UNLABELLED Meningococcal disease is the most significant cause of morbidity and mortality even in the most developed socio-economic surroundings. Meningococcal sepsis and meningitis are caused by Neisseria meningitidis (NM), which is surrounded by polysaharide capsule, which is the main factor of virulence. THE GOAL OF THE WORK was to confirm the frequency and characteristics of meningococcal disease as well as the justification of introducing vaccination. Through retrospective analysis of the history of the disease, a total of 87 patients with meningococcal sepsis hospitalized at the hospital for infectious in Tuzla in the period 1995 to 2004. diseases were included. Out of 87 hospitalized patients, 34 patients (39%) had meningococcal sepsis, meningococcal sepsis and meningitis had 50 patients (57.6%), and only 3 patients (3.4%) had only meningitis. The diseases most frequently appears in males, 54 patients (62.0%), and in females, 33 patients (38.0%). The largest number of diseased is in the period 0-12 months, 39 patients (44.8%), and then in the period from 13-24 months, 19 diseased (21.8%), from 3-6 years of age 12 patients (13.8%), after sixth year of age meningococcal disease appears in a smaller percent. The youngest patient was 3 and a half months old, and the oldest was 23 years old. Diagnosis was established based on the history of the disease, clinical examination, lab researches, biochemical and bacteriological search of liquid. Etiological cause was proved through liquor culture in 24 cases (27.5%), hemoculture in two cases (2.29%). Death was the result in eight cases (9.1%), one patient (1.1%) resulted in the amputation of a finger, and the rest of 78 patient (89.6%) are cured without sequel. Patients are treated with the Penicillin G, Ampicillin, and in a case of the resistance, were treated with cephalospores of third generation. CONCLUSION the meningococcal disease, and especially its form of Waterhause-Friderichsen syndrome represents a hard disease which in 50% of cases has a death as the result.

CO2 pneumoperitoneum is an insuflication of CO2 into abdominal cavity in order to enable visulation of organs, and easier manipulation with instruments during laparoscopic surgery. Pressure that is being used is between 12 to 20 mmHg, but it is usually 14 mmHG, and it is higher than a pressure in the port system, which is between 7 to 10 mmHG. This causes changes in activity of AST, ALT and bilirubin during the laparoscopic surgery. In this research we have had two groups of 30 patients that had laparoscopic holecystectomy (researched group) and laparoscopic (control group) surgical technique. We have had compared values of activity for AST, ALT and bilirubin before and after the surgeries (after 6, 24, 48 and 72 hours). We concluded that changes of activity for AST, ALT and bilirubin during laparoscopic surgery are more outstanding with higher degree of significance than what happened during laparotomic surgery. Changes are of transitory nature and after 72 hours they return to the preoperative values.