Hronični B virusni hepatitis (HHB) i dalje predstavlja veliki zdravstveni svetski problem uprkos obaveznoj i univerzalnoj imunizaciji protiv infekcije hepatitis B virusom (HBV). Kod određenog broja bolesnika hronična hepatitis B virusna infekcija u prirodnom toku bolesti progredira ka cirozi i hepatocelularnom karcionomu te je primarni cilj antivirusne terapije HHB zaustavljanje progresije bolesti. Danas na tržištu postoje dve grupe lekova za lečenje HHB: a)imunomodulatorna terapija konvencionalim interferonom alfa (INF) i pegilovanim interferonom alfa 2 a ( PEG-INF), b) peroralna antivirusna terapija analozima nukleot(z)ida. Lamivudin je dugo bio jedini medikament na našem tržištu za lečenje HBV te je kod većine naših pacijenata došlo do razvoja rezistencije. Od pre dve godine, na tržištu Srbije se registruje novi oralni analog iz grupe nukleotida : tenofovir disoproksil fumarat (TDF). U radu smo analizirali 69 bolesnika sa hroničnim hepatitisom B lečenih u Klinici za Infektivne i tropske bolesti KCS Beograd u periodu od 2012 do 2014 godine. Svi bolesnici uključeni u ovo istraživanje prethodno su bili lečeni LAM, a nakon razvoja rezistencije na LAM, primenjivan je TDF. TDF je pokazao odličnu efikasnost, visoku barijeru za rezistenciju i vrlo malo neželjenih efekata u višegodišnjoj primeni. Naša iskustva sa primenom ovog leka nisu dugotrajna imajući u vidu njegovu krakotrajnu dostupnost na našem tržištu.

Aging of population leads to limitations in functional abilities and in activities of daily living (ADL) which are the essential elements of independent care of oneself. Limitations in performing these activities result in increasing need for assistance and institutionalizing of the elderly. The aim of this study was to investigate the influence of fear of movement, or kinesiophobia, on ADL in elder institutionalized people with chronic pain. The research included 60 individuals older than 65 suffering from chronic musculoskeletal pain, institutionalized in Gerontoloski Centar Nis. The participants` fear of movement was assesed by Tampa Scale of Kinesiophobia, performing ADL was assesed by Katz index and pain intensity was evaluated by Numerical Rating Scale. We found that a large number of participants had high degree of kinesiophobia (63%), as well as that there is statistically significant negative correlation between the values of Katz index and Tampa Scale (r=-0.583, p<0.01). There is no statistically significant negative correlation between the values of Numerical Rating Scale and Katz index (r=0.139, p<0.289). There is no statistically significant positive correlation between the values of Numerical Rating Scale and Tampa Scale (r=0.215, p=0.098). The research showed that kinesiophobia has influence on ADL in elder institutionalized people with chronic pain. Higher degree of fear of movement corresponds to greater dependence of the participants in performing ADL. Pain intensity influenced neither the fear of movement nor the dependence/independence in performing ADL.

The most important adipocytokines affecting the formation and the regression of atheromas plaque in the coronary blood vessels are adiponectin and resistin. The essence of this test is to determine the correlation of the leading biochemical parameters of atherosclerosis, adiponectin and resistin and determine their interdependence with other biochemical parameters in patients with diabetes mellitus and coronary heart disease. Our study group consisted of 140 patients and 40 control group (healthy), 50 with diabetes mellitus and 50 with coronary heart disease (myocardial infarction and angina pectoris). We find that the average value of adiponectin in the group with type 2 diabetes mellitus were significantly lower than in the control group (4.38 to 6.74, p = 0.001, p <0.05). In the same study group average value of resistin was significantly higher than in the control group (15.8 to 7.88, p <0.001). The average value of adiponectin and resistin in patients with myocardial infarction and angina pectoris are no different from the value obtained in diabetes mellitus (4.94 to 4.38 and p = 0.397, 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) and not different than in the group with diabetes mellitus. Values Pearsonovg correlation coefficient shows that the biggest falls inversely proportional dependence of adiponectin with a simultaneous increase in resistin is expressed in patients with myocardial infarction, which is expressed very good correlation coefficient (-0.36). In all the groups, shows that there is a negative correlation between resistin and adiponectin, with increasing values of resistin values of adiponectin are reduced.

Leukoaraiosis is a change in brain white matter with characteristic manifestation in MR and CT head scans. Common leukoaraiosis risk factors include aging and arterial hypertension. A quarter of symptomatic ischemic infarcts belongs to small blood vessel disease group and could be presented as lacunar infarcts. These two crucial pathophysiological mechanisms are in the root of cognitive dysfunction related to small blood vessel disease. 60 lacunar infarct patients were examined and parameters for groups with and without leukoaraiosis were determined. It was found that leukoaraiosis incidence was highest in the group of women older than 70. Neurological assessment was scored on NIH-NINDS scale, functional status was scored with Barthelo index, and cognitive status was determined using Mini Mental State Examination (MMSE) and Alzheimer Disease Assessment Scale Late (ADAS-L). Correlation analysis of these parameters on significance level of *p<0.05, **p<0.01, suggests decrease in neurological status and cognitive performance.

CT dijagnostika peritonealnog prostora predstavlja kompleksan deo za skeniranje i teško ga je predstaviti na aksijalnim presecima, jer je normalno zakrivljen u ravni. Prisustvo „zamagljenog“ ili „misty“ mezenterijuma, najčešći je znak prisustva patoloških procesa u peritonealnoj duplji. Normalno subperitonealna mast je niskih izmerenih atenuacija, te svako povećanje atenuacije ovih struktura (od -60 do 0 HU) dijagnostički je značajno. Cilj istraživanja je bio da procenimo ulogu kompjuterizovane tomografije,u eksploraciji i vizuelizaciji patoloških promena mezenterijuma. Studijom preseka obuhvaćeno je 28 osobakod kojih je obavljen CT pregled abdomena i male karlice u okviru Službe za radiološku dijagnostiku KBC „Dr Dragiša Mišović-Dedinje“ u Beogradu. Korišćen je standardni protokol snimanja abdomena, zasnovan na dinamskom ispitivanju protokolom po Rossi-ju. Sva snimanja obavljena su na 16-slajsnom skeneru. Kod 18 od ukupno 28 osoba (64%), videle su se promene na mezenterijumu koje su bile inflamantornog porekla, od toga promene po tipu “misty” mezenterijumauočene su kod 6 osoba sa pankreatitisom (33%), kod 4 osobe sa apendicitisom (22%), kod 7 osoba sa divertikulitisom (39%), a kod jedne panikulitis sa pseudokapsulom u vidu masnog prstena (6%).U 2 osobe (7%), uočljen je“misty” mezenterijum kao posledica tromboze gornje mezenterične vene,dok je kod 2osobe (7%),mezenterijum bio izmenjen kao posledica hemoragične ishemije tankog creva. Jedna osoba (4%), je imala patološki izmenjeni mezenterijum zbog primarnog tumora tankog creva (karcinoid), a kod 5 osoba (18%) bile su prisutne adhezije kao posledica sekvela nakon hirurških intervencija i zračne terapije.Senzitivnost CT dijagnostike za dobijanje pozitivnih rezultata kod osoba koje imaju inflamantorno izmenjeni mezenterijum iznosila je 90%,specifičnost metode iznosila je 87.5%.. pozitivna prediktivna vrednost 94.7%, a negativna prediktivna vrednost 77.8%, uz tačnost metode 89.3%. Na osnovu visokih vrednosti senzitivnosti i specifičnosti testiranih pregleda u ovoj studiji preseka, CT dijagnostika peritonealnih prostora ima obavezno mesto u dijagnostičkom algoritmu. Zahvaljujući multidetektorskim skenerima proširene su mogućnosti eksploracije peritonealnih prostora, ali uprkos velikom doprinosu softverskih rešenja, minucioznost pri pregledu, kao i visok nivo znanja bitne su pretpostavke u radu, pa pregled ovih prostora uvek predstavlja dijagnostički izazov.

Introduction: Medico-legal expertise and identification of victims during the war and post war conflicts mean for The Republic of Serbia the most important humanitarian, scientific and ethical problem. Aim: Forensic investigations on territory of Kosovo and Metohija are currently going on. Material and methods: In this paper we observe all cases of Serbs and other nonalbanians who were exhumed and identified during first five years after armed conflict (2000-2005.), in few mass graves and in many single grave sites. Results. In the mentioned period of time, 280 dead bodies were exhumed and forensic team did autopsies, 111 dead bodies were identified. Conclusion: Well done forensic expertise is a prerequisite to the successful identification, but also the criminal processing of cases in the category of war crimes, which all together give a distinctive character. The research, published and presented in this paper at the identified human corpses, through the general data, identified violations, determining the cause and manner of death, as well as its origin, with all the available documentation of circumstances that led to the death is also the scientific and historical evidence of the tragic fate of the missing persons and victims.

Introduction: In adults the diagnosis of acute pyelonephritis and glomerulonephritis is primarily based on clinical and laboratory-biochemical testing. In patients where the clinical picture atypical, even if a person does not respond to therapy resorts to radiographic examination. Echotomographic examination is unavoidable in the diagnostic algorithm. Objective: The aim of this study was to establish the individual echotomographic parameters, as well as to determine their diagnostic power in patients with acute infections (pyelonephritis and glomerulonephritis), and comparing them with the appropriate reference tests. Materials and methods: We performed a cross sectional study in the period from October 2014. until May 2015. It included 50 patients with acute inflammation of the kidney which was made echotomographic examination of the abdomen and pelvis, within the Department of Radiological Diagnostics KBC "Dragisa Mišović-Dedinje" in Belgrade. The echotomographic examination of the kidneys included testing of numerous parameters that could indicate the existence of an acute inflammation of the kidney. For the gold standard, we take the findings obtained by CT (computed tomography) imaging of the abdomen and pelvis, as well as histopathological findings obtained by fine needle bio-psy. Results: At 50 patients with acute inflammation of the upper urinary tract, 41 patients (82%) had acute pyelonephritis, and 9 (18%) had acute glomerulonephritis. In 70% of patients with acute pyelonephritis (29 people) were present enlargement of the kidney where the test sensitivity was 79.3% and specificity of 91.7%. The accuracy of the method was 82.9% when the monitored parameters: loss of central echo complex and cortico-medullary differentiation. The sensitivity of the test in which the observed thickening of the pelvic and ureteric wall was 65% and specificity of 90%. The analysis of the presence of calculus in renal parenchyma leads to the values of sensitivity test of 54.8% and specificity of 80%. Hypoechoic focus in the renal parenchyma, enlargement of the kidneys and loss corticomedullar limits are parameters who with great sensitivity and specificity suggest acute glomerulonephritis. Conclusion: On the basis of high values of sensitivity and specificity of the test survey estimates that ultrasound has a required place in the following diagnostics algorithm. The use of echotomography that offer the possibility of high resolutive views, as well as the wide availability and good reproducibility of the method, the low cost of inspection, in favor of the first exploration ultrasound examination. Multidetector CT scan and fine needle biopsy remains the method of choice for the definitive diagnosis.

Refluks želudačnog sadržaja do nivoa ždrela i larinksa naziva se laringofaringealni refluks, koji može postojati kao takav ili laringealni i faringealni refluks kao posebni entiteti, i kao takvi dovesti do drugih oboljenja kao što su rhinitis, sinusitis, otitis media, prekanceroznih i kanceroznih stanja. Utvrditi povezanost i uticaj gastroezofagusne refluksne bolesti na pojavu, učestalost i dužinu trajanja zapaljenskih procesa i oštećenje sluzokože larinksa. Svi pacijenti su obrađeni anamnestički, laboratorijski i kod svih je odrađena indirektna hipofaringo i laringoskopija. Podaci o odrađenoj gastroskopiji dobijeni su na osnovu povratnih specijalističkih izveštaja gastroenterologa. 120 ispitanika sa dispeptičkim tegobama, kod kojih je anamnestički postojao i neki od simptoma oboljenja gornjih disajnih puteva. 62 (51,66%) ispitanika muškog i 58 (48,33%) ženskog pola. Prosečna starosna dob 54 godine . U 82 (68,33%) ispitanika bila je pojačana salivacija (jedan od vodećih simptoma) od tog broja u 61 (74,39%) ispitanika bio je prisutan i laringitis. U 68 (56,66%) slučajeva gde je kašalj bio dominantan simptom, laryngitis je bio prisutan u 26 (38,23%). Kod ukupnog broja pacijenata sa globus senzacijama 70 (58,33%), laringitis je bio prisutan u 38 (54,28%) ispitanika. Pušenje je bilo zastupljeno sa 65,83% (70) ispitanika, procenat ispitanika sa hroničnim laringitisom u ovoj grupaciji iznosio je 69,62% (55) ispitanika. Nakon odrađene gastroskopije i otorinolaringoloških pregleda, kod 62 (51,66%) ispitanika dijagnostifikovana gastroezofagusna refluksna bolest (GERD), od tog broja, kod 43 (69,35%) ispitanika bio dijagnostifikovan i laringitis. Nakon tromesečnog praćenja pacijenata posle uvođenja terapije (H2 blokatori, inhibitori protonske pumpe i antacidi) kod 28 (65,11%) ispitanika (od ukupno tretiranih), došlo je do poboljšanja nalaza. Rezultati ove studije ukazuju na značajnu korelaciju između gastroezofagealne refluksne bolesti i hroničnog laringitisa, kao I na povoljan uticaj i dejstvo antacidne terapije u lečenju laringitisa.

Abnormal liver function tests occur in 3-5% of pregnancies, with many potential causes, including coincidental liver disease (most commonly viral hepatitis or gallstones) and underlying chronic liver disease. Pruritus in pregnancy is common, affecting 23% of pregnancies, of which a small proportion will have obstetric cholestasis. Intrahepatic cholestasis of pregnancy (ICP) is a cholestatic disorder characterized by pruritus with onset in the second or third trimester of pregnancy, elevated serum aminotransferases and bile acid levels, and spontaneous relief of signs and symptoms within two to three weeks after delivery. ICP is observed in 0.4-1% of pregnancies in most areas of Central and Western Europe and North America. Genetic and hormonal factors, but also environmental factors may contribute to the pathogenesis of ICP. Intrahepatic cholestasis of pregnancy increases the risk of preterm delivery (19- 60%), meconium staining of amniotic fluid (27%), fetal bradycardia (14%), fetal distress (22-41%), and fetal loss (0.4-4.1%), particularly when associated with fasting serum bile acid levels >40 μmol/L. Important ICP-induced changes in serum profiles of amidated bile acids were observed, involving both a marked increase in cholic acid concentration and a shift towards a higher proportion of taurine-conjugated species. Ursodeoxycholic acid (10-20 mg/kg/d) is today regarded as the first line treatment for intrahepatic cholestasis of pregnancy. Delivery has been recommended in the 37-38th week when lung maturity has been established.

29 - year Lichen planus is a chronic, inflammatory, autoimmune skin disease, that is often manifested, except on the skin, in the oral cavity in a variety of clinical forms. The prevalence of the disease in the general population is about 1-2%. Etiopathogenesis is not still well understood. Histopathology, in addition to the basic methods, anamnesis and physical examination, is vital for proper diagnosis of oral lichen planus (OLP). Very diverse and loaded histological findings are common for all forms of oral lichen planus. We reported the case of oral lichen planus in a 49 years old male patient, who presented to the Dentistry clinic of Medical faculty of Priština with burning and itching symptoms and changes in the buccal mucosa. Histopathological analysis of biopsy tissue conformed clinical diagnosis of lichen planus. Due to the possibility for malignant transformation of lesions, the long-term follow-up of patients with this disease is of great importance.