Introduction: Widespread opinion that penetrating chest injuries are more urgent, in terms of treatment and care, contributed to underestimation of the urgency of blunt chest trauma, which in most cases is treated conservatively. It remains an open question frequency when the injuries of the heart and pericardium are not timely diagnosed and surgically treated. Aim: To demonstrate the importance of well-timed surgical treatment of blunt chest trauma, when coupled with cardiac and pericardial injuries.Methods: At the Thoracic Surgery Clinic of the University Clinical Centre Banja Luka, Bosnia and Herzego vina, during period of 10 years (01.01. 2008-31.01.2018.), the total of 66 patients were treated for urgent thoracotomy due to clinically and radiologically unclear findings after blunt chest trauma. In general, diagnostic examinations, apart from laboratory analysis, included radiological imaging and Multi Slice Computed Tomography (MSCT) of the chest, followed by an ultrasound of the heart in cases when sternum was injured or when pericardial tamponade was suspected. Results presented in the study where obtained from the retrospective analysis of patients data. This work presents a retrospective observational cross-sectional study, which results in the assessment of the correctness of a particular diagnostic test.Statistical methods used: descriptive statistics, counting measures (frequencies and percentages), central tendency measures (arithmetic mean), variability measures (standard deviation). Results: Sixty six patients were treated with urgent thoracotomy after a blunt trauma of the chest due to the unclear clinical and radiological finding.In the case of 11 patients (10 men and 1 woman), presenting 16.6% of the total sample, pericardial and cardiac injuries were detected and treated intraoperatively. Further, in the case of the one patient, pericardiotomy and suturing of the right heart chamber where performed, with the creation of a pericardial window.Transthoracic echocardiogram was not used as the primary screening module, but rather as a diagnostic test for patients who had unexplained hypotension and arrhythmia.Radiographs of the chest showed cardiomegaly with or without epicardial fat pad sign suggesting a pericardial effusion. Conclusion: Blunt cardiac and pericardial injuries represent a serious therapeutic problem, which, if not treated properly, result in a high mortality rate.Echocardiography is the primary diagnostic method for initial detection of pericardial effusion. Pericardial fluid first accumulates posterior to the heart, when the patient is examined in the supine position. As the effusion increases, it extends laterally and with large effusions the echo-free space expands to surround the entire heart. The size of the effusion may be graded as small (echo free spaces in diastole <10 mm, corresponding to approxymately 300 ml), moderate (10-20 mm, corresponding to 500 ml), and large (>20 mm, corresponding to >700 ml). When the ability of the pericardium to stretch is exceeded by rapid or m...

Introduction: It is estimated that the prevalence of primary hyperparathyroidism in patients over 40 years is about 1 % (men 0.4 %, women 1.6 %). Despite developments in diagnosis today, the highest percentage of patients with hyperparathyroidism remains undetected, and it is estimated that only 10% of cases are diagnosed and treated. In 90% of patients, the cause of hyperparathyroidism is one pathologycally changed parathyroid gland. Aim of the Study: To estimate the efficiency and reliability of a conservative approach in surgical treatment, previously diagnosed with primary hyperparathyroidism, in comparison to a traditional neck exploration showing all four parathyroid glands. Patients and Methods: In the study, we analyzed the results of 71 patients at the University Clinical Center of the Republic of Srpska in the period from 2008 to 2017. The diagnosis of primary hyperparathyroidism was set based on the ultrasonography and scintigraphy of parathyroid glands, neck CT scan, clinical pictures and laboratory findings. The surgery included short cervical incision of 2 cm and 4 cm, placed 2 cm above the jugulum with unilateral neck exploration and extirpation of modified parathyroid gland. Results: In the research were used classification methods, structural-functional analysis, synthesis, comparisons, abstractions, concretisations and simpler statistical method with the use of descriptive statistics to prove the hypothesis set, out of which tables, grafs, and summaries were used. 71 patients diagnosed with primary hyperparathyroidism were operated. The youngest patient was 28-year-old and the oldest 79-year-old. On the basis of the PH findings, targeted parathyroidectomy procedure was successful in 94.3% cases. Conclusion: The goal of the surgical approach, with unilateral neck exploration, allows successful identification of pathologically modified parathyroid gland and efficient treatment of primary hyperparathyroidism.

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Introduction: Spinal column represents a strong and flexible body axis. It is consisted of vertebrae which are connected by the intervertebral disk and solid fibrous joints. Aim of the Study:To ascertain whether or not and to what extent foraminotomy affects the final outcome of lumbar herniated disc surgery.Patients and Methods: This retrospective study analyzed 71 patients who were operated at the Clinic of Neurosurgery in Banja Luka, in the period from 2009 to 2016. Extirpation of disc was performed in 41 respondents, while in 30 patients, a nerve root was further alleviated, along with the extirpation of disc. All patients were operated under the same conditions.Results: There was no statistically significant difference in the age of women and men who underwent classical discectomy and foraminotomy. There was a statistically significant difference in the disc protrusion and extrusion in patients who underwent conventional discectomy and those who underwent foraminotomy, along with conventional discectomy. There was no statistically significant difference in diagnosis in respondents who underwent conventional discectomy and those who underwent foraminotomy, along with conventional discectomy. There was statistically significant difference in the severity of pain in patients who underwent conventional discectomy and those who underwent foraminotomy, along with conventional discectomy. There was a statistically significant difference in clinical recovery, where the findings were in favor of the respondents who underwent foraminotomy, compared to the respondents who did not.Discussion: The treatment of this syndrome is complex, multidisciplinary and with problematic success, and in cases when the operation is performed, the results are not as good as in the primary operation. Conclusion:The results of this study show that the patients who underwent foraminotomy during the operation of prolapsed lumbar disc have a clinically better result.