ABSTRACT Introduction: Central Venous Catheters (CVC) are essential in everyday medical practice, especially in treating patients in intensive care units (ICU). The application of these catheters is accompanied with the risk of complications, such as the complications caused during the CVC insertion, infections at the location of the insertion, and complications during the use of the catheter, sepsis and other metastatic infections. Patients and methods: This study is a retrospective-prospective and it was implemented in the period 1st January 2011- 31st December 2012. It included 108 examinees with CVC placed for more than 7 days. Results: The most common complications occurring in more than 2 attempts of CVC applications are: hearth arrhythmias in both groups in 12 cases, 7 in multi-lumen (12.72%) and 5 in mono-lumen ones (9.43%). Artery puncture occurs in both groups in 7 cases, 5 in multi-lumen (9.09%) and 2 in mono-lumen ones (3.77%). Hematoma occurred in both groups in 4 cases, 3 in multi-lumen CVCs (5.45%) and 1 in mono-lumen ones (1.88%). The most common complication in multi-lumen catheters was heart arrhythmia, in 20 cases (36.37%). The most common complications in mono-lumen CVCs was hearth arrhythmias, in 20 cases as extrasystoles and they were registered in 16 catheter insertions (30.18%). Out of total number of catheters of both groups, out of 108 catheters the complications during insertion occurred in 49 catheters (45.40%). The most common complications in both groups were heart arrhythmias, artery punctures and hematomas at the place of catheter insertion.

ABSTRACT Introduction: Lung cancer is most common cause of cancer-related mortality worldwide. Non-small-cell lung carcinoma (NSCLC) is disease with very low 5-year relative survival rate. For patients with non-small cell lung cancer, roles of current treatments are to prolong survival time and to improve quality of life. Aim: The aim of the work was to compare values of Glasgow Prognostic Score (GPS) before application of the chemotherapy medication with response to chemotherapy and toxic side effects associated with chemotherapy in patients treated with cisplatin-etopozid (PE) and cisplatin-gemcitabin (PG) in stages IIIb and IV of NSCLC. Testing role of Glasgow Prognostic Score as a possible predictor of response to therapy and toxic side effects of chemotherapeutic protocol was another aim of this work. Patients and methods: This prospective study included 60 patients in stages IIIb or IV of NSCLC, with ECOG ≤ 2. The patients were divided in two groups. First group contained 30 patients treated with chemotherapeutic protocol using cisplatin-etopozid (PE), and the same number of patients in the second group were treated with cisplatin-gemcitabin (PG). Results: Glasgow Prognostic Score (GPS) evaluation before the chemotherapy inclusion showed values of 1 (43.30:53.30), then 2 (40.00:36.70) and the lowest 0 (16.70:10.00) which supports the pathological values of GPS in developed lung cancer, i.e. most patients had pathological GPS value in both protocols (83.30:90.00). Monitoring of toxic side effects and response to chemotherapy was done after each cycle of treatment. Discussion: Results of this study revealed importance of GPS in selection of patients for treatment with chemotherapy. Patients with lower values of GPS treated using PE chemotherapeutic protocol had weaker response to therapy. Conclusion: Coefficient of correlation for therapy response in both chemotherapeutic protocol, compared with values of GPS before treatment, were not statistically significant, therefore GPS cannot be considered as a predictor of therapeutic on chemotherapy.

Objective – Teratomas with sacrococcygeal, mediastinal and gonadal locations are the most frequently occurring pediatric germ cell tumors. Cervicofacial and intracranial locations are rare. Approximately 20% of giant cervical teratoma causes airway compression. We report a congenital cervical teratoma with partial airway compression diagnosed post-natally in a preterm infant. Case report – A 27 year old mother delivered a male infant at 35 weeks gestation after her first uneventful pregnancy. The newborn had a notable anterior neck mass measuring 4x5 cm. The alpha fetoprotein level was elevated at 317.5 ng/ml and I²-HCG was less than 1.2 mI U/ml. An MRI scan showed a 24x53x27 mm prelaryngeal and paratracheal solid-cystic mass compressing and shifting the larynx and trachea to the right. The tumor was approached via a wide collar incision. It did not communicate with the oesophagus, trachea or thyroid gland and did not infiltrate the surrounding tissues. It was completely excised. Pathological examination revealed an immature teratoma. The recovery was uneventful. Conclusion – Teratoma in infancy may present in an unusual cervical location. Not only giant tumors may compress the airway.

Malignant tumors of the thyroid gland account for about 1% of thenewly diagnosed malignant tumors each year, and their incidence inwomen is twice the incidence in men. According to the WHO classification (2004) thyroid tumors are divided into: carcinoma of the thyroid,adenoma and similar tumors, and other thyroid tumors whichinclude: teratomas, angiosarcomas, paragangliomas and others, as wellas primary lymphomas and plasmacytomas. Primary thyroid lymphomasare defi ned as lymphomas which originate in the thyroid gland.Th is study presents the case of a 68-year-old patient with a thyroidlymphoma, which caused compression of the airways. In the patientpresented there was reduced activity of the thyroid gland. Th e dominantsymptoms were: breathing diffi culties, hoarse voice and the enlargementof the thyroid. An ultrasound examination was performedbefore surgery on the neck, which showed a multinodular thyroid,with compromised and compressed trachea to the right and rear. Anemergency surgical procedure was performed to reduce the tumor.Pathohistological diagnosis confi rmed diff use large B cell lymphoma.Th e aim of the study was to present a patient with a thyroid lymphoma,who had previously not had any immunological changes to the gland,that is, she had not had any chronic lymphocyte thyroiditis, but due tothe compressive syndrome it was necessary to perform an emergencysurgical procedure to reduce the tumor.

Background: The most comon patohistologi-cal finding in primary hyperparathyroidism is adenoma of the parathyroid gland, followed by hyperplasia and the rarest is carcinoma. However, hyperplasia of the parathyroid glands (PTG) is most commonly found in secondary and tertiary hyperparathyroidism. Objective: To determine the relationship between the localization of the parathyroid glands and pathological diagnosis, as well as the prevalence of individual pathological diagnosis after surgery in patients with hyperparathyroidism. Methods: Analysis of retrospective-prospective database of 79 patiens who underwent parathyreoid-ectomy for hyperparathyroidism in the 7-year study period. Diagnostic methods were used to identify enlarged parathyroid glands as well as to determine their localization: ultrasound examination, scintigraphy and operative finding. Standard hematoxylin eosin staining was used for pathohistological diagnosis. A correlation analysis between parathyroid gland localization and pathohistological diagnosis was performed. Results: The median age of the patients were 51 age (range 20-73) and 67,1% of the patients were female. In the total number of surgically removed parathyroid glands (182), the most common pathohistological diagnosis was hyperplasia. Parathyroid adenoma was found in 21 cases. Other diagnoses (thyroid nodule / tissue, lymph node, thymus, cancer) were found in 11 cases, while a normal finding was found in 12 glands. Pathohistological diagnosis of hyperplasia and adenoma were more common in the lower parathyroid glands. Using the chisquare test, no association was found between pathohistological diagnosis and localization of enlarged parathyroid glands. Conclusion: The most common pathohistological diagnosis in hyperparathyroidism was hyperplasia and was most commonly found in the inferior parathyroid glands. Adenoma as pathohistological diagnosis is also most commonly found in the lower parathyroid glands, but without statistical significance.