The present study revealed a bilateral volume decrease of the caudate nucleus, putamen and hippocampus in PTSD male subjects without therapy. Intensity of volume alterations correlated with Hamilton's depression rating score; regression analysis uncovered correlated changes in the caudate nucleus, putamen and hippocampus, and an inverse correlation with the volume of the lateral ventricle in the PTSD patients.

The degree of patient cooperation plays a key role in the success of antihypertensive drug therapy. Non-adherence is the major health and economic problem in the treatment of arterial hypertension (HTA). The aim of the study was to evaluate the degree of adherence in hypertensive patients and to study risk factors affecting adherence and the effects of non-adherence on blood pressure (BP). We performed a cross-sectional study, which involved 170 outpatients with HTA, treated in primary healthcare. Patients were divided into two groups, depending on the degree of adherence, measured using a validated survey form. Statistical analysis was performed using the Pearson's Chi-square and t-test. Good adherence was observed in 126 (74.12%) outpatients. Elderly patients with longer duration of HTA and larger number of drugs in the therapy showed a lower degree of adherence, with more side-effects (p<0.01). Patients younger than 65 years were found to be more likely to adhere to their medication regimen, compared to elderly patients (χ 2 =21.3; p<0.01; OR=6.0 95%, CI 2.76-13.04). Uncontrolled BP occurred in the significantly higher percentage in non-adherent patients (59.1%) compared to the adherent group (21.4%) (χ 2 =19.84; p<0.01; OR=5.30 95%, CI 2.39-11.85). The most common reason for poor adherence was non-compliance with dosage regimen (27.27%).The medication adherence rate was found to be low among elderly patients. A poor adherence was found to negatively affect BP control. Determining the factors for non-adherence and developing multidisciplinary intervention programs to address the identified factors are necessary to improve adherence to medication and BP control.

Trauma is one of the leading causes of mortality in the world. Traumatic injury has a significant impact on the patient, socially, functionally and financially. Orthopaedic injuries are generally not life-threatening unless they result in significant hemodynamic instability. The outcome of the orthopaedic injuries might lead to mild or severe disability and lost quality of life. Therefore, the orthopaedic surgeon has significant role in treatment of trauma patient. In order to control and prevent traumatic injuries, to improve quality of trauma treatment and outcome, including the costs the National trauma registry is essential. The aim of the study was to collect the datas about the frequency of orthopaedic injuries in polytraumatised patients who were treated in intensive care unit of Emergency Center of Serbia in last two years. There were significant number of orthopaedic injuries (53.2%) in polytraumatised patients. The major cause of the injuries is traffic (78.6%) and most patients were between 30-50 years (30%).

The damage control laparotomy is an advancement in the management of massively injured trauma patients. Massive liver injuries, pelvic trauma and some retroperitoneal injuries are some of the indications for this approach. The damage control laparotomy is the phased approach to severe abdominal injury that might best be described with the acronym STIR (Staged Trauma Injury Repair). The initial procedure requires rapid abdominal exploration with hemorrhage and contamination control, using suture repair combined with abdominal packing. Temporary abdominal wall closure without tension is recommended. After abrevated initial surgical procedure, the patient is transferred to the intensive care unit where continued resuscitation is performed. Careful replacement of blood and blood products along with correction of hypothermia, acidosis and optimalization of oxygen transport represents a critical phase in this management approach. Once the coagulation profile has normalized, planned re-intervention, with repeat abdominal exploration to remove the packs and perform definitive surgical repair and reconstruction takes place. When applied judiciously, the damage control laparotomy with the staged abdominal repair and reconstruction for severe trauma is associated with an improved outcome in the selected group of patients.

Trauma is disease of the young, mainly affecting people between 15-40 years of age. Uncontrolled massive bleeding is the leading cause of early in-hospital mortality, within 48h of admission, and the second leading cause of prehospital death in victims of both military and civilian trauma, accounting for 40-45% of the total fatalities. Coagulopathy develops early after injury and is present in 25-36% of trauma victims upon admission to the emergency department. Coagulopathy correlates to the severity of trauma and is associated with an increased risk of mortality. The aim of this paper is to explain pathophysiology of developing coagulopathy in trauma. The coagulopathy in the trauma patient is complex and multifactorial. It includes: dilutional coagulopathy, hypothermia, acidosis, hyperfibrinolysis, anemia and consumption coagulopathy. When the patient develops the so called "lethal triad" of hypothermia, acidosis and coagulopathy, surgical restoration of vascular integrity may be insufficient to achieve a deffinitive control of blood loss and non-mechanical bleeding from small vessels, usually terminated by spontaneous coagulation, becomes a life-threatening condition.