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.

Fear of falling (FOF) is a significant health problem that can be present in the elderly, both in those that had experienced falling and in those that hadn`t. The aim of the study was to establish correlation of FOF with the following characteristics of the participants: sex, age, education, marital status and the number of falls in the previous year. Performed from October to December 2014, the research included 100 participants from general population older than 65 and covered by health visiting service of Dom Zdravlja Nis. The questionnaire for assessment of FOF - Falls Efficacy Scale (FES) and the epidemiological questionnaire were used in all participants. We established that there is statistically significant difference of FES values (hi-kvadrat=7.668, p<0.05) between different age groups. It was found that median value of FES questionnaire is statistically significantly higher in participants living as singles in relation to those living in a community (U=828.0, p<0.05). There is satistically significant medium correlation between FES values and the number of falls in the previous year (r=0.661, p<0.01). This research established that FOF is associated with age and the number of falls in the previous year, that implies the need for prevention of FOF, especially in elder people and in people that experienced one or more falls. Implementation of prevention is also important in people living alone because FOF is excessive in their case.

Introduction: Psychogenic non-epileptic seizures represent a paroxysmal event followed by a sudden change of behavior, cognition or consciousness, mostly of short duration, which resemble or can be understood as epileptic seizures. They occur in persons without epilepsy and in patients with epilepsy. They are not associated with abnormal EEG discharges because their cause is a psychic disorder. Case report: A 20-year-old patient has been suffering of occasional “morning short-lasting jerking hand movements, staring and fainting” since the age of 14 years. Beside a symptomatic anamnesis for epilepsy and non-specifically changed standard EEG, antiepileptic therapy (valproate and lamotrigine) was introduced. Because of non-response to antiepileptic therapy, the patient was forwarded for further clinical examination involving video EEG telemetry, which indicated that this was a case of psychogenic non-epileptic seizures. A successive withdrawal of antiepileptic drugs was initiated, and also, a psychologist and psychiatrist were included into treatment, which resulted in the reduction of seizures and improvement of the patient's general condition. Conclusion: Psychogenic non-epileptic seizures represent a frequent diagnostic problem requiring team's work, while the video EEG telemetry is the method of choice for diagnosis.

Determination of direction of car impact on pedestrian is complex interdisciplinary biomechanical analysis, which sintetize the work of legal medicine and traffic engineering professions. Injury characteristics depends on constitution and position of pedestrian, and type of passenger car. There are different mechanisms of injury arising from sum of effect of complex mechanical forces, from motion and impact on human body. Results are showing that new generation car, with aerodinamic wedge front, favorize occurrence of hyperextensive injuries, while speed presents dominant factor of intensity of injuries. In modern traffic conditions, we found multiple reduction of number of deaths of pedestrians in road traffic accidents.

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).

During the armed conflict in Kosovo and Metohija, and after it, were killed more than 5 000 people, and according to the International Red Cross Committee in March 2001, 3,338 people were still missing. Until the conclusion of this study, the number of missing persons in Kosovo and Metohia for which the trail is about 1700. This list includes people from all ethnic communities. The primary objective of the forensic investigation is to determine the identity of the missing persons and after that their remains returne to the families, in accordance with Geneva protocols. Experts post-mortem examination after the exhumation determine the cause and manner of death, which indicates a violation of human rights and war crimes.Conclusion. We are facing with reasonable fear that with the passage of time, less interest will be devoted to this issue and the activities on finding and identifying missing persons will completely stop.

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.

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.

Necrotizing otitis externa, also known as malignant type of the inflammatory process, represents an infection of the skin of external hearing canal, a fast development of tissue necrosis and infection spreading to the surrounding structures. Basic clinical characteristics are: strong earache, leaking from ear, granulation findings at the bottom of the hearing canal, the disorder of hearing function and a potential possibility of complications (paralysis of facial nerve, intracranial infections). Mycrobiologically the most present bacerium is Pseudomonas aeruginosa. Other microorganisms that can be isolated are Aspergillus species, Staphylococcus aureus, Proteus mirabilis, Klebsiella oxytoca, Candida parapsilosis. The disease is more common in patients with general diseases, mostly of metabolic nature (diabetes mellitus). The approach to diagnosis and therapy is usually urgent in order to prevent the development of serious complications. This paper shows the results of the analysis of clinical process of malignant otitis in 25 patients from the Clinic of ORL and MFS KCS according to the type of the cause and the development of potentially severe and life threatening complications.

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%).