UNLABELLED The objective of this study is the assessment of the association of burnout syndrome with adrenal exhaustion specific symptoms and signs among 116 patients who were exposed to violence or mobbing at workplace and who were treated during 2005 to 2008 in Department of Occupational Pathology and Toxicology Tuzla; to detect symptoms and signs of adrenal exhaustion differences between patients who were exposed to act of violence as acute catastrophic event and patients who were long-term exposed to mobbing or chronic distress at workplace. MATERIAL AND METHODS Data of 86 employees who were exposed to mobbing > 1 years (chronic distress syndrome) and data of 30 employees who were exposed to act of violence as acute traumatic crisis situation (evaluation in first week after acute stress situation and post control observation 6 months later). TOOLS FOR ASSESSMENT WERE CLINICAL EXAMINATION AND QUESTIONNAIRES: Occupational stress questionnaire (OSQ short version), self-constructed Questionnaire about symptoms and signs of Adrenal exhaustion; self-constructed mobbing questionnaire; and Maslach--Burnout Inventory. RESULTS The patients expressed their traumatic experiences during exposure to stress more than 1 year (long-term exposure) which were compared with acute stress experiences (mostly high level of stress intensity. CONCLUSION when workers constant expose to repeat mobbing behavior or have perception of extended distress reaction after act of violence at workplace they are suffering of Syndrome burnout and clinical picture of adrenal fatigue.

Background. Disorder of hemostasis in hemodialysis patients is focused in two directions, towards the development of thrombosis and bleeding. Both complications make it difficult to treat and are life-threatening for the patient.  Monitoring of hemostatic parameters, it is possible to detect the first changes in the coagulation system and correct the factors that lead to changes and thus prevent or stop the further development of complications. Aim. To determine the hemostatic and dialysis parameters and their influence on the occurrence and development of complications. Patients and methods. From a total of 175 patients, 46 had signs of hemorrhagic syndrome and 16 of them had thrombosis. Parameters of primary and secondary hemostasis were determined and vascular access of ultrasound was examined. Results. In the patients with thrombosis D-dimer level was significantly higher and amounted to 4.18 mg / l, while AT III levels were decreased for 54%. Elevated level of APTT was significant for the patients who had bleeding. In 86% of patients with thrombosis, ultrasound findings correlated with findings of D-dimer. Both complications were more pronounced in the older age group above 46 years. Conclusion. Hemorrhagic syndrome is a frequent complication of thrombosis. The level of D-dimer is directly correlated with ultrasound detection of thrombotic formation. Elevated levels of APTT was in direct correlation with bleeding. The development of complica-tions are affected by other factors, such as: age, access type, type of dialysis membrane, the blood flow. Frequent control of hemostatic parameters is essential for early detection of complications. In the event of changes in coagulation system, type and dose of anticoagulant should be corrected and introducing additional oral anticoagulants should be considered.

The aim of this work is to show our experiences in eye injury care in children. The case involved a 24-hour-old eye injury with traumatic cataract. Immediately after having been admitted in hospital, surgery was performed, under complete anaesthesia, using the phacoemulsification method by implanting an IOL in the posterior chamber. The postoperative development was regular. The sight definition, after the first day of surgery, was 0.4 accompanied by normal intraocular pressure without pathological changes in the posterior eye segment. Two months later, the sight definition was 0.8, with the presence of iridolental synechia (iris-IOL) and pupil irregularity. We decided to perform surgery once more to correct the pupil and prevent secondary glaucoma development. After corneal paracentesis, pupil synechiosis was performed with an iris manipulator and the pupil in central projection. The postoperative period was regular with 0.8 sight definition in the first post-operative week, and 0.9 and 1.0 three months following surgery. The patient's sight definition prognosis was good and control tests were regular, due to the possibility of posterior lens capsule opacification and eventual secondary glaucoma. Eye injuries relate to serious injuries, due to the unpredictability of trauma consequences. Child eye injuries are a particular problem, considering the socioeconomic aspect that determines their future importance. The surgical approach in child injury care is frequently individual, and it depends on the experience and skill of the surgeon himself.

Arterial hypertension is a common finding in patients with end stage renal disease (80% patients are hypertensive). Cardiovascular diseases are the main cause of death in haemodialysis. The present study was performed to asses' successful treatment in hypertensive chronic haemodialysis patients by ultra filtration only and ultra filtration combined with medics. We studied 80 hypertensive adult patients who had been on regular haemodialysis treatment for at least 12 months (average duration of 41 months). All subjects were divided in two different antihypertensive treatment groups including 40 subjects each. The first group of patients were treated with trandolapril and ultra filtration, and the second group of patients were only treated with ultra filtration (control group). Blood pressure measurements before and after HD sessions were performed for each patient. Blood pressure control was defined using World Health Organization criteria 140/90 mm Hg. Average systolic blood pressure levels, after haemodialysis, were in the first group of patients 146.33 +/- 9.7 mm Hg, and in the control group 157,86 +/- 10.33 mm Hg. Average diastolic blood pressure was 87.83 +/- 8.11 mm Hg in the first group of patients and, in the control group it was 91.03 +/- 10.67 mm Hg. There were significant differences between systolic blood pressure level in the first group of patients and the control group of patients as well as in diastolic blood pressure (p < 0.05). We conclude that an antihypertensive therapy by trandolapril is more effective than ultra filtration alone in hypertensive patients on chronic haemodialysis.