Uloge endotelina u kardiovaskularnoj fiziologiji i patofiziologiji od njegovog otkrića do danas su neosporne. U srcu endotelini su značajni za procese razvoja, rasta i remodelovanja kao i za kontrolu kontraktilnosti i ritmičnosti. Srčane endotelne ćelije u endokardu i miokardnim kapilarima predstavljaju glavni izvor endotelina, a kardiomiociti su njihova primarna meta. Endotelin-1 je jedna od najpotentnijih poznatih supstanci sa pozitivnim inotropnim efektom, stoga endotelini imaju ključnu ulogu u srčanoj endotelno-miokardnoj interakciji. Endotelini su familija peptida od 21 amino kiseline koju čine endotelin-1, endotelin-2 i endotelin-3. Ostvaruju svoje efekte aktivacijom endotelinskih receptora, ETA i ETB, koji pripadaju familiji receptora vezanih za G proteine. ETA i ETB receptori su gusto distribuirani na kardiomiocitima, ćelijama provodnog sistema srca, koronarno vaskularnim i endokardno endotelnim ćelijama. U fiziološkim uslovima mesto sinteze endotelina su endotelne ćelije ali u patofiziološkim uslovima i veliki broj neendotelnih ćelija u srcu. Endotelin-1 ima pozitivno hronotropno i inotropno dejstvo. Administracija ET-1 uzrokuje koronarnu vazokonstrikciju, dovodi do ishemije miokarda i letalne ventrikularne aritmije. U akutnom infarktu miokarda ET-1 povećava miokardnu nekrozu i aritmije ali ima povoljan efekat na oporavak srca nakon infarkta u početnoj fazi remodelovanja srca. ET-1 preokreće acidozom indukovan negativan inotropan i luzitropan efekat, bez povećanja intracelularnog kalcijuma. Endotelin može da se suprotstavi aritmogenim efektima kateholamina. Tako, male koncentracije endotelina imaju protektivni efekat na srce. Osnovne indikacije za primenu antagonista endotelina jesu srčana insuficijencija, plućna hipertenzija i rezistentna arterijska hipertenzija. Dobro i pažljivo dizajnirane kliničke studije su potrebne za verifikaciju terapeutskih potencijala novih klasa lekova u kardiovaskularnoj medicini.

After the armed conflicts throughout the nineties of the twentieth century occurred in former Yugoslavia, identification of war victims is a challenging task. This paper gives a detailed description of exhumed remains identification process. One of the study objectives has been a comparison between DNA results and traditional forensic identification methods. This paper deals with the identification of human remains that were exhumed in Kosovo and Metohia in the period 2001-2012, belonging to Serbs and other non-Albanian ethnic communities (Montenegrins, Bosniaks, Roma, Gorani, and others), as well as much lower number of Albanians who were also killed during the war and post-war period.The experience of this process and the experience of other countries show that there is a need to organize appropriate services for identification of human remains in Serbia, capable to react effectively in case of mass disaster.

Akne vulgaris su hronično inflamatorno obolenje pilosebacealne jedinice. Dermatološka obolenja često su asocirana sa psihološkim problemima koje ima pacijent. Psihodermatološke bolesti (akne) su asocirani sa kožnim simptomima koje nisu direktno povezani sa psihom, ali reaguju na emocionalne situacije,kako što je stres. Cilj ovog rada je da se utvrdi da li postoje određene psihološke karakteristike, koje su zajedničke za čitavu grupu obolelih, i da li postoji korelacija između težine kliničke slike i psiholoških parametara. Naše istraživanje je obuhvatilo 30 pacijenata sa tri klinička oblika akni.Za identifikaciju i dijagnostiku psihičkih poremećaja korišćen je test ličnosti Kornel-index. Zastupleni rezultati su neurastenični parametri, parametri konverzije i parametri psihopatije u različitom procentu kod oba pola i različite kliničke slike. Dobili smo pokazatelje za grupisanje više jednovremenih nalaza. Pokazali smo korelaciju udruženih 2-6 psihosomatskih poremećaja kod muškog pola sa lakšim oblikom akni. Kod ženskog pola sa bilo kojim oblikom akni, odgovorni su bili 7-12 udruženih nalaz. Udruženost više psihosomatskih faktora može da bude odgovorna za pojavu bilo kog oblika acne vulgaris

A prominent ear, so called a protruding or “lop” ear, is the most common congenital deformity of the external ear. This deformity persists when the mastoid-helix angle (MHA) is higher than 30 degrees. It is relatively common among the population with the incidence of about 5%. The aim of this study is to present surgical procedure and our results using otoplasty with scoring anterior surface of the auricular cartilage. To analyze objective and subjective surgical procedure effects. Between 2011 and 2014 we treated 28 patients. We found statistically high significance p<0.01 in value mastoid-helix angle (MHA) preoperative and postoperative. In patients with bilateral otoplasty the difference between left and right MHAs after surgical procedure is less than 4 degrees. The difference of head-helix distance (HHD) preoperative and postoperative is statistically important with high significance p<0.05. Preoperative satisfaction by personal appearance was better after surgical procedure p<0.05. Complications occurred in 9 cases (32.4%). Otoplasty by scoring anterior surface of auricular cartilage is safe procedure for correction of prominent ear with excellent results on patient satisfaction by personal appearance. Effect of reducing the MHA and HHD is long lasting.

Astma predstavlja veliki zdravstveni problem širom sveta. Poslednjih decenija je uočen porast u prevalenciji i incidenciji astme u pedijatrijskom uzrastu. To je hronična inflamatorna bolest koja se klinički karakteriše rekurentnim respiratornim simptomima, dispnejom, stezanjem u grudima i kašljem.Simptomi su često praćeni reverzibilnim ograničenjem protoka vazduha kroz disanje puteve. U rutinskoj kliničkoj praksi dijagnostika astme u dečjem uzrastu postavlja se na osnovu anamneze, fizikalnog pregleda, odgovora na bronhodilatatore, alergološkog testiranja i ispitivanja plućnih funkcija. Alergološki testovi su primarna dijagnostička metoda u alergologiji. U kliničkoj dijagnostici se najčešće izvodi prick test (PT), zbog svoje osetljivosti, specifičnosti, reproducibilnosti i dobre korelacije sa nivoom serumskog IgE i bronhijalnom reagibilnošću. Istraživanje je preduzeto s ciljem da se utvrdi učestalost pozitivnog nalaza alergijskih kožnih testova na alergene u dece obolele od astme, obzirom da je alergološko ispitivanje jedan od kriterijuma za postavljanje dijagnoze. Ispitivano je 25-oro dece iz kontrolne grupe i 75-oro dece sa astmom. Podelu na grupe vršili smo prema težini astme i tako oformili tri grupe: deca sa lakom, srednje teškom i teškom astmom. Pozitivne kožne probe uočene su u 44,0% dece u kontrolnoj grupi, 84,0% dece sa lakom astmom, 88,0% dece sa sredenje teškom astmom i kod sve dece sa teškom astmom. Najčešće pozitivne probe su na Dermatophagoides: u grupi dece sa teškom astmom 92,0%, sa srednje teškom astmom 75,0% i sa lakom astmom 63,3%, dok su pozitivni testovi na druge alergene bili zastupljeni u manjem procentu.

Human preterm labor is a syndrome that may arise from different causes. Before 30 weeks of gestation, infection appears to predominate amongst these. In later gestation, premature activation of the fetal HPA axis in response to an adverse intrauterine environment, e.g. hypoxemia, undernutrition (UN) or even infection, may underlie the stimulus to prematurity. A third pathway clearly involves vascular thrombotic processes. Tests on sheep have been shown to there is a premature birth which is a significant change was associated with precocious increases in adrenocorticotrophic hormone (ACTH) and cortisol in the fetal circulation, and increased levels of mRNA encoding proopiomelanocortin (POMC) and prohormone convertase-1 (PC-1) in the pars intermedia of the fetal pituitary. It would seem that these different pathways may occur separately, or be activated to different degrees in the same patient.

 Atrial arrhythmias are an often and common problem in patients with arterial hypertension. Some recent studies have shown that the electrical pulse delay estimated by echocardiography is prolonged in patients with paroxysmal atrial fibrillation compared to healthy persons. To assess the electromechanical function of the left atrium in patients with various degrees of hypertension compared to healthy persons. The study has included 103 patients with artery hypertension, who were divided into four groups according to the degree of arterial hypertension and 46 healthy persons as a control. The volumes of the left atrium were measured by echocardiography using the disk, active and passive emptying volumes of left atrium and the fractions were calculated. Electrical delay within the left atrium and between the two atria were measured using the tissue Doppler. The values of passive left atrial emptying fraction were highest in patients in the control group and in patients with prehypertension they have significantly declined with the increased degree of hypertension (12.8 vs 12.6 vs 11.2 vs .10.2 vs 9.9%, p˂0.001). The values of the active emptying fractions left atrium were higher in patients in the control group and with prehypertension threy have significantly declined as increased degree of arterial hypertension (28 vs 23 vs 40 vs 40 vs 39%). Electrical delay within the left atrium was significantly lower in patients in the control group and it has been significantly increased as a growing belonging to a group with higher levels of arterial hypertension (6 ... 9 ... 15 ... 23 ... 31 ms, p˂0.001). Patients with prehypertension had significantly higher values of electrical delays within the left atrium compared to the patients in the control group. Electrical delay between the two atria grew significantly as a growing belonging to the group with a higher degree of hypertension (15.6 ... 25.3 ... 35.2 ... 50.2 ... 67.4ms, p˂0.001). The study showed that even patients with regulated arterial hypertension have disturbed electromechanical function of the left atrium. Electrical delay in the atrium between the two atria is extended to the increasing degree of arterial hypertension, which can be explained by the higher risk for atrial arrhythmias in these patients.

Pokušaj samoubistva predstavlja aktivnosti koje imaju za cilj oduzimanje sopstvenog života, a koje ne završavaju smrću. Odnos pokušanih i realizovanih samoubistava izražen je tzv. Indeksom opasnosti (Hazard ratio). Faktori rizika koji podstiču samoubilačko ponašanje su: različita emocionalna stanja, crte ličnosti, stresogeni životni događaji, zloupotreba psihoaktivnih supstanci itd. Cilj rada: prikazati učestalost i epidemiološko demografske karakteristike pokušanih samoubistava kod žena i muškaraca. Urađeno je istraživanje na uzorku od 56 pacijenata kod kojih je postavljena dijagnoza pokušaja samoubistva (Tentamen suicidii), na psihijatrijskom odeljenju KBC Priština, Gračanica. Uzorak je analiziran na osnovu pola, starosne dobi, zanimanja/zaposlenosti, psihijatrijske dijagnoze, motiva i načina pokušaja samoubistva. Rezultati: samoubistvo su pokušale 42 žene (75%) i 14 muškaraca (25%). Najveći broj ispitanika (26.8) u našem istraživanju su iz starosne dobi <20 godina. Najzastupljeniji su nezaposleni, 33,3% žena i 50% muškaraca. Najčešća dijagnoza su anksiozni poremećaji, 61,9% žena i 57,1% muškaraca. Najčešći motiv kod žena je patrnerski konflikt 54,8%, kod muškaraca egzistencijalna ugroženost 50%. Od 56 pacijenata njih 51 (91,1%) je pokušalo samoubistvo trovanjem i to anksioliticima. Znatno veći broj pokušaja samoubistva (75%) desio se u popodnevnim i vešernjim časovima, u periodu od 12 do 24h. Zaključak: žene su češće pokušavale samoubistvo u odnosu na muškarce, odnos 3:1. Najčešće nezaposleni kod oba pola ispitanika, najčešća dijagnoza, anksiozni poremećaji. Najzastupljeniji motiv kod žena je partnerski konflikt, kod muškaraca egzistencijalna ugroženost. Kod oba pola ispitanika najčešći način pokušaja samoubistva je trovanje, najčešće u periodu od 12 do 24h.

Post-streptococcal glomerulonephritis (PSGN) is a frequent cause of acute nephritis in children. This case study was done with the aim to point out that the infections caused by Group A streptococci, in spite of antibiotic era, are still present in the population. An 8-year old boy was admitted in our hospital with a two-day history of fewer, tonsillopharyngitis. After hospital admission, patient was treated with penicillin during the period of 10 days, antihypertensive medications (captopril, furosemide), including restricted diet of salt. After the treatment, patient became better. On demission it was found proteinuria and microhematuriaPSGN is very serious disease, which leaves severe complications if the valid therapy with penicillin is not used in propriety time, during the recommended period of 10 days.

Preterm premature rupture of membranes (PPROM) is in obstetrics with incidence of 0,4% of , with risk for chorioamnionitis 35%, risk for premature deli very 19%, and sepsis risk of 1%. Primary risk for fetus is pulmonal hypoplasia due to oligohydramnios in 29%, RDS in 66 % of such pregnancies, sepsis in 19%, and contrac ture of extremities in 3%. Fetal death is more than 30% of cases. Patient came to regular pregnancy check up in 22th week of gestation. US exami nation revealed decreased fluid volume AFI 50, with regular morphology and fetal dynamic. She was admitted to hospital. She was given cortico-steroids and antibiotics. In further course of pregnancy amniocentesis was performed in 32th week of preg nancy to rule out the infection and to check pulmonal maturity. In absence of infection and lung maturity pregnancy was continued until 36th week of gestation when Cesarean Section was. Baby went well and is now healthy child in the age of three. Some studies suggested that delivery can be significantly prolonged. In our case we menaged to gain 14 weeks,from 22th to 36th gestational week. Firstly gynaecologyst nightmare to ask the woman is she accept therapy. The aim is to deliver a healthy child without neurological and other consequen ces and mother with preserved reproductive function. Controversy still exists when is the appropriate time to finish pregnancy with prolonged PPROM.