversial.

Stopa incidence cervikalnog karcinoma u Srbiji je među najvišima u Evropi i iznosi 23,8 na 100000. Papanicolau test, dopunjen kolposkopijom i histologijom, osnovna je metoda sekundarne prevencije cervikalnog karcinoma. Cilj rada je bio ispitati histološko-citološku korelaciju i pouzdanost Papanicolau testa u detekciji cervikalnih lezija. Analizirani su cervikalni razmazi (Papanicolau test) kod 3868 žena. Suspektne nalaze imalo je 190 žena i kod njih je urađena cervikalna biopsija. Kod 77 žena detektovane su premaligne ili maligne promene na cerviksu. LSIL (CIN1) je imalo 43(22,6%), HSIL(CIN2/3) 25(13,2%), a planocelularni karcinom 9 (4,7%) žena. Između histološkog i citološkog nalaza ispitanica postoji statistički značajna pozitivna povezanost (Spearman r=0,829, p<0,001). Najviše ocene dijagnostičkih performansi Papanicolau testa u diskriminaciji LSIL-a(CIN1), HSIL-a(CIN2/3) i planocelularnog karcinoma od cervicitisa su za citološki nalaz ASCH (PA IIIa) (Sp=90,6%, a Sn=100% za Ca planocellulare, Sn=96% za HSIL i Sn=86% za LSIL). U diskriminaciji HSIL-a od LSIL-a najbolja diskriminativnost postiže se za nalaz LSIL (PAIIIb) Papanicolau testa (Sn=72,0%, Sp=67,4%), a u diskriminaciji Ca planocellulare od LSIL najbolja diskriminativnost postiže se za nalaz HSIL (PA IIIb/IV) Papanicolau testa (Sn=77.8%, Sp=97.7%). Na osnovu naših rezultata možemo zaključiti da postoji pozitivna histološko-citološka korelacija nalaza i da je Papanicolau test pouzdaniji u detekciji težih premalignih promena. Citološke dijagnoze ASCH (PAIIIa) i LSIL (PAIIIb) mogu pouzdano ukazati na postojanje premalignih cervikalnih lezija kod žena, pa pacijentkinje sa tim nalazima treba češće kontrolisati i lečiti.

Introduction: Osteoporosis is a disease characterized by bone strength disorder and weakness of the entire skeleton causing the predisposition to fractures to grow. Identification of factors which may influence pathological fractures in postmenopausal women and determining which of the identified factors have the largest influence on the development of osteoporotic fractures. A retrospective study has included 400 postmenopausal women with newly diagnosed osteoporosis examined at the Institute of Rheumatology in Belgrade. We have examined demographic data and the following fracture risk factors: physical activity, menarche, menopause, fractures after the age of forty, osteoporotic fractures in the family, comorbidity: inflammatory rheumatic diseases, intestine diseases, chronic kidney insufficiency and endocrinopathy (hyperthyroidism and diabetes) and taking glucocorticoid therapy. The value of bone density has been measured using DXA method in the spine and hip, and the body mass index has been calculated based on the body height and weight. Logistic regression has been used as the method for analyzing the relation between binary results and potential predictors. Statistical hypotheses have been tested at the statistical significance level of 0.05. In the model of multivariate logistic regression, the significant predictors of osteoporotic fractures are as follows: older age (B = 0.13; p = 0.001), higher BMI values (B = 0.094; p = 0.022) and lower BMD values (hip) (B = -3.060; p = 0.023). Elderly overweight women with lower BMD values in the hip are more susceptible to fractures due to osteoporosis; therefore this subgroup of postmenopausal women is important for the application of the measures of primary and secondary prevention of osteoporotic fractures.

The aim of this study was to perform a comparative analysis applied conventional (traditional) and protective mechanical lung ventilation in clinical conditions with regard to intraoperative parameters changes of oxygenation, ventilation and acid-base status. This was a prospective study that included 240 patients. All patients underwent the same elective surgery (classic cholecystectomy). Patients were divided into two groups of 120 patients, A and B. In group A during the operation had received conventional lung ventilation with tidal volume of 10-15 ml/kg body weight, respiratory rate 12/min. and a PEEP zero. In group B was applied protective lung ventilation with a tidal volume of 6-8 ml/kg body weight, respiratory rate 12/min. and a PEEP of 7 mbar. Monitoring of oxygenation included the monitoring SaO2 and PaO2. Monitoring of ventilation included the determination of the value of tidal volume and minute volume ventilation, peak inspiratory pressure (Ppeak), medium pressure in the airway (Paw.mean), PEEP, PaCO2 and EtCO2. Monitoring of acid-base status was performed via determination of the pH values of arterial blood. Monitoring was carried out in four intervals: T1 - 5-10 minutes after the establishment of the airway, T2 - after opening peritoneum, T3 - after removal of the gallbladder, T4 - after the closure of the abdominal wall. All monitoring results are presented as mean. The statistical significance of differences in mean values was tested by t - test mean values in the case of two independent samples. As a statistical significance test taken as standard values p <0.01 and p <0.001. Comparative analysis of the value of SaO2, PaO2, Ppeak did not reach statistical significance. Statistical significance there is in the analysis of values of tidal volume and Paw.mean (p <0.001). Analysis of PaCO2 and pH of arterial blood showed no statistical significance in the first interval measurements but did interval T2-T4 (p <0.001). Based on the results of this study, it can be concluded that the applied types of mechanical ventilation of lungs during the performance of surgical procedures of medium duration, have not led to significant changes in terms of maintaining the parameters of oxygenation, ventilation and acid-base status, and they stayed in normal, physiological range.

The neurons of the sympathetic trunk as well as the other nerve cells undergo of many changes during life. The most striking of these morphological changes, during normal aging, is the accumulation of lipofuscin-filled vacuoles or neuromelanin. Considering that the pigment is a non-biodegradable and can not be removed by exocytosis, the process of its accumulation in cells is unavoidable. The role of lipofuscin and its impact on cell function is not quite clear. Some authors consider that pigment does not damage the function of the cell, unless it contains lipofuscin in large quantities, and then it mechanically prevents its function so that could lead to cell death. Since we found a very little data in the literature about using morphometric methods in accumulation of pigment in ganglion cells or quantified observed changes, we set that the aim of this study is to confirm the presence of pigment in ganglionar cells of the symphatetic trunk, when it occurs in grater extent, as well as dinamics of its accumulation (quantification of ganglionar cells without pigment, those with partial presence of pigment, and those that were complitely filled with pigment) by using numerical density. For morphometric analysis we used test system M42. To determine the numerical density of ganglionar cells we used a method for thick cuts by Floderus. We found that interneuronal accumulation of lipofuscin is directly correlated with the aging process.