The aim of the present study is to investigate the antioxidant properties of the lichen Cetraria aculeata. Antioxidant activity of the methanol and ethyl acetate extracts of lichen was tested by different methods including determination of total phenolics content, determination of total antioxidant capacity, DPPH free radical scavenging activity, inhibitory activity towards lipid peroxidation, ferrous ion chelating ability and hydroxyl radical scavenging activity. The extracts of the lichen C. aculeata showed significant antioxidant activity. The methanol extract showed higher values for total phenolics and total antioxidant capacity compared to the ethyl acetate extract, while the ethyl acetate extract demonstrated better results for DPPH radical scavenging, inhibitory activity towards lipid peroxidation, chelating ability and hydroxyl radical scavenging than the methanol extract. This is the first report of the antioxidant properties of Cetraria aculeata growing in Serbia. The results of antioxidant activity indicate the application of this lichen as source of natural antioxidants that could be used as a possible food supplement, in the pharmaceutical industry and in the treatment of various diseases.

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%).

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.

Tests have shown that adipose tissue is very important in the production of chemical substances that have a major impact on atherosclerosis. The basic fat cells adiposity is very active in bio secretion hormones and other substances. Adiposities secrete chemical substances such as leptin, resistin, adiponectin, and others who participate in metabolic processes. One of the most important adipocytokine affecting the formation and the regression of atheromas plaque in the coronary blood vessels are adiponectin and resistin. So our aim was to determine the value of the concentration of adiponectin and resistin on patient with myocardial heart attack and determine their correlation with the control group of healthy subjects. In this study were included 68 subjects, 40 with myocardial heart attacks and 28 control groups of normal healthy. In the group with myocardial 78.6% of respondents were male and 21.4% female. Tests have shown that the concentration of adiponectin in the group with myocardial heart attack was significantly lower than the control group (4.94 to 6.74, p=0.043, p<0.05. In the same study group average value of resistin was significantly higher than in the control group (15.73 to 7.88, p=0.001, p<0.01) (Student's t-test, p = 0.581, p> 0.05). All this indicates that in patients with myocardial heart attack there is a decline in the concentration of adiponectin, which has cardio protective effect. The increase in resistin in myocardial heart attack in directly related to the appearance of athermanous plaques in the coronary blood vessels and has a bad prognostic significance.

Meniscus injuries occupy an important place among damages to the knee joint and are crucially important for athlets. Arthroscopy is a method of choice in both diagnostic as well as therapeutic treatment. After the intervention, it is necessary to start physical tretmeant as soon as possible. The study presents the treatment of 14 year old female patient, who started physical therapy five days after the removal of part of the lateral meniscus. Procedures involved electrical and kinesy therapy. Within the kinesy treatment static contractions were included, lymphatic drainage, and also passive exercises in order to increase range of motion. In the end, exercises against resistance were conducted to strengthen the musculature. After one month of therapy the treatment was completed, and patient was advised to continue strengthening the musculature at home. During the last examination the absence of swelling was noted, with painful sensitivity and limited motion in the knee. The MMT score for qvadriceps femoris was 4. The patient was advised to start with the lighter recreative activities. Arthroscopic meniscotomy is relatively rare intervention with adolescents, which was the motive for displaying this case. Applying early rehabilitation is fully exploited regenerative potential of this age and the optimal time for patients to return completely to usual activities.

Introduction: The study of importance of left ventricular contractile reserve presence and changes plasma brain natriuretic peptide levels (BNP) during exercise in patinets with idiopathic dilated cardiomyopathy is very popular today, but these two parametres have rarely been interconnected. The study of response BNP during echocardiography stress tests in patients with idiopathic dilated cardiomyopathy with or without preserved left ventricular contractile reserve. We studied 55 consecutive patients with idiopathic dilated cardiomyopathy (mean age 54.98 ± 9.84, 49 (89.1%) male) treated in the outpatient clinic for heart failure at the Institute of Cardiovascular Diseases "Dedinje". All the patients underwent the echocardiography stress test. Contractile reserve was assessed by measuring of the changes of the left ventricle ejection fraction basally and in the first minute after the strongest stress. Level of BPN was measured at rest, in the first minute and after 20 minutes of maximal exercise stress. Following the kinetics of BNP level during stress testing, we find that in patients with preserved left ventricular contractile reserve BNP level is rising at maximum load achieved (Mediana (IQR) - 59 (22-113) vs. 91 (37-135) vs. 78 (30-159) ng/L, p<0.001), whereas in patients without preserved left ventricular contractile reserve BNP level does not change significantly (Mediana (IQR) – 89 (50-322) vs. 119.5 (61.3-321.8) vs. 136 (72- 281), p=0.102). The increase in BNP in the peak load compared to its value at rest was positively correlated with preserved contractile reserve (r=0.38, p=0.009), better WMSI at rest (r=-0.28, p=0.04), greater difference in the double product (r=0.40, p=0.002), as well as the work accomplished on the test (r = 0.47, p <0.001), and longer duration of the test (r = 0.43, p = 0.001). The increase in BNP during physical exercise in patients with idiopathic dilated cardiomyopathy suggests a preserved contractile reserve of the left ventricle.

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.

Quality of life (QoL) is used in the natural and social sciences as a relatively new category which deserves more attention in research. Quality of life related to health is a term commonly used when QoL on health. An increasing number of research studies that are based on an examination of the QoL. This paper analyzes the concept of the QoL, the possibilities of measuring the QoL, a special emphasis is placed on measuring QoL in dermatovenereology. Given that the skin disease are of particular significance for the patient, the said indices are dermatologically quality of life, especially the quality of life of patients dermatological (DLQI).

Maligni tumori pljuvačnih žlezda su retka oboljenja i u najvećem broju se javljaju u velikim pljuvačnim žlezdama. Cilj istraživanja bio je da se analizira trend incidencije malignih tumora velikih pljuvačnih žlezda kod stanovništva grada Beograda. Podaci su dobijeni iz Registra za maligne tumore centralne Srbije. Analizirani su svi slučajevi malignih tumora velikih pljuvačnih žlezda registrovani u Beogradu od 01. januara 1999. godine do 31. decembra 2010. godine. Trend kretanja i godišnji procenat promene incidencije izračunat je regresionom analizom uz pomoć tačaka spajanja (engl. joinpoint regression analysis). U ispitivanom periodu Registru je prijavljeno je 283 pacijenta (168 muškaraca i 115 žena) sa malignim tumorima velikih pljuvačnih žlezda. Standardizovana stopa incidencije svih tumora u ispitivanom periodu, za oba pola, bila je 0,87/100,000 stanovnika, odnosno 1,13 za muškarace i 0,67 za žene. Standardizovana stopa incidence se uvećavala sa godišnjim procentom promene od 6,4% kod oba pola (p<0,001). Rezultati su pokazali konstantno povećanje trenda incidencije malignih tumora velikih pljuvačnih žlezda kod stanovništva grada Beogradu između 1999. i 2010. godine.

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.