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Background/Aim. The role of the complex sepsis-related immune response has not been fully clarified and remains a subject matter of investigation. Nowadays, sepsis is considered a dynamic syndrome characterized by many, often antagonistic phenomena, ranging from hyperinflammation to anergy and immunoparalysis. The aim of the study was to determine, based on the level of pro- and anti-inflammatory mediators in critically ill patients with secondary sepsis, whether the cytokine profile differs according to the type of bacterial causative agent, as well as to assess the prognostic value regarding the outcome. The outcome measure was in-hospital mortality. Methods. Blood serum samples were taken from 125 critically ill patients admitted to the Surgical Intensive Care Unit with severe secondary sepsis as a consequence of peritonitis, pancreatitis, or trauma. The average age of the patients was 57.7 ± 17.3 years. Of the total number of patients, 84 (67.2%) were males, and 41 (32.8%) were females. The levels of pro-inflammatory interleukin (IL)-1α, IL-1β, IL-6, IL-8, IL-12р70, IL-17А, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, IFN-γ-inducible protein-10 (IP-10), monocyte chemoattractant protein-1(MCP-1), macrophage inflammatory protein (MIP)-1α and MIP-1β, as well as anti-inflammatory mediators IL-4, IL-10, IL-13, IL-27, IL- 31, and IL-33, were determined at three time intervals – on the day of admission (the first day) and then on the third and fifth day. The type of the bacterial causative agent was determined using standard microbiological analyses. Results. On the third day of measurement, significant differences in the cytokine levels regarding the nature of bacteremia were determined in all pro- and anti-inflammatory cytokines, except for IL-8. In general, the lowest levels were observed in patients with polymicrobial blood cultures. On the first and fifth days of measurement, no significant differences in the cytokine levels regarding the nature of bacteremia were found. The only significant predictor of the fatal outcome on the first measurement day was IL-17А, Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of 0.665 (95% confidence interval 0.519–0.791; р = 0.034) in the patients with secondary sepsis as a complication of peritonitis. Conclusion. According to the type of bacterial causative agent, the lowest levels of cytokines have been observed in patients with the polymicrobial blood culture. The low level of IL-17А on the first day of measurement is a good predictor of a fatal outcome in patients with peritonitis as an underlying condition of secondary sepsis. On the other hand, the levels of other cytokines correlated with the out-come only on the fifth day of measurement, and they were higher in survivors than in non-survivors.

Pepper is one of the most important vegetable species in Serbia. The use of pepper fruits is very often determined by their type. Tomato-shaped pepper is a fruit type suitable for the pickle processing industry because of its thick pericarp. In this study, several lines of light-yellow tomato-shaped peppers were evaluated in the open field with the aim to develop new variety with appropriate fruit characteristics and without anthocyanin colouration. Eight of selected lines originated from two crosses while two lines originated from variety Novosađanka. Fruit weight, fruit length, fruit width, fruit index, pericarp thickness, number of locules, and Brix were measured in technological maturity. According to the obtained data, lines 17 and 24 will be used for further selection process. Line 17 was chosen because of the highest pericarp thickness and high fruit weight and line 24 because of the high content of total soluble solids.

Introduction. Melanoma is a solid aggressive tumor characterized by the malignant transformation of melanocytes. To date, only about 35 primary and about 30 metastatic malignant melanomas of the bladder have been reported. Our objective is to report a rare case of secondary tumor of urinary bladder. Case outline. A 57-year-old man presented to the Urologic Clinic due to lower urinary tract symptoms. The urologist indicated transurethral resection (TUR). His medical history was significant for cutaneous malignant melanoma resected 3 years prior, which were localized at scapular region on the left side. Microscopic examination of the TUR specimen showed several fragments of ureter mucosa with presence of tumor and focally with normal urothel. Tumor cells were markedly atypical and polygonal in a solid pattern. The nuclei were large with variation in size and prominent eosinophilic nucleoli. Also, there were present areas with abundant brown pigment. Immunohistochemical analysis of tumor cells showed positivity for Melan A and HMB45 and negativity for GATA3. Molecular analysis showed that BRAF was mutated. Conclusion. The incidence of malignant melanoma is high and increasing, but the urinary bladder is a rare location of metastasis. However, both primary and metastatic melanomas can occur in the bladder, so the urologist and the pathologist have to consider it when it is the primary site of onset, or when it represents the first symptomatic metastasis.

Seed as a highly-valuable resource is preserved in collections for many years. Although the seed is kept under optimal conditions, monitoring of germination and the presence of fungi during seed preservation is of great importance. Therefore the aim of this paper is to examine the seed health status and germination of 43 onion accessions kept in the timespan for 15 years in the Institute of Field and Vegetable Crops collection. Germi­nation of seed samples varied from 7-93%. The presence of fungi in the collection was determined on 33 tested samples. Fungi from the genera Acremonium, Alternaria, Aspergillus, Cladosporium, Epicoccum, Fusarium and Penicillium were developed. The following Fusarium species identified on the seeds were F. proliferatum, F. graminearum, F. sporotrichioides, F. solani, F. pseudograminearum and F. equiseti. Based on factor analysis, Fusarium and Penicillium affected germination, while the occurrence of Alternaria species on onion seed is connected to the year of harvest.

Background/Aim. Randomization allows for study groups to be formed so that they are similar in all characteristics except outcomes. The aim of this study was to examine the frequency of randomization methods and their effect on achieving baseline balance in cluster randomized studies conducted in schools. Methods. A literature search of the Medline bibliographic database showed that the total number of collected articles in the full text was 343, out of which 81 were eligible for inclusion. Each publication was reviewed by two independent reviewers, and data were extracted and analyzed. Results. Stratification was the most commonly applied randomization method, reported in 28 trials (34.6%). There was no statistically significant difference in the number of subjects and clusters, as well as in cluster size between trial groups in studies in which simple randomization was applied. However, there was a statistically significant difference in the number of subjects and clusters between groups in trials in which restricted randomization methods were used. Yet, there was no difference in the cluster size. Conclusion. Although there is no difference in the size of clusters between trial arms, either at the level of the entire sample or in relation to randomization methods applied, additional research should be conducted on a larger sample in order to establish the effect of randomization methods on baseline balance, when the size of clusters is in question.

Intrduction. Tacrolimus (fujimycin or FK506) is a potent immunosuppressive drug with growing usage. It is usually used in prevention of transplanted organ rejection. Its use is highly valuable, but like other immunosupressants, it has adverse effects. One of them is optic neuropathy. Case report. A 47-year-old white male patients who had received tacrolimus therapy for nine years, after kidney transplantation, developed a subacute, painless vision loss on both eyes. He was thoroughly examined on different possible optic neuropathies and other causes of vision loss. After exclusion of other possible causes, the diagnosis of toxic optic neuropathy was established. His therapy was converted to cyclosporine, by his nephrologist, but his vision had improved only slightly. Conclusion. Toxic optic neuropathies are presented in everyday ophthalmological practice, but they are underestimated. Diagnosis can be demanding, especially when it comes to drugs and substances whose possible toxic effect on the optic nerve is not widely known. Unlike other adverse effects of tacrolimus therapy on nervous system, optic neuropathy can causes great and permanent functional impairment.

Introduction. Mucinous tubular and spindle cell carcinoma of the kidney (MTSCC) is a rare and recently described subtype of renal cell carcinoma (RCC). As its name indicates, the tumor is composed of three morphological structures: tubules consisted of cuboidal cells, spindle cells, and extracellular mucus. Case report. A 59-year-old female patient was admitted to the Emergency Center of the Clinical Center of Vojvodina due to injuries sustained in a traffic accident. After diagnostic procedures, computer tomography (CT) revealed a large asymptomatic cyst of the upper pole of the left kidney as an incidental finding. Four months later, after recovering from traumatic injuries, a control CT confirmed a well-circumscribed tumor, 90 mm in diameter, confined to a kidney, and a radical nephrectomy was performed. Histopathological evaluation showed that the necrotic tumor mass consisted of tubules made of cuboidal cells and cords made of spindle cells separated by pale mucinous material in some areas, while other tumor parts were of dense cellularity without mucin. No atypia was found. Conclusion. MTSCC is a variant of papillary RCC, thus, it is usually mistaken with papillary RCC with sarcomatoid differentiation. Because of the same immunoprofile as papillary RCC, histomorphology is imposed as the gold standard for making the diagnosis. MTSCC is a tumor with a generally favorable prognosis, and complete surgical excision appears to be adequate treatment, but single cases with metastatic disease have been reported. In this case, there were no signs of the dis-ease one year after surgery.

Background/Aim. Contrast echocardiography (CE) is an echocardiographic modality where ultrasound contrast echocardiographic agent (CEA) is introduced peripherally for the image enhancement. The aim of this study was to present the initial clinical experience of the use of CEA Optison™ (GE Healthcare, Princeton, NJ) at the Institute for Cardiovascular Diseases of Vojvodina, Serbia and prospectively monitor the occurrence of possible side effects. Methods. A total of 357 patients were referred for resting or stress echocardiographic examinations, with an approved indication for CEA administration. The average age of patients was 63.3 years (range, 21–92 years), 62% of them were men. Most of the patients (77.31%) had some form of ischemic heart diseases. Hypertension was the most frequent risk factor (77.03%), but 57 patients had diabetes mellitus and 33 patients had chronic kidney disease as comorbidity. Most (90.5%) of the patients were on beta blocker therapy, 83.5% of them on angiotensin converting enzyme/angiotensin receptor blockers. Majority (80.3%) of the patients received single or dual (49.5%) antiagregation therapy, 74 (26.3%), of them were on anticoagulation therapy, 55.1% of the patients were taking diuretics. The global ejection fraction (EF) was preserved in 39.85% of them, the majority (136 of them), had left ventricle (LV) impairment, with an EF less than 50%. Patients were followed up for 30 minutes after CEA administration for potential side effects. In 118 patients, vital signs (heart rate, oxygen saturation, body temperature, systolic and diastolic blood pressure) were measured before and 30 minutes after CEA administration. Results. The administration of CEA was not associated with side effects. Diastolic blood pressure drop and heart rate increase were statistically, but not clinically significant (p = 0.027 and p = 0.028, respectively). Conclusion. Changes in analyzed vital signs were clinically non relevant. CE is a safe noninvasive diagnostic modality for patients undergoing rest and stress echocardiography.

Background/Aim. In planning the extraction of posterior teeth, it is necessary to determine their position and correlation with the surrounding anatomical structures. The aim of this study was to perform Cone Beam Computed Tomography (CBCT) analysis in order to evaluate the predictive value of specific orthopantomography (OPT) radiographic signs in determining the proximity of posterior upper teeth to the maxillary sinus and lower teeth to the mandibular canal. Methods. In a prospective study, 460 cases out of 423 patients were analyzed. Seven OPT radiographic signs were assessed to determine the correlation of the third molars to the mandibular canal, while five radiographic signs were followed to determine the correlation of the maxillary sinus floor to the upper posterior teeth. For each OPT radiographic sign, a precise analysis of the axial slices of the CBCT was performed. Results. Interruption of the white line is a radiographic sign showing statistically significant interruption of the integrity of the mandibular canal on the CBCT axial slices (p = 0.002). Also, diversion of the inferior alveolar canal at the axial sections showed statistically significant interruption of the continuity of the mandibular canal (p = 0.003). A radiographic sign, Darkening of the root, showed super-imposition of the anatomical structures, a close relationship with the tooth but often with preserved mandibular canal integrity (p < 0.001). Absence of lamina dura, interruption of the maxillary sinus floor's cortex, and projection of the root apices in the sinus cavity were radiographic signs that were statistically the most commonly associated with interruption of maxillary sinus integrity on CBCT axial slices (p < 0.001). Conclusion. The results of our study indicate that the presence of certain radiographic signs on the OPT may have predictive significance. The exact relationship between anatomical structures and posterior teeth cannot be accurately estimated on OPT. The precise position of the molars and correlation to the mandibular canal and the maxillary sinus can be accurately determined by CBCT imaging.

In this paper author discusses the characteristics of discourse on modern terrorism. When it comes to the terrorism ordinary people gain knowledge mostly through media. The influence of specific image of terrorism is not limited to citizens who live in countries which faced with a terrorist threat or concrete attack but goes further to the different part of the world, some of them very far from the possibility of terrorist attack. Demystification of discourse on modern terrorism begins with analysis of the phenomenological dimension of modern terrorism, in terms of being defined and assigned. We can talk about two different approaches: older and newer, in understanding the terrorism. The new approach gains momentum with the events of 11 September and took shape after similar events on European continent. At the core of understanding of modern terrorism is the discourse on religious-based Islamic terrorism. Specific discourse on modern terrorism affects how it is understood by the general public, and it influences, in particular, the creation of stereotypes about a modern terrorists and the spread of fear of terrorism. The formation and maintenance of stereotypes about modern terrorism, which emphasizes the role of Islam and members of the Islamic community in planning and carrying out terrorist actions, creates a growing gap among people, especially in countries affected by terrorist attacks. The discourse on modern terrorism also implies an appropriate perception of the risk of terrorism all over the world. From that point of view risk of terrorism is real and constant. Similar situation is in Serbia and in that sense the results of limited research about perception of terrorism in Serbia presented in work show to a certain extant the existence of such global influence.

Introduction. Solitary fibrous tumor is a neoplasm that arises most commonly from the pleura, but can occur at other sites. Intrapulmonary solitary fibrous tumor has been rarely reported and therefore is not well recognized. Case outline. We report a case of an asymptomatic 63-year-old woman in whom a large, well-circumscribed mass was incidentally revealed on chest X-ray during preparation for ergometric cardiac testing. Chest computed tomography revealed an abnormal nodule in the lower right lung lobe. Mediastinal and hilar lymphadenopathy was not detected. After transthoracic fine needle aspiration, cytology showed a finding suspicious for spindle cell tumor. Consequently, right anterolateral thoracotomy with right lower lobectomy was performed. On gross examination, the lower right lobe was almost completely replaced with abnormal, white-yellow, well-demarcated solid nodule measuring 13.5 cm in its largest diameter surrounded by a pseudocapsule. After histological examination and applied immunohistochemical analysis, a diagnosis of intrapulmonary solitary fibrous tumor of low malignant potential was set. Due to the presence of unfavorable prognostic parameters (tumor size, as well as the presence of hypercellularity), more frequent follow-up check-ups were recommended. Eighteen months after surgery, the patient remained uneventful, with no evidence of tumor recurrence. Conclusion. Intrapulmonary solitary fibrous tumor is a rare entity challenging for diagnosis, because variegated histology and variability of its growth patterns can resemble other soft tissue tumors. The treatment of choice is complete excision with clear surgical margins, but since morphology cannot be a reliable predictor of clinical behavior, the patients need a long-term follow-up.

Introduction/Objective. Body fat percentage (BFP) is the most reliable indicator of the nutritional status. For clinical practice, it is important but also insufficiently examined whether the determination of BFP should be relied exclusively on the latest methods or whether classical anthropometric methods are also reliable. The aim was to investigate the correlation between the results of BFP measuring using a contemporary method of bioimpedance and classic methods of skin fold thickness (SFT) and body mass index (BMI). Method. There were 279 patients of the Dietetic Counseling Center of the Institute for Public Health in Niš who were included in the research during 2015. BFP was determined using three classic anthropometric methods: SFT over the triceps, SFT over the scapula, and BMI. OMRON BF 302 apparatus was used for BFP measuring using the bioimpedance method. Results. Using single-factor analysis of variance we found a statistically significant difference between the mean values of the BFP obtained with bioimpedance and those obtained with anthropometric methods (F = 24.19, p < 0.05). Post hoc analysis revealed a statistically significant difference between the BFP determined with bioimpedance and SFT over the triceps and the scapula, while the anthropometric method based on BMI gave the results similar to those from bioimpedance. Conclusion. We show that the most reliable anthropometric method of determination of BFP is that based on BMI, as its results correlate best with those obtained with a contemporary method of bioimpedance.

Introduction: The circle of Willis is the major source of collateral blood flow between the carotid and vertebrobasilar system. Its potential depends on the presence and size of arteries that vary greatly among normal individuals and therefore their adequate observation by a radiologist is necessary. Aim: Determine the type of the circle of Willis and their frequency. Determine the type, frequency and localization of anatomical variants of arteries, as well as their average diameter. Compare these variables according to the age and gender of the examinees. Material and methods: A retrospective study was performed at the Center for Radiology of the Clinical Center Nis during 2017. All subjects underwent CT or MR angiography according to a standard endocranial protocol. The anterior and posterior parts of the circle were specially observed, with an emphasis on the presence or absence of anatomical variants of the arteries, with the measurement of their diameter. The obtained data were classified into variants of the front or rear part of the ring as well as the type of ring according to integrity. The frequency of these variables and their comparison by sex and age were measured. Results: The research included 92 examinees. According to the configuration of the Willis arterial ring, the adult type was the most often represented (71.7%). The most common type in terms of integrity was partially complete. The most common anatomical variants obtained in our work was aplasia of AcoA (27.2%) and aplasia of one or both PCoA (21%). PcoA hypoplasia was occured in women with a frequency of 13.5% while in men it was not present. Conclusion: Adequate understanding of the morphology of the circle of Willis by radiological methods is a good guide for neurosurgical and radiological intervention procedures. In this way, potentially significant neurological complications and the risk of morbidity and mortality could be reduced.

In this paper, the author discusses the social context of moral panic, ie the role of various social factors in the creation of moral panic. Starting from the known mechanisms of moral panic (traditional and newer), the author considers the roles of the subjects of informal and formal social control in this process. In that sense, it stands out the activity of various moral activists as representatives of the informal social structure who, by propagating the importance of moral protection, often participate in the process of creating of many moral panics. On the other hand, the activities of formal social control bodies are regulated by an appropriate legal frame-work whose task is to solve the problem of crime in society. This implies a professional attitude of the police, the prosecution and the courts in terms of combating crime. The author points out the problem of the participation of the representatives of these bodies in the creation and development of moral panic, considering it in the context of the culture of control, ie its elements, emphasizing especially the role of the police. The author connects all the mentioned segments of the social function of moral panic with the role of the media as an unavoidable factor in the process of moral panic. At the end of the paper, the author emphasizes the importance of the role of the media in raising awareness of the importance of individual actions of all social actors in order to avoid their participation in the creation of moral panic that unfavorable affects on solving the problem of crime.

Background/Aim. Periodontal disease is an inflammatory disease that occur in the tissues surrounding the teeth in response to bacterial biofilm accumulation (dental plaque). Among others, Tannerela forsythia (Tf) was recognized as one of the most significant and specific bacterial species in periodontal pocket („red complex“ bacteria). Atherosclerosis is a progressive narrowing of arteries that may lead to occlusion, as a consequence of lipid deposition. It underlies coronary heart disease (80%), as well as myocardial and cerebral infarctions. Increasing evidence over the past decade suggests a link between periodontal disease and atherosclerosis, where Tf can enter the systemic circulation directly or indirectly, and be present in atherosclerotic blood vessels. Therefore, the aim of this study was to detect the presence of Tf in atheromatous plaques obtained from different blood vessels in patients with chronic periodontitis. Methods. Ninety patients (male 61, female 29) with periodontal disease and atherosclerosis [recruited for either carotid artery stenosis requiring endartectomy or percutaneous transluminal coronary angioplasty (PTCA)] were included in this study. Clinical periodontal examinations consisted of plaque index (PI) (according to Silness Lӧu), gingival index (GI) (according to Lӧe Silnes), sulcus bleeding index (according to Mühleman-Son) and periodontal probing depth (PPD). Presence of Tf in periodontal pockets and atherosclerotic vessels was detected using polymerase chain reaction (PCR) method with positive control Tf ATCC 43037. Results. Tf was present in subgingival plaques of 68 (75.6%) of the patients, while its presence in atheromatous plaques were registered in 42 (53.3%) of the patients. It was significantly present in coronary blood vessels (41.7%), followed by carotid arteries (35.4%) and a. abdominalis aneurism (12.5%), a. mamaria (8.5%) and a. femoralis (2.1%) while in a. iliaca Tf was not detected at all. Conclusion. The present study suggests strong relationship between periodontal inflammation and atherogenesis; therefore, it should be considered as potential risk factor for atherosclerosis. Accordingly, it would be necessary to control periodontal disease in order to reduce mortality and morbidity associated with atherosclerosis.

Introduction. Partial atrioventricular septal defect (AVSD) is a form of congenital heart disease (CHD) rarely detected in adults. Infective endocarditis represents a severe complication that carries a substantial risk. Case report. We here reported a case of a 43-year-old female with previously diagnosed adult CHD (partial AVSD and bicuspid aortic valve) presented to the hospital with fever and malaise 14 days prior to admission. On the lung computed tomography scan inflammatory consolidations were found and dual antibiotic therapy (ceftazidime and clarithromycin) was administered without significant regression of pulmonary inflammatory consolidations. The antibiotic treatment was continued with amoxicillin/clavulanic acid combined with levofloxacin and metronidazole. Transthoracic and transesophageal echocardiography revealed a large vegetation (dimension, 3.6 x 1.8 cm) attached to the septal leaflet of the tricuspid valve floating between right atrium and right ventricle through tricuspid valve with high embolic potential. Endocarditis team reached a decision for immediate surgical intervention. The operative findings revealed the partial AVSD, common atrioventricular valve with cleft of the anterior mitral leaflet in the A2 segment and detached and cleft septal leaflet of the tricuspid valve. Vegetation (size 4 x 3 cm) was attached to the septal side of the tricuspid annulus, basal segment of the anterior mitral leaflet and edge of the atrial septal defect freely floating between right atrium, right ventricle and left atrium. Excision of the vegetation and AVSD plastics were done, as well as the reconstruction of the mitral and tricuspid annuli and leaflets. The treatment was continued with antibiotics and completed in 18 days with full recovery. Conclusion. Early and precious diagnosis and optimal management that combines both conventional and surgical approaches are crucial for reducing the risk of complications and mortality in patients with infective endocarditis in grown-up congenital heart disease.

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Introduction. The incidence of aortic dissection ranges 3–5 cases per 100,000 person-years. In women under the age of 40 who acquire aortic dissection, almost half of the cases happen during pregnancy. Case outline. We report a case of a 22-year-old pregnant woman in the 16th gestational week with a history of arterial hypertension and known aortic dilatation, who was admitted with aortic dissection. She underwent the Bentall procedure, in which her aortic valve, ascending aorta, and proximal part of the aortic arch were replaced using valved composite graft. On the next day, the evacuation abortion was made, since the fetus didn’t survive the operation. Six years later, the patient stopped taking anticoagulation therapy and was admitted for prosthetic valve thrombosis, which was successfully treated with intravenous heparin. One year later, the patient died of a myocardial infarction due to coronary thromboembolism, confirmed on autopsy. Conclusion. Preconceptional counseling in women with a known aortic disease is of the utmost importance. Aortic dissection in pregnant women is an acute life-threatening condition for both mother and fetus that should be managed by a multidisciplinary team. After a mechanical heart valve implantation, lifetime oral anticoagulants are mandatory.

Introduction/Objective. Heroin is metabolized to 6-monoacetylmorphine (6-MAM) and morphine. The objective of this study is to examine 6-MAM, morphine, and codeine relationships in order to distinguish deaths related to heroin consumption from deaths related to morphine and/or codeine consumption. Methods. The autopsy blood and urine samples from 45 opioid drug addicts were examined. Gas chromatography/mass spectrometry was applied to evaluate morphine, 6-MAM, and codeine. Two groups were formed: 6-MAM-positive (n = 35) and 6-MAM-negative (n = 10). Results. Compared to the 6-MAM-negative group, blood morphine levels were higher in the 6-MAMpositive group (p = 0.022), while blood codeine levels were similar (p = 0.575). In the 6-MAM-negative group, the blood morphine/codeine ratio was 8.3, and it was 4.3 in the 6-MAM-positive group. There was no difference between the groups regarding urine morphine levels (p = 0.859). The urine morphine/ codeine ratio was 6.2 in the 6-MAM-negative group, whilst it was 32.2 in the 6-MAM-positive group. In the blood samples, morphine and codeine concentrations were significantly correlated (r = 0.607; p = 0.006). In urine samples, correlations between morphine and codeine (r = 0.766; p < 0.001), morphine and 6-MAM (r = 0.650; p < 0.001), as well as codeine and 6-MAM (r = 0.620; p < 0.001), were also significant. Conclusion. Analyses of 6-MAM and morphine/codeine ratio in blood and urine autopsy samples may be used as diagnostic tools to distinguish deaths related to the consumption of different opioid drugs.

Introduction The ventricular septal defect (VSD) incidence today is less than 1%. It presents with a rapid clinical deterioration and acute heart failure. A loud systolic murmur appears over the precordium. Doppler echocardiography is the golden standard for diagnosis. Case Report A female patient was admitted to the hospital with the diagnosis of an acute myocardial infarction with the involvement of the inferior wall and right ventricle. At admission, a loud systolic murmur above the precordium was noted and an emergency echocardiography was performed. A suspected interruption of the interventricular septum continuity was registered at the inferoseptal level. An emergency coronography was immediately performed to uncover a subocclusion of the medial segment of the right coronary artery. Ventriculography was performed in the same act and passage of contrast was registered from the left ventricle to the right at the septal level. A cardiac surgeon was consulted, but the patient died while being prepared for surgery. Conclusion Keeping in mind the high mortality rate, a prompt diagnosis and aggressive treatment with a timely surgical intervention are necessary to enable a favorable outcome. Poor prognosis parameters are advanced age and a myocardial infarction involving the inferior wall, which were both present in our patient.

Introduction: Bronchiolitis is an acute viral disease of lower respitatory pathways in children under 2 years of age. It is manifested by coughing, whistling and refusing food intake. The most common cause of bronchiolitis is a respiratory syncytial virus. Vitamin D is a steroid hormone which is synthesized in the skin after sun exposure or food intake. With discovery of Vitamin D receptors and hydroxylated enzymes in immune cells, a potential role for Vitamin D in maintaining immune homeostasis was seen. It has been established that Vitamin D induces a change of the antimicrobial polypeptide, cathelicidin, which has both antibacterial and antiviral roles. Objective: Determine whether the serum Vitamin D levels in acute viral bronchiolitis patients from Central Kosovo is lowered. Methods: This prospective study included 34 children aged up to 2 years, that have been diagnosed with the heavy form of acute viral bronchiolitis. Blood was drawn from all subjects to analyze serum Vitamin D levels. Results:Average levels of Vitamin D, measured in all subjects, was 35.5 ng/ml. After Vitamin D levels stratification, 62% of the subjects had normal levels of serum Vitamin D, while 38% of the subjects had lower levels of serum Vitamin D. 15% of children had lower levels than 20 ng/ml. With children of ages up to 12 months there was a statistical significance of negative direction between Vitamin D serum levels and body height (r=-0.683, p=0.010) and between Vitamin D serum levels and body weight (r=-0.725, p=0.005). With children of ages up to 24 months there was only a statistical significance of negative direction between Vitamin D levels and body height (r=-0.540, p=0.011). Conclusion: Our research confirmed that children with acute viral bronchiolitis have a significant deficiency of Vitamin D, although it's a required addition to nutrition for children under the age of 2 years.

Background/Aim. Tuberculosis in the second decade of the 21st century is an infectious disease with the highest mortality rate. In addition, in developed countries, pneumonia is the major couse of morbidity and mortality in adults. The aim of our study was to point out the differences and similarities between symptoms, laboratory parameters and clinical indicators in patients with pulmonary tuberculosis (PTB) and patients with pneumonia in the general population and in people belonging to the high risk groups for developing tuberculosis. Methods. This prospective study included patients with PTB (n = 70) and pneumonia (n = 75) treated at the Pulmonology Department of Clinical Hospital Center in Kosovska Mitrovica. Results. PTB was more frequent in men, 30–39 years of age (OR; 6:08), mainly from rural areas (p = 0.001), and with lower levels of education (p = 0.031). Pneumonia was more frequent in women older than 60 years of age (p = 0.0012). Night sweats (p = 0.001) and weight loss (p = 0.062) were significantly more frequent in patients with PTB, while chest pain (p = 0.001) and high temperature (p = 0.036) were more common in patients with pneumonia. X-ray changes in patients with PTB were located in the upper fields (p = 0.001), or appeared to be bilateral (p = 0.004). The strongest predictor associated with an increased risk of night sweats was diagnosed PTB (OR = 30.0). The chest pain was a predictor of pneumonia, unilateral changes (OR = 4.65) in the lower lung fields (OR = 0.08). Conclusion. Night sweats, weight loss and chest X-ray abnormalities in upper fields were significant indicators of PTB. Chest pain, fever and chest X-ray abnormalities in lower fields were significant indicators of pneumonia.

The most significant prostate diseases (PD) are benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia (PIN) and prostate cancer (PC). Generally, all PD are rare before the age of 50 with growing number of patients, primarily with BHP, with each next decade, but about decade later the highest number of PIN and PC began to report. The aim of this paper is to examine some of clinical, biochemical and histopathological characteristics of BPH, PIN and PC. Our sample consisted of 169 men. Statisticaly the most common PD was BPH-77.5%, and the rarest PIN-8.3% (p

The paper deals with the issue of moral panic in the context of domestic violence, which as a phenomenon causes great public attention in many countries. The phenomenon of domestic violence has become more visible in our country after the introduction of a special incrimination into the Criminal Code of the Republic of Serbia. In addition to the positive effects of this change reflected in the greater interest of all social actors and in particular the law enforcement agencies to combat domestic violence, there is a negative side that manifests itself through a moral panic. Excessive and inadequate media reporting causes the creation and maintenance of certain stereotypes and misconceptions regarding the extent and characteristics of domestic violence or the actors of this form of crime. In particular, the stereotypical presentation of men as abusers and women and children as victims, as well as media excessive dealing with the heaviest forms of domestic violence, which rarely occur and statistically make a very small share in the total number of all domestic violence cases. It should be kept in mind that most of the cases of domestic violence in which men are victims are hidden, as well as easier forms of domestic violence that are most commonly occurring but which are not media-interest. At the end of the paper the author presents the results of the analysis of media reporting on domestic violence in Serbia and the influence of this media image on the attitude of citizens about this phenomenon.

Introduction. Congenital uveal ectropion (CEU) is a rare, non-progressive condition often accompanied with eyelid ptosis, anterior insertion of the iris, disgenesis of the iridocorneal angle and glaucoma. Case report. We present a case of a seven-year-old girl with a congential unilateral uveal ectropion and a secondary glaucoma which had daily variations from 13 up to 50 mm Hg. The patient had no other abnormalities of the iris or underlying systemic diseases. Introduced local anti-glaucomatous therapy initially normalized intraocular pressure (IOP), but failed to provide long term normalisation. Trabeculectomy normalized the IOP which resulted in the reduction of the cup/disc ratio and restitution of neuroretinal rim. The rim area increased to 1.716 mm2 (0.958 mm2 preoperative) rim volume, was 0.666 mm3 (0.195 mm3 preoperative) while cupdisc (C/D) ratio decreased to 0.330 (0.626 preoperative) as well as linear C/D=0.574 (0.791 preoperative). Neuroretinal rim (NR) was preoperatively preserved in the Ti segment, damaged in T, Ts, N, Ns segments, and borderline in the Ni segment. Postoperatively, neuroretinal rim was preserved in all segments. Conclusion. In the presented case trabeculectomy induced recovery of the nerve tissue of the optic nerve head which was confirmed by Haidelberg Retina Tomograph II (HRT II). The treatment results have been maintained during the follow-up period of nine years without topical or systemic antiglaucomatous therapy. Although CEU is a non-progressive and benign eye disease, associated glaucoma can cause severe optic nerve damage if not detected early and treated properly. As can be seen in the presented case, an adequate treatment can prevent and even reverse optic disc neuropathy.

There were 351 drug addicts examined post mortem from 2006 till 2015 at The Institute of Forensic Medicine in Belgrade. In most of the cases death was accidental, caused by the use of psychoactive substances totaling 219(62,4%), followed by suicidal deaths 35 (10,0%) and deaths from traumas caused in traffic accidents. The most common manner of suicide was death by hanging (48,6%), jump from a height (28,6%), suicide by firearm (17,8%). There were no recorded suicides by overdose. The age of post mortem drug addicts where the suicide was a cause of death, did not statistically differ from others, accidental deaths, caused by the use of psychoactive substances. However, drug addicts died from traumas in traffic accident were statistically significantly younger in comparison to previous two groups. The median blood morphine levels concentration value did not statistically differ significantly in all three examined groups. Quite often there was alcohol presence in blood of drug addicts who died in traffic accidents.

Introduction: A self-assessment health condition provides a general approach to creating a picture of the health status of the population. Aim: The aim of the paper is to show the connection between different categories of self-assessed health with socio-demographic characteristics, risk factors and with the presence of one or more chronic non-communicable disease of adults in Serbian communities in Kosovo and Metohia. Method: The research was carried out as a cross section study. As an instrument for data collection, the questionnaire was applied in the 2013 Survey of the Health of the Population of Serbia (excluding Kosovo and Metohija), which is in line with the European Health Research Questionnaire. For the purposes of our research, the following variables were used; gender, age, education, working status, marital status, the presence of chronic non-communicable diseases, smoking, alcohol use and physical activity. Results: A total of 1067 respondents (51.3% of women) responded, with an average age of 42.2 (± 16.0) years. Most respondents in the survey found that they feel very good or good, a quarter of the middle (not bad or good), while their condition was poor or very poor assessed by just under 5% of respondents. Among the respondents who rated their health condition as poor or very poor, there were significantly more female respondents, middle age and 65 years of age. Also, people with primary and secondary education, economically inactive, and who are inclined to the sedentary way of life, have a poor picture of their health. The frequency of people who assess their health status as bad or very bad is the highest among respondents with two or more chronic diseases. Conclusion: Different categories of self-assessment health show a tendency to connect with different individual characteristics of adult respondents. Our results can help in creating a strategy of action and building preventive programs in a defined area.

Introduction: Solar or artificial UVA radiation play a major role in photoaging of the skin. Objective: The aim of our study was to determine the presence of morphological changes in the dermis of mouse skin exposed to UVA radiation, with or without the usage of photoprotective cream. Methods: This experiment involved the exposure of female BALBc mice, to solarium UVA lamps. The animals were divided into 2 experimental and 2 control groups. Before the radiation exposure, the hair on the backs of the experimental animals and one control group was removed by shaving 3 times a week, and a half an hour before the exposure a broad spectrum photoprotective cream (UVA filter and SPF 50) was applied on half of the experimental animals. The animals were exposed to radiation 5 times a week, 2 hours a day (the dosage of 156 J/ cm2), for 16 weeks, up to a total radiation of 12500 J/cm2. Results: The presence of impaired collagen fibril network was the most pronounced in the experimental group of animals exposed to radiation without the usage of photoprotective cream (p

Validity shows the degree of concurrence between the results received by an actual measuring and that of what an instrument is supposed to measure. There are three main types of validity: content validity, criterion-related validity and construct validity. Factor validity is a special approach to constructive validity, tested by statistical analysis called factor analysis. Hamilton rating scale for depression and Montgomery-Asberg depression scale are the most widely used psychiatric instruments. The aim was to carry out a systematic review of the literature on factor structure of psychiatric scales reported in different times during longitudinal studies. The units of analysis were published papers obtained by searching the two bibliographic databases: MEDLINE and PsycINFO. Factor validity of the HAMD scale was reported in 6 (0.09%) of 6590 studies which used this scale, whereas the factor validity of the MADRS scale was reported in 4 (0.2%) of 2051 studies which used the MADRS scale. The difference between the first and the last measuring in relation to values was not statistically significant: median of the number of extracted factors of the HAMD scale (p=0.371), median of total explained factor variance of the HAMD scale (p=0.250), median of variance explained by the first factor of the HAMD scale (p=0.125). Factor validity of the MADRS scale in repeated measuring also did not have statistically significant difference for the following values: median of the number of extracted factors of the MADRS scale (p=0.174), median of variance explained by the first factor of the MADRS scale (p=0.125). Coefficients of concurrent validity of the HAMD i MADRS depression scales show the trend of increase in longitudinal studies and their values are for about a third higher at the end of studies than in their beginning. Low frequency of reporting the data about reliability and validity of applied rating scales is the main problem in using the meta-analytical methods effectively to study changes in adequacy of measures in longitudinal studies.

Planning cluster randomized studies requires special attention due to their specific design. To achieve balance on a cluster level as well as on individual level, it is necessary to apply randomization techniques which involve restricted randomization. Objective: Determine randomization techniques as well as their frequency in protocols for cluster randomized trials. Materials and method: Searching the MEDLINE bibliographic database, there were 1020 bibliographic units, the analysis included only the protocols for cluster randomized trials, which was a total of 169 trials. Data on randomization techniques, units of randomization and publication years of protocols were extracted. Results: The randomization technique with most frequency was stratification (35.9%). After stratification the most frequent was simple randomization (13.5%), followed by a combination of block and stratification (10%), block randomization (9.4%) and matching (9.4%). The most frequent units of randomization were health facilities (52%). The number of published protocols statistically increases during time (p

Introduction: Tobacco smoke is one of the most important environmental pollutants (ETS). Passive exposure to tobacco smoke is involuntary and it presents a health risk for children. Objective: To establish if there are differences in Peak Expiratory Flow Rates (PEF) values of healthy school children who live in households with and without tobacco smoke. Methods: PEF measurements were taken for 830 school children, from elementary schools in Nis and Laplje Selo. Measurements were obtained with new peak flow meters Vitalograf-normal range (EN 13826), 3 to 5 times. The highest values were taken for analysis. P < 0.05 was considered significant. Results: We considered PEF values for 830 healthy school children, 599 (72.17%) from households with tobacco smoke (ETS), and 231 (27.83%) without ETS. Exposure to parenteral smoking was associated with reduced PEF rates: 312.01 L/min (95% CI=301.38-322.65 L/min), for boys and 284.64 L/min (95% CI=275.73-293.55 L/min), for girls. PEF rates for children from households without ETS are 313.79 L/min (95% CI=295.63-331.93 L/min) for boys, and 302.0 L/min (95% CI=287.02- 316.98 L/min) for girls. PEF rates were significantly lower for girls from households with ETS (p

Introduction: Health food safety is an absolute priority, whether it is a physical-chemical and microbiological safety. This applies particularly to vulnerable population groups. Particularly vulnerable population group is pre-school children. In this age, in addition to health security, as an important segment of the nutritional value of food. Nutritional value represents the energy value of meals, as well as a total in a certain amount (100g), as it looks at the energy density of meals. A reliable indicator of nutritional value, in addition to the mere satisfaction of energy needs, the amount and concentration ratio of macronutrients. This paper deals with the energy value of daily meals in preschools in Macva administrative district. The quality of the meal depends on several factors, such as the selection of food, preparation methods, expertise, personnel to create menus. This work focused on the economic situation in the whole society, as a factor affecting the quality of daily meals in preschools in Macva administrative district. Aim: To investigate the existence of statistically significant differences in the quality of daily meals in 2010, 2011 and 2012. Materials and methods: During the period under review were collected and analyzed data on the quality of the food at nine preschools in Macva administrative district. Data on the total caloric value, energy value in 100 grams, as well as data on the proportion of macronutrients carbohydrates, fats and proteins are analized and compared. The comparison of the results with the current regulations in the Republic of Serbia, and testing the statistical significance of the energy value variation and content of macronutrients in the observed poreioda. Results and Conclusion: The results showed that the total energy value does not satisfy 75% of daily needs, and that there is a significant reduction in the share of protein and increase in the proportion of carbohydrates. Test results indicate that due to the impact of the deterioration of the economic situation decreased quality of daily meals. Reducing the quality is reflected in statistically significant decrease in the share of proteins.

Evaluation of the SOFA score during their stay in ICU patients is a good prognostic indicator in assessing treatment outcomes. The aim this study is to determine the importance of SOFA score in the evaluation of complications, duration of mechanical ventilation (MV), length of stay in ICU and outcome of patients with sepsis and / or septic shock in the ICU. This one year prospective study included 60 critically ill patients. After admittance to the ICU were calculated APACHE II score, and during further treatment in the ICU, patients were evaluated SOFA score of 24, 48, 72 hours and seven days after admittance. Were observed the length of stay in ICU, duration of MV and survival. Patients in non survivel group were elderly than in the group of survivors, they spent significantly more days on MV and more frequently had septic shock as a complication (63%). The length of stay in ICU was not statistically significant between the two groups, as opposed to duration of MV, where he recorded a statistically significant difference. The best calibration had SOFA7d (0.85), which means it has had the smallest statistically significant discrepancy between the expected and the observed deaths. Score with the best discrimination between non survivel and survivel groups was SOFA7d; AUROC (0981). Our study showed that a daily evaluation of the SOFA in the ICU to predict the onset of complications, duration of MV and length of stay patients in the ICU. SOFA value calculated for 7 days showed the best discrimination and calibrati on power.

Introduction: Dental caries is the most common oral disease in all age groups. Being more and more frequent in preschool and school-age children, it has become one of the most important problems in oral pathology. The aim of this study was to determine the incidence of dental caries in schoolchildren aged 12 and 15 years in the northern part of Kosovo and Metohija, as well as to inform them about the importance of oral health. Materials and Methods: The study included 626 schoolchildren of both sexes from five schools from the municipalities of Kosovska Mitrovica, Zvečan and Leposavić. Klein-Palmer DMFT system (D-Decayed, M-Missing, F-filled) was used to estimate the prevalence of dental caries the following indices were also used: Person Caries Index, Teeth Caries Index, Average Caries Index and DMFT structure. All the selected children were examined using standard dental diagnostic agents. Tooth surfaces were examined dry under artificial lighting. Results: The average value of DMFT index for children aged 12 and 15 years was 4.2. On average, 92.3% of the examined children had caries. The mean value of caries index was 15.11%.Conclusion: After these new epidemiological studies, it can be concluded that the state of children's oral health, considering the high levels of untreated caries and all other features of DMFT index, is not satisfactory. This situation points to the necessity of applying modern preventive and prophylactic measures to preserve and improve the population oral health.

Introduction. Neurofibromatosis type 1 (NF1), also known as von Recklinghausen disease, is one of the most common single-gene disorders (mutation on chromosome 17q) and usually associated with cutaneous, musculoskeletal and neurological disorders in humans. NF1 is generally complicated with one or more neurobehavioral disorders or tumors located in the peripheral nervous system such as neurofibromas, peripheral nerve sheath tumor, pheochromocytoma, etc. In the available medical literature, the thoracic manifestations of NF1 have been rarely described in these patients. There are few reports about intrathoracic neurogenic tumors, kyphoscoliosis, pneumonitis and pulmonary fibrosis in patients with NF1. Case report. A 65-year-old female was admitted to the Intensive Care Unit at the Lung Clinic of Belgrade University Clinical Center of Serbia. The patient’s general condition was poor with shortness of breath and present cyanosis. At the same time, the skin changes similar to NF1 were noticed, which were additionally documented by her medical history and diagnosed as NF1. After the application of noninvasive mechanical ventilation and other emergency respiratory medicine measures, the patient soon felt better. The parenchymal changes were viewed by subsequent X-rays and CT scanning of the thorax. Conclusion. This is a case report presenting the NF1 associated with the abnormality of lung parenchyma established during diagnostic procedures at the Intensive Care Unit, Clinic of Pulmonology.

During pregnancy, many women experience vaginal infections due weakening of the immune system and changes in hormonal status. The symptoms that accompany this occurrence are common: burning, itching, pain during sexual intercourse and abundant malodorous discharge. Treatment of these infections is essential and must be vigorously and effectively, both for the mother and the fetus, because women are at high risk of serious complications, such as premature birth and miscarriage. This problem requires serious approach.

Introduction. Bronchobiliary fistula (BBF) is a pathological communication between the bronchial system and the biliary tree that presents with bilioptysis. Many conditions can cause its development. There is still no optimal therapy for BBF. Conservative treatment is rarely indicated, as was published before in a few cases. Case report. We presented a 71-year-old Caucasian Serbian woman with BBF secondary to previous laparotomy due to multiple echinococcus liver cysts. The diagnosis was established by the presence of bilirubin and bile acids in sputum and magnetic resonance cholangiopancreatography (MRCP). A repeat MRCP performed after conservative procedure, did not reveal fistulous communication. Conclusion. We suggest that in small and less severe fistulas between the biliary and the bronchial tract, conservative treatment may be used successfully, and invasive treatment methods are not needed in all patients.

Introduction. Pseudomonas aeruginosa is a common cause of serious infections in hospitalized patients and is associated with high rates of hospital morbidity and mortality. Objective. The aim of this study was to identify the risk factors of nosocomial infections caused by piperacillin­tazobactam­ resistant P. aeruginosa (PT­RPA). Methods. A case­control study was conducted in the Clinical Centre Kragujevac from January 2010 to December 2011. Results. In the observed period, 79 (38.16%) patients had PT­ RPA infections, while 128 (61.84%) patients had infections caused by piperacillin­tazobactam­sensitive P. aeruginosa (PT­SPA). Pneumonia was more frequently found in the PT­RPA group (55.70%) (p

Introduction. Reduced compound glutathione (GSH) in the lens has the function to protect the thiol group of lens proteins, and as a substrate of glutathione peroxidase (GPx) and glutathione S-transferase (GST). Protein containing thiol groups is significant for the normal function of lens epithelium, i.e. enzymes Na-K-ATP-ase, thus influencing cell permeability. The relationship GSH/GSSG (oxidized glutathione) is normally high in the lens and other ocular tissue owing to the glutathioneredox cycle, which is localized in the lens epithelium and cortex surface. Objective. The aim of the study was to investigate non-enzymic factors of the antioxidant protection of non-protein and protein tiol, as well as to determine glutathione-dependent enzyme activity in the corticonuclear blocks of lenses in patients with senile cataract. Methods. Biochemical studies of lens were carried on 101 patients with senile cataract. According to cataract maturity degree, the patients were classified into two groups: senile incipient cataract (N=41) and mature senile cataract (N=60). GSH concentration was determined by Ellman’s reagent. GPx activity was assayed with cumene hydroperoxide, and that of glutathione S-transferase by follow-up of glutathione conjugation and 1-chloro-2.4-dinitrobenzene rates. Results. A significantly higher GSH concentration was found in the corticonuclear blocks of lenses with initial as related to mature cataract (p

The aim of the presented research is improvement of methodology for probability calculation of coinciding occurrence of historic floods and droughts in the same year. The original procedure was developed in order to determine the occurrence probability of such an extreme historic event. There are two phases in calculation procedure for assessment of both extreme drought and flood occurrence probability in the same year. In the first phase outliers are detected as indicators of extreme events, their return periods are calculated and series' statistics adjusted. In the second phase conditional probabilities are calculated: empirical points are plotted, and both extreme drought and flood occurrence probability in the same year is assessed based on the plot. Outlier detection is performed for the territory of Serbia. Results are shown as maps of regions (basins) prone to floods, hydrologic drought, or both. Step-by-step numeric example is given for assessing conditional probability of occurrence of flood and drought for GS Raska on the river Raska. Results of assessment of conditional probability in two more cases are given for combination of extreme flood and 30 day minimum flow.

When providing hydrologic indicators needed for hydro power plant design, knowledge of mean monthly flows allows for estimation of majority of indicators. The paper deals with a problem of obtaining mean monthly flows at the location where flow observation data do not exist. The closest gauge station from the observation network is selected as an analogue location/basin. Since the selected gauge station observation period is rather short, the extension of the data set is achieved by generating synthetic mean monthly flow series by the nonlinear correlation method explained within the paper. Attention is paid to finding the best fit for correlation within the observation period. Four segmentation types of the correlation curve of transformed values are studied. Observed data are used for estimation of applied model quality i.e. spatial interpolation of surrounding gauge stations to the analogue station. At the selected hydro power plant location, synthetic series of mean monthly flow is calculated by scaling series from the analogue gauge station, using basin area ratio as scaling coefficient. Apart from mean annual flow and annual flow distribution, based on the synthetic mean monthly series, daily flow duration curve and maintenance flow were calculated.

River flooding in Serbia is a natural phenomenon which largely exceeds the scope of water management and hydraulic engineering, and has considerable impact on the development of Serbian society. Today, the importance and value of areas threatened by floods are among the key considerations of sustainable development. As a result, flood protection techniques and procedures need to be continually refined and updated, following innovations in the fields of science and technology. Knowledge of high flows is key for sizing hydraulic structures and for gauging the cost-effectiveness and safety of the component structures of flood protection systems. However, sizing of hydraulic structures based on computed high flows does not ensure absolute safety; there is a residual flood risk and a risk of structural failure, if a flood exceeds computed levels. In hydrological practice, such floods are often referred to as historic/loads. The goal of this paper is to present a calculation procedure for the objective identification of historic floods, using long, multiple-year series of data on high flows of natural watercourses in Serbia. At its current stage of development, the calculation procedure is based on maximum annual discharges recorded at key monitoring stations of the Hydro-Meteorological Service of Serbia (HMS Serbia). When applied, the procedure results in the identification of specific historic maximum stages/floods (if any) at all gauge sites included in the analysis. The probabilistic theory is then applied to assess the statistical significance of each identified historic flood and to classify the historic flood, as appropriate. At the end of the paper, the results of the applied methodology are shown in tabular and graphic form for various Serbian rivers. All identified historic floods are ranked based on their probability of occurrence (i.e., return period).