The alternative for open reconstruction of ruptured AAA in haemodynamically stable patients with suitable anatomy and comorbidities could be emergency EVAR in local anesthesia. This technique could provide greater chances for survival with lower intraoperative and postoperative morbidity and mortality, as shown in the presented patient.

Introduction/Objective. Cardiovascular disease is one of the most common comorbidities among subjects with chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate ECG parameters and mortality predictors in COPD patients. Methods. A total of 835 consecutive patients were included. Patients were classified to suffer from COPD if in three consecutive postbronhodilatator measurements FEV1/FVC was <70%. Following ECG changes were observed: axis, p wave, low ORS complex, transitional zone, left bundle branch block (LBBB), right bundle branch block (RBBB), incomplete right bundle branch block, S1S2S3 configuration, negative T in V1-V3. Patients were followed up for mortality in a five years period. Results. Both survivors and non-survivors were similar age, gender and COPD status. FVC and FEV1 as well as GOLD stadium are significantly higher in surviving group (p<0.016, p<0.001, p<0.001 respectively). Normal axis was in significantly higher percentage in non-survived patients (p=0.020). Right RBBB and incomplete RBB are more frequent finding in patients who died as (p?0.001, p?0.05, respectively). LBBB, S1S2S3 configuration is in significantly higher percent in non survivors (p<0.016, p<0.001, respectively). In multivariable logistic model, patients with LBBB have two times higher chance of mortality compared to patients without LBBB. Contrary, patients with RBBB have 1.6 times lower chance to have death outcome. Conclusion. Main ECG predictors of COPD patients? five-year mortality are LBBB and RBBB, but according to statistical model, electrocardiogram should be further explored and possibly obligatory involved in a routine clinical practice as an easy and low-cost screening method.

Adverse drug reactions should be considered in patients with concomitant lung and liver disease. The mainstay of treatment is drug withdrawal and the use of immunosuppressive drugs in severe cases. Consideration should be given to monitor lung and liver function tests during long term nitrofurantoin therapy.

Background/Aim. As lung cancer is considered the greatest contributor to death among all cancer types any help might be valuable in the assessment of treatment effects. The aim of this study was for assess the quality of life (QoL) in patients with non-small cell lung cancer (NSCLC) treated with gemcitabine-cisplatin regimen as the first line of chemotherapy. Methods. The QoL was assessed using certified Serbian translations of the European Organization for Research and Treatment of Cancer Quality Life Questionnaire Core 30 (EORTC QLQ-C30) and Lung Cancer Module (QLQ-LC13)-version 3. The questionnaire was used before starting treatment and after the completion of the 2nd and the 4th cycle of chemotherapy. The questionnaire scales and single items were compared in order to assess the impact of treatment on the QoL. Results. A total of 60 patients started and 51 completed all questionnaires. There were no changes in the global health status score between the baseline, the 2nd and the 4th cycle of chemotherapy (42.78 ± 15.76, 45.56 ± 17.59, 48.20 ± 19.24, respectively; p = 0.1). Social function score, symptom scores: nausea and vomiting, pain, appetite loss, constipation, diarrhea and financial difficulties score differed significantly among chemotherapy cycles, indicating improved or worsened the QoL. In the lung cancer symptom score a significant difference between measurements was observed in cough, alopecia, chest pain and in using analgesics. Conclusion. Monitoring of changes in the QoL among patients with locally advanced and metastatic NSCLC showed that chemotherapy did not decrease the global health status but led to significant changes in the social and financial functioning of patients. Some symptoms associated with the disease reduced in the intensity but some new occurred as a result of chemotherapy. Using questionnaires to assess the QoL helped in easier identification of adverse effects and specific problems for adequate treatment.

Introduction: Although pleural effusion is a common clinical manifestation, the differential diagnosis of the cause of the pleural effusion is often challenging, especially in the early differentiation of tuberculous pleurisy (TP) from other pleural effusion.Case report: We present a previously healthy man who had no contagious or TB contact but developed massive tuberculous pleural effusion which eventually was unexpected tuberculous. He started with therapy per protocol and feeling well. The purpose of this case and review of literature was to remind the physicians that tuberculosis is not a sickening illness, but on the contrary, it is in the expansion.Discussion: When a patient presents with new pleural effusion, the diagnosis of tuberculous pleuritis should be considered. The patient is at great risk for developing pulmonary or extra pulmonary TB if the diagnosis is not made properly. Between 3% and 25% of patients with TB will have TB pleuritic or more in immunocompromised patients.The treatment for TB pleuritis is the same as that for pulmonary TB. Conclusion:The gold standard for the diagnosis of tuberculous pleural effusion remains the detection of Mycobacterium tuberculosis in pleural fluid, or pleural biopsy specimens, either by microscopy and/or culture, or the histological demonstration of caseating granulomas in the pleura along with acid fast bacilli.