Uvod. Patološki procesi u jetri mogu biti difuznog karaktera (zapaljenski,metaboličke bolesti, hematološke bolesti, toksične bolesti) i fokalne (zapaljenske,parazitarne i tumorske). Cilj rada je prikaz fokalnih promjena u jetrinomparenhimu nakon ultrazvučne, laparaskopske i patohistološke dijagnostike.Metode. Retrospektivno-prospektivnim ispitivanjem je obuhvaćeno 147punoljetnih pacijenata oba pola. Fokalne promjene jetrinog tkiva su sagledaneultrazvučnom, laparoskopskom i patohistološkom dijagnostikom.Rezultati. Osnovne karakteristike ispitanika: muškaraca 71 i žena 76 sanajvećim brojem pacijenata (102 - 70%) životne dobi između 40 i 70 godina,sa ravnomjernom distribucijom za svakih deset godina starosti. Međutim,neobično je veliki broj pacijenata ženskog pola registrovan u četvrtoj decenijiživota, čak 14 (9,5%) od ukupnog broja ispitanika, odnosno 18% odispitanika ženskog pola. Metastaze čine 104 (71%) svih fokalnih lezija jetre.U većini slučajeva radilo se o metastazama karcinoma dojke. Iako najčešćeimaju tipičnu ultrazvučnu prezentaciju, metastaze u jetri mogu da daju širokspektar različitih ultrazvučnih slikaZaključak. Najčešće fokalne promjene u jetri su metastaze adenokarcinoma.Samo 3 (2%) fokalne promjene dijagnostikovane ultrazvukom nisu potvrđenekao fokalne laparoskopskom tehnikom i patohistološkom analizom tkiva jetre.

Introduction. Cardiac magnetic resonance imaging (CMR) is considered the reference diagnostic method for quantifying right ventricular size and function, and pulmonary regurgitation in patients with tetralogy of Fallot surgery. The aim of this paper is to confirm the importance of magnetic resonance continuous postoperative monitoring of right and left heart function parameters as a diagnostic method that provides the most precise and accurate assessment.

Methods. The prospective observational study included subjects with TOF surgery who were diagnosed with residual morphological and/or functional disorders on control postoperative echocardiographic examinations. All subjects underwent magnetic resonance imaging of the heart on a 1.5 T scanner with dedicated coils for the heart surface according to the standard protocol for a period of one year from the beginning of the study. Criteria for exclusion from the study were: significant residual pulmonary stenosis, condition after pulmonary valve replacement, existence of residual shunt lesions, contraindications for cardiac magnetic resonance imaging (pacemaker, ICD, claustrophobia). Depending on the time elapsed since the tetralogy of Fallot surgery, the subjects were divided into groups: more than 15 years, 11−15 years, 6−10 years, less than 5 years.

Results. The study included 131 subjects with an average age of 24.18 ± 11.57 years with complete correction of TOF. Intergroup differences in values of right ventricular enddiastolic volume, right ventricular ejection fraction, and left ventricular ejection fraction were demonstrated, but there was no statistically significant intergroup difference in values of pulmonary regurgitation fraction. The negative interaction of the right and left ventricles intensifies during the years of follow-up of patients after TOF surgery, which is especially true fifteen years after surgery.

Conclusion. CMR has the most significant role in research efforts aimed at improving the outcomes of operated patients with tetralogy of Fallot.

Introduction. Clostridium difficile is the leading cause of nosocomial diarrhea, associated with the use of antibiotics. The most common ways of transmitting the infection in hospitals are contaminated surfaces of the premises and the hands of medical staff. Methods. The study involved 68 nurses/technicians employed at the University Hospital Foca in the departments of surgery and internal medicine. As a research instrument, we used a specially designed questionnaire, created by the authors for the purpose of this research. Results. The research showed that 61.8% of respondents knew that hand washing with warm water and soap was considered the most effective prevention of the spread of infections, and 55.88% meant that they used chlorine-based preparations and hydrogen peroxide as the only effective disinfectant. Nurses with a work experience of less than 5 years showed better knowledge than other groups. Conclusion. The knowledge of nurses about the prevention of C. difficile infection is not at a satisfactory level, which indicates the growing need for education of nurses.