Acute appendicitis is the most common surgical disease in the pathology of the population. Incidence in the general population is 6%. In the period from 15.01.2002 to 08.16.2014 as any 627 appendix which je12,4% of the 5055 total patients. Prevalent patients males 55.5% compared to 44.5% female. According to the age of the children present in 393 (68.47%) and 181 adults (31.53%). The greatest incidence is in children aged age group of 15-20 years, 131 (23.06%). In the adult group the highest incidence is represented in the third decade of 21-30 years, with 77 (13.4%). The most common disease of acute appendicitis is in the second decade of the 258 cases (44.9%). Intraoperative pathomorphologically highest incidence wearing Appendicitis phlegmonosa with 317 (52.1%). Peritonitis acuta is the most common complication of severe forms of appendicitis acuta 231 (71.96%). Anterograde apendectomia was performed in 532 (87.5%) patients and retrograde in 76 (12.5%). Abdominal drainage procedures were performed in 145 (23.85%) patients. Postoperative complications 6 (4.68%). Surgical wound infection 4. Fistula appendicularis 1 (3.12%). Mortality 1 (0.16%).

Stevens-Johnson syndrome (SJS) is a severe, episodic, acute mucocutaneous reaction that is most often elicited by drugs and occasionally by infections. The drugs commonly implicated as the cause of SJS are anticonvulsants, sulfonamides, non-steroidal anti-inflammatory drugs and antibiotics. Carbamazepine has been commonly implicated in SJS. We report a case of SJS-TEN overlap syndrome developing in patient who was prescribed carbamazeine after epileptic attack during radiotherapy for the purpose of treatment Glioblastoma multiforme, patients underlying disease, whose symptomatology deteriorated patients condition.

Reforma zdravstvenog sistema podrazumeva prihvatanje inovacija u upravljanju finansijama zdravstvene ustanove. Uspešna promena načina finansiranja zdravstvene zaštite zahteva prethodnu analizu troškova i aktivnosti zdravstvenih ustanova. U radu je izvedena uporedna analiza troškova 27 domova zdravlja primenom inovativnog tabelarnog sistema za analizu i kontrolu troškova korišćenjem „Step Down“ metodologije. Dobijeni rezultati pokazuju da: Dominantni trošak za lična primanja, prosečno oko 80%, ne zavisi od veličine doma zdravlja; Evidentne razlike u procentnim vrednostima troškova za lekove, medicinski potrošni materijal, dijagnostičke službe; Postoji evidentna razlika procentne vrednosti troškova tehničkog održavanja kao posledica neujednačenog procenta broja zaposlenih nemedicinskih radnika, razlika u infrastrukturnoj organizaciji, razlika u stanju i vrsti opreme, razlika u načinu grejanja prostora i vrsti goriva za grejanje, obaveze prevoza bolesnika i specifičnost službe kućnog lečenja i polivalentne patronaže; Postoji velika razlika u troškovima po uprosečenom ambulantnom pregledu, kao posledica neujednačenog broj izvršenih usluga. Osnovni zaključak urađene analize ukazuje na činjenjicu da je u uslovima prikazane neujednačenosti troškova problematično primeniti sistem finansiranja kapitacijom.

Parodontalna bolest (parodontopatija) je hronična inflamatorna bolest u čiju patogenezu su uključene različite ćelije urođenog i stečenog imuniteta, među kojima i makrofagi. Makrofagi su profesionalni fagociti čija je osnovna uloga ingestija i destrukcija mikroorganizama. Pored fagocitoze, ove ćelije su angažovane u produkciji proinflamatornih citokina i u prezentaciji antigena T-ćelijama, te se smatraju ključnim ćelijama urođenog imunskog odgovora. U našem istraživanju praćena je gustina i distribucija makrofaga u zdravoj i inflamiranoj gingive sa ciljem da se proceni njihov značaj u patogenezi parodontopatije. Materijal su činile gingivalne biopsije 96 pacijenata svrstanih u 4 grupe: zdrava gingiva, gingivitis, početna parodontopatija i uznapredovala parodontopatija. Za identifikaciju makrofaga korišćena je imunohistohemijska tehnika bojenja zasnovana na upotrebi monoklonskog antitela anti-CD68. Prema našem istraživanju gustina makrofaga je veća u gingivitisu i parodontopatiji u odnosu na zdravu gingivu. Između gingivitisa i parodontopatije nije nađena značajna razlika u gustini makrofaga. Grupisanje makrofaga u blizini delimično liziranih kolagenih vlakana u parodontopatiji ukazuje na njihovu kolagenolitičku aktivnost. Povećanje broja makrofaga u inflamiranoj gingivi može se dovesti u vezu i sa resorpcijom kosti jer se ove ćelije mogu diferencirati u osteoklaste.

Trachoma is keratoconjunctivitis caused by ocular infection with Chlamydia trachomatis. Endemic trachoma is caused by serovars A, B, Ba and C. Trachoma is probably the third most common cause of blindness worldwide, after cataracta and glaucoma. Active trachoma affects an estimated 84 million people; another 7.6 million have end-stage disease, of which about 1.3 million are blind. Most trachoma programmes use the WHO simplified grading system, by presence or absence of five clinical signs. The World Health Organization is leading a global effort to eliminate blinding trachoma by the year 2020, through the implementation of the SAFE strategy. This involves surgery for trichiasis (S-surgery), antibiotics for infection (A-antibiotic), facial cleanliness (F-face) and environmental improvements to reduce transmission of the organism (Eeducation). Tratment for trachoma includes local and systemic administration of appropriate antibiotics. Surgical correction of trachomatous trichiasis reduces the risk of progressive corneal opacification and blindness.

The number of elderly with chronic kidney disease (CKD) is constantly increasing worldwide, and irregular screening of CKD leads to disease discovering usually in advanced stages. The aim of the study was to examine the presence of CKD biomarkers in the elderly primary care patients, and to analyze whether the presence of diabetes and hypertension in elderly increases the risk for microalbuminuria and reduction of glomerular filtration rate (GFR). Cross-sectional study included 90 patients older than 65 years of age who are registered in the Family medicine teaching centre of Health centre Bijeljina. Patients were divided into three groups: first consisted of 30 patients who had neither hypertension nor diabetes nor other chronic disease, second of 30 patients with type 2 diabetes mellitus and third of 30 patients with arterial hypertension. Data on patients were obtained by interview, analysis of medical records and physical examinations. Serum and urine creatinine, proteinuria, microalbuminuria (MAU, turbidimetry), and urinary sediment were analyzed. Biomarkers of chronic kidney disease (GFR <60 mL / min / 1.73m2, proteinuria and mikroalbuminurija<MAU) were found in 20 (22.2%) patients. Among them, 14 had normal GFR and MAU (12) or MAU and proteinuria (2), whereas 6 had GFR <60 mL / min / 1.73m2 of which 3 had proteinuria and / or MAU. The group with diabetes had significantly more MAU compared to the other two groups, while the groups with diabetes and hypertension had slightly more proteinuria and erythrocyturia than control group. Hypertension and diabetes in the elderly may result in development of CKD biomarkers, so prevention and regular screening of CKD in the patients with these two diseases are necessary.

Among the many antibiotics that treat infections of the respiratory system, the most common and with a large role are penicillins, cephalosporins, and macrolides. Acute otitis media is rapidly formed otitis media, with the duration of the inflammatory process to 3 weeks. As a rule, there is a nasal-pharyngeal route, and causes are viruses, bacteria and / or a viral / bacterial coinfection. To determine the effectiveness of amoxicillin, amoxicillin with clavulanate, ceftriaxone and azithromycin in children aged 0 to 14 years, depending on the number of repeat episodes. 120 patients with acute inflammation of the middle ear, treated in the cabinet of Otorhinolaryngology of Health Center of Gracanica. Diagnosis of the patients was placed and confirmed on the basis of physical examination, laboratory and microbiological analysis and tympanometry findings. 120 children aged 0-14 years. 52 (43.33%) male and 68 (56.67%) female. In 37 (30.83%) an episode of OMA, in 41 (34.86%) two episodes, in 29 (24.16%) three, in 13 (10.83%) cases more than three episodes in the past year. In 23 (19.16%) two epizide acute inflammation shorter than two months, in 11 (9.16%) children 3 episodes in 6 months, and in 13 (10.83%) children four episodes OMA for a period of one year . Causes: Streptococcus pneumoniae (37.64%), Haemophilus inphluenzae (14.11%), Moraxella catarrhalis (12.94%) and Pseudomonas (12.94%), Staphylococcus aureus (4.70%), Escherichia coli (4.70%) and Streptococcus pyogenes (3.52%). Amoxicillin (90 mg / kg bw) and amoxicillin + clavulanate (90 mg / kg bw), azithromycin (5-10 mg / kg bw), ceftriaxone (50mg / kg). Based on our research, we came to the data that is generally consistent with the WHO recommendations for the treatment of OMA in children.

Delivery before 37th week of gestation is defined as preterm, independently of body mass of babies, according to the World Health Organization. Premature birth is the current problem in the world due to the high risk of neonatal morbidity and mortality and incompletely clear etiology. In our country the frequency of preterm delivery is 6%. We have retrospectively analyzed early deliveries in Health Center Kosovska Mitrovica in the period from 2009 to 2013. In this five-year period, there were totaly 3398 deliveries, of which 148 or 4.35 % were preterm delivery. The aim of this study was to investigate the incidence of premature birth in the five-year period in relation to: the total number of births in a given period, the age of the patients, the manner of completion of delivery, gestational week of pregnancy, parity and the most common causes that led to the PTP. In the analysis we have included the body weight and Apgar score of premature infants. We have used protocols of births, maternal history of disease, neonatal protocols and lists of newborns. Most of them were multiparas (41.2 %),56.7 % of pregnant women were aged of 21-30 years and pregnancy in 79.9 % of cases ended with 33 to 37 ng. Vaginal deliveries were completed in 84.4% of premature births, and caesarean in 15.6%. Twin pregnancies with preterm deliveries were represented in 10.2%. The most common weight of premature infants ranged from 2000 to 2500 grams (48.6 %). The most common causes that led to the PTP were PPROM (22.9 %), unknown causes (27. 1 %), multiple pregnancy (18.2 %), genital infection (8.7 %), cervical incompetence (6.7 %), IUGR (5.4%), PIH (4.2%), placental abruption and placenta previa (2.1 %) and other (4.7%) .

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.

Uz tradicionalne faktore rizika smatra se da i inflamacija doprinosi nastanku ishemičnog moždanog udara (IMU). U toku inflamacije neutrofilni leukociti se degranulišu, kada može doći do oslobađanja njihovog enzima mijeloperoksidze (MPO) u ekstracelularni prostor. Osim peroksidazme MPO poseduje i hlorinišuću aktivnost kojom stvara hipohlornu kiselinu i dugoživeće oksidanse hloramine. U ovoj studiji je određivana hlorinišuća aktivnost MPO i koncentracija ukupnih hloramina u serumu. U studiju je bilo uključeno 29 pacijenata sa akutnim IMU, starosti 69.0 godina (64.2–78.0), i 25 ispitanika kontrolne grupe bez IMU, starosti 69.0 godina (67.0–72.0). Nađeno je da je u grupi sa IMU broj neutrofilnih leukocita u perifernoj krvi značajno veći od kontrolnih vrednosti (4.56±1.76 vs. 7.74±3.35 × 109/L, u kontrolnoj grupi i kod pacijenata; p<0.05). Takođe je i hlorinišuća aktivnost MPO seruma bila veća u grupi sa IMU (67.2 U/L vs. 92.3 U/L, kod kontrole i kod pacijenata; p<0.05). Iako je koncentracija ukupnih hloramina bila nešto veća kod IMU nego u kontrolnoj grupi, razlika nije bila statistički značajna (p=0.178). Aktivnost MPO je značajno korelirala sa koncentracijom triglicerida (p<0.05). Korelacija između hlorinišuće aktivnosti MPO i ukupnih hloramina nije bila značajna (p=0.402), dok su korelacije MPO aktivnosti i broja neutrofila (p=0.071) odnosno MPO aktivnosti i prisustva aritmije (p=0.094) bile nešto veće. Rezultati ove studije ukazuju da MPO verovatno ima ulogu u patogenezi IMU, što se delimično može zasnivati na hlorinaciji biološki značajnih molekula vaskularnog kompartmana.