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Objective. The treatment outcome of chronic HCV infection is influenced by numerous host and viral factors (age, sex, stage of fibrosis, immune response, viral load, genotype, etc.). The aim of this study was to estimate the association between the most important predictive factors and the response to therapy in patients with chronic HCV infection. Methods. Our study included 76 patients with chronic HCV hepatitis, who were treated at Clinic for Infectious Diseases in Kragujevac. The treatment was carried out for 24/48 weeks, depending on the genotype of the virus. Results. HCV infection is more common in men, but we did not confirm the association between the age and gender of patients and the treatment outcome. The most common risk factor in patients with a favorable response (SVR and ETR) was the intravenous use of psychoactive substances, whereas blood transfusion and dialysis were the leading risk factors for patients with unfavorable response (NR/RR). The serum aminotransferase and alkaline phosphatase were lower in the SVR and ETR group of patients. The low level of basal viremia was registered in the group of patients with sustained virological response, while the highest values were recorded in the NR/RR group of patients. The most frequent HCV genotype was genotype 1, presented in a high percentage in both groups, the patients with favorable and the ones with unfavorable responses to the therapy. The presence of genotype 2 was observed only in patients with an unfavorable response to the therapy. The highest percentage of patients with absence of fibrosis was found in the group of patients with a favorable response. Conclusion. The results of our study show that a positive response to treatment was achieved in almost 90 % of patients with chronic HCV infection. Viral load, genotype and stage of fibrosis were associated with treatment outcome in chronic HCV patients. Our study has not confirmed the association between age, sex or biochemical parameters and therapy response.

Budući da efekti primene hiperbarične oksigenacije i statina u sepsi do sada nisu poznati, bilo bi od značaja ispitati kombinaciju navedenog farmakološkog i nefarmakološkog manevra na animalnom modelu sepse. Cilj: Ispitivanje uticaja primene hiperbarične oksigenacije i lekova iz grupe statina, kao i njihove kombinovane upotrebe na biohemijske, oksidacionoinflamacijske i kliničke parametre sepse pacova. Metode: 110 muških pacova je bilo svrstano u kontrolnu i grupe sa indukovanom sepsom: 1. pacovi bez terapije, 2. pacovi na standardnoj antibiotskoj terapiji za gram negativne i anaerobne bakterije (cefuroksim/metronidazol u dozi od 10/3,5 mg/kg/dan i.p.), 3. pacovi na tretmanu HBO, 4. pacovi na standardnoj antibiotskoj terapiji uz HBO tretman, 5. pacovi na tretmanu statinima, 6. pacovi na kombinovanom tretmanu HBO i statinima. Sepsa je izazvana korišćenjem modela fekalnog peritonitisa. U studiji su određivane sledeće varijable: procena težine sepse i stope preživljavanja, biohemijski pokazatelji sepse, biomarkeri oksidacionog stresa i inflamacije, i patohistološke odlike organa. Takođe je ispitivana funkcije srca in vivo i eh vivo. Rezultati: Primena antibiotske terapije kao i njeno udruženo dejstvo sa HBO je bilo povezano sa smanjenim vrednostima svih ispitivanih biohemijskih pokazatelja sepse odnosno remisijom kliničkog toka sepse. U ispitivanom eksperimentalnom modelu sepsa nije uzrokovala promene u funkciji i perfuziji izolovanog srca pacova. Samostalna ili kombinovana primena HBO i antibiotika je bila udružena sa najmanjom produkcijom oksidaciono-inflamacijskih biomarkera. Dobijeni nalazi ukazuju da se opravdanost upotrebe HBO u tretmanu sepse može razmatrati pre svega u sklopu adjuvantnog terapijskog pristupa sa kauzalnom antibiotskom terapijom. Introduction: Since the effects of administration of hyperbaric oxygenation and statins in the sepsis are not known so far, it would be important to examine the combination of this pharmacological and non-pharmacological maneuver in an animal model of sepsis. Objective: Investigation of the effects of the use of hyperbaric oxygenation and drugs from the group of statins, as well as their combined application on the biochemical, oxidativeinflammatory and clinical parameters of sepsis in rats. Methods: 110 male rats were classified into control and sepsis-induced groups: 1. rats without therapy, 2. rats on standard antibiotic therapy for gram-negative and anaerobic bacteria (cefuroxime / metronidazole in a dose of 10 / 3.5 mg / kg / day ip), 3. rats on HBO treatment, 4. rats on standard antibiotic therapy with HBO treatment, 5. rats on statin treatment, 6. rats on combined HBO and statin treatment. Sepsis was caused using a model of fecal peritonitis. The study identified the following variables: assessment of sepsis severity and survival rate, biochemical indicators of sepsis, biomarkers of oxidative stress and inflammation, and pathohistological features of organs. Cardiac function was also examined in vivo and ex vivo. Results: The use of antibiotic therapy as well as its combined effect with HBO was associated with reduced values of all examined biochemical indicators of sepsis, ie. remission of the clinical course of sepsis. In the examined experimental model, sepsis did not cause changes in the function and perfusion of the isolated rat heart. The independent or combined use of HBO and antibiotics was associated with the lowest production of oxidative-inflammatory biomarkers. The obtained findings indicate that the justification of the use of HBO in the treatment of sepsis can be considered primarily as part of an adjuvant therapeutic approach with causal antibiotic therapy.

Uvod: Izrada modela koji bi prepoznao obrasce abnormalnih rezultata laboratorijskih testova jetrene funkcije i povezao ih sa najverovatnijom etiologijom mogla bi da pomogne kliničarima kod prve orjentacije ka definitivnoj dijagnozi kod pacijenata sa oštećenjem jetre. Cilj ove studije bio je dizajniranje, konstruisanje i validacija modela koji na osnovu obrasca abnormalnih vrednosti laboratorijskih testova jetrene funkcije kod pacijenata sa oštećenjem jetre predlaže najverovatniju etiologiju. Materijal i metode: Obrazac abnormalnih vrednosti laboratorijskih testova jetrene funkcije za određenu etiologiju oštećenja jetre preuzet je iz distribucije stvarnih vrednosti koje su preuzete iz medicinske literature o pacijentima čija je etiologija oštećenja jetre dokazana pouzdanim dijagnostičkim metodama. Posle postavljanja modela, njegova dijagnostička vrednost je proverena u stvarnim uslovima, na uzorku pacijenata sa oštećenjem jetre čija je etiologija ustanovljena zlatnim standardom dijagnostike (biopsija ili drugo). Studija validacije modela obavljena je na Vojnomedicinskoj akademiji u Beogradu tokom dvogodišnjeg perioda (2015-2016). Rezultati: Za sve testirane dijagnoze, model je pokazao veoma značajnu razliku između površine ispod ROC (Receiver-operator curves) i vrednosti od 0,5 (p < 0,001), a uočen je i visok stepen senzitivnosti (više od 90%, osim modela za hronični i akutni hepatitis) kao i relativno visoka specifičnost (više od 75%), što ukazuje na dobru sposobnost modela da otkrije etiologiju oštećenja jetre. Zaključak: Novi modeli pokazali su zadovoljavajuću osetljivost i specifičnost za otkrivanje glavnih etiologija oštećenja jetre. Introduction/Objective: Development of a model that would identify the patterns of abnormal laboratory liver function test results and link them to the most probable etiology could help clinicians in their initial orientation towards a definitive diagnosis in patients with liver damage. The objective of this study was to design, construct and validate a model that based on a pattern of abnormal values in laboratory liver function tests of a patient with liver damage would propose the most probable etiology. Material and methods: Patterns of abnormal laboratory liver function test values for certain etiology of liver damage were taken over from distributions of actual values taken over from medical literature about patients whose etiology of liver damage was proven by reliable diagnostic tests. After setting up the model with the patterns extracted, its diagnostic value was checked under real-life conditions, on a sample of patients with liver damage whose etiology was established by the gold standard of diagnostics (biopsy or else). The model validation study was carried out at the Military Medical Academy in Belgrade during a two-year period (2015–2016). Results: For all tested diagnoses, the model demonstrated a highly significant difference between the area under the ROC (Receiver-operator curves) values and the value of 0.5 (p < 0.001), and high level of sensitivity (more than 90%, except for the model for chronic and acute hepatitis) as well as relatively high specificity (more than 75%) were noted, indicating good ability of the model to detect etiology of liver damage. Conclusion: New models showed satisfactory sensitivity and specificity for revealing major liver damage etiologies.

Uvod: HIV-infekcija se karakteriše progresivnim manjkom CD4+ T-ćelija zbog njihove smanjene sinteze, povećanog uništavanja i izrazite aktivacije i ekspanzije CD8+ T limfocita. CD4/CD8 odnos (količnik, engl. ratio) se sve više pojavljuje kao marker različitih ishoda kod HIV-inficiranih pojedinaca. S druge strane CRP je tradicionalno opisivan kao dobar marker akutne upale i danas je jedan od standardnih testova koji se koriste u svakodnevnoj kliničkoj praksi, za postavljanje dijagnoze i praćenje prognoze upale. Međutim, uloga CRP-a u različitim fiziološkim procesima, naročito kod perzistentne infekcije i imunske aktivacije nije do kraja jasna. Efikasnom i savremenom terapijom HIVa život ovakvih pacijenta je značajno produžen. Primarni cilj antiretrovirusne terapije (ART) je spriječiti HIV-povezane bolesti i smrtnost, a sekundarni cilj je da se smanji rizik od prijenosa HIV-a. Ovaj cilj se najbolje postiže pomoću efikasne cART, kojom se maksimalno inhibira HIV replikacija, tako da plazmatska HIV RNK (viremija) ostaje ispod nivoa kojeg je moguće detektovati pomoću komercijalno dostupnih testova. Cilj: Osnovni cilj ovog istraživanja je da se ispita kolika je moć CD4/CD8 odnosa i CRP-a da predvidi razvoj rizika kardiovaskularne bolesti (KVB) kod HIV pozitivnih pacijenata koji primaju cART terapiju. Materijal i metode: U retrospektivno-prospektivnoj kohortnoj studiji ponovljenih mjerenja bilo je uključeno 76 HIV pozitivnih ispitanika. Za određivanje udjela (procenta) CD4+ i CD8+ ćelija, iz periferne krvi pacijenata, korištena je metoda protočne citometrije. U ovoj studiji evaluirane su vrijednosti biohemijskih paremetara (CRP-a, lipidnog statusa), parametara krvne slike (eritrociti, hemogbin, hematokrit, trombociti), leukociti i leukocitarna formula te sedimentacija kao nespecifični parametri akutne upale, potom imunološki parametar CD4/CD8 odnos, antropometrijska mjerenja- ITM, te vrsta cART terapije. Za statističku analizu korišten je softver SPSS, odnosno parametrijski i neparamterijski testovi, Spirmanova (rho) korelacija, standardna regresiona analiza i ROC kriva. Rezultati: U istraživanje je uključeno 76 ispitanika, 67 (88,2 %) muškaraca i 9 (11,8 %) žena. Ispitanici su prosječne starosti 35,2±8,7 godina, najmlađi ispitanik imao je 18, a najstariji 57 godina. Standardnom regresionom analizom, ispitivan je uticaj nezavisnih prediktora (starosti, pola, navike pušenja, familijarne anameze za KVB, ITM, cART,5 sistolnog i dijastolnog pritiska, holesterola, triglicerda, HDL-a, ŠUK-a, CRP-a, CD4 i CD4/CD8) na zavisno promjenljivu rizik za KVB bazično i nakon 3, 6, 12, 18 i 24 mjeseca cART. Od 12. do 24. mjeseca osim standardnih rizikofaktora za predikciju razvoja KVB, CD4/CD8 odnos i CRP se javljaju kao značajni prediktori. Nakon 24 mjeseca cART, CRP se pokazao kao najbolji prediktor rizika za KVB (beta=0,224; p=0,026), veće vrijednosti ovog parametara utiču na veći rizik za KVB, potom CD4/CD8 odnos (beta=-0,200; p=0,025), s tim da veći odnos smanjuje vjerovatnoću za rizik KVB. Terapija (cART) u ovom regresionom modelu prvi put je nakon 24 mjeseca pokazala statistički značajan uticaj na rizik za KVB (beta=0,197; p=0,013). Ispitanici koji su u kombinovanoj terapiji imali PI, imaju veći rizik za KVB. Od 18. mjeseca cART CRP može biti marker srednjeg rizika za KVB, a nakon 24 mjeseca vrijednosti CRP-a od 5,31 mg/L ima najveću senzitivnost 78,3% i najveću specifičnost 86,8%, kao marker srednjeg u odnosu na niski rizik za KVB (p=0,0001; AUC=0,882). Od 12 mjeseca cART CD4/CD8 odnos može biti marker niskog rizika za KVB. Nakon 24 mjeseca terapije prosječna vrijednost CD4/CD8 odnosa od 0,53 ima najveću senzitivnost 66,0% i najveću specifičnost 73,9%, kako marker niskog u odnosu na srednji rizik za KVB (p=0,001; AUC =0,762). Zaključci: Količnik CD4/CD8 i CRP su se pokazali se kao značajni prediktori za rizik KVB, i kao markeri koji mogu razlikovati nizak/srednji rizik za KVB kod HIV pacijenata nakon 12 mjeseci cART. Introduction: HIV infection is characterized by a progressive deficiency of CD4+ T cells due to their reduced synthesis, increased destruction and marked activation and expansion of CD8+ T lymphocytes. The CD4/CD8 ratio is increasingly emerging as a marker of different outcomes in HIV-infected individuals. On the other hand, CRP has traditionally been described as a good marker of acute inflammation and is today one of the standard tests used in everyday clinical practice to diagnose and monitor inflammation prognosis. However, the role of CRP in various physiological processes, especially in persistent infections and immune activation, is not entirely clear. The primary goal of antiretroviral therapy (ART) is to prevent HIV-related diseases and mortality, and the secondary goal is to reduce the risk of HIV transmission. This goal is best achieved by using efficient combination ART (cART), which maximally inhibits HIV replication, so that plasma HIV RNA (viral load) remains below the level that can be detected by commercially available tests. Aim: The main objective of this study is to examine the power of the CD4/CD8 ratio and CRP in predicting the risk of development of cardiovascular disease (CVD) in HIV positive patients receiving cART therapy. Methods: In the retrospective-prospective cohort study of repeated measurements, 76 HIV positive subjects were included. The method of flow cytometry was used to determine the percentage of CD4+ and CD8+ cells in the peripheral blood of patients. In this study the values of biochemical parameters (CRP, lipid status), blood parameters (erythrocytes, hemoglobin, hematocrit, platelets), leukocytes, leukocyte formula, and sedimentation as non-specific parameters of acute inflammation were evaluated, followed by immunocompetent CD4/CD8 ratio, anthropometric measurements - ITM, and cART therapy type. For statistical analysis SPSS software was used, i.e. parametric and nonparametric tests, Spearman's (rho) correlation, standard regression analysis and ROC curve. Results: The study included 76 subjects, 67 (88.2%) males and 9 (11.8%) women. The average age of subjects was 35.2 ± 8.7 years; the youngest subject was 18 and the oldest 57 years old. By standard regression analysis, the influence of independent predictors (age, gender, smoking habits, familial anamnesis for CVD, ITM, cART, systolic and diastolic7 pressure, cholesterol, triglycerides, HDL, blood sugar, CRP, CD4 and CD4/CD8 ratio) on the dependent variable risk of CVD, baseline and after 3, 6, 12, 18 and 24 months of cART was examined. From 12 to 24 months apart from the standard risk factors for predicting the development of CVD, CD4/CD8 ratio and CRP appear as significant predictors. After 24 months of cART, CRP proved to be the best risk predictor of CVD (beta = 0.224; p = 0.026), higher values of this parameter affect higher risk for CVD, then CD4/CD8 ratio (beta -0.200, p = 0.025), with a higher ratio decreasing the likelihood of CVD risk. Therapy (cART) in this regression model showed the first time after 24 months a statistically significant impact on CVD risk (beta = 0.197; p = 0.013). Subjects who had PI in combination therapy had a higher risk for CVD. From 18 months of cART CRP may be a medium risk marker for CVD, and after 24 months the CRP value of 5.31 mg/L has the highest sensitivity of 78.3% and the highest specificity of 86.8%, as a marker of medium compared to low risk for CVD (p = 0.0001; AUC = 0.882). After 12 months of cART CD4/CD8 ratio can be a low risk marker for CVD. After 24 months of therapy, the average CD4/CD8 ratio of 0.53 had the highest sensitivity 66.0% and the highest specificity was 73.9%, as the marker of low compared to medium risk for CVD (p = 0.001, AUC = 0.762). Conclusion: CD4/CD8 ratio and CRP counts have been shown to be significant CVD risk predictors, and as markers that may differentiate low and intermediate risk for CVD in HIV patients after 12 months of cART.

SAŽETAK Uvod: Svetska zdravstvena organizacija (SZO) ističe da ishrana i zdravstvena bezbednost hrane kao međusobno zavisne komponente predstavljaju ključne elemente javnog zdravlja. Zdravstveno bezbedna hrana je ona koja ne sadrži fizičke, hemijske ni mikrobiološke kontaminente, odnosno, nakon konzumiranja neće dovesti do poremećaja zdravlja. Iako su preventabilne, incidenca bolesti koje se prenose hranom je u stalnom porastu. Prema poslednjim dostupnim podacima SZO objavljenim u oktobru 2017. godine, 600 miliona ljudi, odnosno 1 od 10 ljudi, u svetu, se razboli nakon konzumiranja kontaminirane hrane, od čega 420 000 umre svake godine. Brojna istraživanja su pokazala da ponašanje zaposlenih tokom rukovanja hranom predstavlja značajan faktor za prevenciju nastanka trovanja hranom. Edukacija o bezbednosti hrane je prepoznata, ali nedovoljno iskorištena preventivna javnozdravstvena intervencija koja sprečava nastanak velikog broja oboljenja različite etiologije. Bolesti koje se prenose hranom usled prisustva mikrobioloških, hemijskih ili fizičkih kontaminanata predstavljaju ozbiljnu pretnju za zdravlje miliona ljudi. Cilj: Ispitati stavove, ponašanje i znanje zaposlenih koji rade sa hranom u ugostiteljskim objektima o higijeni i zdrvstvenoj bezbednosti hrane pre i posle interventne edukacije i utvrditi da li interventna edukacija o bezbednosti hrane može dovesti do smanjenja rizika od nastanka bolesti koje se prenose hranom, kao i utvrditi eventualne propuste i najčešće razloge nehigijenskog rukovanja hranom, te identifikovati ključne elemente u kojima ugostiteljski objekti mogu da poboljšaju higijenu i bezbednost hrane. Meterijal i metod: Istraživanje je dizajnirano kao epidemiološko-opservaciona i interventna prospektivna studija koja je sprovedena u četiri faze. Prva faza je bila pre, a treća i četvrta nakon druge faze, odnosno edukacije. U istraživanju je učestvovalo 385 ispitanika zaposlenih u 110 ugostiteljskih objekata. Kao instrument istraživanja korišćeni su posebno strukturisan upitnik, zatvorenog tipa za procenu znanja, stavovai ponašanja, ček lista za ocenu higijensko-sanitarnog stanja i uzorci hrane za mikrobiološku analizu, kao i uzorci briseva radi određivanja stanja hiigijene u objektima obuhvaćenim studijom ABSTRACT Introduction: The World Health Organization (WHO) points out that nutrition and food safety as interdependent components are key elements of public health. Healthy food is one that does not contain physical, chemical or microbiological contaminants, that is, after consuming it will not lead to a health disorder. Although preventable, the incidence of foodborne diseases is constantly increasing. According to the latest available WHO data released in October 2017, 600 million people, or 1 in 10 people worldwide, are ill after consuming contaminated food, of which 420 000 die every year. Numerous studies have shown that the behavior of employees during food handling is a significant factor in the prevention of food poisoning. Food safety education is recognized but underutilized preventive public health intervention that prevents the emergence of a large number of diseases of different aetiology. Foodborne diseases due to the presence of microbiological, chemical or physical contaminants pose a serious threat to the health of millions of people. Objective: To examine the attitudes, behavior and knowledge of employees working with food in catering facilities on hygiene and health food safety before and after interventional education and to determine whether interventional education on food safety can lead to a reduction in the risk of developing foodborne diseases , ascertaining possible omissions and the most common reasons for unsanitary food handling, and identifying key elements in which catering facilities can improve hygiene and food safety. Meterial and method: The research was designed as an epidemiological-observational and interventional prospective study that was conducted in four phases. The first phase was before, and the third and fourth after the second phase, respectively education. The survey involved 385 respondents employed in 110 restaurants. As a research instrument, a specially structured questionnaire, closed type for assessment of knowledge, attitudes and behavior, check list for the hygienic-sanitary situation and food samples for microbiological analysis were used, as well as samples of swabs in order to determine the hygienic state in the facilities covered by the study.

Apstrakt: Hepatitis S virusna infekcija (HCV), jedan od najčešćih uzroka bolesti jetre, česta je komplikacija kod pacijenata sa terminalnom bubrežnom insuficijencijom (eng. end-stage renal disease, ESRD). ESRD se definiše kao smanjena glomerularna filtracija, a takođe je praćena i poremećenom funkcijom imunskog sistema. Galektin-3 je lektin koji povezuje β-galaktozide, uključen u različite biološke procese, uključujući patogenezu hronične bubrežne bolesti. Cilj naše studije je bio da se ispita težina bolesti kod ESRD+ HCV+ pacijenata i analiziraju serumske koncentracije citokina; Anti- HCV antitela; i galektina-3. Takođe, pokušali smo da odredimo potencijalnu korelaciju između nivoa galektina-3 i parametara težine bolesti ALT i AST. Naši rezultati pokazuju smanjene nivoe ALT i AST (p = 0.00), što ukazuje na manje oštećenje jetre kod ESRD+ HCV+ pacijenata u odnosu na HCV+ pacijenate. Povećana koncentracija IL-6 (p = 0.03) implicira hepatoprotektivnu ulogu IL -6 kod ovih pacijenata. Takođe, nivo galektina-3 (r = 0.00) u serumu ESRD+ HCV+ pacijenata veći je nego kod HCV+ pacijenata. Ovu promenu „prati― negativna korelacija između galektina-3 i AST-a i ALT-a (p = 0.029; p = 0.033). Prisustvo povećanih sistemskih vrednosti IL-6 i Gal-3 kod ESRD+ HCV+ pacijenata može biti kompenzatorni mehanizam da se izbegnu ili ograniče tekući proinflamacijski procesi i da se suprimira hronična inflamacija, što ukazuje na nove aspekte HCV infekcije kod pacijenata sa ESRD. Abstract: Hepatitis C virus infection (HCV), one of the greatest causes of liver disease, is a frequent complication in patients with end-stage renal disease (ESRD) on dialysis. ESRD is defined as decreased glomerular filtration and also accompanied by impaired function of the immune system. Galectin-3 is a β-galactoside-binding lectin, involved in various biological processes including pathogenesis of chronic renal disease. The aim of our study was to estimate disease severity in ESRD HCV+ patients and analyze the serum concentrations of cytokines; anti-HCV antibodies; and galectin-3. Also, we attempted to determine potential correlation between galectin-3 level and parameters of disease severity ALT and AST. Our results showed decreased levels of ALT and AST (p = 0 00), demonstrating less liver destruction in ESRD HCV+ patients in comparison to HCV+ patients. Increased levels of IL-6 (p = 0 03) implicate a hepatoprotective role of IL-6 in these patients. Also, level of galectin-3 (p = 0 00) in the serum of ESRD HCV+ patients was higher than that of HCV+ patients. This alteration was accompanied with negative correlation between galectin-3 and AST and ALT, respectively (p = 0 029; p = 0 033). The presence of increased systemic levels of IL-6 and Gal-3 in ESRD HCV+ patients may be an attempt to counteract or limit ongoing proinflammatory processes and to downregulate chronic inflammation, suggesting the new aspects of HCV infection in ESRD patients.

Febrilna stanja nepoznatog porekla predstavljaju veliki izazov za kliničare, jer diferencijalna dijagnoza obuhvata više poremećaja, nego bilo koje drugo medicinsko stanje. Febrilnost nejasnog porekla (FUO, engl. Fever of unknown origin) su prvi put definisali Petersdorf i Besson 1961. godine kao temperaturu koja traje duže od tri nedelje, u nekoliko navrata prelazi 38,3˚S i čiji uzrok ostaje neotkriven nakon jedne nedelje hospitalnog ispitivanja. Napretkom savremene medicine postojala je potreba za nekoliko modifikacija prvobitne definicije. Trideset godina kasnije Durack i Street predlažu dve izmene koje su i danas prihvaćene kao zlatni standard u definisanju FUO. Izmene se odnose na razliku između klasičnog FUO i febrilnih stanja koja su udružena sa neutropenijom, virusom humane imunodeficijencije (HIV) i nozokomijalnim infekcijama, kao i na kraće trajanje hospitalnog ispitivanja, umesto sedam, tri dana. Febrilna stanja nejasnog porekla predstavljaju veliki izazov za kliničare jer diferencijalna dijagnoza obuhvata više poremećaja nego bilo koje drugo medicinsko stanje. Do sada je otkriveno preko 200 različitih uzročnika FUO kojima pripadaju veoma retki, ali i relativno česti klinički entiteti. Prema etiološkim uzročnicima FUO se dele u četiri velike grupe oboljenja: infektivna, maligna, reumatološka i druge bolesti koje uključuju granulomatozne bolesti, temperaturu izazvanu lekovima i izmišljenu temperaturu. Uprkos razvoju brzih laboratorijskih testova i moćnih dijagnostičkih uređaja broj nedijagnostikovanih slučajeva FUO je i dalje značajan. Ciljevi istraživanja se odnose na diferencijalnu dijagnozu između infektivnih i neinfektivnih bolesti kod bolesnika koji ispunjavaju kriterijume za febrilna nejasna stanja nepoznate etiologije, a zatim i na diferecijalnu dijagnozu između infektivnih, reumatoloških, malignih i drugih bolesti. Naši rezultati pokazuju da neinfektivne bolesti predstavljaju češći uzrok febrilnosti nepoznatog porekla u odnosu na infektivne bolesti. To ukazuje da tradicionalno vezivanje febrilnosti za infektivne bolesti, u slučaju dugotrajne febrilnosti, nema uvek svoje mesto. Rezultati istraživanja pokazuju da kliničke manifestacije i nespecifične laboratorijske analize imaju značaj u diferencijalnoj dijagnozi nejasnih febrilnih stanja. Analizom osnovnih laboratorijskih analiza utvrđeno je da postoji statistički značajna razlika između grupe infektivnih i neinfektivnih bolesti u vrednostima S-reaktivnog proteina, feritina i prokalcitonina. U cilju evaluacije analiziran je doprinos ciljanih dijagnostičkih procedura i utvrđeno je da su bakteriološke analize imale najveći značaj u grupi ciljanih laboratorijskih analiza, dok su ehosonografski pregledi imali najveći udeo u grupi vizualizirajućih procedura, Analizom citokinskog profila pokazano je da solubilni ST-2 može imati ulogu dijagnostičkog markera u evaluaciji infektivnih i neinfektivnih bolesti kod bolesnika sa nejasnim febrilnim stanjem. Najviše vrednosti sa postojanjem statistički značajne razlike u odnosu na druge grupe kod FUO bolesnika, zabeležene su u grupi reumatoloških bolesti, zbog čega sST-2, u slučaju febrilnih stanja nepoznatog uzroka, može ukazivati na reumatološke bolesti. Febrile conditions of unknown origin present a great challenge for clinicians because the differential diagnosis includes more disorders than any other medical condition. Fever of unknown origin (FUO) were first defined by Petersdorf and Besson in 1961 as fever that lasts longer than three weeks, on several occasions exceeds 38,3˚S and whose cause remains undetected after one week hospital's testing. In modern medicine, there is a need for several modifications of the original definition. Thirty years later, Durack and Street propose two changes that are today accepted as the gold standard in defining FUO. Changes relating to the difference between a conventional FUO and febrile conditions associated with neutropenia, human immunodeficiency virus (HIV) infection and nosocomial infections, as well as to shorter duration of hospital tests, instead of seven, for three days. Febrile conditions of unknown origin present a great challenge for clinicians because the differential diagnosis includes more disorders than any other medical condition. Until now has been discovered over 200 different causes of FUO they belong to a very rare, but relatively common clinical entities. According to the etiological causes of FUO are divided into four major groups of diseases: infectious, malignant, rheumatic and other diseases involving granulomatous diseases, drug-induced fever and fictional temperature. Despite the rapid development of laboratory tests, and powerful diagnostic tools FUO number of undiagnosed cases is still significant. Research goals refer to the differential diagnosis and distinction between infectious and non-infectious diseases in patients who meet the criteria for unclear febrile status of unknown etiology. They also refer to the differential diagnosis between infectious, rheumatic, cancer and other diseases. Our results show that non-infestious diseases are more frequent cause of fever of unknown origin compared to infectious diseases. This suggests that the traditional binding of fever to infectious diseases, in the case of prolonged fever, is not always apropriate. Our results show that the clinical manifestations and nonspecific laboratory tests are important in the differential diagnosis of unclear febrile illness. The analysis of basic laboratory tests demonstrated that there is a statistically significant difference between the group of infectious and non-infectious diseases in the values of C-reactive protein, ferritin and procalcitonin. We also analized the importance of targeted diagnostic procedures and demonstrated that the bacteriological analysis had the greatest significance, while echo sonographic procedures had the greatest share among vizualizing procedures. Cytokine profile analysis has shown that a soluble ST-2 may play a role as a valuable diagnostic markers for differentiation of infectious and non-infectious causes in patients with fever of unknown origin. In the group of rheumatic diseases values of sST-2 were significantly higher compared to other groups of FUO patients. Elevated levels of sST-2 in sera, in the case of febrile illness of unknown cause, may indicate rheumatic cause.

Kvalitet života u vezi sa zdravljem obolelih od hroničnih virusnih hepatitisa se već dugi niz godina nalazi u fokusu brojnih istraživanja. Rezultati većine tih istraživanja ukazuju da hronični hepatitisi dovode do redukcije fizičkog i psihičkog aspekta kvaliteta života u vezi sa zdravljem, dok je uticaj na socijalni aspekt veoma oskudno proučavan. Globalna prevalenca hroničnih hepatitisa i činjenica da su raznolikog i promenljivog toka sa mogućnošću progresije do ciroze i hepatocelularnog karcinoma nameće potrebu za temeljnijim ispitivanjem problema sa kojima se suočavaju oboleli u obavljanju svakodnevnih aktivnosti kako u profesionalnom, tako i u porodičnom i širem društvenom okruženju. Cilj ovog istraživanja bio je ispitivanje uticaja vrste hepatitisa na socijalni aspekt kvaliteta života obolelih od hroničnog hepatitisa B i hroničnog hepatitisa C. U skladu sa ovim opštim ciljem postavljeni su i sledeći specifični ciljevi: 1. Ispitivanje pouzdanosti generičkog upitnika Sickness Impact Profile – SIP – u populaciji obolelih od hroničnog oblika hepatitisa B i C; 2. Ispitivanje socijalnog aspekta kvaliteta života obolelih od hroničnog hepatitisa B i C; 3. Utvrđivanje uticaja pojedinih demografskih karakteristika i karakteristika oboljenja na socijalni aspekt kvaliteta života obolelih od hroničnog hepatitisa B i C i 4. Utvrđivanje razlike u socijalnom aspektu kvaliteta života obolelih od hepatitisa B u odnosu na obolele od hepatitisa C. Quality of life related to health of patients with chronic viral hepatitis has been, for many years, a focus of numerous studies. Findings of the most of these studies indicate that chronic hepatitis leads to the reduction of physical and mental/psychological aspects of quality of life related to health, while its impact on the social aspect has been rather sparingly studied. Global prevalence of chronic hepatitis and the fact of having diversified and changing course with a possibility of progression to cirrhosis and hepatocellular carcinoma, arises the need for more thorough investigation/research of the problems faced by the diseased in their daily activities both in their professional as well as in family and wider social environment. Aim of this study was to investigate the influence of the hepatitis types on the social aspect of the quality of life of patients with chronic hepatitis B and chronic hepatitis C. In accordance with this overall objective, there were set the following specific goals: 1. Testing the reliability of the generic questionnaire named Sickness Impact Profile – SIP, among the population of patients with chronic hepatitis B and C; 2. Investigating the social aspect of the quality of life of patients with chronic hepatitis B and C; 3. Determining the impact of certain demographic features and disease characteristics on the social aspect of the quality of life of patients with chronic hepatitis B and C, and 4. Defining the difference in the social aspect of the quality of life between patients with hepatitis B and patients with hepatitis C.