The prospective study, which ran from January 2011 to January 2015, included the respondents who were treated from various non-tumor breast changes and breast tumors. The respondents were divided into 2 groups. First one, group A (280 respondents), consisted of the respondents who are residing in the rural area. Second one, group B (343 respondents), consisted of the respondents who have residence in urban area. The aim is to analyze the attitude to non-tumor diseases and breast tumors by women of rural and urban environment. The observed parameters are the reasons for coming to the breast examination: palpable formation in the breast, regular examination, breast pain, breast swelling and other changes. Parameters to compare the results were time intervals from the detection of palpable formations to examination. There was no statistically significant difference in inflammatory diseases of the breast, except in the case of breast abscess formation which is more common in the group A. A statistically significant difference among the groups was not found in the incidence of benign and / or malignant tumors of the breast, neither. It turned out that immediately after tumor detection by palpation, 4 patients in group A went to examination the next day. Patients in group B went 3 times more often to examination after a few days of the initial palpation of the tumor than patients in group A. There are much more women in group A who after only one year from the moment of palpable formation came to examination. The number of women, who have come to examination after a few months and / or years, is almost identical. Patients in group A have less responsible attitude towards non-tumor diseases and breast tumors, so it is possible for this group to be in higher degree of risk of late diagnosis of malignant tumors.

The prospective study, which ran from January 2010 to January 2015, included the respondents treated for breast carcinoma. The respondents were divided into 3 groups. The first, the A group (63 respopndents), consists of women with (not) completed elementary school. The second, group B (60 resppondents), consists of women who have secondary education, while the third, group C (33 respondents) make women with college or university degrees. The aim is to analyze the impact of the level of education on early diagnosis of breast carcinoma in women. The observed parameters are the age of respondents and the primary risk factors. Parameters for the comparison of the results were: the attitude of the respondents to breast tumors, history of the breast self-examination, breast ultrasound examinations, data on mammography, as well as information on the diameter of the tumor at the moment of the discovery. There was no statistical difference in attitude of respondents about breast tumors when it comes to fear and / or phobia of breast carcinoma. It is almost identical to the number of respondents who have no opinion on breast tumors. Concerning the attitude of respondents that there is no risk of breast carcinoma, if nobody in the family previously had breast carcinoma, then in terms of the attitude that they do not want "their breasts to be explored", as well as the attitude that "any breast examination does not help much", a statistical difference between the studied groups was found. It was found that breast self-examination is performed by most of the respondents, but that patients in group C do it more often. It has been shown that ultrasound and mammography are more often performed by patients in group C and this characteristic makes a significant statistical difference. In Group C, the tumor was detected in diameter to 2 cm which proved statistically different. One of the reasons for early detection of tumors (diameter to 2 cm) in group C may be better enlightenment or a higher level of education of this group.

INTRODUCTION High prevalence of metabolic syndrome (MetS) in children and adolescents is a great concern of the modern society. OBJECTIVE bjective: Our aim was to determine the influence of previously investigated, but also and potentially novel risk factors for the development of metabolic syndrome in children and adolescents. METHODS Observational case-control clinical study was conducted involving children and adolescents with obesity/metabolic syndrome, treated on inpatient basis from January 2008 to January 2012 at the Pediatric Clinic of the Clinical Centre Kragujevac, Kragujevac, Serbia. The group of"cases"(n=28) included patients aged 10-16 years with the diagnosis of metabolic syndrome according to the International Diabetes Federation (IDF) criteria, while the control group included twice as many obese patients (n=56) matched to the compared group. RESULTS Presence of maternal gestational diabates (ORadjusted: 39.426; 95% Cl: 1.822-853.271; p=0.019), and/or lack of breastfeeding in the first six months of life (ORadjusted: 0.079; 95% CI: 0.009-0.716; p=0.024) were significant predictors for developing MetS. Also, microalbuminuria is associated with MetS in obese children and adolescants (ORadjusted: 1.686; 95% Cl: 1.188-2.393; p=0.003) CONCLUSION: Presence of maternal gestational diabetes and/or lack of infant breastfeeding are considered as relevant factors that may contribute to the increased risk of developing MetS syndrome, while microalbuminuria is frequently associated with MetS in obese children and adolescents.

1 Department of Pharmacology, Th e Faculty of Medical Sciences, University of Kragujevac, Serbia 2 Department of Economics, Center for Children and Childhood Studies, Rutgers University, the State University of New Jersey, U.S.A. 3 Department of Epidemiology & Community Health, School of Health Sciences & Practice, New York Medical College, U.S.A. 4 Clinic for Neurology and Psychiatry for Children and Youth, Clinical Center of Serbia, Belgrade, Serbia 5 Psychiatric Clinic, University Clinical Center Kragujevac, Serbia 6 Centre for Clinical Pharmacology, Medical Faculty, Military Medical Academy University of Defence, Belgrade Serbia 7 Faculty of Medical Sciences University of Kragujevac, Serbia 8 Primary Care Facility Svilajnac, Serbia

Background: Dry socket is a disturbance in the healing of tooth extraction, characterized by the absence of blood clot and persistence of intense pain. The aim of this study was to determine the costs of treating dry socket, as in Serbia, until now, there has been no adequate estimation of the expenses and cost structure for treating patients with dry socket. Material and Methods: The costs of treating dry socket were analyzed on the sample of 455 adults with confirmed diagnosis of dry socket. All the patients were treated at the Oral Surgery Department, Institute of Dental Medicine in Kragujevac, during 2012. Direct costs per patient, concerning the acquisition of medicines and medical supplies, as well as medical services, were recorded in accordance with the Blue Code Book of the National Health Insurance Fund. Results: Out of total 12.652 teeth extracted, 455patients (3.6%) were diagnosed with dry socket. Total direct cost for treating dry socket in 2012 was 1.298,58 ± 468.93 RSD per patient, of which 1.065,16 RSD ± 394.49 RSD (82.02%) was the total price of the service and 1. 298,58 ± 468.93 RSD (17.98%) was spent on dental supplies. Conclusion: The actual cost of treating dry socket in Serbia shows that there is a need for the implementation of the relevant preventive measures. Global economic crisis, worsens the constant lack of available resources in dental healthcare services. Dry socket, as one of the most frequent post-extraction complications, although quite harmless in terms of clinical prognosis represents substantial economic loss for Serbia.

Postoperative nausea and vomiting emerge during the first 240-48 hours from surgery. Prevalence of postoperative nausea and vomiting is as high as 30% among all patients undergoing surgery, and almost 80% among the patients with high risk of postoperative vomiting. Since postoperative nausea and vomiting create very unpleasant experience and could lead to serious complications, they should be either prevented or treated. There are several perioperative factors which may initiate postoperative vomiting: opioids, inhalation anesthetics, anxiety, adverse drug effects and transporting the patient. More than one neurotransmitter system is involved in regulation of nausea and vomiting: cholinergic, dopaminergic, serotonergic, histaminergic and neurokinin system. Procedures which may decrease prevalence of postoperative vomiting are: use of local or regional anesthesia instead of general one and use of propofol for anesthesia induction (prevalence of vomiting drops for 30%). Ondansetron, dexamethasone and droperidol are equally effective: when administered prophylactically, they decrease risk of posoprative vomiting for 25%. These drugs have additive effect, since their mechanisms of action are different. The patients with extreme risk of postoperative vomiting should receive long-acting antiemetic, like transdermal scopolamine or palonosetron, or combinations of two antiemetics. If a patient who already received antiemetic prophylaxis still develops nausea and vomiting, he or she should be treated by new antiemetic having another mechanism of action.