BACKGROUND/AIM High morbidity and mortality rates, chronic course of disease and numerous clinical complications, make diabetes mellitus (DM) type 2 bear significant financial burden for healthcare system of Serbia. The aim of this study was to compare true disease-related expenses measured in the random sample of patients originating from the Central Serbia in 2007 and national estimate of total expenses based on available evidence on antidiabetic drugs and insulins acquisition costs in the same fiscal year. METHODS The study design was prevalence-based, bottom-up cost of illness analysis. It was implemented on a randomized sample of 99 adults with confirmed diagnosis of DM type 2. During 2007 all direct (drug acquisition, medical services, medical devices usage) and indirect costs associated with their primary disease (premature death, impaired working ability, early retirement, absentism), were taken into account. Other approach was to calculate average national rate of antidiabetic drugs and insulin utilization and sales at the domestic market during the mentioned period of time. Taking into consideration available estimate from the Institute of Public Health of Serbia of 475,000 people with this disease at the national level, we were able to compare these data. Assuming that our sample was enough representative and that the structure of costs was approximately similar at the local and national level, we were able to calculate an estimate of total cost of the disease. All costs were expressed in Serbian official currency, dinar (CSD). RESULTS Values of costs measured per patient in our sample in a given year were for drug acquisition 20,352.45 CSD, medical services 24,338.26 CSD, medical devices 3174.46 CSD and loss of productivity and absentism 5547.78 CSD. There were 2 cases of early retirement due to the disease and no cases of dialysis treatment or premature death. A total number of sickness absence days of employed patients, was 1025 and a total number of hospital treatment days was 360. A total amount of all costs was 53,412.96 CSD per patient per year. According to the National Medicines and Medical Devices Agency an overall value of oral antidiabetic drug sales for 2007 per patient was 1835.32 CSD and for insulins and analogs 2948.18 CSD. CONCLUSION Comparing true size of national financial burden of DM type 2 with experiences of other authors, we can see that it is comparable with European OECD average. But, if the structure of expenses is taken into account, Serbia is more similar tothose countries reported in the Third World economies. Ourlocal findings on a sample of diabetic population show that real patient expenses were even 2.28 times higher than those estimated at the national level.

Introduction: Till the end of the 1980s, frame-based stereotaxy was the standard method for accurately localizing small brain lesions by introducing catheters into the lesion or for determining the tumor volume in space. The objective of this study was to analyze the caracteristics of frame-based stereotactic localization of brain lesion for excision and to compare the results of frame-based stereotactic localization of brain lesion for excision with results of craniotomy without using stereotaxy. Material and methods: This study analyzed the results of 100 surgically treated patients for brain lesion excision in the period of 2002-2006 at Department of neurosurgery University clinical center of Tuzla. There were 60 patients operated on by a craniotomy without using stereotaxy and 40 patients operated on by using frame-based stereotactic localization of brain lesion for excision. The Karnofsky Performance Score (KPS) was used to estimate the patient every day activity before and after surgery. Length of incision, size of craniotomy and duration of surgery were compared between two groups. Result: An average age in patients operated on by using frame-based stereotactic tumor localization (Group A) was 49.5 (SD +13 years) and in patients operated on by craniotomy without using stereotactic localization (Group B) 53 years (SD +12 years). The mean length of skin incision in Group A was 7 cm (SD +5.5) and in Group B 14.5 cm (SD +4.7). The mean size of craniotomy in frame-based stereotactic localization for brain lesion removal was 10.7 cm2 (SD +9.8), and in craniotomy without stereotaxy 18.5 cm2 (SD +7.7). Duration of surgery in patients of Group A was 68 minutes (SD +43), and in Group B 125 minutes in average (SD +47). In the Group A there was no significant change in Karnofsky, but in the Group B there was drop. Discussion and Conclusion: Frame-based stereotactic localization of brain lesion for excision gives advantages comparing craniotomy without using stereotaxy. Frame-based stereotaxy remains the gold standard for accurate targeting of smaller lesions.