Aim of this study was to identify the most relevant epidemiological risk factors for acquiring tularemia. Method used in the study was cross section. During period 2000-2006 at the territory of Serbia (excluding Kosovo and Metohia region) 254 tularemia cases were identified. No lethal outcomes were noted. Tularemia was registered in 11 districts of Central Serbia, while no cases of the disease were noticed in region of Vojvodina. In Serbian enclaves in Kosovo and Metohia there were 4 cases of Tularemia. 4 epidemics with 21 diseased persons were reported at territory of Central Serbia. Majority of patients were 20-60 years old (86%). No significance difference in sex distribution was observed. Almost the same number of male (129) and female (125) patients was affected. This could be explained by identical exposure of both sexes to diseases causative agents. The disease has seasonal character. It occurs most often in late autumn and winter due to contact with diseased rabbits during hunting season, meat consummation, and inhalation of dust containing diseased animal excreta. During observation period linear trend of incidence rate have not shown statistically significant elevation neither decrease.

Its analyzed from a epidemic figurante aspect. The childrens department, health headquarters from Kosovska Mitrovica in the year of 2007. They were able to bring 748 children for healing. Down North Kosovo, they had 81% of children and another 7% from the village Priluzje and Plementina come. There was a increase in the number of incoming children in January and Febuary. And then the same time, in september and October. Half of the healed childrens age varies up to 2 years old. In a period of 6 days, they are able to heal 72, 6% of children. In the 94 stuctured diagnosises, they were able to show all the morbidity. Dominating sickness of the respitory system, in the winter season. And the digestive system in the fall season.

Rheumatoid arthritis is a complex disease, which produces articular symptoms and damage, leading to disability. The aim of the study was the estimate frequency comorbidity, functional ability of patients with rheumatoid arthritis.This study included 60 patients (48 female and 12 male) with rheumatoid arthritis, mean age 53,92±7,06. Anatomical stage and functional class were analyzed according to Steinbrocker`s criteria. Functional disability was perfo-rmed using health assessment questionnaire (HAQ) score. Comorbidity was observed in 36 (60%) of patients (33 female and 3 male). Hypertension were found in 19 (31,67%) of patients, whereas 8 (13,33%) of patients had diabetes. It was established that 7(11,67%) of patients suffered osteoarthritis. The median HAQ score was 1,25±0,70. Poorer functional status was observed in 40% of the patients with comorbidity (HAQ score ≥2), than in the group of patients without comorbidity (21,67 %). The results of the study are showing large frequency coexisting disease in patients with rheumatoid arthritis. The frequency of hypertension and diabetes was greater comparing to general population. The patients with rheumatoid arthritis show harder anatomical stage and comorbidity and greater functional disability, as compared to the patients without coexisting disease.

Background: Cardiovascular disease is the predominant cause of morbidity and mortality in hemodialysis patients. Left ventricular hypertrophy is a major cardiovascular risk factor in hemodialysis patients.The present study was aimed at assessing the prevalence of left ventricular hypertrophy by doppler echocardiography in hemodialysis patients. Methods: We studied 20 patients on maintenance hemodialysis in Dialysis Centre in Kosovska Mitrovioca. LV mass was measured by both Doppler echocardiography. Left ventricular mass was estimated by the modified formula using measure2 ments obtained in accordance with the Penn convention. Left ventricular mass was divided by body surface area in m to obtain the left ventricular mass index. Results:This clinical observation study involved 20 patients (9 males and 11 females) with end-stage renal diseases undergoing maintenance hemodialysis with a mean age of 55,26 years, mean time on dialysis was 38,74 months. Main causes for developing chronic renal failure was arterials hypertension and polycystic kidney. Arterial hypertension (60%), diabetes mellitus (20%) and hyperholesterolemia (10%), were the most frequent risk factors for cardiovascular disease among the dialysis patients. Left ventricular hypertrophy were detected in 14 (70%) patients. Mean left ventricular mass wass 153,62g/m2 (males), and 142,71 g/m2 (females). To conclude, the present study shows that hemodialysis patients have higher left ventricular mass and higher prevalence of left ventricular hypertrophy.

The most important characteristic of calcium channels is a selective regulation of a slow incoming current of calcium into the tissue cells with tendency of a slow growth of the action potential. Such tissues include smooth muscles of the blood vessels, cardiocities and hearth noduses (AVand SAnode). Different calcium antagonists have different influences on the mentioned tissues, because they also have different chemical components. Verapamil, Nifedipin and Diltiazem have the most common usage. Verapamil is a product of papaverine, nifedipin is a product of dehydroperidine while diltiazem is a product of benzodiazepine. Their common characteristic is blocking the calcium channels which cause blood vessels vasodilatation, negative inotropic and negative chronotropic influence. By blocking calcium to enter through channels spores of miofibrile smooth muscles, calcium antagonists are reducing the amount of available calcium for contraction, which causes vasodilatation. One of the best-known and the commonest calcium antagonist is verapamil. In electrophysiological terms, it inhibits action potential of the heart noduses (especially AV node), where the most important thing for depolarisation, is a slow entrance of calcium. By extending the refractory period of SA node, it reduces the frequency of impulse generation (heart frequency), while by extending the refractory period of AVnode, it slows down the work of chambers in cases of flater and atrium fibrillation. Taking into consideration the fact that verapamil shows cardiodepresive effects, the aim of our work is to study closely its effects on electrocardiogram and hemodynamic parameters. The experiment was conducted on six adult, healthy dogs which were, after 10 minutes 0,9% NaCl infusion, treated with i.v. bolus verapamil injections on every 5 minutes until the appearance of intoxication signs, which causes bradycardia, heart rhythm disorder and the fall of arterial blood pressure. The average verapamil dose was 4 mg per kilogram. After i.v. verapamil administration, heart frequency and middle arterial pressure have a significant fall, while central venous pressure has a significant rise. Larger verapamil doses nd rd can significantly extend T-P and P-R interval with the appearance of AV-block (2 and 3 grade), while the Q-T interval doesn't show any significant change.

Conclusion about efficacious of some medication can be given based on reducing morbidity and mortality in patients treated with that medication.. Aim of this work was to estimate intrahospital mortality in patients with acute myocardial infarction (AMI), role of myocardial reinfarction in that and side effects of medications in patients who were different treated in initial phase of AMI, based on what they were separated in three different therapeutic groups: group treated with thrombolytic therapy, group treated with beta-blockers and group treated with nitrates. It was shown that intrahospital mortality is highest in patients treated with nitrates but there was not significant difference between thera-peutic groups in frequency of myocardial reinfarction while frequency of complications and side effects were in range as in others similar studies.

The Early Warning Score is a simple physiological scoring system that can be calculated at the patient's bedside, using parameters which are mesured in the majority of unwell patients. Patients suffering in-hospital cardiac arrest often have abnormal clinical observations documented prior to the arrest. Study objestives:This study assesses wheather these patients have less favourable outcome following in-hospital cardiac arrest. Matherials and the methods:For the present study, the patients' hospital charts were reviewed to identify possible abnormal observations within 8 h prior to the arrest. Results: From the total of 100 patients who sufferd in-hospital cardiac arrest, 64 patients had documentation of vital signs and 9 patients had no documentation of vital signs. Of the patients with documented vital signs 27 (29,7%) had normal vital signs and 64 (70,3%) had abnormal observations. Among these 64 patients the distribution was as follows: 17 patients (13,1%) had respiatory rate below 8 or over 20 per min, 40 (30,8%) had puls rate below 40 or over 140 beats per min, 20 patients (15,4%) had systolic arterial blood pressure below 90 or over 200 mmHg, 5 (3,7%) had temperature (˚C) below 36,1 or over 37,9 ˚C, 20 (15,4%) had oxygen saturation below 90%, 14 (10,8%) had decrease in consciousness and 14 (10,8%) had urine output below 50 ml/2hours). Compared with patients whose EWS were 0-2 (ОR 1,2; 95% CI: 0,935-1,507) patients with EWS 3 or more were 6,5 times more likely to die in first 24 hours (OR: 7,8; 95% CI: 1,205-50,205). Conclusions:Patients with documented clinically abnormal observations prior to in-hospital cardiac arrest have a worse outcome than those without. The main implication of these is that these patients need to be identified in time thereby possibly avoiding arrest. This can also be used when assessing the prognosis of in-hospital patients after achieved ROSC.

Endometrial carcinoma is still one of the most common malignant tumor of the female genital system in the most industrialized countries. Endometrial cancer is due to 3,9% of all female malignant tumors. The occurence of endometrial cancer varies with age. In 75% of all cases endometral carcinoma tipically occurs in postmenopausal women, with the highest incidence between 50 and 59 year. The high frequence of endometrial carcinoma in younger age is also found in women with ovarian estrogen-secreting tumors. About 10% of all endometrial carcinomas also in association with a genetic predisposition, but the most cases of endometrial carcinomas are sporadic. The most important prognostic factors for endometral carcinomas are: clinical stage, age, histopathological type and grade, as wel as hormonal receptors. Younger nulliparous women with early detected well-diferentiated endometrial carcinoma are usually treated by high doses of progesterone. Older women with endometrial carcinoma are usually treated by hysterectomy. Administration of postoperative radiation and chemiotherapy depends on clinical stage.

Helical ventricula myocardial bend of Torrent-Guasp is the revolutionary new concept in understanding global, three-dimansional, functional architecture of the ventricular myocardium. Anatomy of the VMB, and recent proofs for its segmental electrical and mechanical activation, undoubtedly indicates that ventricular filling is the consequente of an active muscular contraction. Specific septal arrangment of the ascedent segments fibers, their interaction with adjacent descedent segment fibers, elastic elements and intracavitary blood volumen explein the physical principes involvel in this action. Understanding this mechanism cudld be of particular importance in our efforts to prevent and treat diastolic heart failure.

Autors reports 20 ten old boy received penetrating vulns thorasic with naif at midle linea.subksifoid area. Patient with angina pectoris, hypovolemic shock end cardiac arrest received at department intensive care Clinic hospital centre Prishtine in Gracanica. In cardiogenic arrest under reanimation is introduction in general endotracheal anestesy and intervention surgery. Maden midle sternotomy and verification laesio pericardii under right cordis longth of 20 mm,hematopericard and vulnus at parietis diaphragmalis right ventricular in area septoapicalis.Past evacuation sangui from pericard heart mobilisation and made compresion phingin.Placement closure laesion with cardiorraphia prolen 0000 sec.Cooley.Lesion right pleurae mediastinalis and placement drain in right torasic cavum and drain mediastine in restrosternal area i aspiration undervother sec. Bilay. Fixation sternum with fillum metalicum sec. Kurschner. Reanimation intensive care all time and past realisation complete haemostasis along linae sutturae heart folow up substitution adecquat failure volumen total sangui plasm and cristolid. Realisation total stability hemodinamic and patient move at department intensive care. Control EKG, echocardiography and cardiac ensims 5 and 10 dely psotoperative show fingins corectly. Not signs ischemic laesaoin and disfunction conducti and arrhythmi. Haert pariets is all corectly viability and cinesy.