Surgical treatment and formation of a stoma can be lifesaving for colorectal cancer patients. However, the quality of life is often impaired in patients with stoma. The goal of this study is to determine the quality of life of patients with stoma and cancer, and the relationship between the quality of life and characteristics of these patients. The study was conducted from 2018 to 2020 and included a total of 64 patients of both sexes with colorectal cancer and temporary or permanent stoma. The European Organization for Research and Treatment of Cancer with Quality of Life Questionnaire (EORTC QLQC29-30) and the anonymous WHO Quality of Life Questionnaire SF-36 were used for self-assessment of quality of life. Our study included 39 (61.0%) men and 25 (39.0%) women. 24 patients (37.5%) had colostomy, 14 patients (21.9%) had ileostomy, and 26 patients (40.6%) underwent surgery for resection of colorectal cancer without stoma. A significant number of women were in the group of patients with a permanent stoma (p = 0.01). There was no statistically significant difference in the assessment of general health (p = 0.680) and quality of life (p = 0.721) during the past month in relation to gender. Patients without a stoma rated their general health better compared to those with stoma and the difference reached statistical significance (p = 0.035). There was no statistically significant difference in the assessment of quality of life between the group of patients with stoma and without stoma, as well as between the patients of different age groups. Patients with stoma rated their general health as worse, but not their quality of life.

Paraovarian cysts originate from the mesothelium and are presumed to be remnants of Müllerian or Wolffian ducts. In majority of cases they are found to be 10-80 mm in diameter and do not cause any symptoms. Paraovarian cysts can be found unexpectedly during an operation or on ultrasound examination performed for other reasons. They are most freequently discovered on ultrasound examination. However, due to the proximity of the ovary for which cystic formations are not rare, the diagnosis of these lesions can be a challenge. They are mostly asymptomatic and only large lesions (≤20 cm in diameter) become symptomatic. Although these are mostly benign tumors, in rare cases they can become borderline or true malignancies. Most paraovarian cysts are found in the third and fourth decade of life. Paraovarian cyst complications include: compression of the surrounding structures of the pelvis minor and abdomen, pelvic pain, cyst torsion and rupture. Except for the already mensioned complications available literature has so far failed to show cases of uterine prolapse caused by an increase of intra-abdominal pressure due to the expansive growth of giant paraovarian cystic formation.

Introduction. Cardiac magnetic resonance imaging (CMR) is considered the reference diagnostic method for quantifying right ventricular size and function, and pulmonary regurgitation in patients with tetralogy of Fallot surgery. The aim of this paper is to confirm the importance of magnetic resonance continuous postoperative monitoring of right and left heart function parameters as a diagnostic method that provides the most precise and accurate assessment.Methods. The prospective observational study included subjects with TOF surgery who were diagnosed with residual morphological and/or functional disorders on control postoperative echocardiographic examinations. All subjects underwent magnetic resonance imaging of the heart on a 1.5 T scanner with dedicated coils for the heart surface according to the standard protocol for a period of one year from the beginning of the study. Criteria for exclusion from the study were: significant residual pulmonary stenosis, condition after pulmonary valve replacement, existence of residual shunt lesions, contraindications for cardiac magnetic resonance imaging (pacemaker, ICD, claustrophobia). Depending on the time elapsed since the tetralogy of Fallot surgery, the subjects were divided into groups: more than 15 years, 11−15 years, 6−10 years, less than 5 years. Results.The study included 131 subjects with an average age of 24.18 ± 11.57 years with complete correction of TOF. Intergroup differences in values of right ventricular end-diastolic volume, right ventricular ejection fraction, and left ventricular ejection fraction were demonstrated, but there was no statistically significant intergroup difference in values of pulmonary regurgitation fraction. The negative interaction of the right and left ventricles intensifies during the years of follow-up of patients after TOF surgery, which is especially true fifteen years after surgery. Conclusion.CMR has the most significant role in research efforts aimed at improving the outcomes of operated patients with tetralogy of Fallot.

Miokarditis je ograničeno ili difuzno zapaljenje srčanog mišića koje možebiti posljedica infekcije (virusi, bakterije, gljivice, rikecije, paraziti, protozoe)ili je neinfektivne prirode (sistemske bolesti, metaboličke bolesti, toksini).Postoje i miokarditisi kod kojih se etiološki faktor ne može utvrditi i svrstavajuse u grupu idiopatskih miokarditisa. Klinička slika zavisi od intenzitetazapaljenskog procesa i topografskog rasporeda lezija pa varira od blagogoblika do teškog malignog karditisa sa razvojem srčane insuficijencije i fatalnimishodom u toku nekoliko dana. Mirovanje se preporučuje kao osnovnaterapijska mjera kod svih bolesnika sa sumnjom na miokarditis. Ukolikopostoje znaci srčane insuficijencije obavezno se uvodi antikongestivnaterapija diureticima, vazodilatatorima, digitalisom, a ako ova terapija nijeuspješna neophodno je primijeniti inotropne lijekove (dobutamin ili inhibitorifosfodiesteraze) u intravenskoj infuziji. Poremećaji ritma kod bolesnikasa miokarditisom zahtjevaju što hitniju terapiju odgovarajućim antiaritmicima.U liječenju najtežih, fulminantnih, oblika miokarditisa danas se koristeimunoglubulini u visokim dozama i kortikosteroidi. Akutni perikarditisje zapaljenje perikarda koje odlikuje bol u grudima, perikardijalno trenje iserijske elektrokardiografske promjene. Svijest o ovoj bolesti se povećalazbog uvođenja neinvazivnih dijagnostičkih tehnika, kao što su ehokardiografija,CT skeniranje i kardijalna magnetna rezonanca (CMRI). Bolest možebiti teška i čak smrtonosna, posebno kod djece na imunosupresivnoj terapiji.Uzročnik se može identifikovati iz perikardijalne tečnosti kulturom iliosjetljivijim testovima (PCR) ili iz uzoraka perikardijalne biopsije.

Napredak u dijagnostici i liječenju doveli su do značajnog poboljšanja sudbinedjece rođene sa tetralogijom Fallot sa perioperativnim mortalitetomod 2-3% i tridesetogodišnjom stopom preživljavanja od 90%. Ipak, većinaovih pacijenata ima rezidualne postoperativne morfološke i hemodinamskeporemećaje kao i poremećaje srčanog ritma, prvenstveno zbog volumenaopterećenja desne komore uzrokovanog hroničnom pulmonalnomregurgitacijom. Unaprijeđene hirurške procedure smanjile su ranu smrtnostna manje od 3%, ali se godišnja stopa smrtnosti višestruko povećava20-30 godina nakon inicijalne hirurške sanacije, uglavnom zbog neželjenihkardioloških događaja. U longitudinalnom praćenju pacijenata poslijeoperacije tetralogije Fallot veliki značaj ima rano otkrivanje morfoloških ihemodinamskih rezidualnih poremećaja kako kod asimptomskih tako ipacijenata sa simptomima radi pravovremenog opredjeljenja za nove terapijskemjere (npr. zamjena pulmonalne valvule), a sve u cilju poboljšanjatoka i ishoda liječenja. Magnetna rezonanca srca je dijagnostička metodakoja pruža najprecizniju i najtačniju procjenu pojedinih parametara srčanedisfunkcije i loših ishoda kao i definisanje prediktivne vrijednosti pojedinihparametara. Dosadašnja brojna istraživanja svjedoče da je povećanje rizikasmrtnosti povezano sa progresivnom dilatacijom i disfunkcijom desnekomore, a preko ventrikulo-ventrikularne interreakcije i disfunkcijom lijevekomore. Identifikаcijа pаrаmetаrа, koji mogu dа predvide rizik zа budućeneželjene kаrdijаlne dogаđаje kao što su ventrikularna tahikardija i srčanainsuficiencija, može da pomogne prilаgođаvаnju terаpijskog pristupа, kojibi vodio unаpređenju kvaliteta života i preživljаvаnjа bolesnikа.