Summary The presence of diabetes mellitus leads to a decrease in life quality in all domains. The aim of our study was to evaluate the quality of life (QOL) in diabetic patients and the factors affecting it in type 2 diabetic mellitus patients. We conducted a cross-sectional study that included 86 patients with type 2 diabetes mellitus, in the territory of the City of Niš. Health-related QOL of patients was measured using the short form survey (SF-36) that produces an 8-scale health profile. The average duration of diabetes was 12.76±8.08 years. The best QOL in all areas was observed in patients diagnosed with diabetes less than 10 years ago p<0.05) and younger than 65 years. Male respondents perceived a better QOL compared to women, especially in the vitality and pain domains. The patients with comorbidity (93.64%) had lower QOL score in all domains. There was no significant difference in the QOL of patients with diabetes compared to the level of education. High QOL represents an ultimate goal and an important outcome of all medical interventions in diabetic patients. Factors related to lower QOL included: older age, female gender, and existence of comorbidities. Uncontrolled diabetic patients had a lower QOL than controlled diabetics.

Diagnostic Importance of CA-125 in Detection of Recurrence and Progress of the Disease in Stages III and IV of Epithelial Ovarian Carcinoma In 60 patients operated in stages III and IV of epithelial ovarian carcinoma continuous determination of CA 125 from serum was done during the following 2 years. The main condition for entering the survey were elevated values of CA 125 in serum > 35 U/mL and histologically verified epithelial ovarian carcinoma. The aim of the survey was to perform statistical assessment of serum CA 125 determination in diagnostics of recurrence and progression of the disease in stages III and IV of epithelial ovarian carcinoma, and percentage (%) of false positive and negative results. Determination of CA 125 from serum during 2 postoperative years is a reliable but not completely certain diagnostic parameter in detection of the disease progression in stages III and IV of epithelial ovarian carcinoma (sensitivity 79.3%, specificity 97.1%, positive predictive value 91.2%, negative predictive value 92.4%, test accuracy 92.1%). False positive (0.7%) and false negative results (4.7%) of individual tests were present in 5.4% of all samples.

Spinalna anestezija je jedna od najstarijih, najkorisnijih i do danas najčešće primenjivanih tehnika regionalne anestezije. Ubrizgavanjem lokalnog anestetika u subarahnoidalni prostor nastaje tranzitorni prekid sprovođenja nervnih impulsa u spinalnim nervnim korenovima i paraliza autonomnih, senzitivnih i motornih nervnih završetaka. Blokada simpatikusa, uzrokovana spinalnom anestezijom, dovodi do hemodinamskih promena. Hipotenzija i bradikardija su najčešći kardiovaskularni efekti viđeni kod simpatičke denervacije. Cilj rada: Cilj rada je bio da se utvrdi kakav uticaj hronična terapija beta-blokatorima ima na promene arterijskog krvnog pritiska tokom spinalne anestezije, s obzirom na to da su im efekti slični, te da se sagleda značaj hemodinamskog monitoringa (merenja arterijskog krvnog pritiska) pri izvođenju spinalne anestezije kod ove grupe pacijenata. Materijal i metode: Nakon odobrenja od strane Etičkog odbora Univerzitetskog kliničkog centra Banjaluka, sprovedena je prospektivna, case-control studija, koja je trajala od 01.06.2013. do 31.05.2016. godine na hirurškim klinikama ove ustanove. U studiju je uključeno 70 bolesnika podeljenih u dve grupe, starosne dobi od 35-65 godina. Grupu N1, radnu grupu, sačinjavalo je 35 pacijenata koji su zbog esencijalne hipertenzije upotrebljavali beta-blokator metoprolol u hroničnoj terapiji. Druga grupa je bila kontrolna grupa (N2) i nju je činilo 35 pacijenata iste dobne granice, ASA I statusa. Pacijenti su bili podvrgnuti spinalnoj anesteziji za "beskrvne" operacije preponske kile, tumora mokraćne bešike, operacije prostate, uretre i donjih ekstremiteta. U rad nisu bile uključene trudnice, te pacijenti sa dijabetesom, bu-Summary Introduction: Spinal anesthesia is one of the oldest, most useful and most commonly used techniques of regional anesthesia. The injection of local anesthetics into the subarachnoidal space creates a transient interruption of nerve impulses in the spinal nerve roots and paralysis of autonomic, sensitive and motor nerve endings. Sympathic blockade caused by spinal anesthesia leads to haemodynamic changes. Hypotension and bradycardia are the most common cardiovascular effects seen in sympathetic denervation. The goal of the work: Determine the effects of chronic therapy with beta-blockers on changes in arterial blood pressure during spinal anesthesia, since their effects are similar, and see the importance of hemodynamic monitoring (measurement of arterial pressure) in performing spinal anesthesia in this group of patients. Material and methods: After the approval by the Ethics Board of the University Clinical Center Banja Luka, a prospective, case-control study was conducted, which lasted from 01.06.2013. until 31.05.2016. at the surgical clinics of this institution. The study included 70 patients divided into two groups, aged 35-65 years. Group N1, a working group, consisted of 35 patients who, due to essential hypertension, used a beta-blocker, metoprolol, in chronic therapy. The second group was the control group, N2, and it consisted of 35 p...

Introduction: Spinal anesthesia (synonyms: subarachnoidal nerve block, subdural nerve block, subdural anesthesia, lumbar anesthesia, subarachnoid anesthesia) occurs by injection of local anesthetics within the subarachnoid space in the lumbal interspace. 1 It is also called a neuroaxial blockade that represents the primary anesthetic technique in one-third of surgical procedures. 2 A local anesthetic, given in this way, transits blocking the transmission of sensory, motor and autonomic nerve impulses transiently, resulting in the desired effects, sensory and motor blockade, as well as the side effects due to blocking autonomic nerve fibers, when unwanted effects of spinal anesthesia, hyopotension, bradycaria, nausea, vomiting and retention of urine occur. In this paper we examined the effect of spinal anesthesia on cardiovascular functions in patients whose sympathetic tonus is partly suppressed due to the chronic use of β-blockers due to essential hypertension. We wanted to know whether spinal anesthesia is a safe anesthetics technique in this group of patients or their effects are summed up, which would lead to cardiovascular instability that would result in greater use of pharmacological agents for the treatment of hypotension and bradycardia. Aim of the Study: To examine cardiovascular stability during spinal anesthesia in patients on β-blocker therapy and determine the safety of its use in this group of patients. Patients and Methods: After approval by the Ethics Committee of UCC Banja Luka, a prospective, observation study was conducted on 70 patients divided into two groups, aged 35-65 years, and it lasted from June 1st, 2013. until May 31st, 2016. Group N1, a working group, consisted of 35 patients who used beta-blocker, Metoprolol, in chronic therapy due to essential hypertension. The second group was a control group, N2, and it consisted of 35 healthy patients of the same age limit. Patients underwent spinal anesthesia for "bloodless" surgery on the inguines, perineum, urinary bladder, prostate, urethrae and lower extremities. No pregnant women, diabetic patients, kidney, liver and heart disease were involved in the work. Results: The results showed that there were a significantly higher number of patients with a critical drop in blood pressure, in the group of patients undergoing therapy with beta-blockers, ≥30%, and alone with this more frequent use of vasopressor. Likewise, in the group of patients on beta-blocker therapy, significantly more patients developed bradycardia, i.e. a pulse of 50/min, which required the use of Atropine. Conclusion: Spinal anesthesia is not a safe anesthetic technique in patients on beta-blocking therapy