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Introduction. Pelvic malignancy (cervical, rectal and endometrial carcinoma) is a very common and deadly disease. Adjuvant therapy consists of regimens that include both concurrent chemotherapy/radiotherapy (RT) and adjuvant chemotherapy. The aim of the study was to evaluate and analyze renal function through the changes in GFR (Glomerular Filtration Rate), using 3D conformal radiotherapy (3DCRT) techniques in the treatment of patients with pelvic malignancy. Methods. This study was conducted at the Clinical Center of Kosovo, Oncology Department. Several variables were evaluated in 75 patients: sex, age, type of primary malignancy, median tumor dose (TD) evidence over 50 and above 50 Gray (Gy). Time of the appearance of toxicity was followed by GFR changes during3- and 6-month follow-up period. Patients with pretreatment genitourinary morbidity (PGUM) were excluded from the study. Results. Our cohort consisted of 75 patients with pelvic malignancy, of whom 53(70.7%) were female and 22(29.3%) male. The average age of the patients included in the study was 57.5±11.2 years. Thirty (40.0%) of the 75 patients had rectal carcinoma, 28 (37.3%) cervical cancer (CC) and 17 (22.7%) endometrial carcinoma. The average value of GFR in the beginning was 71.7± 23.1ml/min, it was 75.6±25.6ml/min three months after beginning of therapy and 79.1±25.9 ml/min six months after therapy. The test of comparison showed a signifycant statistical difference between the values of GFR at the baseline of treatment vs three months after therapy (P

Introduction. The normal anatomy of the cystic duct (CD) has been described a long time ago, but the basic description is valid up today: average length 2-4 mm, caliber 1-1.5 mm, and reduced volume by the spiral mu­­cous folds of Heister. Anatomic variants of the CD and its aberrant insertion lead to confusion during pre­opera­tive imaging examinations, and particularly to un­­pleasant situation during surgery, when the surgeon has to confirm positive identification of the anatomical struc­tures, in order to avoid iatrogenic biliary lesion. The aim of this prospective observation study was to evaluate the eventual bond between the low insertion of the CD in the common hepatic duct (CHD) and the onset of the pan­creatic cephalic carcinoma (PCC).Methods. In this study we examined 21 patients with PCC. The inclusion criteria was diagnosed PCC in ope­rable stage. The method for estimation of both, the ope­ra­bility and the site of insertion of the CD into CHD cons­isted of: ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), CT and MRI. Finally, the surgical procedure was extensive duodenopan­cre­a­tectomy, Whipple procedure. The surgical procedure was supplemented with periarterectomy and bilateral coeliac ganglienectomy in purpose of radical treat­ment and denervation.Results. Of the total of 21 patients, we revealed low in­sertion of the CD (LICD) in 6 patients (28%). In 4 pa­tients (3 male and 1 female), the LICD was presented with complete dilatation of the biliary tree, including CD, CHD and the gallbladder, while in 2 patients the CD and its low insertion were absent on the images-ERCP, CT. In these 2 patients the appearance was amid the cranial infiltration and growth of the carcinoma.Conclusions. Comparison with other reference radiolo­gical and anatomical studies, our results significantly di­ffer in the frequency of the appearance of the LICD. This may partially be due to different definitions and criteria referring to LICD. On the other hand, the observed diffe­rences may be caused by the eventually present connec­tion between the LICD and PCC. Therefore, further stu­dies with a larger number of participants are necessary (anatomical, pathological and genetic), to confirm or to deny the predicted bond between the LICD and PCC.

Cerebrovascular and cardiovascular events are among the most common causes of death in patients with a functioning graft. Hypertension has been well-known as major “traditional” risk factor for atherosclerotic cardiovascular disease being also frequent in kidney transplant recipients. A number of factors may contribute to developing or aggravating hypertension after transplantation. Among them, a central role is played by calcineurin inhibitors, corticosteroids and allograft dysfunction. Apart from the increased risk of myocardial infarction and sudden cardiac death, post-transplant hypertension also has implications on the graft outcome and survival. Considering kidney transplantation as the best treatment option for renal replacement therapy with an improved quality of life and survival compared to other treatments, the management of hypertension becomes crucial issue after kidney transplantation. In addition to pharmacologic and lifestyle interventions, risk reduction may also require tailoring a patient's immunosuppressive regimen to achieve optimal balance between efficacy and adverse events.

Introduction. Kidney transplantation from a living donor is a superior method for treatment of end-stage renal disease (ESRD). The aim of this report is to show that the intellectual inferiority should not be an obstacle for the success of this treatment modality. Case report. We present a 25-year-old female patient with physical and intellectual impairment, with focal-segmental glomerulonephritis diagnosed in 2006 as primary cause of ESRD, regularly followed up at the Department of nephrology. She was initiated on hemodialysis (HD) since July 2014. Although with a bad compliance and hypertension, a good dialysis adequacy was managed with a reduction of the extracellular volume (ECV) and kidney transplantation was indicated as a more convenient treatment option. With psychological assessment of the intellectual inferiority being not contraindication for kidney transplantation and highly motivated family she was transplanted in March 2015. Postoperatively, she was with prolonged hospitalization because of the delayed graft recovery and a couple of perioperative urinary and surgical site infections. In the following months she was slowly adapting to a regular hygienic and diet regimen and intake of medication, with a number of consultations at the Department along with the family. At present, the patient has an excellent health condition and significantly better quality of life. Conclusion. The physical handicap of a moderate degree and mild intellectual impairment are not a contraiidication for treatment of the terminal kidney disease. A successful kidney transplantation reduces the morbidity and mortality from the primary disease, and improve patient’s overall quality of life.